Asian Journal of Urology最新文献

{"title":"Risk analysis of adverse pathological changes in cT2cN0M0 prostate cancer after robot-assisted radical prostatectomy: Results from a population-based study","authors":"Jianhui Qiu ,&nbsp;Ruiyi Deng ,&nbsp;Jiaheng Shang ,&nbsp;Zihou Zhao ,&nbsp;Jingcheng Zhou ,&nbsp;Lin Cai ,&nbsp;Kan Gong ,&nbsp;Yi Liu","doi":"10.1016/j.ajur.2024.09.005","DOIUrl":"10.1016/j.ajur.2024.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>To explore clinicopathological predictors of adverse pathological changes (APCs) (upgrading, upstaging, and positive surgical margin [PSM]) after robot-assisted radical prostatectomy (RARP) in clinical tumor stage 2c (cT2c) prostate cancer (PCa) patients.</div></div><div><h3>Methods</h3><div>From January 2018 to December 2022, cT2cN0M0 PCa patients who underwent prostate biopsies and subsequent RARP at the Peking University First Hospital with an interval between biopsy and RARP of ≤90 days were included. Univariable and stepwise multivariable logistic regression analyses were performed to identify independent risk factors associated with APCs. Nomograms were constructed based on these predictive models. The performance of the nomograms was evaluated by receiver operating characteristic curves, decision curve analyses, and calibration plots.</div></div><div><h3>Results</h3><div>A total of 423 eligible cT2cN0M0 PCa patients were included. The rates of upgrading, upstaging, and PSM in our cohort were 33%, 51%, and 35%, respectively. The stepwise multivariate logistic analysis suggested that PSA density and the percentage of positive cores in systematic biopsy were significantly associated with the occurrence of APCs. The score of the Prostate Imaging Reporting and Data System, PSA density, and the International Society of Urological Pathology grade group (IGG) of needle-biopsy specimens (or clinical IGG [cIGG]) were significantly associated with upgrading. The PSA density, percentage of positive cores in systematic biopsy, and largest tumor percentage in all cores of each patient (LTP) were significantly associated with upstaging. The PSA density and LTP were significantly associated with the PSM. Based on these results, four nomograms were developed. Receiver operating characteristic curves, decision curve analyses, and calibration plots implied that the nomograms exhibited excellent accuracy.</div></div><div><h3>Conclusion</h3><div>The predictive models we developed could help to identify high-risk PCa early, and optimize clinical decisions of cT2cN0M0 PCa patients.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 338-349"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing postoperative functional recovery: Impact of the MAIA™ telerehabilitation platform in robot-assisted radical prostatectomy patients","authors":"Daniele Amparore ,&nbsp;Sabrina De Cillis ,&nbsp;Michele Sica ,&nbsp;Federico Piramide ,&nbsp;Enrico Checcucci ,&nbsp;Alberto Piana ,&nbsp;Alberto Quara ,&nbsp;Edoardo Cisero ,&nbsp;Federica Pini ,&nbsp;Cecilia Gatti ,&nbsp;Matteo Manfredi ,&nbsp;Cristian Fiori ,&nbsp;Francesco Porpiglia","doi":"10.1016/j.ajur.2024.07.005","DOIUrl":"10.1016/j.ajur.2024.07.005","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and user satisfaction of the MAIA™ telemedicine platform for postoperative telemonitoring and telerehabilitation in patients undergoing robot-assisted radical prostatectomy (RARP).</div></div><div><h3>Methods</h3><div>Patients undergoing RARP (from April 2022 to January 2023) were divided into Group A, following the standard rehabilitation protocol, and Group B using the MAIA™ platform for the first 30-day post-intervention period. Perioperative, pathological, and functional variables (continence and potency rates, assessed via validated questionnaires) were collected and telerehabilitation protocol's adherence was monitored. The telerehabilitation system included an online platform for medical providers and a patient application, facilitating data acquisition, management, treatment planning, and monitoring. Patient and provider satisfaction were evaluated using the visual analogue scale score and validated telemedicine satisfaction questionnaire.</div></div><div><h3>Results</h3><div>Totally, 227 patients were enrolled. No differences in perioperative or pathological variables were found. Group B had higher potency recovery rates than Group A (<em>p</em>=0.031); the potency recovery rates at 1 month and 3 months for Group B were 45% and 57%, respectively, and in Group A were 34% and 48%, respectively. At the multivariate analysis, MAIA™ use and the nerve-sparing (NS) were independent predictors of erectile function at both 1 month (MAIA™ use: odd ratio [OR] 2.03, 95% confidence interval [CI] 1.13–3.63, <em>p</em>=0.018; NS: OR 2.08, 95% CI 1.06–4.12, <em>p</em>=0.034) and 3 months (MAIA™ use: OR 1.89, 95% CI 1.07–3.34, <em>p</em>=0.028; NS: OR 1.90; 95% CI 1.02–3.54, <em>p</em>=0.044). Adherence monitoring revealed 4.6% of patients in Group B reported exercise issues due to pelvic pain onset and 10% did not take oral phosphodiesterase 5-inhibitors due to myalgia. All those patients restarted the rehabilitation program after televisit to address the causing problem, allowing restarting of a rehabilitation program. Patients reported high satisfaction with the MAIA™ platform use (mean visual analogue scale score: 88.7).</div></div><div><h3>Conclusion</h3><div>The MAIA™ telemedicine platform seems to have a role in optimizing early potency recovery after RARP. Patient and provider satisfaction levels were high, emphasizing the user-friendliness of the platform.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 366-374"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Aboutaleb H, Sultan M, Zaghloul A, Farahat Y, Gawish M, Zanaty F. Is fluoroscopy-free single-use flexible ureteroscopy a feasible treatment for kidney stones with abnormal renal anatomy? Asian J Urol 2024;11:591–5. Fluoroscopic-free procedures: Is this the future of endourology?","authors":"Guglielmo Mantica,&nbsp;Alessandro Calarco","doi":"10.1016/j.ajur.2025.03.014","DOIUrl":"10.1016/j.ajur.2025.03.014","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 417-418"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation exposure in flexible ureteroscopy with a flexible and navigable suction ureteral access sheath: A European Association of Urology–Endourology multicenter study","authors":"Vineet Gauhar ,&nbsp;Olivier Traxer ,&nbsp;Thomas R.W. Herrmann ,&nbsp;Daniele Castellani ,&nbsp;Hatem Kamkoum ,&nbsp;Wissam Kamal ,&nbsp;Tzevat Tefik ,&nbsp;Heng Chin Tiong ,&nbsp;Mehmet Ilker Gökce ,&nbsp;Michael Y.C. Wong ,&nbsp;Khi Yung Fong ,&nbsp;Ben Hall Chew ,&nbsp;Manoj Monga ,&nbsp;Vincent de Connick ,&nbsp;Bhaskar Kumar Somani ,&nbsp;Steffi Kar Kei Yuen","doi":"10.1016/j.ajur.2025.01.002","DOIUrl":"10.1016/j.ajur.2025.01.002","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to study the effect of flexible ureteroscopy (FURS) for renal stones using a flexible and navigable suction ureteral access sheath (FANS) on intraoperative radiation dose and time.</div></div><div><h3>Methods</h3><div>This was a multicenter study of adults who underwent FURS with FANS. The correlation analysis was done to identify factors affecting radiation dose and time measured by the C-arm fluoroscopy intraoperatively.</div></div><div><h3>Results</h3><div>We analyzed 110 patients, with a median age of 50 years. Of them, 72% were pre-stented prior to the procedure. The median stone volume was 1503 mm³ and the median operative time was 39 min. The median radiation dose was 7.4 mSv and median radiation time was 0.6 min. Totally, 91% of patients achieved stone-free status (Grade A or B) on the non-contrast CT scan within 30 days postoperatively. There were no cases of postoperative sepsis. Body mass index, stone volume, and total operation time were associated with a higher radiation dose. Procedures performed under general anesthesia had a lower radiation dose and time than those performed under spinal anesthesia. Disposable scopes were associated with higher radiation time than reusable scopes but not dose. A low-power holmium laser had longer radiation time than other laser sources, but only the thulium fiber laser was associated with a significantly lower radiation dose.</div></div><div><h3>Conclusion</h3><div>Our study is the first to highlight the multitude of factors affecting radiation exposure in FURS with FANS. Although not a direct measure of surgeons' actual exposure, it has important implications for the As Low As Reasonably Achievable principle which is commonly used to minimize radiation exposure to patients and operating room staff.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 385-392"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erectile function after laparoscopic versus robotic-assisted radical prostatectomy: A systematic review and meta-analysis","authors":"Ana J. Pina ,&nbsp;Vitor C. Melo ,&nbsp;Vinícius W. Carlos ,&nbsp;Luca S. Tristão ,&nbsp;Clara L. Santos ,&nbsp;Wanderley M. Bernardo ,&nbsp;Aguinaldo C. Nardi","doi":"10.1016/j.ajur.2024.10.002","DOIUrl":"10.1016/j.ajur.2024.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>Prostate cancer is a common malignancy in men over 50 years old, and radical prostatectomy, particularly via laparoscopic and robotic-assisted techniques, significantly impacts quality of life, especially in terms of erectile dysfunction. This systematic review and meta-analysis aimed to evaluate the preservation of erectile function following robotic-assisted and laparoscopic radical prostatectomy, with a separate analysis of randomized clinical trials and non-randomized studies.</div></div><div><h3>Methods</h3><div>This review was carried out using randomized and non-randomized studies involving adult patients diagnosed with localized prostate cancer undergoing radical prostatectomy, according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and registered in PROSPERO. Applicable literature from PubMed, Cochrane, Embase, and the Latin American and Caribbean Health Sciences Literature database was analysed. The bias in randomized clinical trials was assessed using the Cochrane Risk of Bias 2.0 tool, and observational studies were evaluated via the Newcastle-Ottawa Scale. The statistical analysis was performed using Review Manager version 5.4.</div></div><div><h3>Results</h3><div>Our analysis included 13 studies involving 6281 patients. Comparative meta-analysis of non-randomized studies demonstrated that robotic techniques were significantly more effective in preserving erectile function at 3 months (risk difference [RD] 0.05, 95% confidence interval [CI] 0.00–0.11; <em>p</em>=0.040), 6 months (RD 0.10, 95% CI 0.03–0.17; <em>p</em>=0.006), and 12 months postoperatively (RD 0.06, 95% CI 0.02–0.10; <em>p</em>=0.002).</div></div><div><h3>Conclusion</h3><div>Robotic-assisted surgery showed greater preservation of erectile function 3 months, 6 months, and 12 months after radical prostatectomy. However, additional studies with meticulous methodological criteria are necessary for future analysis.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 281-289"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the brain weep? Post-hysterectomy vaginal leak may not always be urine!","authors":"Sajal Gupta,&nbsp;Abheesh Varma Hegde,&nbsp;Geover Joslen Lobo","doi":"10.1016/j.ajur.2025.03.007","DOIUrl":"10.1016/j.ajur.2025.03.007","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 412-413"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of postoperative infectious complications after partial nephrectomy: Analysis at a referral institution","authors":"Riccardo Bertolo ,&nbsp;Francesco Ditonno ,&nbsp;Alessandro Veccia ,&nbsp;Francesca Montanaro ,&nbsp;Francesco Artoni ,&nbsp;Alberto Baielli ,&nbsp;Michele Boldini ,&nbsp;Davide Brusa ,&nbsp;Sonia Costantino ,&nbsp;Marcella Sibani ,&nbsp;Vincenzo De Marco ,&nbsp;Filippo Migliorini ,&nbsp;Antonio Benito Porcaro ,&nbsp;Riccardo Rizzetto ,&nbsp;Maria Angela Cerruto ,&nbsp;Riccardo Autorino ,&nbsp;Alessandro Antonelli","doi":"10.1016/j.ajur.2024.06.002","DOIUrl":"10.1016/j.ajur.2024.06.002","url":null,"abstract":"<div><h3>Objective</h3><div>Infectious complications after partial nephrectomy (PN) remain a significant concern. We aimed to analyze predictive factors of postoperative infectious complications (PICs) occurring after PN.</div></div><div><h3>Methods</h3><div>Data on patients undergoing PN for renal masses between January 2018 and May 2023 were retrieved from prospectively maintained institutional database and retrospectively analyzed. Patients were stratified into two groups based on the occurrence of PICs during admission for PN. A PIC was defined by clinical and/or imaging findings of an infectious process plus microbial isolation upon culture examination. Multivariable logistic regression analysis after adjusting for potential confounders evaluated predictors of a PIC.</div></div><div><h3>Results</h3><div>Six-hundred and twenty-seven patients underwent PN; rough incidence of PICs was 11%, with median time to PIC onset of 1 (interquartile range 0–3) day. Compared to patients without PIC events, the PIC group showed a significantly higher proportion of open surgeries (54% <em>vs.</em> 20%, <em>p</em>&lt;0.001), bleeding events (23% <em>vs.</em> 10%, <em>p</em>&lt;0.01), postoperative transfusion (19% <em>vs.</em> 5.0%, <em>p</em>&lt;0.001), and urinary leakage (4.2% <em>vs.</em> 0.18%, <em>p</em>=0.01), and a statistically significantly higher median hemoglobin drop from baseline (−2.6 g/dL <em>vs</em>. −1.7 g/dL, <em>p</em>=0.001). At multivariable logistic regression, the odds of experiencing a PIC were statistically significantly lower after minimally-invasive surgery compared to open surgery (odds ratio 0.32, 95% confidence interval 0.17–0.59), and higher for patients who received transfusion (odds ratio 1.68, 95% confidence interval 1.10–2.54).</div></div><div><h3>Conclusion</h3><div>We underlined factors that impact the occurrence of PICs and, consequently, duration of hospitalization following PN. By addressing these predictors, clinicians can promote enhanced patient recovery.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 236-243"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic uro-oncology applications of the SSI Mantra™ surgical robotic system","authors":"Sudhir K. Rawal ,&nbsp;Ashish Khanna ,&nbsp;Amitabh Singh ,&nbsp;Sarbartha K. Pratihar ,&nbsp;Ishan Malla ,&nbsp;Mujahid Ali ,&nbsp;Vivek Vasudeo ,&nbsp;Kaushik Jaganthan ,&nbsp;Bhuvan Kumar ,&nbsp;Nikhil Saurabh","doi":"10.1016/j.ajur.2024.04.009","DOIUrl":"10.1016/j.ajur.2024.04.009","url":null,"abstract":"<div><h3>Objective</h3><div>To report our preliminary clinical experience and outcomes of uro-oncology procedures conducted utilizing the SSI Mantra™ surgical robotic system.</div></div><div><h3>Methods</h3><div>Data of consecutive patients who underwent various robot-assisted uro-oncology procedures using the SSI Mantra™ surgical robotic system at our institution between July 2022 and September 2023 were recorded. The specific surgical configurations employed with the SSI Mantra™ for these procedures were duly noted. We assessed the feasibility of these procedures with this novel surgical robotic system and report the outcomes.</div></div><div><h3>Results</h3><div>A total of 156 patients were operated with the SSI Mantra™ surgical robotic system. The spectrum of procedures performed comprised robot-assisted laparoscopic radical prostatectomy with bilateral extended pelvic lymph node dissection (<em>n</em>=77), robot-assisted radical cystectomy with bilateral extended pelvic lymph node dissection with extracorporeal urinary diversion (<em>n</em>=39), robot-assisted radical nephrectomy (<em>n</em>=32), robot-assisted partial nephrectomy (<em>n</em>=6), robot-assisted radical nephroureterectomy with bladder cuff excision (<em>n</em>=1), and bilateral robot-assisted video endoscopic inguinal lymph node dissection (<em>n</em>=1). One robot-assisted laparoscopic radical prostatectomy had to be converted to open in view of system malfunction. However, no system-related intraoperative complications or injuries were encountered.</div></div><div><h3>Conclusion</h3><div>The SSI Mantra™ surgical robotic system demonstrates significant promise as an innovative robotic platform. In this single-center experience, we have demonstrated the feasibility of a diverse array of surgical procedures using this platform. Further research, involving a larger cohort of patients, is imperative to refine the operative techniques and comprehensively understand the perioperative outcomes of the SSI Mantra™ surgical robotic system, particularly in comparison to other robotic surgical platforms.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 143-151"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic urologic applications of the hinotori™ Surgical Robot System","authors":"Shunsuke Miyamoto,&nbsp;Tomoya Hatayama,&nbsp;Hiroyuki Shikuma,&nbsp;Kazuma Yukihiro,&nbsp;Kyohsuke Iwane,&nbsp;Ryo Tasaka,&nbsp;Yuki Kohada,&nbsp;Takafumi Fukushima,&nbsp;Kenshiro Takemoto,&nbsp;Miki Naito,&nbsp;Kohei Kobatake,&nbsp;Yohei Sekino,&nbsp;Hiroyuki Kitano,&nbsp;Kenichiro Ikeda,&nbsp;Keisuke Goto,&nbsp;Akihiro Goriki,&nbsp;Keisuke Hieda,&nbsp;Nobuyuki Hinata","doi":"10.1016/j.ajur.2024.05.002","DOIUrl":"10.1016/j.ajur.2024.05.002","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the safety and effectiveness of urological tumor surgeries using the hinotori™ Surgical Robot System (hinotori) in a real-world clinical setting.</div></div><div><h3>Methods</h3><div>All surgeries including robot-assisted radical prostatectomy (RARP), robot-assisted partial nephrectomy (RAPN), robot-assisted radical nephrectomy (RARN), robot-assisted nephroureterectomy (RANU), robot-assisted adrenalectomy (RAA), and robot-assisted radical cystectomy with intracorporeal urinary diversion (RARC+ICUD) for urological tumors with the hinotori and da Vinci surgical system (da Vinci) from January 2022 to September 2023 were enrolled. We evaluated the safety and effectiveness of surgeries using the hinotori compared with those using the da Vinci.</div></div><div><h3>Results</h3><div>Robotic surgeries using the hinotori were performed in a total of 91 cases, comprising 42 cases of RARP, 18 cases of RAPN, six cases of RARN, 10 cases of RANU, 13 cases of RAA, and two cases of RARC+ICUD; no major intraoperative complications were observed in any of the cases using the hinotori; no major postoperative complications occurred in any of the cases; no case experienced an unrecoverable equipment error during surgery. Meanwhile, robotic surgeries using the da Vinci were performed in a total of 277 cases, comprising 126 cases of RARP, 94 cases of RAPN, 12 cases of RARN, 10 cases of RANU, 20 cases of RAA, and 15 cases of RARC+ICUD; major intraoperative complications occurred in two cases; major postoperative complications occurred in seven cases; seven cases required transfusion; one case underwent conversion to open surgery; during the study period, no case experienced an unrecoverable equipment error. Surgical outcomes for cases with the hinotori were comparable to those with the da Vinci.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that the hinotori is a safe and feasible tool for robotic surgeries in the field of urology.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 162-168"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of deferred cytoreductive nephrectomy on survival in advanced renal cell carcinoma: A systematic review and meta-analysis","authors":"Mohammad Taufiq Alamsyah ,&nbsp;Fauriski Febrian Prapiska ,&nbsp;Syah Mirsya Warli","doi":"10.1016/j.ajur.2024.06.003","DOIUrl":"10.1016/j.ajur.2024.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>Stage IV renal cell carcinoma (RCC) is associated with a significant decrease in survival rates. Cytoreductive nephrectomy (CN) is one of the treatments for stage IV RCC. However, there are studies showing that delayed CN might have benefits for the survival of the patients. We aimed to examine the impact of deferred CN on the survival of patients with advanced RCC in relation to sequential management with targeted therapy (TT).</div></div><div><h3>Methods</h3><div>A literature search was conducted in PubMed, EMBASE, EBSCOhost, MedRxiv, and Scopus. We included the randomized clinical trial and non-randomized study of intervention comparing the overall survival (OS) of upfront CN with deferred CN in patients with advanced RCC undergoing TT. Meta-analysis was carried out using Review Manager v5.4 software. The fixed-effect and random-effects models were used to obtain pooled estimates using the hazard ratio and standard error, presented using the forest plot with 95% confidence interval.</div></div><div><h3>Results</h3><div>Four studies were analyzed quantitatively. Our analysis revealed that patients with upfront TT followed by deferred CN had significantly improved OS compared to those who underwent upfront CN followed by TT (hazard ratio 0.50, 95% confidence interval 0.40–0.64, <em>p</em>&lt;0.001).</div></div><div><h3>Conclusion</h3><div>The findings of the study suggest that considering upfront TT followed by deferred CN may lead to improved OS in patients with advanced RCC. However, more research is needed to fully understand the role, optimal timing, and sequencing of TT and CN in the treatment of advanced RCC.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 204-209"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}