首页 > 最新文献

Advances in Urology最新文献

英文 中文
Fast Track Surgery as the Latest Multimodal Strategy of Enhanced Recovery after Urethroplasty. 快速通道手术是提高尿道成形术后恢复的最新多模式策略。
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2023-01-01 DOI: 10.1155/2023/2205306
Vladimir Beloborodov, Vladimir Vorobev, Temirlan Hovalyg, Igor Seminskiy, Svetlana Sokolova, Ekaterina Lapteva, Aleksandr Mankov

Fast track surgery (FTS), as well as ERAS (enhanced recovery after surgery/rapid recovery programs), is the latest multimodal treatment strategy, designed to reduce the disability period and improve the medical care quality. The study aims to analyze the enhanced recovery protocol effectiveness in a comparative study of elective urethral stricture surgery. A prospective study included 54 patients with an established diagnosis of urethral stricture in 2019-2020 in the urological hospital of the Irkutsk City Clinical Hospital No. 1. All 54 patients have completed the study. There were two groups of patients FTS-group (group II, n = 25) and standard group (group I, n = 29). In terms of preoperative parameters, the comparison groups have statistical homogeneity. The comparative intergroup efficacy analysis of the treatment based on the criteria established in the study demonstrated good treatment results for 5 (17.2%) patients of group I and 20 (80%) patients of group II (p=0.004). The overall efficacy of urethroplasty surgeries, regardless of the treatment protocol, was comparable (86.2% vs 92%; p=0.870), as well as the likelihood of relapse within two years (p=0.512). The predictors of recurrence were technical complications and urethral suture failure (OR 4.36; 95% CI 1.6; 7.11; p=0.002). The FTS protocol reduced the treatment period (p < 0.001) and decreased the severity of postoperative pain (p < 0.001). The use of the "fast track surgery" protocol in urethroplasty with generally similar treatment results makes it possible to achieve a better functional and objective condition of patients in the postoperative period due to less pain, shorter catheterization, and hospitalization.

快速通道手术(FTS)以及ERAS(术后增强恢复/快速恢复计划)是最新的多模式治疗策略,旨在缩短残疾期并提高医疗质量。本研究旨在分析选择性尿道狭窄手术中增强恢复方案的有效性。一项前瞻性研究纳入了伊尔库茨克市第一临床医院泌尿科医院2019-2020年确诊为尿道狭窄的54例患者。所有54名患者都完成了研究。两组患者分为fts组(II组,n = 25)和标准组(I组,n = 29)。在术前参数方面,各组具有统计学上的同质性。根据本研究建立的标准对治疗进行组间疗效比较分析,I组5例(17.2%)、II组20例(80%)患者治疗效果良好(p=0.004)。无论治疗方案如何,输尿管成形术的总体疗效是相当的(86.2% vs 92%;P =0.870),以及2年内复发的可能性(P =0.512)。预测复发的因素是技术性并发症和尿道缝合失败(OR 4.36;95% ci 1.6;7.11;p = 0.002)。FTS方案缩短了治疗时间(p < 0.001),降低了术后疼痛的严重程度(p < 0.001)。在尿道成形术中使用“快速通道手术”方案,治疗效果大致相似,由于疼痛更少,导尿时间更短,住院时间更短,术后患者的功能和客观状况更好。
{"title":"Fast Track Surgery as the Latest Multimodal Strategy of Enhanced Recovery after Urethroplasty.","authors":"Vladimir Beloborodov,&nbsp;Vladimir Vorobev,&nbsp;Temirlan Hovalyg,&nbsp;Igor Seminskiy,&nbsp;Svetlana Sokolova,&nbsp;Ekaterina Lapteva,&nbsp;Aleksandr Mankov","doi":"10.1155/2023/2205306","DOIUrl":"https://doi.org/10.1155/2023/2205306","url":null,"abstract":"<p><p>Fast track surgery (FTS), as well as ERAS (enhanced recovery after surgery/rapid recovery programs), is the latest multimodal treatment strategy, designed to reduce the disability period and improve the medical care quality. The study aims to analyze the enhanced recovery protocol effectiveness in a comparative study of elective urethral stricture surgery. A prospective study included 54 patients with an established diagnosis of urethral stricture in 2019-2020 in the urological hospital of the Irkutsk City Clinical Hospital No. 1. All 54 patients have completed the study. There were two groups of patients FTS-group (group II, <i>n</i> = 25) and standard group (group I, <i>n</i> = 29). In terms of preoperative parameters, the comparison groups have statistical homogeneity. The comparative intergroup efficacy analysis of the treatment based on the criteria established in the study demonstrated good treatment results for 5 (17.2%) patients of group I and 20 (80%) patients of group II (<i>p</i>=0.004). The overall efficacy of urethroplasty surgeries, regardless of the treatment protocol, was comparable (86.2% vs 92%; <i>p</i>=0.870), as well as the likelihood of relapse within two years (<i>p</i>=0.512). The predictors of recurrence were technical complications and urethral suture failure (OR 4.36; 95% CI 1.6; 7.11; <i>p</i>=0.002). The FTS protocol reduced the treatment period (<i>p</i> < 0.001) and decreased the severity of postoperative pain (<i>p</i> < 0.001). The use of the \"fast track surgery\" protocol in urethroplasty with generally similar treatment results makes it possible to achieve a better functional and objective condition of patients in the postoperative period due to less pain, shorter catheterization, and hospitalization.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2023 ","pages":"2205306"},"PeriodicalIF":1.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10195176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9508532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Outcomes of Top-Down Holmium Laser Enucleation of Prostate for Recurrent/Residual Benign Prostatic Hyperplasia: One-Year Follow-Up. 自顶向下钬激光前列腺摘除治疗复发/残留良性前列腺增生的疗效:1年随访。
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2022-09-20 eCollection Date: 2022-01-01 DOI: 10.1155/2022/5185114
Ahmed S Zakaria, Amr Hodhod, Loay Abbas, Moustafa Fathy, Ruba Abdul Hadi, Waleed Shabana, Anastasia Alexandra MacDonald, Ahmed Gamaleldin, Mohamed Abdallah, Mohamed Elgharbawy, Abdulrahman Ahmad, Adam Roos, Ahmed Kotb, Walid Shahrour, Hazem Elmansy

Materials and methods: We carried out a retrospective analysis of patients who underwent top-down HoLEP for the management of recurrent BPH at our institution. Patients who had previously undergone TURP were assigned to group I, while those with no history of prostate surgery were allocated to group II. Preoperative clinical characteristics, enucleation time, resected tissue weight, morcellation time, energy used, and intraoperative and postoperative complications were recorded and statistically analyzed. Patients were followed up postoperatively at 1, 3, 6, and 12 months. The evaluation included the International Prostate Symptom Score (IPSS), quality of life assessment (QoL), maximum urinary flow rate (Q max), postvoid residual urine test (PVR), and continence status.

Results: Two hundred and sixty-nine patients were included in this study. Group I consisted of 68 patients with recurrent BPH, while group II included 201 patients. There were no statistically significant differences in preoperative characteristics between both groups. The median enucleation time for group I (67.5 min (25-200)) was not significantly longer than that for group II (60 min (19-165) (p=0.25)). Operative outcomes, including morcellation time, resected weight, catheter duration, and hospital stay, were comparable between both groups. At 1, 3, 6, and 12 months, all urinary functional outcomes showed significant improvement, and there were no significant differences between the two groups. At 3 months' follow-up, two patients in group I and three patients in group II experienced stress urinary incontinence (SUI). At the last follow-up visit, one patient from group I presented with persistent SUI.

Conclusions: For managing recurrent and nonrecurrent cases of BPH, top-down HoLEP is safe with comparable urinary functional outcomes. Patients with a history of previous prostate surgery can be counselled that their prior transurethral procedure does not reduce the benefits of HoLEP.

材料和方法:我们对我院接受自上而下HoLEP治疗复发性前列腺增生的患者进行了回顾性分析。先前接受过TURP的患者被分配到I组,而没有前列腺手术史的患者被分配到II组。记录术前临床特征、去核时间、切除组织重量、粉碎时间、能量消耗、术中术后并发症等,并进行统计分析。术后随访1、3、6、12个月。评估包括国际前列腺症状评分(IPSS)、生活质量评估(QoL)、最大尿流率(qmax)、空后残尿试验(PVR)和尿失禁状况。结果:269例患者纳入本研究。I组68例复发性前列腺增生症患者,II组201例。两组患者术前特征差异无统计学意义。I组的中位去核时间(67.5 min(25-200))与II组的中位去核时间(60 min(19-165))差异无统计学意义(p=0.25)。两组的手术结果,包括分拆时间、切除重量、导管持续时间和住院时间,具有可比性。在1、3、6和12个月时,所有泌尿功能结果均有显著改善,两组间无显著差异。随访3个月,1组2例、2组3例出现应激性尿失禁(SUI)。最后一次随访时,1组1例患者出现持续性SUI。结论:对于治疗复发性和非复发性BPH病例,自上而下的HoLEP是安全的,泌尿功能结果相当。既往有前列腺手术史的患者可被告知其既往经尿道手术不会降低HoLEP的益处。
{"title":"Outcomes of Top-Down Holmium Laser Enucleation of Prostate for Recurrent/Residual Benign Prostatic Hyperplasia: One-Year Follow-Up.","authors":"Ahmed S Zakaria,&nbsp;Amr Hodhod,&nbsp;Loay Abbas,&nbsp;Moustafa Fathy,&nbsp;Ruba Abdul Hadi,&nbsp;Waleed Shabana,&nbsp;Anastasia Alexandra MacDonald,&nbsp;Ahmed Gamaleldin,&nbsp;Mohamed Abdallah,&nbsp;Mohamed Elgharbawy,&nbsp;Abdulrahman Ahmad,&nbsp;Adam Roos,&nbsp;Ahmed Kotb,&nbsp;Walid Shahrour,&nbsp;Hazem Elmansy","doi":"10.1155/2022/5185114","DOIUrl":"https://doi.org/10.1155/2022/5185114","url":null,"abstract":"<p><strong>Materials and methods: </strong>We carried out a retrospective analysis of patients who underwent top-down HoLEP for the management of recurrent BPH at our institution. Patients who had previously undergone TURP were assigned to group I, while those with no history of prostate surgery were allocated to group II. Preoperative clinical characteristics, enucleation time, resected tissue weight, morcellation time, energy used, and intraoperative and postoperative complications were recorded and statistically analyzed. Patients were followed up postoperatively at 1, 3, 6, and 12 months. The evaluation included the International Prostate Symptom Score (IPSS), quality of life assessment (QoL), maximum urinary flow rate (<i>Q</i> <sub>max</sub>), postvoid residual urine test (PVR), and continence status.</p><p><strong>Results: </strong>Two hundred and sixty-nine patients were included in this study. Group I consisted of 68 patients with recurrent BPH, while group II included 201 patients. There were no statistically significant differences in preoperative characteristics between both groups. The median enucleation time for group I (67.5 min (25-200)) was not significantly longer than that for group II (60 min (19-165) (<i>p</i>=0.25)). Operative outcomes, including morcellation time, resected weight, catheter duration, and hospital stay, were comparable between both groups. At 1, 3, 6, and 12 months, all urinary functional outcomes showed significant improvement, and there were no significant differences between the two groups. At 3 months' follow-up, two patients in group I and three patients in group II experienced stress urinary incontinence (SUI). At the last follow-up visit, one patient from group I presented with persistent SUI.</p><p><strong>Conclusions: </strong>For managing recurrent and nonrecurrent cases of BPH, top-down HoLEP is safe with comparable urinary functional outcomes. Patients with a history of previous prostate surgery can be counselled that their prior transurethral procedure does not reduce the benefits of HoLEP.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2022 ","pages":"5185114"},"PeriodicalIF":1.4,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33516419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Diagnosing Oncocytoma by Core Needle Biopsy: A Single-Center Experience. 核心针活检诊断癌细胞瘤:单中心经验。
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2022-08-29 eCollection Date: 2022-01-01 DOI: 10.1155/2022/1589040
Chen Mayer, Yasmin Abu-Ghanem, Zohar A Dotan, Iris Barshack, Eddie Fridman

Background: Oncocytoma is one of the most common benign kidney tumors, accounting for 3-7% of all solid renal masses. Diagnosing oncocytomas using renal biopsy remains a controversy in the uro-pathologic community. With the increasing use of biopsies for assessment of renal lesions, reaching this pathologically benign diagnosis may prevent further surgical measures and have significant clinical benefit.

Objective: To demonstrate our center's results using renal biopsy to diagnose oncocytomas and to suggest that this diagnosis can be made with high success rates.

Design: , Setting, and Participants. From our center's database, we retrospectively identified and retrieved all cases of oncocytoma diagnosed between the years 2011 and 2020 by renal biopsy. Medical records of those patients were then reviewed to view follow-up meetings and imaging of the lesions biopsied. Outcome Measurements and Statistical Analysis. In 21 biopsies performed on 19 patients, diagnosis was supported by subsequent follow-up averaging at 3.44 years per patient. Results and Limitations. The lesions exhibited benign behavior during follow-up after biopsy, consistent with the diagnosis of oncocytoma.

Conclusions: Our study demonstrates that with good patient selection and proficient cooperation between urologists, radiologists and dedicated uro-pathologists, correctly diagnosing oncocytomas using RCB is a viable task. Patient Summary. Oncocytomas are benign lesions of the kidney. In our study, we reviewed all cases of oncocytomas pathologically diagnosed using renal biopsy from our center's database. We found that in subsequent follow-up later to biopsy, the lesions displayed benign behavior consistent with oncocytoma. The use of percutaneous biopsies to reach this diagnosis could save patients more extensive surgeries.

背景:嗜瘤细胞瘤是最常见的良性肾脏肿瘤之一,占所有肾实性肿块的3-7%。肾活检诊断嗜瘤细胞瘤在泌尿病理学界仍然存在争议。随着越来越多地使用活检来评估肾脏病变,达到这种病理良性诊断可以防止进一步的手术措施,并具有显著的临床效益。目的:展示本中心肾活检诊断嗜瘤细胞瘤的结果,并提示该诊断具有较高的成功率。设计、环境和参与者。从我们中心的数据库中,我们回顾性地确定并检索了2011年至2020年间通过肾活检诊断的所有嗜瘤细胞瘤病例。然后回顾这些患者的医疗记录,以查看后续会议和病变活检成像。结果测量和统计分析。在对19例患者进行的21次活组织检查中,诊断得到了后续随访的支持,平均每位患者随访3.44年。结果和局限性。在活检后的随访中,病变表现为良性,与嗜瘤细胞瘤的诊断一致。结论:我们的研究表明,在泌尿科医生、放射科医生和专业泌尿病理学家良好的患者选择和熟练的合作下,使用RCB正确诊断癌细胞瘤是一项可行的任务。病人总结。嗜瘤细胞瘤是肾脏的良性病变。在我们的研究中,我们回顾了我们中心数据库中所有通过肾活检病理诊断的嗜瘤细胞瘤病例。我们发现,在随后的活检随访中,病变表现出与嗜瘤细胞瘤一致的良性行为。使用经皮活检达到这种诊断可以节省患者更广泛的手术。
{"title":"Diagnosing Oncocytoma by Core Needle Biopsy: A Single-Center Experience.","authors":"Chen Mayer,&nbsp;Yasmin Abu-Ghanem,&nbsp;Zohar A Dotan,&nbsp;Iris Barshack,&nbsp;Eddie Fridman","doi":"10.1155/2022/1589040","DOIUrl":"https://doi.org/10.1155/2022/1589040","url":null,"abstract":"<p><strong>Background: </strong>Oncocytoma is one of the most common benign kidney tumors, accounting for 3-7% of all solid renal masses. Diagnosing oncocytomas using renal biopsy remains a controversy in the uro-pathologic community. With the increasing use of biopsies for assessment of renal lesions, reaching this pathologically benign diagnosis may prevent further surgical measures and have significant clinical benefit.</p><p><strong>Objective: </strong>To demonstrate our center's results using renal biopsy to diagnose oncocytomas and to suggest that this diagnosis can be made with high success rates.</p><p><strong>Design: </strong>, <i>Setting</i>, <i>and Participants</i>. From our center's database, we retrospectively identified and retrieved all cases of oncocytoma diagnosed between the years 2011 and 2020 by renal biopsy. Medical records of those patients were then reviewed to view follow-up meetings and imaging of the lesions biopsied. <i>Outcome Measurements and Statistical Analysis</i>. In 21 biopsies performed on 19 patients, diagnosis was supported by subsequent follow-up averaging at 3.44 years per patient. <i>Results and Limitations</i>. The lesions exhibited benign behavior during follow-up after biopsy, consistent with the diagnosis of oncocytoma.</p><p><strong>Conclusions: </strong>Our study demonstrates that with good patient selection and proficient cooperation between urologists, radiologists and dedicated uro-pathologists, correctly diagnosing oncocytomas using RCB is a viable task. <i>Patient Summary</i>. Oncocytomas are benign lesions of the kidney. In our study, we reviewed all cases of oncocytomas pathologically diagnosed using renal biopsy from our center's database. We found that in subsequent follow-up later to biopsy, the lesions displayed benign behavior consistent with oncocytoma. The use of percutaneous biopsies to reach this diagnosis could save patients more extensive surgeries.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2022 ","pages":"1589040"},"PeriodicalIF":1.4,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9444412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33448055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Role and Utility of Mixed Reality Technology in Laparoscopic Partial Nephrectomy: Outcomes of a Prospective RCT Using an Indigenously Developed Software 混合现实技术在腹腔镜部分肾切除术中的作用和效用:使用国产开发软件的前瞻性随机对照试验的结果
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2022-05-16 DOI: 10.1155/2022/8992051
N. Gadzhiev, I. Semeniakin, A. Morshnev, A. Alcaraz, V. Gauhar, Z. Okhunov
Objective To develop a software for mixed reality (MR) anatomical model creation and study its intraoperative clinical utility to facilitate laparoscopic partial nephrectomy. Materials and Methods After institutional review board approval, 47 patients were prospectively randomized for LPN into two groups: the control group (24 patients) underwent operation with an intraoperative ultrasound (US) control and the experimental group (23 patients) with smart glasses HoloLens 2 (Microsoft, Seattle, WA, USA). Our team has developed an open-source software package called “HLOIA,” utilization of which allowed to create and use during surgery the MR anatomical model of the kidney with its vascular pedicle and tumor. The study period extended from June 2020 to February 2021 where demographic, perioperative, and pathological data were collected for all qualifying patients. The objective was to assess the utility of a MR model during LPN and through a 5-point Likert scale questionnaire, completed by the surgeon, immediately after LPN. Patient characteristics were tested using the chi-square test for categorical variables and Student's t-test or Mann–Whitney test for continuous variables. Results Comparison of the variables between the groups revealed statistically significant differences only in the following parameters: the time for renal pedicle exposure and the time from the renal pedicle to the detection of tumor localization (p < 0.001), which were in favor of the experimental group. The surgeon's impression of the utility of the MR model by the proposed questionnaire demonstrated high scores in all statements. Conclusions Developed open-source software “HLOIA” allowed to create the mixed reality anatomical model by operating urologist which is when used with smart glasses has shown improvement in terms of time for renal pedicle exposure and time for renal tumor identification without compromising safety.
目的开发一种混合现实(MR)解剖模型创建软件,并研究其在腹腔镜肾部分切除术中的临床应用。材料和方法在机构审查委员会批准后,47名患者前瞻性地随机分为两组:对照组(24名患者)接受术中超声(US)对照的手术,实验组(23名患者)使用智能眼镜HoloLens 2(Microsoft,Seattle,WA,USA)。我们的团队开发了一个名为“HLOIA”的开源软件包,利用该软件包可以在手术中创建和使用带有血管蒂和肿瘤的肾脏的MR解剖模型。研究期从2020年6月延长至2021年2月,收集了所有符合条件的患者的人口统计学、围手术期和病理学数据。目的是通过外科医生在LPN后立即完成的5点Likert量表,评估MR模型在LPN期间的效用。使用分类变量的卡方检验和连续变量的Student t检验或Mann-Whitney检验来测试患者特征。结果两组之间的变量比较显示,仅在以下参数上存在统计学显著差异:肾蒂暴露时间和从肾蒂到检测到肿瘤定位的时间(p<0.001),这有利于实验组。外科医生通过所提出的问卷对MR模型的实用性的印象在所有陈述中都得到了高分。结论开发的开源软件“HLOIA”允许手术泌尿科医生创建混合现实解剖模型,当与智能眼镜一起使用时,在不影响安全性的情况下,显示出肾蒂暴露时间和肾肿瘤识别时间的改善。
{"title":"Role and Utility of Mixed Reality Technology in Laparoscopic Partial Nephrectomy: Outcomes of a Prospective RCT Using an Indigenously Developed Software","authors":"N. Gadzhiev, I. Semeniakin, A. Morshnev, A. Alcaraz, V. Gauhar, Z. Okhunov","doi":"10.1155/2022/8992051","DOIUrl":"https://doi.org/10.1155/2022/8992051","url":null,"abstract":"Objective To develop a software for mixed reality (MR) anatomical model creation and study its intraoperative clinical utility to facilitate laparoscopic partial nephrectomy. Materials and Methods After institutional review board approval, 47 patients were prospectively randomized for LPN into two groups: the control group (24 patients) underwent operation with an intraoperative ultrasound (US) control and the experimental group (23 patients) with smart glasses HoloLens 2 (Microsoft, Seattle, WA, USA). Our team has developed an open-source software package called “HLOIA,” utilization of which allowed to create and use during surgery the MR anatomical model of the kidney with its vascular pedicle and tumor. The study period extended from June 2020 to February 2021 where demographic, perioperative, and pathological data were collected for all qualifying patients. The objective was to assess the utility of a MR model during LPN and through a 5-point Likert scale questionnaire, completed by the surgeon, immediately after LPN. Patient characteristics were tested using the chi-square test for categorical variables and Student's t-test or Mann–Whitney test for continuous variables. Results Comparison of the variables between the groups revealed statistically significant differences only in the following parameters: the time for renal pedicle exposure and the time from the renal pedicle to the detection of tumor localization (p < 0.001), which were in favor of the experimental group. The surgeon's impression of the utility of the MR model by the proposed questionnaire demonstrated high scores in all statements. Conclusions Developed open-source software “HLOIA” allowed to create the mixed reality anatomical model by operating urologist which is when used with smart glasses has shown improvement in terms of time for renal pedicle exposure and time for renal tumor identification without compromising safety.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46787693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Combined Training Intervention Targeting Medical and Nursing Staff Reduces Ciprofloxacin Use and Events of Urinary Tract Infection 针对医护人员的联合培训干预减少了环丙沙星的使用和尿路感染事件
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2022-04-11 DOI: 10.1155/2022/2474242
J. Forster, Petra Schulze, Claudia Burger, M. Krone, U. Vogel, Güzin Surat
Inappropriate diagnosis of urinary tract infections (UTI) contributes to antimicrobial overuse. A combined training intervention for medical and nursing staff mainly addressing the analytic process reduced UTI events (9.20 vs. 7.36 per 1000 PD, −20.0%, p = 0.003) and the utilization rate of ciprofloxacin (11.6 vs. 3.5, −69.6 p = 0.001) in a Bavarian University Hospital. Combined training intervention—as part of an antibiotic stewardship program—can be effective in avoiding unnecessary urinalysis and reducing antibiotic consumption.
尿路感染(UTI)诊断不当会导致抗生素过度使用。主要针对分析过程的医护人员联合培训干预减少了尿路感染事件(9.20 vs.7.36/1000 PD,−20.0%,p = 0.003)和环丙沙星的利用率(11.6对3.5,−69.6 p = 0.001)在巴伐利亚大学医院。作为抗生素管理计划的一部分,联合训练干预可以有效避免不必要的尿液分析和减少抗生素消耗。
{"title":"Combined Training Intervention Targeting Medical and Nursing Staff Reduces Ciprofloxacin Use and Events of Urinary Tract Infection","authors":"J. Forster, Petra Schulze, Claudia Burger, M. Krone, U. Vogel, Güzin Surat","doi":"10.1155/2022/2474242","DOIUrl":"https://doi.org/10.1155/2022/2474242","url":null,"abstract":"Inappropriate diagnosis of urinary tract infections (UTI) contributes to antimicrobial overuse. A combined training intervention for medical and nursing staff mainly addressing the analytic process reduced UTI events (9.20 vs. 7.36 per 1000 PD, −20.0%, p = 0.003) and the utilization rate of ciprofloxacin (11.6 vs. 3.5, −69.6 p = 0.001) in a Bavarian University Hospital. Combined training intervention—as part of an antibiotic stewardship program—can be effective in avoiding unnecessary urinalysis and reducing antibiotic consumption.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2022 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43928765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
DU Is Induced by Low Levels of Urinary ATP in a Rat Model of Partial Bladder Outlet Obstruction: The Incidence of Both Events Decreases after Deobstruction 低水平尿ATP在膀胱部分出口梗阻大鼠模型中诱导DU:梗阻后两种事件的发生率均降低
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2022-02-28 DOI: 10.1155/2022/6292457
L. Vale, A. Charrua, H. Cavaleiro, R. Ribeiro-Oliveira, A. Avelino, T. Antunes-Lopes, A. Albino-Teixeira, F. Cruz
Objectives To investigate, in initial phases of bladder outlet obstruction (BOO), the urinary ATP levels, the incidence of detrusor underactivity (DU), and if they change after deobstruction. Methods Adult female Wistar rats submitted to partial BOO (pBOO) and sham-obstruction were used. Cystometry was performed 3 or 15 days after pBOO and fluid was collected from the urethra for ATP determination. Bladders were harvested for morphological evaluation of the urothelium. DU was defined as the average of voiding contractions (VC) of sham-operated animals, with 3 SD at 15 days after the sham surgery. In another group of animals in which pBOO was relieved at 15 days and bladders were let to recover for 15 days, the incidence of DU and ATP levels were also accessed. The Kruskal–Wallis test was followed by Dunn's multiple comparisons test, and Spearman's correlation test was used. Results DU was present in 13% and 67% of the bladders at 3 and 15 days after pBOO, respectively, and in 20% of the bladders at 15 days after deobstruction. ATP levels were significantly lower in DU/pBOO versus sham and non-DU/pBOO rats. A strong positive correlation between ATP levels and VC/min was obtained (r = 0.63). DU bladders had extensive areas in which umbrella cells appeared stretched, the width exceeding that presented by sham animals. Conclusions Low urothelial ATP parallels with a high incidence of DU early after pBOO.
目的探讨膀胱出口梗阻(BOO)初期尿ATP水平、逼尿肌活动不足(DU)的发生率,以及在解除梗阻后是否发生变化。方法成年雌性Wistar大鼠接受部分BOO(pBOO)和假梗阻。在pBOO后3或15天进行膀胱测量,并从尿道收集液体用于ATP测定。采集Bladder用于尿路上皮的形态学评估。DU被定义为假手术动物的平均排尿收缩(VC),假手术后15天为3 SD。在另一组动物中,pBOO在15天时缓解,膀胱在15天内恢复,DU和ATP水平的发生率也得到了评估。Kruskal–Wallis检验之后是Dunn的多重比较检验,并使用Spearman的相关性检验。结果在pBOO后3天和15天,DU分别出现在13%和67%的膀胱中,在去梗阻后15天,出现在20%的膀胱中。DU/pBOO大鼠的ATP水平显著低于假手术和非DU/pBOO大鼠。ATP水平与VC/min呈正相关(r = 0.63)。DU膀胱具有广泛的伞状细胞拉伸区域,其宽度超过了假动物的宽度。结论低尿路上皮ATP与pBOO术后早期DU的高发病率相似。
{"title":"DU Is Induced by Low Levels of Urinary ATP in a Rat Model of Partial Bladder Outlet Obstruction: The Incidence of Both Events Decreases after Deobstruction","authors":"L. Vale, A. Charrua, H. Cavaleiro, R. Ribeiro-Oliveira, A. Avelino, T. Antunes-Lopes, A. Albino-Teixeira, F. Cruz","doi":"10.1155/2022/6292457","DOIUrl":"https://doi.org/10.1155/2022/6292457","url":null,"abstract":"Objectives To investigate, in initial phases of bladder outlet obstruction (BOO), the urinary ATP levels, the incidence of detrusor underactivity (DU), and if they change after deobstruction. Methods Adult female Wistar rats submitted to partial BOO (pBOO) and sham-obstruction were used. Cystometry was performed 3 or 15 days after pBOO and fluid was collected from the urethra for ATP determination. Bladders were harvested for morphological evaluation of the urothelium. DU was defined as the average of voiding contractions (VC) of sham-operated animals, with 3 SD at 15 days after the sham surgery. In another group of animals in which pBOO was relieved at 15 days and bladders were let to recover for 15 days, the incidence of DU and ATP levels were also accessed. The Kruskal–Wallis test was followed by Dunn's multiple comparisons test, and Spearman's correlation test was used. Results DU was present in 13% and 67% of the bladders at 3 and 15 days after pBOO, respectively, and in 20% of the bladders at 15 days after deobstruction. ATP levels were significantly lower in DU/pBOO versus sham and non-DU/pBOO rats. A strong positive correlation between ATP levels and VC/min was obtained (r = 0.63). DU bladders had extensive areas in which umbrella cells appeared stretched, the width exceeding that presented by sham animals. Conclusions Low urothelial ATP parallels with a high incidence of DU early after pBOO.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45468775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
ERAS vs. Traditional Protocol in Patients Who Had Radical Cystectomy with Ileal Conduit: A Retrospective Comparative Analysis of 182 Cases 回肠导管根治性膀胱切除术的ERAS与传统方案:182例回顾性比较分析
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2022-02-28 DOI: 10.1155/2022/7335960
A. S. Guleser, Yasar Basaga
Objective To examine the effects of ERAS protocol application on hospital stay, postoperative antibiotic use, and gastrointestinal recovery time in radical cystectomy patients with ileal conduit. Materials and Methods This retrospective study included 182 patients (112 traditional vs. 72 ERAS) who underwent radical cystectomy (RC) with ileal conduit between November 2017 and December 2020. Patients were compared in terms of time to start enteral feeding (SEF), length of hospital stay (LOS), time to first stool, duration of postoperative intravenous antibiotic use, postoperative ileus rate, and serum albumin levels. Results The traditional and ERAS groups contained 112 and 72 patients, respectively. LOS (14.79 ± 6.44 vs. 10.44 ± 4.64 days, p=0.003), first stool time (4.43 ± 2.39 vs. 2.89 ± 1.81 days, p=0.011), and duration of postoperative intravenous antibiotic use (8.79 ± 5.17 vs. 4.61 ± 4.90, p=0.004) were to be found significantly shorter in the ERAS group. Conclusion According to the results of this study, the ERAS protocol shortened the length of hospital stay, duration of antibiotic use, and time of first stool in patients who underwent RC with ileal conduit.
目的探讨ERAS方案应用对回肠导管膀胱切除术患者住院时间、术后抗生素使用和胃肠道恢复时间的影响。材料和方法这项回顾性研究包括182名患者(112名传统ERAS,72名ERAS),他们在2017年11月至2020年12月期间接受了回肠导管根治性膀胱切除术(RC)。比较患者开始肠内喂养的时间(SEF)、住院时间(LOS)、首次排便的时间、术后静脉注射抗生素的持续时间、术后肠梗阻率和血清白蛋白水平。结果传统组112例,ERAS组72例。洛斯(14.79 ± 6.44对10.44 ± 4.64天,p=0.003),首次排便时间(4.43 ± 2.39对2.89 ± 1.81天,p=0.011)和术后静脉注射抗生素的持续时间(8.79 ± 5.17对4.61 ± 4.90,p=0.004)在ERAS组中显著缩短。结论根据本研究的结果,ERAS方案缩短了带回肠导管的RC患者的住院时间、抗生素使用时间和首次排便时间。
{"title":"ERAS vs. Traditional Protocol in Patients Who Had Radical Cystectomy with Ileal Conduit: A Retrospective Comparative Analysis of 182 Cases","authors":"A. S. Guleser, Yasar Basaga","doi":"10.1155/2022/7335960","DOIUrl":"https://doi.org/10.1155/2022/7335960","url":null,"abstract":"Objective To examine the effects of ERAS protocol application on hospital stay, postoperative antibiotic use, and gastrointestinal recovery time in radical cystectomy patients with ileal conduit. Materials and Methods This retrospective study included 182 patients (112 traditional vs. 72 ERAS) who underwent radical cystectomy (RC) with ileal conduit between November 2017 and December 2020. Patients were compared in terms of time to start enteral feeding (SEF), length of hospital stay (LOS), time to first stool, duration of postoperative intravenous antibiotic use, postoperative ileus rate, and serum albumin levels. Results The traditional and ERAS groups contained 112 and 72 patients, respectively. LOS (14.79 ± 6.44 vs. 10.44 ± 4.64 days, p=0.003), first stool time (4.43 ± 2.39 vs. 2.89 ± 1.81 days, p=0.011), and duration of postoperative intravenous antibiotic use (8.79 ± 5.17 vs. 4.61 ± 4.90, p=0.004) were to be found significantly shorter in the ERAS group. Conclusion According to the results of this study, the ERAS protocol shortened the length of hospital stay, duration of antibiotic use, and time of first stool in patients who underwent RC with ileal conduit.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46512097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Extended Use of The Spanner® Temporary Prostatic Stent in Catheter-Dependent Men with Comorbidities. Spanner®临时前列腺支架在有合并症的导管依赖患者中的延长使用
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2022-02-03 eCollection Date: 2022-01-01 DOI: 10.1155/2022/7367851
Angelo J Cambio, Richard M Roach, Paul Arnold, Joseph Cambio, Clifford D Gluck, Sean P Heron

Purpose: This US FDA investigational device exemption (IDE) study evaluated the extended use of The Spanner® Temporary Prostatic Stent in catheter-dependent men with urinary retention who were not deemed candidates for corrective surgery but demonstrated bladder contractility.

Materials and methods: The Spanner was placed for 3 cycles of 30 days in catheter-dependent men with comorbid conditions, confirmed detrusor contractility, and catheter-associated discomfort. At each visit, postvoid residual, maximum flow rate, international prostate symptom score, quality of life, and adverse events were assessed. Voiding success was defined as PVR ≤ 150 ml at all visits.

Results: One hundred seven men were enrolled at 8 US sites; 82/107 (76.6%) completed the trial, and 79/107 (73.8%) successfully maintained PVR ≤ 150 ml for the trial duration. Patients were 77.1 ± 10.6 years old; 63/107 (58.9%) were dependent on Foley and 40/107 (37.4%) on intermittent catheterization for 36.0 ± 39.3 days and 30.2 ± 45.8 days, respectively. 25/107 (23.4%) discontinuations were primarily due to voluntary patient withdrawal 9/107 (8.4%), investigator-initiated withdrawal 8/107 (7.5%), or lack of effectiveness 4/107 (3.7%). During Spanner use, the mean Q max was 11.2 ± 6.6, mean IPSS was 7.5 ± 6.4, and mean QOL was 2.0 ± 1.6. The most prevalent device-related adverse events were asymptomatic bacteriuria 25/107 (23.4%), discomfort 10/107 (9.4%), and urinary urgency 8/107 (7.5%). No device-related serious AEs were reported.

Conclusions: This study demonstrates that catheter-dependent men with sufficient bladder contractility can achieve volitional voiding and successful bladder drainage using The Spanner Temporary Prostatic Stent for extended periods of time.

目的:这项美国FDA试验性器械豁免(IDE)研究评估了Spanner®临时前列腺支架在尿潴留依赖导管的男性患者中的延长使用,这些患者不被认为需要进行矫正手术,但表现出膀胱收缩性。材料和方法:将Spanner放置在有合并症、确认逼尿肌收缩和导管相关不适的依赖导管的男性患者中,放置3个周期,每30天。每次访问时,评估空腔后残留、最大血流率、国际前列腺症状评分、生活质量和不良事件。排尿成功定义为每次就诊PVR≤150ml。结果:117名男性在美国8个站点被纳入研究;82/107(76.6%)完成了试验,79/107(73.8%)在试验期间成功维持PVR≤150 ml。患者年龄77.1±10.6岁;63/107例(58.9%)依赖Foley, 40/107例(37.4%)依赖间歇置管,时间分别为36.0±39.3天和30.2±45.8天。25/107(23.4%)停药主要是由于患者自愿停药9/107(8.4%)、研究者主动停药8/107(7.5%)或缺乏有效性4/107(3.7%)。Spanner使用期间,平均qmax为11.2±6.6,平均IPSS为7.5±6.4,平均生活质量为2.0±1.6。最常见的器械相关不良事件是无症状菌尿25/107(23.4%)、不适10/107(9.4%)和尿急8/107(7.5%)。未报告与设备相关的严重ae。结论:本研究表明,膀胱收缩能力足够的导管依赖患者使用Spanner临时前列腺支架延长时间后,可以实现自主排尿和膀胱引流成功。
{"title":"Extended Use of The Spanner® Temporary Prostatic Stent in Catheter-Dependent Men with Comorbidities.","authors":"Angelo J Cambio,&nbsp;Richard M Roach,&nbsp;Paul Arnold,&nbsp;Joseph Cambio,&nbsp;Clifford D Gluck,&nbsp;Sean P Heron","doi":"10.1155/2022/7367851","DOIUrl":"https://doi.org/10.1155/2022/7367851","url":null,"abstract":"<p><strong>Purpose: </strong>This US FDA investigational device exemption (IDE) study evaluated the extended use of The Spanner® Temporary Prostatic Stent in catheter-dependent men with urinary retention who were not deemed candidates for corrective surgery but demonstrated bladder contractility.</p><p><strong>Materials and methods: </strong>The Spanner was placed for 3 cycles of 30 days in catheter-dependent men with comorbid conditions, confirmed detrusor contractility, and catheter-associated discomfort. At each visit, postvoid residual, maximum flow rate, international prostate symptom score, quality of life, and adverse events were assessed. Voiding success was defined as PVR ≤ 150 ml at all visits.</p><p><strong>Results: </strong>One hundred seven men were enrolled at 8 US sites; 82/107 (76.6%) completed the trial, and 79/107 (73.8%) successfully maintained PVR ≤ 150 ml for the trial duration. Patients were 77.1 ± 10.6 years old; 63/107 (58.9%) were dependent on Foley and 40/107 (37.4%) on intermittent catheterization for 36.0 ± 39.3 days and 30.2 ± 45.8 days, respectively. 25/107 (23.4%) discontinuations were primarily due to voluntary patient withdrawal 9/107 (8.4%), investigator-initiated withdrawal 8/107 (7.5%), or lack of effectiveness 4/107 (3.7%). During Spanner use, the mean <i>Q</i> <sub>max</sub> was 11.2 ± 6.6, mean IPSS was 7.5 ± 6.4, and mean QOL was 2.0 ± 1.6. The most prevalent device-related adverse events were asymptomatic bacteriuria 25/107 (23.4%), discomfort 10/107 (9.4%), and urinary urgency 8/107 (7.5%). No device-related serious AEs were reported.</p><p><strong>Conclusions: </strong>This study demonstrates that catheter-dependent men with sufficient bladder contractility can achieve volitional voiding and successful bladder drainage using The Spanner Temporary Prostatic Stent for extended periods of time.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2022 ","pages":"7367851"},"PeriodicalIF":1.4,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8831058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39611298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Management of Bladder Pain Syndrome (BPS): A Practical Guide. 膀胱疼痛综合征(BPS)的处理:实用指南。
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2022-01-10 eCollection Date: 2022-01-01 DOI: 10.1155/2022/7149467
Patrick Juliebø-Jones, Karin M Hjelle, Jannike Mohn, Gigja Gudbrandsdottir, Ingunn Roth, Adeel Asghar Chaudhry, Anne Kvåle Bergesen, Christian Beisland

Bladder pain syndrome (BPS) is a prevalent and pervasive disease. The physical and psychological sequelae can be very burdensome for the patient, and the condition represents a real challenge for the clinician as well. With no simple pathognomonic test, finding harmony in navigating patient care can be demanding. Diagnosis and management rely upon a multidisciplinary and holistic approach. Treatment options include conservative measures and pharmacotherapies as well as bladder instillation therapies. Ultimately, surgery may be offered but only in cases of refractory disease. This article offers a pragmatic guide for clinicians managing this challenging disease.

膀胱疼痛综合征(BPS)是一种普遍存在的疾病。身体和心理上的后遗症对病人来说是非常沉重的负担,对临床医生来说也是一个真正的挑战。由于没有简单的病理测试,在病人护理中找到和谐是非常困难的。诊断和管理依赖于多学科和整体的方法。治疗方案包括保守措施和药物治疗以及膀胱灌注治疗。最终,只有在难治性疾病的情况下才能进行手术。本文为临床医生管理这种具有挑战性的疾病提供了实用的指南。
{"title":"Management of Bladder Pain Syndrome (BPS): A Practical Guide.","authors":"Patrick Juliebø-Jones,&nbsp;Karin M Hjelle,&nbsp;Jannike Mohn,&nbsp;Gigja Gudbrandsdottir,&nbsp;Ingunn Roth,&nbsp;Adeel Asghar Chaudhry,&nbsp;Anne Kvåle Bergesen,&nbsp;Christian Beisland","doi":"10.1155/2022/7149467","DOIUrl":"https://doi.org/10.1155/2022/7149467","url":null,"abstract":"<p><p>Bladder pain syndrome (BPS) is a prevalent and pervasive disease. The physical and psychological sequelae can be very burdensome for the patient, and the condition represents a real challenge for the clinician as well. With no simple pathognomonic test, finding harmony in navigating patient care can be demanding. Diagnosis and management rely upon a multidisciplinary and holistic approach. Treatment options include conservative measures and pharmacotherapies as well as bladder instillation therapies. Ultimately, surgery may be offered but only in cases of refractory disease. This article offers a pragmatic guide for clinicians managing this challenging disease.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2022 ","pages":"7149467"},"PeriodicalIF":1.4,"publicationDate":"2022-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8763550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Open Partial Nephrectomy with Zero Ischaemia Using a Supra 12th Rib Miniflank Incision: A Minimally Invasive Open Approach for Small Renal Masses. 经第12肋上小腹侧切口无缺血开放性肾部分切除术:小肾肿块的微创开放性手术方法。
IF 1.4 Q3 UROLOGY & NEPHROLOGY Pub Date : 2021-12-31 eCollection Date: 2021-01-01 DOI: 10.1155/2021/5569254
Syed Ali Ehsanullah, Abida Sultana, Brian Kelly, Charlotte Dunford, Zaheer Shah

Introduction: To assess a minimally invasive open technique for partial nephrectomy with zero ischaemia time.

Methods: A review was performed in a prospectively maintained database of a single surgeon series of all patients undergoing partial nephrectomy using a supra 12th rib miniflank incision with zero ischaemia. Data of seventy one patients who underwent a partial nephrectomy over an 82-month period were analyzed. Data analyzed included operative time, estimated blood loss, pre and postoperative renal function, complications, final pathological characteristics, and tumour size.

Results: Seventy one partial nephrectomies were performed from February 2009 to October 2015. None were converted to radical nephrectomy. Mean operative time was 72 minutes (range 30-250), and mean estimated blood loss was 608 mls (range 100-2500) with one patient receiving blood transfusion. The mean pre and postoperative haemoglobin levels were 144 and 112 g/l. The mean pre and postoperative creatinine levels were 82 and 103 Umol/L. There were 8 Clavian-Dindo Grade 2 complications and 1 major complication (Clavian IIIa). Histology confirmed 24 benign lesions and 47 malignant lesions, 46 cT1a lesions, 24 cT1b lesions, and 1 cT2 lesion. Median follow-up was 38 months with no local recurrence or progression of disease with 5 patients having a positive margin (7%).

Conclusion: Our results demonstrate that a supra 12th miniflank incision open partial nephrectomy with zero ischaemic time for SRMs has satisfactory outcomes with preservation of renal function. A minimally invasive open partial nephrectomy remains an important option for units that cannot offer patients a laparoscopic or a robotic procedure.

目的:探讨零缺血时间的微创开放性肾部分切除术。方法:在前瞻性维护的数据库中,对所有采用第12肋上小腹切口进行部分肾切除术的患者进行回顾性分析。在82个月的时间里,我们分析了71例接受部分肾切除术的患者的资料。分析的数据包括手术时间、估计失血量、术前和术后肾功能、并发症、最终病理特征和肿瘤大小。结果:2009年2月至2015年10月共施行肾部分切除术71例。没有一例转为根治性肾切除术。平均手术时间为72分钟(范围30-250),平均估计失血量为608毫升(范围100-2500),一名患者接受输血。术前和术后平均血红蛋白水平分别为144和112 g/l。术前和术后平均肌酐水平分别为82和103 Umol/L。Clavian- dindo 2级并发症8例,主要并发症(Clavian IIIa) 1例。组织学证实良性病变24例,恶性病变47例,cT1a病变46例,cT1b病变24例,cT2病变1例。中位随访时间为38个月,无局部复发或疾病进展,5例患者有阳性边缘(7%)。结论:我们的研究结果表明,在缺血时间为零的情况下,对SRMs进行第12小侧腹切口部分肾切除术的结果令人满意,并保留了肾功能。对于不能为患者提供腹腔镜或机器人手术的单位来说,微创开放式部分肾切除术仍然是一个重要的选择。
{"title":"Open Partial Nephrectomy with Zero Ischaemia Using a Supra 12th Rib Miniflank Incision: A Minimally Invasive Open Approach for Small Renal Masses.","authors":"Syed Ali Ehsanullah,&nbsp;Abida Sultana,&nbsp;Brian Kelly,&nbsp;Charlotte Dunford,&nbsp;Zaheer Shah","doi":"10.1155/2021/5569254","DOIUrl":"https://doi.org/10.1155/2021/5569254","url":null,"abstract":"<p><strong>Introduction: </strong>To assess a minimally invasive open technique for partial nephrectomy with zero ischaemia time.</p><p><strong>Methods: </strong>A review was performed in a prospectively maintained database of a single surgeon series of all patients undergoing partial nephrectomy using a supra 12<sup>th</sup> rib miniflank incision with zero ischaemia. Data of seventy one patients who underwent a partial nephrectomy over an 82-month period were analyzed. Data analyzed included operative time, estimated blood loss, pre and postoperative renal function, complications, final pathological characteristics, and tumour size.</p><p><strong>Results: </strong>Seventy one partial nephrectomies were performed from February 2009 to October 2015. None were converted to radical nephrectomy. Mean operative time was 72 minutes (range 30-250), and mean estimated blood loss was 608 mls (range 100-2500) with one patient receiving blood transfusion. The mean pre and postoperative haemoglobin levels were 144 and 112 g/l. The mean pre and postoperative creatinine levels were 82 and 103 Umol/L. There were 8 Clavian-Dindo Grade 2 complications and 1 major complication (Clavian IIIa). Histology confirmed 24 benign lesions and 47 malignant lesions, 46 cT1a lesions, 24 cT1b lesions, and 1 cT2 lesion. Median follow-up was 38 months with no local recurrence or progression of disease with 5 patients having a positive margin (7%).</p><p><strong>Conclusion: </strong>Our results demonstrate that a supra 12th miniflank incision open partial nephrectomy with zero ischaemic time for SRMs has satisfactory outcomes with preservation of renal function. A minimally invasive open partial nephrectomy remains an important option for units that cannot offer patients a laparoscopic or a robotic procedure.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":"2021 ","pages":"5569254"},"PeriodicalIF":1.4,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8741386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39661860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Advances in Urology
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1