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https://www.readbyqxmd.com/read/28646936/surgical-flow-disruptions-during-robotic-assisted-radical-prostatectomy
#1
Christopher J Dru, Jennifer T Anger, Colby P Souders, Catherine Bresee, Matthias Weigl, Elyse Hallett, Ken Catchpole
INTRODUCTION: We sought to apply the principles of human factors research to robotic-assisted radical prostatectomy to understand where training and integration challenges lead to suboptimal and inefficient care. MATERIALS AND METHODS: Thirty-four robotic-assisted radical prostatectomy and bilateral pelvic lymph node dissections over a 20 week period were observed for flow disruptions (FD) - deviations from optimal care that can compromise safety or efficiency. Other variables - physician experience, trainee involvement, robot model (S versus Si), age, body mass index (BMI), and American Society of Anesthesiologists (ASA) physical status - were used to stratify the data and understand the effect of context...
June 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28646463/patterns-of-failure-after-radical-prostatectomy-in-prostate-cancer-implications-for-radiation-therapy-planning-after-68-ga-psma-pet-imaging
#2
Kilian Schiller, K Sauter, S Dewes, M Eiber, T Maurer, J Gschwend, S E Combs, G Habl
BACKGROUND: Salvage radiotherapy (SRT) after radical prostatectomy (RPE) and lymphadenectomy (LAE) is the appropriate radiotherapy option for patients with persistent/ recurrent prostate cancer (PC). (68)Ga-PSMA-PET imaging has been shown to accurately detect PC lesions in a primary setting as well as for local recurrence or for lymph node (LN) metastases. OBJECTIVE: In this study we evaluated the patterns of recurrence after RPE in patients with PC, putting a highlight on the differentiation between sites that would have been covered by a standard radiation therapy (RT) field in consensus after the RTOG consensus and others that would have not...
June 23, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28646238/-bladder-neck-sclerosis-following-prostate-surgery-which-therapy-when
#3
REVIEW
J J Rassweiler, H Weiss, A Heinze, M Elmussareh, M Fiedler, A S Goezen
Secondary bladder neck sclerosis represents one of the more frequent complications following endoscopic, open, and other forms of minimally invasive prostate surgery. Therapeutic decisions depend on the type of previous intervention (e.g., radical prostatectomy, TURP, HoLEP, radiotherapy, HIFU) and on associated complications (e.g., incontinence, fistula). Primary treatment in most cases represents an endoscopic bilateral incision. No specific advantages of any type of the applied energy (i.e., mono-/bipolar HF current, cold incision, holmium/thulium YAG laser) could be documented...
June 23, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28645325/performance-characteristics-of-prostate-specific-antigen-density-and-biopsy-core-details-to-predict-oncological-outcome-in-patients-with-intermediate-to-high-risk-prostate-cancer-underwent-robot-assisted-radical-prostatectomy
#4
Masahiro Yashi, Akinori Nukui, Yuumi Tokura, Kohei Takei, Issei Suzuki, Kazumasa Sakamoto, Hideo Yuki, Tsunehito Kambara, Hironori Betsunoh, Hideyuki Abe, Yoshitatsu Fukabori, Yoshimasa Nakazato, Yasushi Kaji, Takao Kamai
BACKGROUND: Many urologic surgeons refer to biopsy core details for decision making in cases of localized prostate cancer (PCa) to determine whether an extended resection and/or lymph node dissection should be performed. Furthermore, recent reports emphasize the predictive value of prostate-specific antigen density (PSAD) for further risk stratification, not only for low-risk PCa, but also for intermediate- and high-risk PCa. This study focused on these parameters and compared respective predictive impact on oncologic outcomes in Japanese PCa patients...
June 23, 2017: BMC Urology
https://www.readbyqxmd.com/read/28643068/effects-of-barbed-suture-during-robot-assisted-radical-prostatectomy-on-postoperative-tissue-damage-and-longitudinal-changes-in-lower-urinary-tract-outcome
#5
Nobuhiro Haga, Noriaki Kurita, Tomohiko Yanagida, Soichiro Ogawa, Michihiro Yabe, Hidenori Akaihata, Junya Hata, Yuichi Sato, Kei Ishibashi, Osamu Hasegawa, Yoshiyuki Kojima
OBJECTIVE: To compare the postoperative tissue damage and longitudinal changes in functional and patient-reported outcomes after vesicourethral anastomosis with barbed suture and nonbarbed suture in robot-assisted laparoscopic radical prostatectomy (RARP). MATERIALS AND METHODS: This was a prospective cohort study involving 88 consecutive patients who underwent RARP. These patients were categorized into the barbed suture group (n = 50) and the nonbarbed suture group (n = 38)...
June 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28642049/post-prostatectomy-incontinence-how-common-and-bothersome-is%C3%A2-it%C3%A2-really
#6
REVIEW
Vera Trofimenko, Jeremy B Myers, William O Brant
INTRODUCTION: The implications of post-prostatectomy urinary incontinence (PPI) on quality of life pose a matter of great concern for urologists and patients alike. Efforts to mitigate this devastating complication have met with varying degrees of success and the literature has shown a discrepancy between patient- and surgeon-reported outcomes. AIM: To describe the multifactorial physiology of PPI, its evaluation, and its effect on health-related quality of life and sexual function and to review preoperative predictive factors for PPI and explore the disparity between patient- and surgeon-reported outcomes...
June 19, 2017: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/28641974/prostate-cancer-local-recurrence-detected-with-both-18-f-fluciclovine-and-psma-targeted-18-f-dcfpyl-pet-ct
#7
Michael A Gorin, Kenneth J Pienta, Martin G Pomper, Steven P Rowe
We present the case of a 79-year-old man with an elevated post-prostatectomy PSA level who was sequentially imaged with PET/CT using (18)F-fluciclovine followed by PSMA-targeted (18)F-DCFPyL. Although both imaging tests successfully identified the same pelvic recurrence, each radiotracer had its relative merits. This case highlights the differences between these two PET radiotracers which are increasingly being used to image men with recurrent prostate cancer.
June 19, 2017: Urology
https://www.readbyqxmd.com/read/28637364/comparison-of-perioperative-outcomes-between-holmium-laser-enucleation-of-the-prostate-and-robotic-assisted-simple-prostatectomy
#8
Mimi Zhang, Marawan El Tayeb, Michael Borofsky, Casey Dauw, Kristofer R Wagner, Patrick S Lowry, Erin T BIrd, Tillman C Hudson, James E Lingeman
OBJECTIVES: To compare perioperative outcomes for patients undergoing holmium laser enucleation of the prostate (HoLEP) and robotic assisted simple prostatectomy (RSP) for benign prostatic hypertrophy (BPH). METHODS: Patient demographics and perioperative outcomes were compared between 600 patients undergoing HoLEP and 32 patients undergoing RSP at two separate academic institutions between 2008 and 2015. RESULTS: Patients undergoing HoLEP and RSP had comparable ages (71 vs...
June 22, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28635569/stratification-model-based-on-early-postprostatectomy-prostate-specific-antigen-kinetics-may-help-to-reduce-the-risk-of-overtreatment-in-candidates-for-adjuvant-radiotherapy
#9
Stepan Vesely, Ladislav Jarolim, Marek Schmidt, Joana Do Carmo Silva, Katerina Duskova, Marko Babjuk
OBJECTIVE: The aim of this study was to construct a stratification model based on early postoperative kinetics of prostate-specific antigen (PSA) to select the most suitable high-risk patients for early intervention after radical prostatectomy (RP). MATERIALS AND METHODS: The study evaluated 205 men who had undergone RP without any adjuvant treatment. All of the patients had positive surgical margins, extracapsular extension and/or seminal vesicle invasion. The patients underwent multiple ultrasensitive PSA measurements on days 14, 30, 60 and 90 after RP, and subsequently at 3 month intervals...
February 24, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28634911/novel-insights-into-a-reputably-irreversible-process-combined-mrna-and-mirna-profiling-of-tissue-from-vesicourethral-anastomotic-stenosis-after-radical-prostatectomy
#10
T S Worst, K Daskalova, A Steidler, K Berner-Leischner, R Röth, B Niesler, C-A Weis, M C Kriegmair, P Erben, D Pfalzgraf
PURPOSE: Until recently, tissue fibrosis-ultimately leading to permanent scaring-has been considered an irreversible process. However, recent findings indicate that it may be reversible after all. Vesicourethral anastomotic stenosis (VUAS) as fibrous narrowing is a frequent complication after radical prostatectomy with high recurrence rates and requires invasive treatment. The pathophysiology is poorly understood. Therefore, a combined mRNA and miRNA transcription profiling in tissue from VUAS was performed using nCounter technology...
June 20, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28634646/the-role-of-robotics-in-the-invasive-management-of-bladder-cancer
#11
REVIEW
Pramit Khetrapal, Wei Shen Tan, Benjamin Lamb, Melanie Tan, Hilary Baker, James Thompson, Ashwin Sridhar, John D Kelly, Tim Briggs
Robot-assisted radical cystectomy (RARC) has been adopted widely in many centres, owed largely to the success of robot-assisted laparoscopic prostatectomy (RALP). It aims to replicate the oncological outcomes of open radical cystectomy (ORC), while providing a shorter recovery period. Despite this, previous RCTs have failed to show a benefit for RARC over ORC. These trials have compared extracorporeal RARC (eRARC) with ORC, which requires a further incision to mobilise the bowel for urinary reconstruction with an open technique...
August 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28632890/minimally-invasive-surgery-and-its-impact-on-30-day-postoperative-complications-unplanned-readmissions-and-mortality
#12
A Sood, C P Meyer, F Abdollah, J D Sammon, M Sun, S R Lipsitz, M Hollis, J S Weissman, M Menon, Q-D Trinh
BACKGROUND: A critical appraisal of the benefits of minimally invasive surgery (MIS) is needed, but is lacking. This study examined the associations between MIS and 30-day postoperative outcomes including complications graded according to the Clavien-Dindo classification, unplanned readmissions, hospital stay and mortality for five common surgical procedures. METHODS: Patients undergoing appendicectomy, colectomy, inguinal hernia repair, hysterectomy and prostatectomy were identified in the American College of Surgeons National Surgical Quality Improvement Program database...
June 20, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28631720/contemporary-management-of-men-with-high-risk-localized-prostate-cancer-in-the-united-states
#13
A B Weiner, R S Matulewicz, E M Schaeffer, S L Liauw, J M Feinglass, S E Eggener
BACKGROUND: Surgery and radiation-based therapies are standard management options for men with clinically localized high-risk prostate cancer (PCa). Contemporary patterns of care are unknown. We hypothesize the use of surgery has steadily increased in more recent years. METHODS: Using the National Cancer Data Base for 2004-2013, all men diagnosed with high-risk localized PCa were identified using National Comprehensive Cancer Network criteria. Temporal trends in initial management were assessed...
June 20, 2017: Prostate Cancer and Prostatic Diseases
https://www.readbyqxmd.com/read/28629566/pi-rads-version-2-preoperative-role-in-the-detection-of-normal-sized-pelvic-lymph-node-metastasis-in-prostate-cancer
#14
Sung Yoon Park, Su-Jin Shin, Dae Chul Jung, Nam Hoon Cho, Young Deuk Choi, Koon Ho Rha, Sung Joon Hong, Young Taik Oh
OBJECTIVES: To analyze whether Prostate Imaging Reporting and Data System (PI-RADSv2) scores are associated with a risk of normal-sized pelvic lymph node metastasis (PLNM) in prostate cancer (PCa). MATERIALS AND METHODS: A consecutive series of 221 patients who underwent magnetic resonance imaging and radical prostatectomy with pelvic lymph node dissection (PLND) for PCa were retrospectively analyzed under the approval of institutional review board in our institution...
June 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28628624/heterogeneity-of-mirna-expression-in-localized-prostate-cancer-with-clinicopathological-correlations
#15
Ahmed Hussein Zedan, Søren Garm Blavnsfeldt, Torben Frøstrup Hansen, Boye Schnack Nielsen, Niels Marcussen, Mindaugas Pleckaitis, Palle Jörn Sloth Osther, Flemming Brandt Sørensen
INTRODUCTION: In the last decade microRNAs (miRNAs) have been widely investigated in prostate cancer (PCa) and have shown to be promising biomarkers in diagnostic, prognostic and predictive settings. However, tumor heterogeneity may influence miRNA expression. The aims of this study were to assess the impact of tumor heterogeneity, as demonstrated by a panel of selected miRNAs in PCa, and to correlate miRNA expression with risk profile and patient outcome. MATERIAL AND METHODS: Prostatectomy specimens and matched, preoperative needle biopsies from a retrospective cohort of 49 patients, who underwent curatively intended surgery for localized PCa, were investigated with a panel of 6 miRNAs (miRNA-21, miRNA-34a, miRNA-125b, miRNA-126, miRNA-143, and miRNA-145) using tissue micro-array (TMA) and in situ hybridization (ISH)...
2017: PloS One
https://www.readbyqxmd.com/read/28626868/intrathecal-dexamethasone-vs-meperidine-for-prevention-of-shivering-during-transurethral-prostatectomy-a-randomized-controlled-trial
#16
S M Moeen, A M Moeen
BACKGROUND: Shivering is a common complication after spinal anesthesia. Also, during transurethral prostatectomy a large amount of irrigating fluids is used which may cause hypothermia and shivering. We hypothesized that intrathecal dexamethasone could effectively attenuate post-spinal shivering following transurethral prostatectomy as intrathecal meperidine. METHODS: Ninety male patients, ASA II-III, 50-75 years old were included in this prospective and randomized double-blind study...
June 18, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28626111/-initial-experience-with-robot-assisted-laparoscopic-prostatectomy-for-complicated-cases
#17
Kun Yao, Leye He, Bin Liu, Jin Tang, Yingbo Dai, Zhi Long, Jianye Liu, Yichuan Zhang
To present our initial experience with robot-assisted laparoscopic prostatectomy (RALP) for complicated cases.
 Methods: Clinical and pathological data from 4 complicated prostate cancer cases, who underwent RALP from October to November in 2015, were analyzed retrospectively. All the cases were conducted transurethral plasmakinetic enucleation of prostate and hormonal therapy before RALP.
 Results: All surgeries were done successfully. The age, baseline prostatic special antigen, clinical tumor stage, operation time and estimated blood loss were 58-70 years, 6...
May 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28625844/post-prostatectomy-radiotherapy-does-salvage-really-equal-adjuvant
#18
EDITORIAL
Alberto Bossi, Cesare Cozzarini
No abstract text is available yet for this article.
June 15, 2017: European Urology
https://www.readbyqxmd.com/read/28625507/contemporary-patterns-of-care-and-outcomes-of-men-found-to-have-lymph-node-metastases-at-the-time-of-radical-prostatectomy
#19
Piotr Zareba, James Eastham, Peter T Scardino, Karim Touijer
PURPOSE: A thorough understanding of the natural history and consensus regarding the optimal management of pathologic lymph node-positive (pN1) prostate cancer are lacking. Our objective was to describe patterns of care and outcomes of a contemporary cohort of men with pN1 prostate cancer. MATERIALS AND METHODS: The National Cancer Data Base (NCDB) was used to identify 7,791 men who were found to have LN metastases at the time of radical prostatectomy (RP). Multinomial logistic regression and Cox proportional hazards regression were used to identify patient, tumor and facility characteristics associated with choice of post-RP management strategy and overall survival (OS), respectively...
June 15, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28624554/outcomes-of-urethroplasty-to-treat-urethral-strictures-arising-from-artificial-urinary-sphincter-erosions-and-rates-of-subsequent-device-replacement
#20
Sorena Keihani, Jason C Chandrapal, Andrew C Peterson, Joshua A Broghammer, Nathan Chertack, Sean P Elliott, Keith F Rourke, Nejd F Alsikafi, Jill C Buckley, Benjamin N Breyer, Thomas G Smith, Bryan B Voelzke, Lee C Zhao, William O Brant, Jeremy B Myers
OBJECTIVE: To evaluate the success of urethroplasty for urethral strictures arising after erosion of an artificial urinary sphincter (AUS) and rates of subsequent AUS replacement. PATIENTS AND METHODS: From 2009-2016, we identified patients from the Trauma and Urologic Reconstruction Network of Surgeons and several other centers. We included patients with urethral strictures arising from AUS erosion undergoing urethroplasty with/without subsequent AUS replacement...
June 14, 2017: Urology
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