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Cancer Urinary Bladder In Surgery

James W F Catto, Pramit Khetrapal, Gareth Ambler, Rachael Sarpong, Muhammad Shamim Khan, Melanie Tan, Andrew Feber, Simon Dixon, Louise Goodwin, Norman R Williams, John McGrath, Edward Rowe, Anthony Koupparis, Chris Brew-Graves, John D Kelly
INTRODUCTION: Bladder cancer (BC) is a common malignancy and one of the most expensive to manage. Radical cystectomy (RC) with pelvic lymphadenectomy is a gold standard treatment for high-risk BC. Reductions in morbidity and mortality from RC may be achieved through robot-assisted RC (RARC). Prospective comparisons between open RC (ORC) and RARC have been limited by sample size, use of extracorporeal reconstruction and use of outcomes important for ORC. Conversely, while RARC is gaining in popularity, there is little evidence to suggest it is superior to ORC...
August 8, 2018: BMJ Open
Linda Varga, Zoltán Bajory, László Pajor, János Révész, Farkas Sükösd, Anikó Maráz
INTRODUCTION: Mortality of prostate carcinoma can be significantly decreased by the use of modern diagnostic and therapeutic options. Patients in early stages can be cured by radical surgery or radiotherapy. AIM: Overview and comparison of previous and present diagnostic and therapeutic methods regarding accuracy of diagnosis, improvement of efficiency and decrease of toxicities. We also aimed to explore general correlations in case of serious complications. METHOD: By the help of two prostate cancer patients we demonstrate the importance of accuracy and change of histological diagnosis, significance of proper imaging techniques, and also show parameters of conventional and modern radiotherapy and their acute and chronic complications...
August 2018: Orvosi Hetilap
Daniel Sagalovich, Juan Garisto, Riccardo Bertolo, Nitin Yerram, Julien Dagenais, Jaya Sai Chavali, Georges-Pascal Haber, Jihad Kaouk, Robert Stein
OBJECTIVES: to describe robotic ureteroneocystostomy performed by bilateral Boari flap. METHODS: An 82 year-old female with bilateral mid ureteral strictures secondary to uterine cancer treated with radiation was managed with ureteral stenting and bilateral nephrostomy tubes. Nevertheless, patient had severe colic and recurrent urinary tract infections and thus agreed to undergo bilateral robotic ureteral reconstructive surgery. Patient positioning and ports placement were similar to those of robotic prostatectomy...
August 2, 2018: Urology
G Cochetti, M Del Zingaro, A Boni, D Cocca, M Panciarola, Alessandra Tiezzi, G Gaudio, F Balzarini, P Ursi, E Mearini
Colovesical fistula (CVF) is an abnormal communication between bowel and urinary bladder. Main causes are represented by complicated diverticular disease, colonic and bladder cancer and iatrogenic complications. Diagnosis is often based on patognomonic signs: faecaluria, pneumaturia and recurrent urinary tract infections. Treatment of CVF includes non-surgical and surgical strategy. The non-surgical treatment is reserved to selected patients who are unfit for surgery. Surgery of CVFs is determined by the site of the colonic lesion and patient's comorbidity...
July 2018: Il Giornale di Chirurgia
Janet Baack Kukreja, Michael J Metcalfe, Wei Qiao, Ashish M Kamat, Colin P N Dinney, Neema Navai
BACKGROUND: Health-related quality of life is important for patients undergoing radical cystectomy (RC). OBJECTIVE: To determine the cost-effectiveness of robotic-assisted RC (RARC) compared to open cystectomy (OC) for bladder cancer and factors that contribute to cost-effectiveness. DESIGN, SETTING, AND PARTICIPANTS: A decision analytic model was used to compare health-related quality of life and medical costs for RARCs with intracorporeal urinary diversion and OCs performed between 2007 and 2015...
July 19, 2018: European Urology Focus
Marta Swalarz, Grzegorz Swalarz, Kajetan Juszczak, Piotr Maciukiewicz, Krzysztof Czurak, Marcin Matuszewski, Dominika Gajewska, Marcin Słojewski, Rafał Bogacki, Piotr Bryniarski, Andrzej Paradysz, Mateusz Kadłubowski, Tomasz Drewa, Ewa Genge
BACKGROUND: Nutrition is the 3rd most important factor in surgery, following anesthesia and asepsis. Until now, it has been a poorly explored field of urology. The relationship between malnutrition and postoperative complications has been proven beyond doubt in general surgery, where 30% of patients are operated in a malnutrition state. OBJECTIVES: The aim of our work was to assess the influence of malnutrition, defined by nutritional risk screening (NRS) scale and body mass index (BMI), on postoperative results in patients with bladder cancer after radical cystectomy...
July 18, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Harmke J Groot, Sjoukje Lubberts, Ronald de Wit, Johannes A Witjes, Jan Martijn Kerst, Igle J de Jong, Gerard Groenewegen, Alfons J M van den Eertwegh, Philip M Poortmans, Heinz-Josef Klümpen, Hetty A van den Berg, Tineke J Smilde, Ben G L Vanneste, Maureen J Aarts, Luca Incrocci, Alfons C M van den Bergh, Katarzyna Jóźwiak, Alexandra W van den Belt-Dusebout, Simon Horenblas, Jourik A Gietema, Flora E van Leeuwen, Michael Schaapveld
Purpose Testicular cancer (TC) treatment increases risk of subsequent malignant neoplasms (SMNs). It is unknown whether changes in TC treatment over time have affected SMN risk. Methods Solid SMN risk was evaluated in a multicenter cohort comprising 5,848 1-year survivors treated for TC before age 50 years between 1976 and 2007. SMN incidence was compared with cancer incidence in the general population. Treatment-specific risks were assessed using multivariable regression in a case-cohort design. Results After a median follow-up of 14...
July 10, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Hsiang-Ying Lee, Hsin-Chih Yeh, Wen-Jeng Wu, Jiun-Shiuan He, Chun-Nung Huang, Hung-Lung Ke, Wei-Ming Li, Chien-Feng Li, Ching-Chia Li
BACKGROUND: To clarify if diagnostic ureteroscopy (URS) before radical nephroureterectomy for patients with upper tract urothelial carcinoma (UTUC) will increase the risk of intravesical recurrence. METHODS: From retrospective review of cohort at our institution, 502 patients with UTUC who underwent radical nephroureterectomy with bladder cuff excision were enrolled from 1990 to 2013. Cox proportional hazards model was used to analyze the overall survival (OS), disease-free survival (DFS), metastasis-free survival (MFS), and intravesical recurrence-free survival (IVRFS)...
July 9, 2018: World Journal of Surgical Oncology
Dipen J Parekh, Isildinha M Reis, Erik P Castle, Mark L Gonzalgo, Michael E Woods, Robert S Svatek, Alon Z Weizer, Badrinath R Konety, Mathew Tollefson, Tracey L Krupski, Norm D Smith, Ahmad Shabsigh, Daniel A Barocas, Marcus L Quek, Atreya Dash, Adam S Kibel, Lynn Shemanski, Raj S Pruthi, Jeffrey Scott Montgomery, Christopher J Weight, David S Sharp, Sam S Chang, Michael S Cookson, Gopal N Gupta, Alex Gorbonos, Edward M Uchio, Eila Skinner, Vivek Venkatramani, Nachiketh Soodana-Prakash, Kerri Kendrick, Joseph A Smith, Ian M Thompson
BACKGROUND: Radical cystectomy is the surgical standard for invasive bladder cancer. Robot-assisted cystectomy has been proposed to provide similar oncological outcomes with lower morbidity. We aimed to compare progression-free survival in patients with bladder cancer treated with open cystectomy and robot-assisted cystectomy. METHODS: The RAZOR study is a randomised, open-label, non-inferiority, phase 3 trial done in 15 medical centres in the USA. Eligible participants (aged ≥18 years) had biopsy-proven clinical stage T1-T4, N0-N1, M0 bladder cancer or refractory carcinoma in situ...
June 23, 2018: Lancet
Ekrem İslamoğlu, Hakan Anıl, İbrahim Erol, Selim Taş, Mutlu Ateş, Murat Savaş
OBJECTIVE: To present the surgical and pathological results of robotic radical cystectomy (RRC) operations performed in our clinic. MATERIAL AND METHODS: A total of 18 patients, who underwent RRC and intracorporeal urinary diversion between October 2016 and September 2017 for clinically localized bladder cancer in our clinic, were included in the study. The results were evaluated under three headings. 1. operative outcomes (total operation time, perioperative blood loss, postoperative hematocrit decrease) 2...
July 2018: Turkish Journal of Urology
Hangchuan Shi, Han Yu, Joaquim Bellmunt, Jeffrey J Leow, Xuanyu Chen, Changcheng Guo, Hongmei Yang, Xiaoping Zhang
PURPOSE: The question of whether orthotopic neobladder (ONB) reconstruction is superior to ileal conduit diversion (ICD) with respect to health-related quality of life (HRQoL) remains controversial. The goal of this study is to perform a meta-analysis to compare post-ICD and post-ONB HRQoL in patients with bladder cancer. METHODS: A systematic search of Medline, Embase, the Cochrane Central Register of Controlled Trials, and the annual congress abstracts of the European Association of Urology (EAU), the American Urological Association (AUA) and the Société Internationale d'Urologie (SIU) up to June 2017 was conducted to identify all relevant clinical trials using validated questionnaires to assess HRQoL...
June 20, 2018: Quality of Life Research
Yu G Alyaev, L M Rapoport, A Z Vinarov, N I Sorokin, A M Dymov, D A Kislyakov, E V Afanasyevskaya, V Yu Lekarev
Currently, transurethral resection of a bladder tumor (TUR) is the gold standart treatment for non-muscle invasive bladder cancer (NMIBC). Standard TUR for a bladder wall tumor has a high recurrence rate, which is caused mainly by malignant cell implantation during the surgery. Besides, specimens obtained with conventional TUR are insufficient for accurate pathological staging. The non-conformity of the standard TUR with the established oncological principle of dissecting through normal tissue prompted a search for the optimal surgical modality...
May 2018: Urologii︠a︡
Edwin J Aslim, Min Hoe Chew, Ghee Kheng Chew, Lui Shiong Lee
BACKGROUND: Pelvic exenteration (PE) for locally advanced pelvic malignancy requires a multi-disciplinary approach and is associated with significant morbidity. Urinary reconstruction forms a major component of this procedure. The aim of the study is to review the urological outcomes following PE in a newly established pelvic oncology unit, to compare with those following radical cystectomy (RC) for bladder cancer. METHODS: Patients were identified from prospectively maintained PE and bladder cancer databases, inclusive of all cases performed between January 2012 and December 2016...
June 12, 2018: ANZ Journal of Surgery
Lotte Linnemann Rønfeldt, Dorthe Hjort Jakobsen, Henrik Kehlet, Henriette Lipczak, Kasper Wennervaldt
INTRODUCTION: Clinical practice guidelines (CPGs) support enhanced post-operative recovery and decrease morbidity. In addition, patient information leaflets (PILs) are associated with enhanced overall outcomes and improved patient satisfaction. The aim of this study was to provide an overview of the quality of CPGs and PILs in cancer surgery departments undertaking pulmonary lobectomy, nephrectomy, cystectomy, whipples, colorectal and ovarian surgery. METHODS: We conducted a cross-sectional descriptive study within 44 surgical departments in six cancer subspecialties: lung (n = 4), kidney (n = 9), bladder (n = 5), pancreas (n = 4), colorectal (n = 18) and ovarian (n = 4)...
June 2018: Danish Medical Journal
Francesco Massari, Matteo Santoni, Vincenzo di Nunno, Liang Cheng, Antonio Lopez-Beltran, Alessia Cimadamore, Silvia Gasparrini, Marina Scarpelli, Nicola Battelli, Rodolfo Montironi
Urothelial carcinoma (UC) of the bladder and upper urinary tract still results an open challenge for clinical oncologists. Excluding selected patients who will particularly benefit from chemo-radiotherapy combined to endoscopic tumour removal, surgery represents the only curative approach for localized stages. Unfortunately, over 50% of operated patients do experience local or distant recurrence of the disease. Several pre and/or postoperative treatments are under evaluation in patients with UC in order to effectively reduce the difficulty and morbidity of more extensive procedures and to increase the Disease-Free Survival (DFS)...
July 2018: Cancer Treatment Reviews
Ryo Ataka, Shinsuke Sato, Kazuyosi Matsubara, Masakazu Takagi, Ichiro Chihara, Naoki Kohei, Koji Yoshimura
A 74-year-old man presented at our hospital with complaints of abdominal pain, nausea, and vomiting. He had undergone laparoscopic radical cystectomy and ileal conduit for urinary bladder cancer 1 month earlier. The patient had abdominal distention, resonant sounds on percussion, and diffuse abdominal tenderness without rebound or guarding. Abdominal CT revealed dilated jejunal loops herniated through a cord-like structure. Based on these findings, emergency surgery was performed, and intestinal dilatation into the space between the ureter, the ileal conduit, and the sacral bone was detected...
June 7, 2018: Asian Journal of Endoscopic Surgery
J Juráček, M Staník, B Peltanová, S Adamcová, J Doležel, M Fedorko, L Radová, O Slabý
BACKGROUND: Currently, there are no urinary-based tumour markers with sufficient sensitivity and specificity to replace cystoscopy in the detection of bladder cancer (BCA). Urinary microRNAs are emerging as clinically useful class of biomarkers for early and non-invasive detection of urologic malignancies. PATIENTS AND METHODS: In this study, 155 patients with BCA and 83 healthy controls were enrolled. Expression profiles of urinary miRNAs were obtained using Affymetrix miRNA microarrays and candidate miRNAs further validated in independent cohort using specific TaqMan assays and quantitative real-time polymerase chain reaction method...
2018: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
Bernard H Bochner, Guido Dalbagni, Karim H Marzouk, Daniel D Sjoberg, Justin Lee, Sheri M Donat, Jonathan A Coleman, Andrew Vickers, Harry W Herr, Vincent P Laudone
BACKGROUND: Open radical cystectomy (ORC) has proven to be an important component in the treatment of high-risk bladder cancer (BCa). ORC surgical morbidity remains high; therefore, minimally invasive surgical techniques have been introduced in an attempt to improve patient outcomes. OBJECTIVE: To compare cancer outcomes in BCa patients managed with ORC or robotic-assisted radical cystectomy (RARC). DESIGN, SETTING, AND PARTICIPANTS: A prospective, randomized trial was completed between 2010 and 2013...
May 18, 2018: European Urology
Krystian Kaczmarek, Artur Lemiński, Aleksandra Bańcarz, Alicja Zakrzewska, Marcin Słojewski
BACKGROUND: Post-operative infection after radical cystectomy is a common complication. It is essential to identify modifiable risk factors that can predict post-operative infection to reduce the incidence of infection after radical cystectomy. We investigated the incidence of post-operative infection, associated pathogens, and risk factors for post-operative infection after radical cystectomy. PATIENTS AND METHODS: Patients who underwent radical cystectomy for bladder cancer in a single urologic department from 2014 to 2016 were included...
May 2018: Surgical Infections
Louis Lenfant, Gregory Verhoest, Riccardo Campi, Jérôme Parra, Vivien Graffeille, Alexandra Masson-Lecomte, Dimitri Vordos, Alexandre de La Taille, Mathieu Roumiguie, Marine Lesourd, Lionel Taksin, Vincent Misraï, Pietro Grande, Christophe Vaessen, Guillaume Ploussard, Benjamin Granger, Morgan Rouprêt
PURPOSE: To compare perioperative outcomes and complications of extracorporeal (ECUD) vs intracorporeal urinary diversion (ICUD) in patients after undergoing robot-assisted radical cystectomy (RARC) at five referral centers in France. METHODS: We retrospectively reviewed our multi-institutional, prospectively-collected database to select patients undergoing RARC between 2010 and 2016 with at least 3 months of follow-up. At each center, the surgery was performed by one surgeon with extensive experience in robotic surgery and radical cystectomy but no prior experience in RARC...
May 9, 2018: World Journal of Urology
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