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Shawn Dason, Alvin C Goh
PURPOSE OF REVIEW: More than a century of development has led to contemporary urinary diversion. It is paramount that robotic intracorporeal diversions uphold the principles defined by open surgery. RECENT FINDINGS: In this review, we discuss the fundamental open surgical principles that have led to contemporary techniques of urinary diversion. We then outline the technical aspects of several recently described robotic intracorporeal urinary diversions in the context of these surgical principles...
March 15, 2018: Current Urology Reports
Young Dong Yu, Jin Ho Hwang, Young Eun Seo, Byung Do Song, Yeon Soo Jung, Dong Hwan Lee, Sung Kyu Hong, Seok-Soo Byun, Sang Eun Lee, Jong Jin Oh
This study aimed to evaluate the effects of ketorolac, a commonly used non-steroidal anti-inflammatory drug (NSAID) as patient controlled intravenous infusion analgesia (PCIA) for the patients underwent radical cystectomy (RC) due to bladder cancer regarding post-operational indices of recovery. Total seventy patients who underwent radical cystectomy for the treatment of bladder cancer were included in the study. 35 patients received ketorolac as PCIA (NSAIDS group) and 35 patients had morphine infusion as PCIA (morphine group)...
March 15, 2018: Scientific Reports
Philip A Fontenot, Brian D Barnes, William P Parker, Hadley Wyre, Eugene K Lee, Jeffrey M Holzbeierlein
OBJECTIVES: To compare complication rates, perioperative outcomes, and survival after radical cystectomy (RC) in patients with prior abdominal and/or pelvic radiation therapy (RT) versus those without an RT history. METHODS: We retrospectively reviewed patients undergoing RC for urothelial carcinoma (UC) between January 2008 and January 2016. Patients were stratified by receipt of RT, and differences in complications (any, minor, and major) at 30 and 90 days, as well as, estimated blood loss, length of surgery, length of hospital stay, and pathologic stage were compared...
March 12, 2018: Urology
John A Brockman, Joel Vetter, Vicky Peck, Seth A Strope
OBJECTIVES: To determine whether an enhance recovery protocol for radical cystectomy patient affected the length of stay or the number and type of readmissions that occurred after hospital discharge. METHODS: We prospectively assessed 152 cystectomy patients after initiation of the pathway. These patients were compared to the previous 147 patient operated on prior to the pathway initiation. Eligible patients were those undergoing radical cystectomy with any diversion at our institution...
March 12, 2018: Urology
Jeffrey A Cadeddu
No abstract text is available yet for this article.
May 2017: Journal of Urology
Rong-Xing Zhou, Hai-Jie Hu, Wen-Jie Ma, Yong Jiang, Fu-Yu Li
RATIONALE: Pancreatic alveolar echinococcosis (AE) is an exceptionally rare disease; no more than 10 cases have been published to date. It is characterized as extensive local tissue infringement and destruction; thus, extended surgical resection, such as duodenopancreatectomy, is often needed to obtain a negative resection margin so as to improve the long-term outcome and prognosis. PATIENT CONCERNS: A middle-aged Tibetan man was admitted due to a 16-year history of recurrent pain in the right upper abdomen...
March 2018: Medicine (Baltimore)
Bente T Jensen, Susanne V Lauridsen, Jørgen B Jensen
PURPOSE OF REVIEW: Whether prehabilitation in radical cystectomy adds to the effort of reducing postoperative morbidity and impairments in the survivorship phase has until recently received limited attention. This narrative review aims to summarize the current evidence base on prehabilitaion interventions focusing on the efficacy of procedure-specific interventions and the influence on postoperative outcomes. RECENT FINDINGS: Given the oncological risk, there is a relative short window to intervene and proactively optimize the patient before radical cystectomy...
March 13, 2018: Current Opinion in Urology
M Stanik, A Poprach, D Macik, I Capak, D Maluskova, N Mareckova, R Lakomy, J Jarkovsky, J Dolezel
Patients with clinically node-positive bladder cancer have a poor prognosis, with many receiving only palliative chemo- therapy. We evaluated oncological results in bladder cancer patients with clinically regional and supraregional lymph- adenopathy treated with induction chemotherapy (IC) and consolidative cystectomy. Twenty-five patients with clinically node-positive bladder cancer (including pelvic and retroperitoneal nodes) were treated with 2-4 cycles of IC followed by consolidative cystectomy between 2010 and 2016...
2018: Neoplasma
Christian Doll, Kevin Dauter, Korinna Jöhrens, Stefan Hartwig, Jan Oliver Voss, Martin Klein, Max Heiland, Jan-Dirk Raguse
OBJECTIVE: the aim of this study was to evaluate clinical parameters and expression patterns of Ki-67, cyclin D1 and p53 in odontogenic keratocysts. MATERIAL AND METHODS: In this study, fifty-three patients with 80 odontogenic keratocysts were included. The medical records of these patients were reviewed retrospectively. To elucidate the molecular pathogenesis of the disease, the expression of p53, Ki-67 and cyclin D1 was analyzed using immunohistochemistry. RESULTS: A total of 53 patients (mean age 38 years) with a median follow-up of 4...
March 9, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
H Roman, M Ballester, J Loriau, M Canis, P A Bolze, J Niro, S Ploteau, C Rubod, C Yazbeck, P Collinet, B Rabischong, B Merlot, X Fritel
The article presents French guidelines for surgical management of endometriosis. Surgical treatment is recommended for mild to moderate endometriosis, as it decreases pelvic painful complaints and increases the likelihood of postoperative conception in infertile patients (A). Surgery may be proposed in symptomatic patients with ovarian endometriomas which diameter exceeds 20mm. Cystectomy allows for better postoperative pregnancy rates when compared to ablation using bipolar current, as well as for lower recurrences rates when compared to ablation using bipolar current or CO2 laser...
March 8, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
P-A Bolze, P Paparel, F Golfier
Urinary tract involvement by endometriosis is reported in 1% of endometriosis patients (NP3). Consequences range from pelvic pain for bladder localizations to silent kidney loss in case of chronic ureteral obstruction (NP3). The feasibility of laparoscopic management was widely proven (NP3) and may reduce hospital stay length (NP4). Radical surgery with partial cystectomy for bladder localizations was shown to significantly and durably reduce pain symptoms with low risk of a severe postoperative complications (NP3)...
March 8, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Eric J Kirshenbaum, Robert H Blackwell, Belinda Li, Anai N Kothari, Paul C Kuo, Robert C Flanigan, Alex Gorbonos, Gopal N Gupta
INTRODUCTION: The purpose of this article is to assess the incidence of pulmonary aspiration following major urologic surgery, predictors of an aspiration event, and subsequent clinical outcomes. MATERIALS AND METHODS: The Healthcare Cost and Utilization Project State Inpatient Database for California between 2007-2011 was used to identify cystectomy, prostatectomy, partial and radical nephrectomy patients. Aspiration events were identified within 30 days of surgery...
February 2018: Canadian Journal of Urology
Joshua S Jue, Tulay Koru-Sengul, Kevin J Moore, Feng Miao, Mahmoud Alameddine, Bruno Nahar, Sanoj Punnen, Dipen J Parekh, Chad R Ritch, Mark L Gonzalgo
INTRODUCTION: To investigate the impact of perioperative factors on overall survival among patients with histologic variants of bladder cancer treated with radical cystectomy. MATERIALS AND METHODS: The National Cancer Data Base was utilized to identify patients diagnosed with muscle-invasive bladder cancer (cT2-4, N0, M0) from 2004-2013. Variant histology bladder cancers (non-mucinous adenocarcinoma, mucinous/signet ring adenocarcinoma, micropapillary urothelial carcinoma, small cell carcinoma, and squamous cell carcinoma) were compared to urothelial carcinoma with respect to overall survival...
February 2018: Canadian Journal of Urology
Vivek Wadhawa, Jigar Shah, Chirag Doshi, Jaydip Ramani, Ketav Lakhia, Divyesh Rathod, Reema Tavar, Jignesh Kothari
OBJECTIVES: The purpose of this study was to describe our experience with the presentation and management of cardiac echinococcosis and the outcomes. METHODS: We performed a retrospective study from January 2012 to September 2017 in 10 patients operated on for cardiac echinococcosis. There were 6 men and 4 women; the age range was 17-55 years (mean age, 35.9 ± 12.04 years). Among the 10 patients, 3 had multiple cysts and of the 7 patients with a solitary cyst, 5 cysts were in the left ventricle, 1 was in the right ventricle and 1 was in the interventricular septum...
March 7, 2018: Interactive Cardiovascular and Thoracic Surgery
Rafael Uña Orejón, Estrella Mateo Torres, Iván Huercio Martínez, Cristina Jofré Escudero, Juan Gómez Rivas, Jesús Díez Sebastián, Maria Prado Ureta Tolsada
OBJECTIVE: The enhanced recovery after surgery program (ERAS) has become the base of perioperative management in various surgical specialties. However, limited data are available for radical cystectomy. METHODS: We have analyzed 124 patients undergoing radical cystectomy. For retrospective analysis, the patients were divided into two groups:Group A (n=72) included patients whose surgery was performed before the introduction of the ERAS protocol; and Group B (n=52) included patients who were treated following the items included in the ERAS protocol...
March 2018: Archivos Españoles de Urología
Tobias Gross, Marc Furrer, Petra Schorno, Patrick Y Wuethrich, Marc P Schneider, George N Thalmann, Fiona C Burkhard
OBJECTIVES: To compare functional and oncological outcomes of reproductive organ sparing cystectomy (ROSC) compared to standard cystectomy (SC) in females undergoing orthotopic ileal bladder substitution (OBS). PATIENTS AND METHODS: From 1995 to 2016, 121 consecutive females undergoing OBS were prospectively included in this single center non-randomized clinical follow up study including a ROSC and SC group. Urinary continence, the need for intermittent self-catheterization (ISC), lateral standing micturition cystourethrogram (MCUG), urethral pressure profiles findings, if available, and oncological outcomes were assessed and compared for ROSC or SC...
March 9, 2018: BJU International
Touko Asano, Koji Ohnishi, Takuya Shiota, Takanobu Motoshima, Yutaka Sugiyama, Junji Yatsuda, Tomomi Kamba, Kazuhiro Ishizaka, Yoshihiro Komohara
CD169+ macrophages are suggested to play a pivotal role in establishing anti-tumor immunity. They capture dead tumor cell-associated antigens and transfer their information to lymphocytes including CD8+ T cells, which is important for successful tumor suppression. This study aimed to determine the prognostic significance of CD169+ macrophages residing in the tumor-draining lymph nodes from cases of bladder cancer. In this retrospective study, 44 bladder cancer patients who received radical cystectomy were examined...
March 9, 2018: Cancer Science
Roman Mayr, Hans-Martin Fritsche, Florian Zeman, Marieke Reiffen, Leopold Siebertz, Christoph Niessen, Armin Pycha, Bas W G van Rhijn, Maximilian Burger, Michael Gierth
PURPOSE: A single-center study was conducted to investigate the impact of sarcopenia as a predictor for 90-day mortality (90 dM) and complications within 90 days after radical cystectomy for bladder cancer. METHODS: In total, 327 patients with preoperative available digital computed tomography (CT) scans of the abdomen and pelvis were identified. The lumbar skeletal muscle index was measured using preoperative abdominal CT to assess sarcopenia. Complications were recorded and graded according to Clavien-Dindo (CD)...
March 8, 2018: World Journal of Urology
Jill M Hamilton-Reeves, Abigail Stanley, Misty D Bechtel, Thomas M Yankee, Prabhakar Chalise, Lauren K Hand, Eugene K Lee, Woodson Smelser, Moben Mirza, Hadley Wyre, Holly Hull, Susan E Carlson, Jeffrey M Holzbeierlein
PURPOSE: Poor preoperative nutritional status is associated with higher complication rates in bladder cancer patients after radical cystectomy (RC). Given the short lag time between diagnosis and RC, we compared a short-term Specialized IMmunonutrition (SIM) to a standard oral nutrition supplement (ONS) on the acute inflammatory response and arginine status in RC patients. MATERIALS AND METHODS: Twenty-nine men received SIM (n = 14) or ONS (n = 15) to drink three cartons/day for five days before and five days after RC in a prospective, randomized study...
March 5, 2018: Journal of Urology
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