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Robotic prostatectomy

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https://www.readbyqxmd.com/read/28803034/variations-in-the-costs-of-radical-cystectomy-for-bladder-cancer-in-the-usa
#1
Jeffrey J Leow, Alexander P Cole, Thomas Seisen, Joaquim Bellmunt, Matthew Mossanen, Mani Menon, Mark A Preston, Toni K Choueiri, Adam S Kibel, Benjamin I Chung, Maxine Sun, Steven L Chang, Quoc-Dien Trinh
BACKGROUND: Radical cystectomy (RC) for muscle-invasive bladder cancer (BCa) has potential for serious complications, prolonged length of stay and readmissions-all of which may increase costs. Although variations in outcomes are well described, less is known about determinants driving variation in costs. OBJECTIVE: To assess surgeon- and hospital-level variations in costs and predictors of high- and low-cost RC. DESIGN, SETTING, AND PARTICIPANTS: Cohort study of 23 173 patients who underwent RC for BCa in 208 hospitals in the USA from 2003 to 2015 in the Premier Healthcare Database...
August 9, 2017: European Urology
https://www.readbyqxmd.com/read/28801217/evaluation-of-unplanned-hospital-readmissions-after-major-urologic-inpatient-surgery-in-the-era-of-accountable-care
#2
Benjamin V Stone, Matthew R Cohn, Nicholas M Donin, Michael Schulster, James S Wysock, Danil V Makarov, Marc A Bjurlin
OBJECTIVE: To provide a multi-institutional analysis of clinical factors predicting unplanned hospital readmission after major inpatient urologic surgery. MATERIALS AND METHODS: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) is a risk-adjusted data collection mechanism for analyzing clinical outcomes data including 30-day perioperative readmissions and complications. We identified 23,108 patients who underwent major inpatient urologic surgery from 2011 to 2012...
August 8, 2017: Urology
https://www.readbyqxmd.com/read/28799065/laparoscopic-inguinal-hernioplasty-after-robot-assisted-laparoscopic-radical-prostatectomy
#3
M Sakon, Y Sekino, M Okada, H Seki, Y Munakata
PURPOSE: To evaluate the efficacy and safety of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair in patients who have undergone robot-assisted laparoscopic radical prostatectomy (RALP). METHODS: From July 2014 to December 2016, TAPP inguinal hernia repair was conducted in 40 consecutive patients who had previously undergone RALP. Their data were retrospectively analyzed as an uncontrolled case series. RESULTS: The mean operation time in patients who had previously undergone RALP was 99...
August 10, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28798877/previously-undiagnosed-spinal-and-bulbar-muscular-atrophy-as-a-cause-of-airway-obstruction-after-robot-assisted-laparoscopic-prostatectomy
#4
Miyuki Niki, Taihei Tachikawa, Yuka Sano, Hiroki Miyawaki, Aisa Matoi, Yukari Okano, Nobutaka Kariya, Tsuneo Tatara, Munetaka Hirose
BACKGROUND: Preoperative vocal cord paralysis is a risk factor for postoperative respiratory distress following extubation after general anesthesia. We present an unusual case where a geriatric patient developed airway obstruction after robot-assisted laparoscopic prostatectomy. CASE PRESENTATION: A 67-year-old male, who had suffered from left vocal cord paralysis of unknown etiology, was scheduled for robot-assisted laparoscopic prostatectomy (RALP). General anesthesia was performed without any problems...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/28798829/does-surgical-delay-for-radical-prostatectomy-affect-patient-pathological-outcome-a-retrospective-analysis-from-a-canadian-cohort
#5
Marc Zanaty, Mansour Alnazari, Kelsey Lawson, Mounsif Azizi, Emad Rajih, Abdullah Alenizi, Pierre-Alain Hueber, Malek Meskawi, Cedric Lebacle, Thierry Lebeau, Serge Benayoun, Pierre I Karakiewicz, Assaad El-Hakim, Kevin C Zorn
INTRODUCTION: We sought to assess the impact of surgical wait time (SWT) to robot-assisted radical prostatectomy (RARP) on final pathological outcome. METHODS: A retrospective review of RARP patient records operated between 2006 and 2015 was conducted. SWT was defined as period from prostate biopsy to surgery. Primary outcome was the impact on postoperative Cancer of the Prostate Risk Assessment (CAPRA-S) score. Patients were stratified according to D'Amico risk categories...
August 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28791870/end-2017-0250-or-r2
#6
Chandru P Sundaram
This study demonstrates the use of retrograde perfusion sphincterometry (RPS) to measure retrograde leak point pressure (RLPP) during robot assisted laparoscopic radical prostatectomy (RALP) before establishment of pneumoperitoneum, after insufflation; and before and after the use of an autologous sub-urethral sling using vas deferens, after the anastomosis was completed. The adjustment of the sling to achieve optimal sub-urethral support was achieved by measuring the RLPP intra operatively using RPS. While the study does demonstrate the use of a simple technique to study the RLPP during RALP, data to confirm that the sling helps with early urinary continence (EUC) is lacking...
August 9, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28791222/an-objective-measurement-of-urinary-continence-recovery-with-pelvic-floor-physiotherapy-following-robotic-assisted-radical-prostatectomy
#7
Niranjan Jude Sathianathen, Liana Johnson, Damien Bolton, Nathan L Lawrentschuk
BACKGROUND: To assess the impact of structured pelvic floor physiotherapy including repeated standardized measurements in regaining urinary continence in those men who have undergone a robotic-assisted laparoscopic radical prostatectomy (RALP). METHODS: A retrospective database was created on men who had undergone a RALP while under the care of two senior urological surgeons between January 2013 and July 2016 and then took part in a formal pelvic floor rehabilitation program were included in the study...
July 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28780722/validation-and-head-to-head-comparison-of-three-nomograms-predicting-probability-of-lymph-node-invasion-of-prostate-cancer-in-patients-undergoing-extended-and-or-sentinel-lymph-node-dissection
#8
Nikolaos Grivas, Esther Wit, Corinne Tillier, Erik van Muilekom, Floris Pos, Alexander Winter, Henk van der Poel
PURPOSE: The updated Winter nomogram is the only nomogram predicting lymph node invasion (LNI) in prostate cancer (PCa) patients based on sentinel node (SN) dissection (sLND). The aim of the study was to externally validate the Winter nomogram and examine its performance in patients undergoing extended pelvic lymph node dissection (ePLND), ePLND combined with SN biopsy (SNB) and sLND only. The results were compared with the Memorial Sloan Kettering Cancer Center (MSKCC) and updated Briganti nomograms...
August 5, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28770286/preoperative-ct-findings-of-subclinical-hernia-can-predict-for-postoperative-inguinal-hernia-following-robot-assisted-laparoscopic-radical-prostatectomy
#9
Ki Choon Sim, Deuk Jae Sung, Na Yeon Han, Beom Jin Park, Min Ju Kim, Sung Bum Cho, Kyung-Sook Yang
PURPOSE: To evaluate preoperative CT features that predict the development of postoperative inguinal hernia after robot-assisted laparoscopic radical prostatectomy (RALRP). METHODS: We enrolled 160 men who underwent CT, subsequent RALRP, and at least three years of follow-up. CT was retrospectively reviewed in consensus by two radiologists for the presence of asymmetric spermatic cord fat and scrotal fluid collection. The diagnostic power of each CT feature for the development of postoperative inguinal hernia was calculated...
August 2, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28768375/response-to-editorial-comment-to-predictors-of-operative-time-during-radical-retropubic-prostatectomy-and-robot-assisted-laparoscopic-prostatectomy
#10
Stephen J Freedland, Lauren E Howard
No abstract text is available yet for this article.
August 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28768373/editorial-comment-to-predictors-of-operative-time-during-radical-retropubic-prostatectomy-and-robot-assisted-laparoscopic-prostatectomy
#11
Masaki Shimbo
No abstract text is available yet for this article.
August 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
https://www.readbyqxmd.com/read/28768259/prospective-controlled-study-of-invasiveness-and-post-aggression-metabolism-in-patients-undergoing-robotic-assisted-radical-prostatectomy
#12
Andreas Martinschek, Lisa Stumm, Manuel Ritter, Elmar Heinrich, Christian Bolenz, Lutz Trojan
OBJECTIVES: To evaluate in a prospective, controlled, nonrandomized study the surgical stress and acute-phase systemic response in robotic-assisted laparoscopic prostatectomy (RALP) compared to open radical retro-pubic prostatectomy (ORRP) by measuring humoral mediators. METHODS: Forty consecutive patients undergoing either RALP or ORRP were prospectively included to assess the extent of systemic response. Blood samples were collected before surgery (T1), at the time of prostatectomy (T2), at the time of wound closure (T3), and 12 h (T4), 24 h (T5), and 48 h (T6) after surgery, and assayed for interleukins (IL-6 and IL-10), C-reactive protein (CRP), and hemoglobin...
July 29, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28765067/development-and-validation-of-objective-performance-metrics-for-robot-assisted-radical-prostatectomy-a-pilot-study
#13
Andrew J Hung, Jian Chen, Anthony Jarc, David Hatcher, Hooman Djaladat, Inderbir S Gill
PURPOSE: We explore and validate objective surgeon performance metrics using a novel recorder ("dVLogger") to directly capture surgeon manipulations on the da Vinci robot. We present the initial construct and concurrent validation study of objective metrics during pre-selected steps of robot-assisted radical prostatectomy (RARP). METHODS: Kinematic and events data were recorded for expert (≥100 cases) and novice (<100 cases) surgeons performing bladder mobilization (BM), seminal-vesicle dissection (SVD), anterior vesicourethral anastomosis (AA) and right pelvic lymphadenectomy (RLD)...
July 29, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28757826/an-observational-study-effects-of-tenting-of-the-abdominal-wall-on-peak-airway-pressure-in-robotic-radical-prostatectomy-surgery
#14
Avinash Sahebarav Kakde, Harshal D Wagh
BACKGROUND: Robotic radical prostatectomy (RRP) is associated with various anesthetic challenges due to pneumoperitoneum and deep Trendelenburg position. Tenting of the abdominal wall done in RRP surgery causes decrease in peak airway pressure leading to better ventilation. Herein, we aimed to describe the effects of tenting of the abdominal wall on peak airway pressure in RRP surgery performed in deep Trendelenburg position. METHODS: One hundred patients admitted for RRP in Kokilaben Dhirubhai Ambani Hospital of American Society of Anesthesiologists 1 and 2 physical status were included in the study...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28754145/changes-in-cardiac-function-and-hemodynamics-during-robot-assisted-laparoscopic-prostatectomy-with-steep-head-down-tilt-a-prospective-observational-study
#15
Naomi Ono, Junko Nakahira, Shoko Nakano, Toshiyuki Sawai, Toshiaki Minami
OBJECTIVE: Robot-assisted laparoscopic prostatectomy requires the patient to be placed in a steep head-down tilt. The aim of our study was to investigate changes in cardiac index and left ventricular end-diastolic volume in a steep had-down tilt. This is a prospective observational study. We investigated the influence of steep head-down tilt on cardiac function and hemodynamics without fluid restriction in 12 men of American Society of Anesthesiologists physical status I-II undergoing robot-assisted laparoscopic prostatectomy...
July 28, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28753892/primary-treatment-for-prostate-cancer-in-an-elderly-man
#16
R Jeroen A van Moorselaar, Jan Hein T M van Waesberghe, André N Vis
Since the patient wanted both his lower urinary tract symptoms and his prostate cancer to be treated together, he decided to undergo robot-assisted radical prostatectomy.
July 19, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28753874/systematic-review-of-the-volume-outcome-relationship-for-radical-prostatectomy-a-2017-update
#17
REVIEW
Jeffrey J Leow, Eugene K Leong, Emily C Serrell, Steven L Chang, Russell L Gruen, Keng Siang Png, Lisa T Beaule, Quoc-Dien Trinh, Mani M Menon, Jesse D Sammon
CONTEXT: Radical prostatectomy (RP) is one of the most complex urological procedures performed. Higher surgical volume has been found previously to be associated with better patient outcomes and reduced costs to the health care system. This has resulted in some regionalization of care toward high-volume facilities and providers; however, the preponderance of RPs is still performed at low-volume institutions. OBJECTIVE: To provide an updated systematic review of the association of hospital and surgeon volume on patient and system outcomes after RP, including robot-assisted RP...
April 6, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28753847/incidence-risk-factors-management-and-complications-of-rectal-injuries-during-radical-prostatectomy
#18
Philipp Mandel, Anna Linnemannstöns, Felix Chun, Thorsten Schlomm, Raisa Pompe, Lars Budäus, Clemens Rosenbaum, Tim Ludwig, Roland Dahlem, Margit Fisch, Markus Graefen, Hartwig Huland, Derya Tilki, Thomas Steuber
Rectal injury (RI) during radical prostatectomy (RP) is a severe complication. So far, only limited data describing the incidence, risk factors, management, and complications of RI are available. In an analysis of data for 24178 patients, we identified 113/24076 patients (0.47%) undergoing open or robotic RP and 7/102 patients (6.86%) after salvage RP who experienced an RI. Besides salvage RP, local tumor stage, Gleason grade, lymph node status, and surgical experience, but not surgical approach (robotic vs open), could be identified as risk factors for RI in univariate and multivariate analysis...
February 7, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28753822/five-year-outcomes-for-a-prospective-randomised-controlled-trial-comparing-laparoscopic-and-robot-assisted-radical-prostatectomy
#19
Francesco Porpiglia, Cristian Fiori, Riccardo Bertolo, Matteo Manfredi, Fabrizio Mele, Enrico Checcucci, Stefano De Luca, Roberto Passera, Roberto Mario Scarpa
BACKGROUND: The literature is lacking randomised controlled trials comparing robot-assisted (RARP) and laparoscopic (LRP) radical prostatectomy, especially for follow-up >1 yr. OBJECTIVE: To report 5-yr outcomes for our previously published prospective randomised study comparing RARP and LRP. DESIGN, SETTING, AND PARTICIPANTS: From January 2010 to January 2011, 120 patients with organ-confined prostate cancer were enrolled and randomly assigned to RARP or LRP...
November 23, 2016: European Urology Focus
https://www.readbyqxmd.com/read/28753802/oncologic-outcomes-after-robot-assisted-radical-prostatectomy-a-large-european-single-centre-cohort-with-median-10-year-follow-up
#20
Prabhakar Rajan, Anna Hagman, Prasanna Sooriakumaran, Tommy Nyberg, Anna Wallerstedt, Christofer Adding, Olof Akre, Stefan Carlsson, Abolfazl Hosseini, Mats Olsson, Lars Egevad, Fredrik Wiklund, Gunnar Steineck, N Peter Wiklund
BACKGROUND: Robot-assisted radical prostatectomy (RARP) for prostate cancer (PCa) treatment has been widely adopted with limited evidence for long-term (>5 yr) oncologic efficacy. OBJECTIVE: To evaluate long-term oncologic outcomes following RARP. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study of 885 patients who underwent RARP as monotherapy for PCa between 2002 and 2006 in a single European centre and followed up until 2016...
November 2, 2016: European Urology Focus
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