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The clinical outcomes of laser with suction device in mini-percutaneous nephrolithotomy

Asian Journal of Urology 2022年第1期9卷 63-68页

作者： Abhishek Gajendra Singh sundaram palaniappan Shrikant Jai Gopal Tak Arvind Ganpule Ravindra Sabnis Mahesh Desai Department of Urology Muljibhai Patel Urological HospitalVirendradesai MargNadiadGujaratIndia

Objective:To evaluate the safety,efficacy and feasibility of laser with suction device in mini-percutaneous nephrolithotomy(mini-PCNL).Methods:A retrospective study was conducted including 200 patients who underwent mini-PCNL for renal *** patients underwent PCNL using Electro-Medical Systems *** addition to the laser in 100 patients,a suction device was used(laser with suction[LWS]).In the other 100,suction device was not used(laser with no additional suction[LOS]).Mini-PCNL was performed using standard technique and Karl Storz minimally invasive PCNL-medium system was *** end point was stone ***:Both the groups were comparable in terms of demographic *** stone size was 15.24±5.90 mm and 16.16±5.53 mm in LWS and LOS,*** Hounsfield unit of stone was 1285.64 and 1206.79 in LWS and LOS,*** time was less in LWS group(56.89±19.65 min)as compared to LOS(62.01±28.81 min).At one-month follow-up,radiological complete clearance was 96%in LWS and 92%in *** subgroup analysis of stones larger than 18 mm,the clearance rate was in favour of LWS(85.7%vs.100%)and also the need for nephrostomy placement was less in LWS ***:LWS device is safe and efficacious when used with *** stones greater than 18 mm,it has a better stone free rate as compared to using no suction.

关键词： Mini-percutaneous nephrolithotomy Laser with suction Stone clearance

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Mini versus ultra-mini percutaneous nephrolithotomy in a paediatric population

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Asian Journal of Urology 2022年第1期9卷 75-80页

作者： Dilip K.Mishra Sonia Bhatt sundaram palaniappan Talamanchi V.K.Reddy Vinothkumar Rajenthiran Y.L.Sreeranga Madhu S.Agrawal Department of Urology Global Rainbow HospitalAgraUttar PradeshIndia Department of Pediatrics F H Medical CollegeAgraUttar PradeshIndia Department of Urology Sengkang General HospitalSingapore

Objective:To evaluate whether there would be a difference in outcome when the smaller ultra-mini 12 Fr sheath was used instead of the mini 16 Fr sheath for percutaneous nephrolithotomy(PCNL)in paediatric patients for stones less than 25 ***:This was a prospective cohort study of patients who underwent PCNL in our hospital in a 2-year period from July 2016 to June 2018 by a single *** was performed in a prone position and tract was dilated to the respective size using single step *** was used to fragment the ***-free outcome was defined as absence of stone fragment at 3 months on kidney,ureter,and bladder ***:There were 40 patients in each *** stone size was comparable between the two groups(14.5 mm vs.15.0 mm).The procedure was completed faster in the 16 Fr group compared to 12 Fr group(24.5 min vs.34.6 min).Stone clearance was highly successful in both groups(97.5%vs.95.0%).There was no difference in complications between the two *** decrease in hemoglobin was minimal in both groups(0.2 g/dL vs.0.3 g/dL).Conclusion:We found that the success rates were similar in both mini PCNL and the smaller ultra-mini PCNL *** significant difference in bleeding was noted in our pilot study,however,operative time was longer in the ultra-mini group as compared to the mini sheath group.

关键词： Percutaneous nephrolithotomy Mini percutaneous nephrolithotomy Ultra-mini percutaneous nephrolithotomy Minimally invasive percutaneous nephrolithotomy Paediatric percutaneous nephrolithotomy Renal stone Urolithiasis

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Patients with small prostates and low-grade intravesical prostatic protrusion e A urodynamic evaluation

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Asian Journal of Urology 2017年第4期4卷 247-252页

作者： Han Jie Lee Alvin Lee Hong Hong Huang palaniappan sundaram Keong Tatt Foo Department of Urology Singapore General HospitalSingapore

Abstract Objective:Despite high-grade intravesical prostatic protrusion(IPP)being closely related to bladder outlet obstruction(BOO),up to 21%of patients with low IPP remain *** study evaluates the characteristics and urodynamic findings of men with small prostates and low ***:One hundred and fourteen men aged>50 years old with lower urinary tract symptoms(LUTS)were assessed with symptoms,uroflowmetry,serum prostate-specific antigen(PSA),transabdominal ultrasound measurement of prostate volume(PV),IPP and post-void residual urine(PVRU).All patients underwent pressure flow *** with PV<30 mL and IPP10 mm were examined for parameters correlating with BOO or impaired detrusor ***:Thirty-six patients had PV<30 mL and IPP<10 *** patients(25.0%)had urodynamic BOO,all with normal bladder *** patients(38.9%)had poor detrusor contractility and all had no ***,PVRU and IPP were significantly associated with BOO,with IPP showing greatest positive *** Qmax and IPP were significantly associated with detrusor *** 5-year follow-up,most patients responded to medical *** three out of nine patients(33.3%)with BOO eventually underwent surgery,and all had a high bladder neck seen on the *** one patient(7.1%)with poor detrusor contractility eventually required surgery after repeat pressure flow study revealed ***:In men with small prostates and low IPP,the presence of BOO is associated with higher PV,PVRU and IPP,and most respond well to medical *** can possibly be explained by elevation of the bladder neck by a small subcervical adenoma.

关键词： Male Prostate hyperplasia Pathology Prostate Ultrasonography Urodynamics Intravesical prostatic protrusion

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Large cell neuroendocrine carcinoma of the ampulla of Vater

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Hepatobiliary & Pancreatic Diseases International 2006年第3期5卷 465-467页

作者： Eswaran Selvakumar Velayutham Vimalraj Shanmugasundaram Rajendran Tirupporur G.Balachandar Devy G.Kannan Satyanesan Jeswanth palaniappan Ravichandran Arunachalam sundaram Rajagopal Surendran Departments of Pathology and Surgical Gastroenterology Center for G.I.Bleeding & Division of Hepatobiliary Pancreatic Diseases Government Stanley Medical College Hospitalthe Tamilnadu Dr.M.G.R.Medical UniversityChennaiTamilnaduIndia

BACKGROUND: Neuroendocrine tumors of the ampulla of Vater are extremely rare, and few cases of large cell neuroendocrine carcinoma (LCNEC) of the ampulla have been reported. METHODS: A 48-year-old male with obstructive jaundice was admitted to our hospital. On examination the patient was found to have a periampullary growth and subsequently underwent the Whipple's procedure. RESULTS: Histopathological examination and immunohistochemistry revealed features of LCNEC of the ampulla of Vater. The patient developed multiple liver metastases 6 months after Whipple's procedure. CONCLUSION: LCNEC of the ampulla of Vater is rare and highly aggressive, with a dismal prognosis.

关键词： large cell neuroendocrine carcinoma ampulla of Vater Whipple's procedure periampullary growth

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