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Three-dimensional imaging reconstruction of the kidney’s anatomy for a tailored minimally invasive partial nephrectomy:A pilot study

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Asian Journal of Urology 2022年第3期9卷 263-271页

作者： Daniele Amparore Angela Pecoraro Federico Piramide paolo verri Enrico Checcucci Sabrina De Cillis Alberto Piana Mariano Burgio Michele Di Dio Matteo Manfredi Cristian Fiori Francesco Porpiglia Department of Urology San Luigi Gonzaga HospitalUniversity of TurinOrbassanoTurinItaly European Association of Urology(EAU)Young Academic Urologists(YAU)Renal Cancer Working Group ArnhemNetherlands European Association of Urology(EAU)Young Academic Urologists(YAU)Uro-technology and SoMe Working Group ArnhemNetherlands Division of Urology Department of SurgerySS Annunziata HospitalCosenzaItaly

Objective:The aim of the study was to evaluate three-dimensional virtual models(3DVMs)usefulness in the intraoperative assistance of minimally-invasive partial nephrectomy in highly complex renal ***:At our institution cT1-2N0M0 all renal masses with Preoperative Aspects and Dimensions Used for an Anatomical classification score≥10 treated with minimally-invasive partial nephrectomy were considered for the present *** inclusion a baseline contrast-enhanced computed tomography in order to obtain 3DVMs,the baseline and postoperative serum creatinine as well as estimated glomerular filtration rate values were *** patients,in which 3DVMs were used to assist the surgeon in the planning and intraoperative guidance,were then compared with a control group of patients who underwent minimally-invasive partial nephrectomy with the same renal function assessments,but without *** logistic regression models were used to predict the margin,ischemia,and complication score ***:Overall,79 patients met the inclusion criteria and were compared with 143 complex renal masses without 3DVM *** 3DVM group showed better postoperative outcomes in terms of baseline-weighted differential estimated glomerular filtration rate(-17.7%vs.-22.2%,p=0.03),postoperative complications(16.5%vs.23.1%,p=0.03),and major complications(Clavien Dindo>III,2.5%vs.5.6%,p=0.03).At multivariable logistic regression 3DVM assistance independently predicted higher rates of successful partial nephrectomy(odds ratio:1.42,p=0.03).Conclusion:3DVMs represent a useful tool to plan a tailored surgical approach in case of surgically complex *** can be used in different ways,matching the surgeon's needs from the planning phase to the demolitive and reconstructive phase,leading towards maximum safety and efficacy outcomes.

关键词： Three-dimensional Kidney cancer Renal cell carcinoma Robotic Laparoscopic Nephron-sparing surgery Complex renal mass

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Robot-assisted oncologic pelvic surgery with Hugo™robot-assisted surgery system:A single-center experience

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Asian Journal of Urology 2023年第4期10卷 461-466页

作者： Angelo Territo Alessandro Uleri Andrea Gallioli Josep Maria Gaya paolo verri Giuseppe Basile Alba Farré Alejandra Bravo Alessandro Tedde Óscar Rodríguez Faba Joan Palou Alberto Breda Department of Urology FundacióPuigvertAutonomous University of BarcelonaBarcelonaSpain

Objective To report the outcomes of intra-and extra-peritoneal robot-assisted radical prostatectomy(RARP)and robot-assisted radical cystectomy(RARC)with Hugo™robot-assisted surgery(RAS)system(Medtronic,Minneapolis,MN,USA).Methods Data of twenty patients who underwent RARP and one RARC at our institution between February 2022 and January 2023 were *** primary endpoint of the study was to report the surgical setting of Hugo™RAS system to perform RARP and *** secondary endpoint was to assess the feasibility of RARP and RARC with this novel robotic platform and report the *** Seventeen patients underwent RARP with a transperitoneal approach,and three with an extraperitoneal approach;and one patient underwent RARC with intracorporeal ileal *** intraoperative complications *** docking and console time were 12(interquartile range[IQR]7-16)min and 185(IQR 177-192)min for transperitoneal RARP,15(IQR 12-17)min and 170(IQR 162-185)min for extraperitoneal *** intraoperative complications *** patient submitted to extraperitoneal RARP had a urinary tract infection in the postoperative period that required an antibiotic treatment(Clavien-Dindo Grade 2).In case of transperitoneal RARP,two minor complications occurred(one pelvic hematoma and one urinary tract infection;both Clavien-Dindo Grade 2).Conclusion Hugo™RAS system is a novel promising robotic platform that allows to perform major oncological pelvic *** showed the feasibility of RARP both intra-and extra-peritoneally and RARC with intracorporeal ileal conduit with this novel platform.

关键词： Bladder cancer Prostate cancer Radical cystectomy Radical prostatectomy Robotic surgery

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Small renal masses in kidney transplantation:Overview of clinical impact and management in donors and recipients

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Asian Journal of Urology 2022年第3期9卷 208-214页

作者： Alberto Piana Iulia Andras Pietro Diana paolo verri Andrea Gallioli Riccardo Campi Thomas Prudhomme Vital Hevia Romain Boissier Alberto Breda Angelo Territo Department of Urology Fundacio PuigvertAutonoma University of BarcelonaSpain Department of Urology San Luigi Gonzaga HospitalUniversity of TurinOrbassanoTurinItaly Urology Department Iuliu Hatieganu University of Medicine and Pharmacy and Municipal HospitalCluj-NapocaRomania Unit of Urological Robotic Surgery and Renal Transplantation University of FlorenceCareggi HospitalFlorenceItaly Department of Experimental and Clinical Medicine University of FlorenceFlorenceItaly Department of Urology and Kidney Transplantation Toulouse University HospitalToulouseFrance Hospital Universitario Ramon y Cajal.Alcala University Instituto Ramon y Cajal de Investigacion Sanitaria(IRYCIS)MadridSpain Aix-Marseille universite service de chirurgie urologique et de transplantation renaleCHU ConceptionAP-HMMarseilleFrance

Kidney transplantation is the best replacement treatment for the end-stage renal ***,the imbalance between the number of patients on a transplant list and the number of organs available constitutes the crucial limitation of this *** expand the pool of organs amenable for transplantation,kidneys coming from older patients have been employed;however,the combination of these organs in conjunction with the chronic use of immunosuppressive therapy increases the risk of incidence of graft small renal *** narrative review aims to provide the state of the art on the clinical impact and management of incidentally diagnosed small renal tumors in either donors or *** to the most updated evidence,the use of grafts with a small renal mass,after bench table tumor excision,may be considered a safe option for high-risk patients in *** the other hand,an early small renal mass finding on periodic ultrasound-evaluation in the graft should allow to perform a conservative treatment in order to preserve renal ***,in case of a renal tumor in native kidney,a radical nephrectomy is usually recommended.

关键词： Small renal mass Renal cancer Kidney transplantation Nephron-sparing treatment

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Treatment with plasmapheresis, immunoglobulins and rituximab for chronic-active antibody-mediated rejection in kidney transplantation: Clinical, immunological and pathological results

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World Journal of Transplantation 2018年第5期8卷 178-187页

作者： Alberto Mella Ester Gallo Maria Messina Cristiana Caorsi Antonio Amoroso paolo Gontero Aldo verri Francesca Maletta Antonella Barreca Fabrizio Fop Luigi Biancone Renal Transplantation Center "A. Vercellone" Division of Nephrology Dialysis and Transplantation Department of Medical Sciences Città della Salute e della Scienza Hospital and University of Turin Immunogenetics and Transplant Biology Service AOU Città della Salute e della Scienza di Torino and Department of Medical Sciences University of Turin Division of Urology Department of Surgical Sciences Città della Salute e della Scienza Hospital and University of Turin Division of Vascular Surgery Department of Thoracic-Vascular Surgery Città della Salute e della Scienza Hospital Division of Pathology Transplantation Department of Medical Sciences University of Turin

AIM To evaluate the role of a therapeutic regimen with plasma exchange, intravenous immunoglobulins and rituximab in chronic-active antibody-mediated rejection(c AMR) *** We compared 21 kidney transplant recipients(KTRs) with a diagnosis of c AMR in a retrospective casecontrol analysis: nine KTRs treated with plasmapheresis, intravenous immunoglobulins and rituximab(PE-IVIGRTX group) vs 12 patients(control group) not treated with antibody-targeted therapies. We examined kidney survival and functional outcomes 24 mo after diagnosis. Histological features and donor-specific antibody(DSA) characteristics(MFI and C1 q-fixing ability) were also *** No difference in graft survival between the two groups was noted: three out of nine patients in the PE-IVIG-RTX group(33.3%) and 4/12 in the control group(33.3%) experienced loss of allograft function at a median time after diagnosis of 14 mo(min 12-max 18) and 15 mo(min 7-max 22), respectively. Kidney functional tests and proteinuria 24 mo after cA MR diagnosis were also similar in both groups. Only microvascular inflammation(glomerulitis + peritubular capillaritis score) was significantly reduced after PE-IVIG-RTX in seven out of eight patients(87.5%) in the PE-IVIG-RTX group(median score 3 in pre-treatment biopsy vs 1.5 in post-treatment biopsy; P = 0.047), without any impact on kidney survival and/or DSA characteristics. No functional or histological parameter at diagnosis was predictive of clinical *** Our data showed no difference in the two year posttreatment outcome of kidney grafts treated with PE-IVIGRTX for c AMR diagnosis, however there were notable improvements in microvascular inflammation in posttherapy protocol biopsies. Further studies, especially involving innovative therapeutic approaches, are required to improve the management and long-term results of this severe condition.

关键词： Chronic-active antibody-mediated rejection Kidney transplantation Donor-specific antibody Rituximab

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