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Transurethral prostate surgery in prostate cancer patients: A population-based comparative analysis of complication and mortality rates

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Asian Journal of Urology 2024年第1期11卷 48-54页

作者： Michele Marchioni Giulia Primiceri Alessandro Veccia Marta Di Nicola Umberto Carbonara Fabio Crocerossa Ugo Falagario Ambra Rizzoli Riccardo Autorino luigi schips Laboratory of Biostatistics Department of MedicalOral and Biotechnological Sciences“G.d'Annunzio”University of ChietiChietiItaly Urology Unit Department of MedicalOral and Biotechnological Sciences“G.d'Annunzio”University of ChietiChietiItaly Division of Urology VCU HealthRichmondVAUSA

Objective:Prostate cancer(PCa)patients might experience lower urinary tract symptoms as those diagnosed with benign prostatic hyperplasia(BPH).Some of them might be treated for their lower urinary tract symptoms instead of *** aimed to test the effect of PCa versus BPH on surgical outcomes after transurethral prostate surgery,namely complication and mortality ***:Within the American College of Surgeons National Surgical Quality Improvement Program database(2011-2016),we identified patients who underwent transurethral resection of the prostate,photoselective vaporization,or laser *** were stratified according to postoperative diagnosis(PCa ***).Univariable and multivariable logistic regression models evaluated the predictors of perioperative morbidity and mortality.A formal test of interaction between diagnosis and surgical technique used was ***:Overall,34542 patients were *** all,2008(5.8%)had a diagnosis of *** multivariable logistic regression model failed to show statistically significant higher rates of postoperative complications in PCa patients(odds ratio:0.9,95%confidence interval:0.7-1.1;p=0.252).Moreover,similar rates of perioperative mortality(p=0.255),major acute cardiovascular events(p=0.581),transfusions(p=0.933),and length of stay of more than or equal to 30 days(p=0.174)were ***,all tests failed to show an interaction between post-operative diagnosis and surgical technique ***:Patients diagnosed with PCa do not experience higher perioperative morbidity or mortality after transurethral prostate surgery when compared to their BPH ***,the diagnosis seems to not influence surgical technique outcomes.

关键词： Prostatecancer Transurethral surgery of the prostate Prostate surgery Population-based analysis Benign prostatic hyperplasia Lasersurgery

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Single-site laparoscopic partial nephrectomy: Where are we going?

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World Journal of Clinical Urology 2014年第3期3卷 358-363页

作者： Roberto Castellucci Luca Cindolo Mario Alvaréz-Maestro Guido Giusti Francesco Berardinelli Fabio Pellegrini luigi schips Urology Department Hospital "Infanta Sofia"65129 Madrid Spain Urology Department Hospital "S.Pio da Pieterelcina"66054 Vasto Italy Stone Center Urology Department Humanitas Clinical and Research Center20089 Rozzano Italy

AIM:To review an evolution of laparoscopic surgery,there has been a growing interest in laparoendoscopic single-site surgery(LESS).METHODS:A comprehensive electronic literature search was conducted using PubM ed database to identify all publications relating to LESS-partial nephrectomy(PN).The research includes articles published from April 2008 to January *** focused our attention only on articles in which were cited the single-site surgical technique(laparoscopic and robotic),tumour stage and grade,mean tumour size,intraoperative variables,blood loss and transfusion rate,length of postoperative stay and complication rates,Clavien classification,positive of surgical margins,pain assessment at ***:A total of 9 studies were collected with 221patients *** mean patients age was 62 *** mean tumor size was 2.35 cm with a mean operative time of 181 min(range 111-270 min)and 58.3%were done by *** mean ischemia time was *** 25.8%of patients underwent an unclamp *** estimated blood loss was 296 mL and median length of hospital stay was 4 *** rate of severe post-operative complications(≥Clavien gradeⅢ)was 5.4%.Not all surgical series of LESS-PN or Robotic-LESS-PN shows conversion in Multiport Laparoscopic or Open *** oncologic outcomes,surgical margins were positive 4%of patients(9/221),no distant or port-site metastases were ***:LESS-PN and RLESS-PN are feasible and associated with reduced postoperative pain,shorter median hospital stay,shorter recovery time,and better cosmetic satisfaction without compromising surgical and oncological safety.

关键词： Nephron sparing surgery Partial nephrectomy Laparoendoscopic single-site surgery Single-port access surgery Single-incision laparoscopic surgery Robotic single-port partial nephrectomy

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Potential benefit of lymph node dissection during radical nephrectomy for kidney cancer:A review and critical analysis of current literature

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Asian Journal of Urology 2022年第3期9卷 215-226页

作者： Michele Marchioni Daniele Amparore Igino Andrea Magli Riccardo Bertolo Umberto Carbonara Selcuk Erdem Alexandre Ingels Constantijn H.J.Muselaers Onder Kara Marco Mascitti Tobias Klatte Maximilian Kriegmair Nicola Pavan Eduard Roussel Angela Pecoraro Laura Marandino Riccardo Campi luigi schips Department of Urology SS Annunziata Hospital“G.D’Annunzio”University of ChietiChietiItaly Division of Urology Department of OncologySchool of MedicineSan Luigi HospitalUniversity of TurinOrbassanoTurinItaly Department of Urology San Carlo Di Nancy HospitalRomeItaly Department of Emergency and Organ Transplantation-Urology Andrology and Kidney Transplantation UnitUniversity of BariBariItaly Division of Urologic Oncology Department of UrologyIstanbul University Istanbul Faculty of MedicineIstanbulTurkey Department of Urology University Hospital Henri MondorAPHPCreteilFrance Department of Urology Radboud University Medical CenterNijmegenthe Netherlands Department of Urology Kocaeli University School of MedicineKocaeliTurkey Department of Urology Royal Bournemouth HospitalBournemouthUK Department of Urology University Medical Centre MannheimMannheimGermany Urology Clinic Department of MedicalSurgical and Health ScienceUniversity of TriesteTriesteItaly Department of Urology University Hospitals LeuvenLeuvenBelgium Department of Medical Oncology Fondazione IRCCS Istituto Nazionale dei TumoriMilanItaly Unit of Urological Robotic Surgery and Renal Transplantation University of FlorenceCareggi HospitalFlorenceItaly

Objective:The role of lymph node dissection(LND)is still controversial in patients with renal cell carcinoma undergoing *** aimed to provide a comprehensive review of the literature about the effect of LND on survival,prognosis,surgical outcomes,as well as patient selection and available LND ***:Recent literature(from January 2011 to December 2021)was assessed through PubMed and MEDLINE databases.A narrative review of most relevant articles was ***:The frequencies in which LNDs are being carried out are decreasing due to an increase in minimally invasive and nephron sparing ***,randomized clinical trials and meta-analyses failed to show any survival advantage of LND versus no ***,retrospective studies suggest a survival benefit of LND in high-risk patients(bulky tumors,T3-4 stage,and cN1 patients).Moreover,extended LND might provide important staging information,which could be of interest for adjuvant treatment ***:No level 1 evidence of any survival advantage deriving from LND is currently available in ***,the role of LND is limited to staging ***,low grade evidence suggests a possible role of LND in high-risk *** clinical trials are warranted to corroborate these findings.

关键词： Renal cell carcinoma Lymph node dissection Radical nephrectomy Salvage lymph node dissection

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经腹机器人辅助腹腔镜肾部分切除术治疗T2期肾肿瘤的国际多中心临床研究

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中华泌尿外科杂志 2018年第6期39卷 407-412页

作者：过菲张超王富博王林辉杨庆叶华茂吕晨肖成武汪洋 Giuseppe Simone Ithaar Derweesh Andrea Minervini Daniel Eun Francesco Porpiglia Sisto Perdona James Porter Matteo Ferro Alexandre Mottrie Robert Uzzo luigi schips Wesley White Ken Jacobsohn Prokar Dasgupta Riccardo Autorino Clayton Lau Chandru Sundaram Umberto Capitanio 孙颖浩杨波上海长海医院泌尿外科 200433 上海长征医院泌尿外科意大利里贾纳埃琳娜国家癌症研究所泌尿中心美国加州大学圣地亚哥分校泌尿中心意大利佛罗伦萨大学CARGGI医院泌尿外科美国天普大学路易斯卡茨医学院泌尿外科意大利都灵大学圣路易吉冈萨加医院意大利PASCALE基金会和癌症研究和护理研究所泌尿中心美国西雅图瑞典泌尿组意大利米兰IEO泌尿外科比利时OLV医院泌尿中心美国福克斯蔡斯癌症中心泌尿外科意大利安南齐塔医院泌尿外科美国田纳西大学医学中心泌尿外科美国威斯康星医学院泌尿外科英国盖伊医院泌尿外科美国弗吉尼亚联邦大学泌尿外科美国希望之城医学中心泌尿外科印第安纳大学泌尿外科意大利米兰圣拉斐尔奥克斯代尔IRCCS中心泌尿外科

目的通过国际多中心研究探讨临床T2期肾肿瘤行经腹机器人辅助腹腔镜肾部分切除术的安全性及有效性。方法回顾性分析2012年1月至2017年12月国际19家泌尿中心378例临床T2期肾肿瘤行经腹机器人肾部分切除术和经腹机器人根治性肾切除术患者... 详细信息

目的通过国际多中心研究探讨临床T2期肾肿瘤行经腹机器人辅助腹腔镜肾部分切除术的安全性及有效性。方法回顾性分析2012年1月至2017年12月国际19家泌尿中心378例临床T2期肾肿瘤行经腹机器人肾部分切除术和经腹机器人根治性肾切除术患者的临床资料。根据手术方式不同，分为部分切除组和根治组。部分切除组159例，男118例，女41例；年龄（59.3±13.2）岁，体重指数（28.7±5.4） kg/m^2，术前GFR （77.3±22.1）ml/min；肿瘤位于左侧72例，右侧87例；肿瘤直径（83±16）mm；R.E.N.A.L.评分（8.6±2.2）分。根治组219例，男156例，女63例；年龄（62.0±12.9）岁，体重指数（28.7±6.1） kg/m^2，术前GFR （71.4±20.3）ml/min；肿瘤位于左侧112例，右侧105例，双侧2例；肿瘤直径（92±25）mm；R.E.N.A.L.评分（9.7±1.5）分。两组患者性别、体重指数、肿瘤位置的差异均无统计学意义（P〉0.05）。部分切除组患者年龄、肿瘤直径、R.E.N.A.L.评分均低于根治组（P〈0.05），术前GFR优于根治组（P=0.012）。比较两组围手术期资料、肿瘤病理类型、随访时间、复发时间及术后GFR等。结果378例手术均顺利完成。部分切除组手术时间中位值150 min（65-353 min），短于根治组[180 min（85-361 min），P〈0.001]，术中出血量中位值150 ml（40-3 000 ml），多于根治组[100 ml （10-1 100 ml），P〈0.001]。术中并发症发生率部分切除组为5.7%（9/159），根治组为3.2%（7/219），两组差异无统计学意义（P=0.240）。部分切除组术后并发症发生率高于根治组[19.5%（31/159）与10.5%（23/219），P=0.014]，但≥3级并发症发生率的差异无统计学意义[4.4%（7/159）与2.3%（5/219），P=0.246]。部分切除组无复发生存率高于根治组[91.4%（117/128）与81.9%（167/204），P=0.013]。部分切除组术后GFR降低值16.9 ml/min（10.4-84.7 ml/min）明显少于根治组29.0 ml/min（14.0-54.0 ml/min），肾部分切除术更利于术后肾功能的保护（P〈0.001）。结论临床T2期肾肿瘤行机器人肾部分切除术可获得有效的肿瘤控制率，同时可以更好地保护肾功能，可作为临床T2期肾肿瘤有效的手术方式。

关键词：肾肿瘤局部进展期肾部分切除术肾功能根治性肾切除术

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