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Total mesorectal excision for mid and low rectal cancer: laparoscopic vs robotic surgery

World Journal of Gastroenterology 2016年第13期22卷 3602-3610页

作者： Francesco Feroci Andrea Vannucchi Paolo Pietro Bianchi Stefano Cantafio Alessia Garzi Giampaolo Formisano Marco Scatizzi department of General and oncological Surgery Santo Stefano Hospital department of General and Minimally Invasive Surgery Misericordia Hospital

AIM: To compare the short- and long-term outcomes of laparoscopic and robotic surgery for middle and low rectal ***: This is a retrospective study on a prospectively collected database containing 111 patients who underwent minimally invasive rectal resection with total mesorectal excision (TME) with curative intent between January 2008 and December 2014 (robot, n = 53; laparoscopy, n = 58). The patients all had a diagnosis of middle and low rectal adenocarcinoma with stage I-III disease. The median follow-up period was 37.4 mo. Perioperative results, morbidity a pathological data were evaluated and compared. The 3-year overall survival and disease-free survival rates were calculated and ***: Patients were comparable in terms of preoperative and demographic parameters. The median surgery time was 192 min for laparoscopic TME (L-TME) and 342 min for robotic TME (R-TME) (P < 0.001). There were no differences found in the rates of conversion to open surgery and morbidity. The patients who underwent laparoscopic surgery stayed in the hospital two days longer than the robotic group patients (8 d for L-TME and 6 d for R-TME, P < 0.001). The pathologic evaluation showed a higher number of harvested lymph nodes in the robotic group (18 for R-TME, 11 for L-TME, P < 0.001) and a shorter distal resection margin for laparoscopic patients (1.5 cm for L-TME, 2.5 cm for R-TME, P < 0.001). The three-year overall survival and disease-free survival rates were similar between ***: Both L-TME and R-TME achieved acceptable clinical and oncologic outcomes. The robotic technique showed some advantages in rectal surgery that should be validated by further studies.

关键词： Robotic surgery Laparoscopic surgery Rectal cancer Total mesorectal excision Minimally invasive surgery

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Antioxidant treatment for oligoasthenoteratozoospermia and varicocele:a DBPC trial to evaluate the impact of age and body mass index

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Asian Journal of Andrology 2024年第3期26卷 239-244页

作者： Gian Maria Busetto Bernarde F Rodrigues Ashraf Virmani Andrea Checchia Antonella Ninivaggi Anna Ricapito Giovanni Barbieri Piero Fischetti Ugo G Falagario Pasquale Annese Nicola d’Altilia Vito Mancini Matteo Ferro Felice Crocetto Angelo Porreca Carlo Bettocchi Luigi Cormio Ashok Agarwal Giuseppe Carrieri University of Foggia Foggia 71122Italy department of urology and Renal Transplantation Policlinico of FoggiaFoggia 71122Italy department of urology Human Reproduction SectionFederal University of Sao PauloSao Paulo 05403-000Brazil Alfasigma Healthscience Utrecht 3528 BGThe Netherlands urology Unit “G.Tatarella”HospitalCerignola 71042Italy urology Unit European Institute of Oncology(IEO)IRCCSMilan 20142Italy University of Naples Federico II Naples80126Italy department of oncological urology Veneto Institute of Oncology(IOV)IRCCSPadua 35039Italy urology Unit “L.Bonomo”HospitalAndria 70031Italy Global Andrology Forum Moreland HillsOH 44022USA

Oxidative stress is one of the main mechanisms responsible for male *** conditions such as varicocele,obesity,advanced age,and lifestyle can lead to an increase in reactive oxygen species,causing an oxidative imbalance in the *** are sensitive to reactive oxygen species and require energy to carry out their main function of fertilizingthe *** reactive oxygen species can affect sperm metabolism,leading to immobility,impaired acrosome reaction,and celldeath,thereby impairing reproductive *** double-blind randomized study evaluated the effect of supplementation withL-carnitine,acetyl-L-carnitine,vitamins,and other nutrients on semen quality in 104 infertile patients with or without varicocele,while also investigating the impact of factors such as obesity and advanced age on *** concentration significantlyincreased in the supplemented group compared to the placebo group(P=0.0186).Total sperm count also significantly increasedin the supplemented group(P=0.0117),as did sperm motility(P=0.0120).The treatment had a positive effect on patients upto 35 years of age in terms of sperm concentration(P=0.0352),while a body mass index(BMI)above 25 kg m^(−2) had a negativeeffect on sperm concentration(P=0.0110).Results were not showing a net benefit in stratifying patients in accordance withtheir BMI since sperm quality increase was not affected by this *** conclusion,antioxidant supplementation may bebeneficial for infertile patients and has a more positive effect on younger patients with a normal weight.

关键词： aging antioxidants body mass index oligoasthenoteratozoospermia varicocele

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COVID-19 outbreak impact on urolithiasis treatments:A multicenter retrospective study across 9 urological centers in Italy

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Current urology 2024年第4期18卷 301-306页

作者： Giorgio Mazzon Stefania Ferretti Emanuele Serafin Francesco Claps Pietro Acquati Davide Brusa Federico Germinale Giuseppe Celentano Andrea Pescuma Andrea Vismara Fugini Davide Campobasso Umberto Maestroni Giovanni Costa Tonino Morena Flavia Di Marco Andrea Baudo Massimiliano Creta Nicola Pavan Marco Ticonosco Angelo Peroni Devis Collura Maria Angela Cerruto Alessandro Antonelli Luca Carmignani Salvatore Micali Carlo Trombetta Giovanni Muto Antonio Celia department of urology AULSS7 PedemontanaSan Bassiano HospitalBassano del GrappaItaly department of urology University Hospital of PamaParmaItaly department of urology University of VeronaAzienda Ospedaliera Universitaria Integrata VeronaVeronaItaly Urological Clinic Department of MedicineSurgery and Health SciencesUniversity of TriesteTriesteItaly department of urology IRCCS Policlinico San DonatoMilanItaly department of urology Humanitas Gradenigo HospitalTurinItaly department of Neurosciences Reproductive and Oral SciencesUniversity of Naples Federico IINaplesItaly urology department University of Modena&Reggio EmiliaModenaItaly department of urology Poliambulanza Foundation HospitalBresciaItaly urology Section Department of SurgicalOncological and Oral SciencesUniversity of PalermoPalermoItaly

Background The coronavirus disease(COVID-19)pandemic has posed challenges to the global health care community,affecting the management of upper urinary tract *** and methods This retrospective study involved 9 Italian *** compared the 12-month period prior to COVID-19(March 1,2019,to February 28,2020;Period A)with the COVID-19 period(March 1,2020,to February 28,2021,Period B).This study aimed to compare outcomes during Periods A and B,specifically focusing on the overall number of treatments,rate of urgent/elective cases,and operational *** A total of 4018 procedures were collected,comprising 2176 procedures during Period A and 1842 during Period B,indicating a loss of 15.35%(p<0.001).In the elective cases,1622 procedures were conducted in Period A,compared with 1280 in Period B,representing a 21.09%reduction in cases(p=0.001).All types of stone treatments were affected:extracorporeal shock wave lithotripsy(−29.37%,p=0.001),percutaneous nephrolithotomy(−26.47%,p=0.008),retrograde surgeries for renal stones(−10.63%,p=0.008),and semirigid ureterolithotripsy(−24.86%,p=0.008).Waiting lists experienced significant delays during Period *** waiting time(WT)for elective procedures increased during Period B(p<0.001).For ureteral stones,the mean WT in Period A was 61.44 days compared with 86.56 days in Period B(p=0.008).The WT for renal stones increased from 64.96 days in Period A to 85.66 days in Period B for retrograde intrarenal surgery(p=0.008)and from 96.9 days to 1103.9 days(p=0.035)for percutaneous nephrolithotomy *** Our study demonstrates that COVID-19 significantly disrupted endourological services across the *** data underline how patients received treatment over a prolonged period,potentially increasing the risk of stone-related complications and patient discomfort.

关键词： COVID-19 Urolithiasis Percutaneous nephrolithotomy Retrograde intrarenal surgery Extracorporeal shock wave lithotripsy

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Minimally invasive surgical therapies(MISTs)for lower urinary tract symptoms(LUTS):promise or panacea?

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Asian Journal of Andrology 2024年第2期26卷 135-143页

作者： Gian Maria Busetto Andrea Checchia Marco Recchia Edoardo Tocci Ugo G Falagario Gennaro Annunziata Pasquale Annese Nicola d'Altilia Vito Mancini Matteo Ferro Felice Crocetto Octavian Sabin Tataru Luca Di Gianfrancesco Angelo Porreca Francesco Del Giudice Ettore De Berardinis Carlo Bettocchi Luigi Cormio Giuseppe Carrieri University of Foggia Foggia 71122Italy department of urology and Renal Transplantation Policlinico of FoggiaFoggia 71122Italy urology Unit "G.Tatarlla"HospitalCerignola 71042Italy urology Unit European Institute of Oncology(IE0)IRCcSMilan 20141Italy University of Naples Federico Il Naples 80126Italy G.E.Palade University of Medicine PharmacyScienceand Technology of Targu MuresTargu Mures 540142Romania department of oncological urology Veneto Institute of Oncology(IOv)IRccSPadua 35128Italy department of Maternal-Infant and Urological Sciences Sapienza Rome UniversityRoma 00161Italy urology Unit "L.Bonomo"HospitalAndria 76123Italy

The increasing importance of treatment of lower urinary tract symptoms(LUTS),while avoiding side effects and maintaining sexual function,has allowed for the development of minimally invasive surgical therapies(MiSTs).Recently,the European Association of urology guidelines reported a paradigm shift from the management of benign prostatic hyperplasia(BPH)to the management of nonneurogenic male *** aim of the present review was to evaluate the efficacy and safety of the most commonly used MisTs:ablative techniques such as aquablation,prostatic artery embolization,water vapor energy,and transperineal prostate laser ablation,and nonablative techniques such as prostatic urethral lift and temporarily implanted nitinol device(iTIND).MiSTs are becoming a new promise,even if clinical trials with longer follow-up are still *** of them are still under investigation and,to date,only a few options have been given as a recommendation for *** cannot be considered as standard of care and are not suitable for all *** and disadvantages should be underlined,without forgetting our objective:treatment of LUTS and re-treatment avoidance.

关键词： aquablation iTIND prostatic artery embolization prostatic urethral lift transperineal prostate laser ablation water vapor energy

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Animal models of vascularized nerve grafts:a systematic review

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Neural Regeneration Research 2023年第12期18卷 2615-2618页

作者： Francesca Toia Daniele Matta Federico De Michele Roberto Pirrello Adriana Cordova Plastic and Reconstructive Surgery.department of Surgical Oncological and Oral Sciences.University of PalermoPalermoItaly

The aim of this review is to present and compare the various animal models of vascularized nerve grafts described in the literature as well as to summarize preclinical evidence for superior functional results compared to non-vascularized free nerve grafts. We also will present the state of the art on prefabricated vascularized nerve grafts. A systematic literature review on vascularized nerve graft models was conducted via the retrieval with the Pub Med database on March 30, 2019. Data on the animal, nerve, and vascularization model, the recipient bed, the evaluation time points and methods, and the results of the study results were extracted and analyzed from selected articles. The rat sciatic nerve was the most popular model for vascularized nerve grafts, followed by the rabbit;however, rabbit models allow for longer nerve grafts, which are suitable for translational evaluation, and produced more cautious results on the superiority of vascularized nerve grafts. Compared to free nerve grafts, vascularized nerve grafts have better early but similar long-term results, especially in an avascular bed. There are few studies on avascular receiving beds and prefabricated nerve grafts. The clinical translation potential of available animal models is limited, and current experimental knowledge cannot fully support that the differences between vascularized nerve grafts and free nerve grafts yield a clinical advantage that justifies the complexity of the procedure.

关键词： nerve animal models nerve grafts nerve regeneration peripheral nerves prefabricated vascularized nerve grafts vascularized nerve grafts

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Testicular fine needle aspiration as a diagnostic tool in nonobstructive azoospermia

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Asian Journal of Andrology 2005年第3期7卷 289-294,页

作者： A.Bettella A.Ferlin M.Menegazzo M.Ferigo I.M.Tavolini P.F.Bassi C.Foresta department of Histology Microbiology and Medical BiotechnologiesCentre for Male Gamete Cryopreservation department of Surgical and oncological Sciences Clinical UrologyUniversity of PadovaPadova 35121Italy

Aim： To report the fine needle aspiration cytology （FNAC） of the testes used as a diagnostic tool in non-obstructive azoospermic patients. Methods： One hundred and twenty-five non-obstructive azoospermic male candidates to intracytoplasmic sperm injetion （ICSI） were analysed for follicle stimulating hormone （FSH）, luteinizing hormone （LH）, testosterone and inhibin B plasma levels. They were classified into three groups on the basis of FNAC： 1） Sertoli cell-only syndrome （SCOS）（70）; 2） severe hypospermatogenesis （42）; and 3） maturation arrest （13）, Then, all men underwent testicular sperm extraction （TESE） for sperm recovery for ICSI. Results： Mature spermatozoa were detected by FNAC in 24 of 42 men with severe hypospermatogenesis and nine of 13 men with maturation arrest; while they were retrieved by TESE in 29 of 70 men with SCOS, 35 of 42 men with severe hypospermatogenesis （including the 24 by FNAC） and 10 of 13 men with maturation arrest （including the nine by FNAC）. The sensitivity and specificity of FNAC were 44.6 % and 100 %, respectively. There was no difference on testicular volume and hormonal parameters in men with and without sperm retrieved. Conclusion： These findings suggest that FNAC may be a simple and valid diagnostic parameter in non-obstructive azoospermic men and it may represent a valid positive prognostic parameter for sperm recovery at TESE, （Asian J Androl 2005 Sep; 7： 289-294）

关键词： oligospermia fine needle aspiration diagnosis ICSI

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Single-incision laparoscopic colorectal surgery for cancer: State of art

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World Journal of Gastroenterology 2014年第20期20卷 6073-6080页

作者： Fabio Cianchi Fabio Staderini Benedetta Badii department of Surgery and Translational Medicine Center of Oncological Minimally Invasive Surgery University of Florence 50134 Florence Italy

A number of clinical trials have demonstrated that the laparoscopic approach for colorectal cancer resection provides the same oncologic results as open surgery along with all clinical benefits of minimally invasive surgery. During the last years, a great effort has been made to research for minimizing parietal trauma, yet for cosmetic reasons and in order to further reduce surgery-related pain and morbidity. New techniques, such as natural orifice transluminal endoscopic surgery (NOTES) and single-incision laparoscopy (SIL) have been developed in order to reach the goal of “scarless” surgery. Although NOTES may seem not fully suitable or safe for advanced procedures, such as colectomies, SIL is currently regarded as the next major advance in the progress of minimally invasive surgical approaches to colorectal disease that is more feasible in generalized use. The small incision through the umbilicus allows surgeons to use familiar standard laparoscopic instruments and thus, perform even complex procedures which require extraction of large surgical specimens or intestinal anastomosis. The cosmetic result from SIL is also better because the only incision is made through the umbilicus which can hide the wound effectively after operation. However, SIL raises a number of specific new challenges compared with the laparoscopic conventional approach. A reduced capacity for triangulation, the repeated conflicts between the shafts of the instruments and the difficulties to achieve a correct exposure of the operative field are the most claimed issues. The use therefore of this new approach for complex colorectal procedures might understandingly be viewed as difficult to implement, especially for oncologic cases.

关键词： Colorectal cancer Laparoscopic surgery Single-incision surgery Single-access surgery Scarless surgery Technical challenges

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Paraneoplastic myopathy-related rhabdomyolysis and pancreatic cancer:A case report and review of the literature

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World Journal of Clinical Cases 2023年第28期11卷 6823-6830页

作者： Andrea Costantini Lucia Moletta Elisa Sefora Pierobon Simone Serafini Michele Valmasoni Cosimo Sperti department of Surgical Oncological and Gastroenterological SciencesUOC Chirurgia Generale 1University of PaduaPadua 35128Italy department of Surgical Oncological and Gastroenterological SciencesUOC Chirurgia Generale 2University of PaduaPadua 35128Italy

BACKGROUND Rhabdomyolysis is a life-threatening condition,often leading to progressive renal failure and *** is caused by destruction of skeletal muscle and the release of myoglobin and other intracellular contents into the *** most frequent cause of this condition is“crush syndrome”,although several others have been described and paraneoplastic inflammatory myopathies associated with various types of cancer are repeatedly *** SUMMARY We describe a rare case of a patient with pancreatic cancer who developed rhabdomyolysis early on,possibly due to paraneoplastic myositis leading to acute renal failure and eventually to rapid death.A 78-year-old Caucasian woman was referred to our hospital for obstructive jaundice and weight loss due to a lesion in the pancreatic *** presented increasingly severe renal insufficiency with anuria,a dramatic increase in creatine phosphokinase(36000 U/L,n.v.20-180 U/L)and myoglobin(>120000μg/L,n.v.12-70μg/L).On clinical examination,the patient showed increasing pain in the lower limbs associated with muscle weakness which was severe enough to immobilize *** myopathy linked to the malignant lesion of the pancreatic head was *** patient was treated with hemodialysis and intravenous *** all the efforts to prepare the patient for surgery,her general condition rapidly deteriorated and she eventually died 30 d after hospital *** The possible causes of rhabdomyolysis in this patient with pancreatic cancer are discussed,the development of paraneoplastic myopathy being the most *** should bear in mind that these syndromes may become clinically manifest at any stage of the cancer course and their early diagnosis and treatment could improve the patient’s prognosis.

关键词： Paraneoplastic myopathy Rhabdomyolysis Pancreatic cancer Acute renal failure Paraneoplastic myositis Prognosis Case report

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Zoledronic acid combined with androgendeprivation therapy may prolong time to castration-resistant prostate cancer in hormone-naı¨ve metastatic prostate cancer patients e A propensity scoring approach

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Asian Journal of urology 2016年第1期3卷 33-38页

作者： Kazuhiro Nagao Hideyasu Matsuyama Masahiro Nozawa Isao Hara Tsukasa Nishioka Takahiro Komura Atsunobu Esa Shigeya Uejima Masaaki Imanishi Yasunari Uekado Takatoshi Ogawa Hiroshi Kajikawa Hirotsugu Uemura department of urology Graduate School of MedicineYamaguchi UniversityJapan department of urology Kinki University Faculty of MedicineJapan department of urology Wakayama Medical University School of MedicineJapan department of urology Sakai HospitalKinki University Faculty of MedicineJapan department of urology Naga HospitalJapan department of urology NTT Osaka HospitalJapan department of urology National Hospital Organization Osaka Minami Medical CenterJapan department of urology Nara Hospital Kinki University Faculty of MedicineJapan department of urology Tondabayashi HospitalJapan department of urology Wakayama Rosai HospitalJapan department of urology Kainan Municipal HospitalJapan department of urology Izumiotsu Municipal HospitalJapan

Objective:To clarify the oncological benefit of zoledronic acid for hormone-naive metastatic prostate cancer,patient outcome of androgen deprivation therapy with zoledronic acid(ADT+Z)and androgen deprivation therapy alone(ADT)was ***:Fifty-two patients with pathologically confirmed metastatic prostate cancer were prospectively enrolled and treated with combined androgen blockade(goserelin and bicalutamide)with zoledronic acid(4 mg every 4 weeks for 24 months).A propensity score-match with logistic regression analysis was applied to select 50 pair-matched cohorts(both from ADT+Z and from historical control cohorts who had undergone ADT alone),and patient outcomes were ***:Patients with ADT+Z had significantly longer time to progression(TTP)than those with ADT(median TTP;24.2 vs.14.0 months,p=0.0092),while no significant difference of overall survival between two groups(p=0.1502).Multivariate analysis for biochemical recurrence revealed treatment with ADT was the sole independent prognostic factor(HR:1.724,95%CI:1.06-2.86,p=0.0297).Conclusion:Combination of zoledronic acid with ADT may prolong time to castration resistant prostate cancer.

关键词： Zoledronic acid Hormone-naive prostate cancer Biochemical recurrence Propensity scorematch analysis

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Peritoneal metastases of colorectal origin treated by cytoreduction and HIPEC: An overview

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World Journal of Gastrointestinal Oncology 2014年第10期6卷 407-412页

作者： Alvaro Arjona-Sánchez Francisco Javier Medina-Fernández Francisco Cristobal Mu?oz-Casares Angela Casado-Adam Juan Manuel Sánchez-Hidalgo Sebastián Rufián-Pe?a Unit of oncological and Pancreatic Surgery Department of General and Digestive Surgery University Hospital Reina Sofia 14004 Cordoba Spain

Colorectal peritoneal carcinomatosis was considered a terminal condition with a merely palliative treatment that included only supportive care, palliative surgery and the best systemic chemotherapy. Since the birth of a new approach, cytoreductive surgery with peritonectomy procedures together with hyperthermic intraperitoneal chemotherapy and/or early postoperative intraperitoneal chemotherapy to treat peritoneal carcinomatosis, many research groups contributed with promising results using this procedure being up to date this strategy the only one that has shown curative benefits on colorectal peritoneal carcinomatosis achieving reported overall survival rates up to 64 mo and fiveyear survival rates up to 51%. The aim of this paper is to expose an updated overview of the therapeutic possibilities of these procedures in colorectal peritoneal metastases in the same way that our Unit of Oncologic Surgery has performed since 1997 with more than four hundred procedures.

关键词： Carcinomatosis peritoneal Colon cancer Intraperitoneal chemotherapy Cytoreduction Perito-nectomy

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