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Prostate health index can stratify patients with Prostate Imaging Reporting and Data System score 3 lesions on magnetic resonance imaging to reduce prostate biopsies

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Asian Journal of Andrology 2024年第1期26卷 20-24页

作者： John Shung-Lai Leung Wai-Kit Ma Brian Sze-Ho Ho Stacia Tsun-Tsun Chun Rong Na Yongle Zhan Chi-Yuen Ng Chi-Ho Ip Ada Tsui-Lin Ng Yiu-Chung Lam Division of urology Department of SurgeryQueen Mary HospitalUniversity of Hong KongHong KongChina Division of urology Department of SurgeryPrincess Margaret HospitalHongKongChina

We aim to evaluate prostate health index as an additional risk-stratification tool in patients with Prostate Imaging Reporting and Data System score 3 lesions on multiparametric magnetic resonance *** with biochemical or clinical suspicion of having prostate cancer who underwent multiparametric magnetic resonance imaging in two tertiary centers(Queen Mary Hospital and Princess Margaret Hospital,Hong Kong,China)between January 2017 and June 2022 were ***-magnetic resonance imaging fusion biopsies were performed after prostate health index *** who only had Prostate Imaging Reporting and Data System score 3 lesions were further stratified into four prostate health index risk groups and the cancer detection rates were *** of the 747 patients,47.3%had Prostate Imaging Reporting and Data System score 3 lesions *** detection rate of clinically significant prostate cancer in this group was 15.0%.The cancer detection rates of clinically significant prostate cancer had statistically significant differences:5.3%in prostate health index<25.0,7.4%in prostate health index 25.0-34.9,17.9%in prostate health index 35.0-54.9,and 52.6%in prostate health index≥55.0(P<0.01).Among the patients,26.9%could have avoided a biopsy with a prostate health index<25.0,at the expense of a 5.3%risk of missing clinically significant prostate *** health index could be used as an additional risk stratification tool for patients with Prostate Imaging Reporting and Data System score 3 *** could be avoided in patients with low prostate health index,with a small risk of missing clinically significant prostate cancer.

关键词： biopsy fusion biopsy magnetic resonance imaging prostate cancer prostate health index

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Performance in the Fundamentals of Laparoscopic surgery: Does it reflect global rating scales in the Objective Structured Assessment of Technical Skills in porcine laparoscopic surgery?

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Asian Journal of urology 2024年第3期11卷 443-449页

作者： Ho Yee Tiong Wei Zheng So Jeremy Yuen-Chun Teoh Shuji Isotani Gang Zhu Teng Aik Ong Eddie Shu-Yin Chan Peggy Sau-Kwan Chu Kittinut Kijvikai Ming Liu Bannakji Lojanapiwat Michael Wong Anthony Chi-Fai Ng Yong Loo Lin School of Medicine Department of SurgeryNational University of SingaporeSingapore S.H.Ho urology Centre Department of SurgeryThe Chinese University of Hong KongHong KongChina Department of urology Juntendo University Graduate School of MedicineTokyoJapan Department of urology National University HospitalSingapore Department of urology Beijing United Family HospitalBeijingChina Department of surgery University of Malaya Specialist CentreKuala LumpurMalaysia Division of urology Department of SurgeryTuen Mun HospitalHong Kong Department of urology Ramathibodi HospitalMahidol UniversitySalayaThailand Department of urology Beijing HospitalBeijingChina Department of urology Chiangmai Ram HospitalChiang MaiThailand International urology Fertility&Gynaecology CentreSingapore

Objective:To correlate the utility of the Fundamentals of Laparoscopic surgery(FLS)manual skills program with the Objective Structured Assessment of Technical Skills(OSATS)global rating scale in evaluating operative ***:The Asian Urological surgery Training and Educational Group(AUSTEG)Laparoscopic Upper Tract surgery Course implemented and validated the FLS program for its usage in laparoscopic surgical ***’basic laparoscopic skills were assessed using three different training models(peg transfer,precision cutting,and intra-corporeal suturing).They also performed live porcine laparoscopic surgery at the same *** surgery skills were assessed by blinded faculty using the OSATS rating ***:From March 2016 to March 2019,a total of 81 certified urologists participated in the course,with a median of 5 years of post-residency *** differences in task time did not reach statistical significance,those with more surgical experience were visibly faster at completing the peg transfer and intra-corporeal suturing FLS ***,they took longer to complete the precision cutting task than participants with less *** OSATS scores correlated weakly with all three FLS tasks(peg transfer time:r=0.331,r^(2)=0.110;precision cutting time:r=0.240,r^(2)=0.058;suturing with intracorporeal knot time:r=0.451,r^(2)=0.203).Conclusion:FLS task parameters did not correlate strongly with OSATS globing rating scale *** FLS task models demonstrated strong validity,it is important to assimilate the inconsistencies when benchmarking technical proficiency against real-life operative competence,as evaluated by FLS and OSATS,respectively.

关键词： TheFundamentalsof Laparoscopic surgery The Objective Structured Assessment of Technical Skills Laparoscopic training Surgical education Surgical training Urological laparoscopic surgery

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A prospective cohort of men with localized prostate cancer on active surveillance protocol in Hong Kong,China:what did we learn?

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Asian Journal of Andrology 2024年第3期26卷 245-249页

作者： Xiaobo Wu Ivan Ching-Ho Ko Cindy Yeuk-Lam Hong Samuel Chi-Hang Yee Jeremy Yuen-Chun Teoh Samson Yun-Sang Chan Ho-Man Tam Chi-Kwok Chan Chi-Fai Ng Peter Ka-Fung Chiu SH Ho urology Centre Department of SurgeryFaculty of MedicineThe Chinese University of Hong KongHong KongChina

This study aimed to report the outcomes of active surveillance(AS)in the management of low-risk prostate cancer(PCa).It recruited87 men who were prospectively followed up according to the Prostate Cancer Research International Active Surveillance(PRIAS)protocol with local adaptation at SH Ho urology Centre,Prince of Wales Hospital,Hong Kong,*** investigated the predictorsof disease progression and found that baseline prostate-specific antigen density(PSAD)and the presence of the highest ProstateImaging-Reporting and Data System(PI-RADS)score 5 lesion on magnetic resonance imaging(MRI)are significantly correlatedwith disease ***,men with PSAD>0.2 ng ml^(−2)or PI-RADS 4 or 5 lesions had significantly worse upgradingfree survival compared to those with PSAD≤0.2 ng ml−2 and PI-RADS 2 or 3 *** study concludes that AS is a safe andeffective management strategy for selected patients to defer radical treatment and that most disease progression can be detectedafter the first repeated *** combination of PSAD>0.2 ng ml^(−2)and PI-RADS 4 or 5 lesions may serve as a useful predictorof early disease progression and provide a guide to optimize follow-up protocols for men in different risk groups.

关键词： active surveillance cohort localized prostate cancer

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Intraplaque injections of hyaluronic acid for the treatment of stable-phase Peyronie’s disease:a retrospective single-center experience

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Asian Journal of Andrology 2024年第3期26卷 268-271页

作者： Simone Cilio Roberto La Rocca Giuseppe Celentano Claudio Marino Massimiliano Creta Gianluigi Califano Celeste Manfredi Giorgio Ivan Russo Afonso Morgado Marco Falcone Marco Capece YAU Working Group Sexual and Reproductive Health Department of Neurosciences Reproductive Sciences and OdontostomatologyUrology UnitUniversity of Naples“Federico II”Naples 80131Italy urology Unit Department of WomenChild and General and Specialized Surgery“Luigi Vanvitelli”UniversityNaples 80131Italy urology Section Department of SurgeryUniversityof CataniaCatania 95131Italy Department of urology Centro Hospitalar Universitário São JoãoPorto 4200-319Portugal urology Clinic-A.O.U.“Cittàdella Salute edella Scienza”-Molinette Hospital University of TurinTurin 10100Italy 不详

Peyronie’s disease(PD)is a condition of penile connective tissue affecting up to 10%of men *** the complexity ofits management,nonsurgical treatments,such as intraplaque injections,are gaining *** current literature shows dataon the efficacy of intraplaque injections of hyaluronic acid(HA)mainly in acute-phase ***,data on injections of HA instable-phase PD are *** for this retrospective study were derived from a prospectively maintained database of privatepatients presenting at a private medical practice affiliated to the University of Naples“Federico II”(Naples,Italy)with stable-phasePD between January 2020 and March *** underwent a standard protocol of three injections,each administered at atwo-week *** the intervals,patients performed vacuum device therapy,penile stretching,and modeling *** compiled the Peyronie’s Disease Questionnaire(PDQ)and Global Assessment of Peyronie’s Disease(GAPD)at baselineand 2 weeks after the third injection.A penile Doppler ultrasound was performed 2 weeks after the last injection to record thefinal ***,we recruited 62 patients with stable-phase PD and a mean(±standard deviation[s.d.])curvature of52.7°(±9.7°).After 6 weeks,eight(12.9%)patients did not experience any curvature *** remaining 54 patientshad a final mean(±s.d.)curvature of 40.3°(±9.1°)with P<0.001,compared to that before *** found improvement inall PDQ domains(all P≤0.01),and 50(80.6%)patients reported subjective improvement of the penile curvature according to *** conclusion,we demonstrated that after three injections of HA administered according to the adopted protocol,patientswith stable-phase PD could experience significant improvements in penile curvature,and physical and psychological consequencesof the disease without significantly relevant side effects.

关键词： hyaluronic acid intraplaque injection Peyronie’s disease stable-phase therapy

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Incidence of urinary incontinence following endoscopic laser enucleation of the prostate by en-bloc and non-en-bloc techniques:a multicenter,real-world experience of 5068 patients

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Asian Journal of Andrology 2024年第3期26卷 233-238页

作者： Daniele Castellani Vineet Gauhar Khi Yung Fong Mario Sofer Moisés Rodríguez Socarrás Azimdjon N Tursunkulov Lie Kwok Ying Sarvajit Biligere Ho Yee Tiong Dean Elterman Abhay Mahajan Mark Taratkin Sorokin Nikolai Ivanovich Tanuj Pal Bhatia Dmitry Enikeev Nariman Gadzhiev Mohammed Taif Bendigeri Jeremy Yuen-Chun Teoh Marco Dellabella Fernando Gómez Sancha Bhaskar Kumar Somani Thomas Reinhard William Herrmann urology Unit IRCCS INRCAAncona 60127Italy urology Unit Marche University HospitalLe Marche Polytechnic UniversityAncona 60126Italy Department of urology Ng Teng Fong General HospitalSingapore 609606Singapore Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore Department of urology Tel Aviv Sourasky Medical CenterAffiliated to the Sackler School of MedicineTel Aviv UniversityTel Aviv 6423906Israel Department of urology and Robotic surgery ICUA-Clínica CEMTROMadrid 28701Spain urology Division Akfa Medline HospitalTashkent 100211Uzbekistan Advanced urology Gleneagles HospitalSingapore 258499Singapore Department of urology National University HospitalSingapore 119228Singapore Divisionof urology Department of SurgeryUniversity of TorontoOntarioToronto M5G 2C4Canada Department of urology Mahatma Gandhi Mission’s Medical College and HospitalAurangabad 431003India Institute for urology and Reproductive Health Sechenov UniversityMoscow119435Russian Federation Department of urologyand Andrology Lomonosov Moscow State UniversityMoscow 119992Russian Federation Department of urology Sarvodaya Hospital and Research CentreFaridabadHaryana 121006India Department of urology Medical University of ViennaVienna 1090Austria Department of urology Saint-Petersburg State University HospitalSaint-Petersburg 199034Russian Federation Department of urology Asian Institute of Nephrology and UrologyHyderabad 500082India S.H.Ho urologyCentre Department of SurgeryFaculty of MedicineThe Chinese University of Hong KongHong Kong 96H2+Q9China Department of urology University Hospitals Southampton NHS TrustSouthampton SO166YDUnited Kingdom Department of urology Cantonal Hospital Thurgau AGFraunfeld 8500Switzerland

We aim to evaluate the incidence of incontinence following laser endoscopic enucleation of the prostate(EEP)comparing en-bloc(Group 1)versus 2-lobe/3-lobe techniques(Group 2).We performed a retrospective review of patients undergoing EEP for benign prostaticenlargement in 12 centers between January 2020 and January *** were presented as median and interquartile range(IQR).Univariable and multivariable logistic regression analysis was performed to evaluate factors associated with stress urinary incontinence(SUI)and mixed urinary incontinence(MUI).There were 1711 patients in Group 1 and 3357 patients in Group *** in Group 2were significantly younger(68[62–73]years vs 69[63–74]years,P=0.002).Median(interquartile range)prostate volume(PV)wassimilar between the groups(70[52–92]ml in Group 1 vs 70[54–90]ml in Group 2,P=0.774).There was no difference in preoperativeInternational Prostate Symptom Score,quality of life,or maximum flow ***,morcellation,and total surgical time weresignificantly shorter in Group *** 1 month,overall incontinence rate was 6.3%in Group 1 versus 5.3%in Group 2(P=0.12),and urge incontinence was significantly higher in Group 1(55.1%vs 37.3%in Group 2,P<0.001).After 3 months,the overall rate ofincontinence was 1.7%in Group 1 versus 2.3%in Group 2(P=0.06),and SUI was significantly higher in Group 2(55.6%vs 24.1%in Group 1,P=0.002).At multivariable analysis,PV and IPSS were factors significantly associated with higher odds of transient SUI/***,surgical time,and no early apical release technique were factors associated with higher odds of persistent SUI/MUI.

关键词： benign prostatic hyperplasia en-bloc enucleation endoscopic enucleation of the prostate laser therapy stress urinaryincontinence urge urinary incontinence

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Robotic management of urinary fistula

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Asian Journal of urology 2024年第3期11卷 357-365页

作者： Luis G.Medina Randall A.Lee Valeria Celis Veronica Rodriguez Jaime Poncel Aref S.Sayegh Rene Sotelo The Catherine and Joseph Aresty Department of urology USC Institute of UrologyKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCAUSA Division of urology Department of SurgeryFox Chase Cancer CenterTemple University Health SystemPhiladelphiaPAUSA

Objectives:To highlight critical preoperative and intraoperative considerations in approaching fistula repair ***:A search of the literature was conducted to identify relevant articles pertaining to robotic management of urinary ***:Fistulae of the genitourinary tract can be a challenging dilemma for urologists,as definitive management may require surgical *** of both enteric and non-enteric fistulae are multifactorial,and successful repair hinges on the meticulous perioperative evaluation,planning,and *** open techniques can subject patients to increased morbidity and prolonged *** its introduction,the robotic surgical platform has continued to expand its *** three-dimensional visualization and tremor free wristed instrument movements have made the robotic platform an attractive option for genitourinary fistula ***:Robotic management of complex urinary fistulae is feasible in expert hands;more studies are needed to define its role in the treatment algorithm of this devastating conditions.

关键词： Fistula Robotic surgery Rectourethral Rectovesical Vesicovaginal

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Prevalence and risk evaluation of cardiovascular disease in the newly diagnosed prostate cancer population in China:A nationwide,multi-center,population-based cross-sectional study

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Chinese Medical Journal 2024年第11期137卷 1324-1331页

作者： Weiyu Zhang Huixin Liu Ming Liu Shi Ying Renbin Yuan Hao Zeng Zhenting Zhang Sujun Han Zhannan Si Bin Hu Simeng Wen Pengcheng Xu Weimin Yu Hui Chen Liang Wang Zhitao Lin Tao Dai Yunzhi Lin Tao Xu Department of urology Peking University People’s HospitalBeijing 100044China Department of Clinical Epidemiology and Biostatistics Peking University People’s HospitalBeijing 100044China Department of urology Beijing HospitalNational Center of GerontologyBeijing 100005China Institute of Geriatric Medicine Chinese Academy of Medical SciencesBeijing 100005China Department of urology Wuhan Union HospitalHuazhong University of Science&TechnologyWuhanHubei 430022China Department of urology The Third People’s Hospital of ChengduChengduSichuan 610014China Department of urology West China Hospital of Sichuan UniversityChengduSichuan 610041China Department of Urologic Oncology Tianjin Medical University Cancer Institute&HospitalTianjin 300060China Department of urology Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China National Cancer Center Beijing 100021China National Clinical Research Center for Cancer Beijing 100021China Department of urology Liaoning Cancer HospitalShenyangLiaoning 110801China Department of urology The Second Hospital of Tianjin Medical UniversityTianjin 300141China Tianjin Institute of urology Tianjin Medical UniversityTianjin 300141China Department of urology Lu’an Affiliated Hospital of Anhui Medical UniversityLu’anAnhui 237322China Department of urology Renmin Hospital of Wuhan UniversityWuhanHubei 430060China Department of urology Harbin Medical University Affiliated Cancer HospitalHarbinHeilongjiang 150081China Department of urology The Second Hospital of Dalian Medical UniversityDalianLiaoning 116023China Department of urology surgery Fujian Cancer HospitalFuzhouFujian 350014China Department of urology surgery Hunan Cancer HospitalChangshaHunan 410031China Department of urology surgery The First Affiliated Hospital of Fujian Medical UniversityFuzhouFujian 350004China

Background:Cardiovascular disease(CVD)has emerged as the leading cause of death from prostate cancer(PCa)in recent decades,bringing a great disease burden *** with preexisting CVD have an increased risk for major adverse cardiovascular events when treated with androgen deprivation therapy(ADT).The present study aimed to explore the prevalence and risk evaluation of CVD among people with newly diagnosed PCa in ***:Clinical data of newly diagnosed PCa patients were retrospectively collected from 34 centers in China from 2010 to 2022 through convenience *** was defined as myocardial infarction,arrhythmia,heart failure,stroke,ischemic heart disease,and *** risk was estimated by calculating Framingham risk scores(FRS).Patients were accordingly divided into low-,medium-,and high-risk groups.χ2 or Fisher’s exact test was used for comparison of categorical ***:A total of 4253 patients were enrolled in the present study.A total of 27.0%(1147/4253)of patients had comorbid PCa and CVD,and 7.2%(307/4253)had two or more *** enrolled population was distributed in six regions of China,and approximately 71.0%(3019/4253)of patients lived in urban *** imaging and pathological evaluation,most PCa patients were diagnosed at an advanced stage,with 20.5%(871/4253)locally progressing and 20.5%(871/4253)showing *** of them initiated prostatectomy(46.6%,1983/4253)or regimens involving ADT therapy(45.7%,1944/4253)for prostate *** the present PCa cohort,43.1%(1832/4253)of patients had hypertension,and half of them had poorly controlled blood *** FRS stratification,as expected,a higher risk of CVD was related to aging and metabolic ***,we also found that patients with treatment involving ADT presented an originally higher risk of CVD than those without *** was in accordance with clinical practice,i.e.,aged patients or patients at advanced oncological stages were inclined to accept sys

关键词： Prostate cancer Castration Cardiovascular disease Prevalence Cardiovascular risk

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Defining minimal invasive surgical therapy for benign prostatic obstruction surgery: Perspectives from a global knowledge, attitude, and practice survey

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Asian Journal of urology 2024年第1期11卷 55-64页

作者： Bryan Kwun-Chung Cheng Steffi Kar-Kei Yuen Daniele Castellani Marcelo Langer Wroclawski Hongda Zhao Mallikarjuna Chiruvella Wei-Jin Chua Ho-Yee Tiong Yiloren Tanidir Jean de la Rosette Enrique Rijo Vincent Misrai Amy Krambeck Dean S.Elterman Bhaskar K.Somani Jeremy Yuen-Chun Teoh Vineet Gauhar Department of surgery United Christian HospitalHong KongChina S.H.Ho urology Centre Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongHong KongChina Department of urology University Hospital“Ospedali Riuniti”and Polytechnic University of Marche RegionAnconaItaly Hospital Israelita Albert Einstein Sao PauloSPBrazil BP—A Beneficencia Portuguesa de Sao Paulo Sao PauloSPBrazil Faculdade de Medicina do ABC Santo AndreSPBrazil Department of urology Asian Institute of Nephrology and UrologyHyderabadTGIndia Department of urology National University HospitalSingapore Department of urology Marmara University School of MedicineIstanbulTurkey Department of urology Medipol Mega University HospitalIstanbul Medipol UniversityIstanbulTurkey Department of urology Hospital Quiron BarcelonaBarcelonaSpain Department of urology Clinique PasteurToulouseFrance Department of urology Indiana University School of MedicineIndianapolisINUSA Division of urology Department of SurgeryUniversity Health NetworkUniversity of TorontoTorontoCanada Department of urology University Hospital Southampton NHS TrustSouthamptonUK Department of urology Ng Teng Fong General HospitalNUHSSingapore

Objective:To scrutinize the definitions of minimal invasive surgical therapy(MIST)and to investigate urologists’knowledge,attitudes,and practices for benign prostatic obstruction ***:A 36-item survey was developed with a Delphi *** on definitions of MIST and attitudes and practices of benign prostatic obstruction surgeries were *** were invited globally to complete the online *** was achieved when more than or equal to 70%responses were“agree or strongly agree”and less than or equal to 15%responses were“disagree or strongly disagree”(consensus agree),or when more than or equal to 70%responses were“disagree or strongly disagree”and less than or equal to 15%responses were“agree or strongly agree”(consensus disagree).Results:The top three qualities for defining MIST were minimal blood loss(n=466,80.3%),fast post-operative recovery(n=431,74.3%),and short hospital stay(n=425,73.3%).The top three surgeries that were regarded as MIST were Urolift®(n=361,62.2%),Rezum®(n=351,60.5%),and endoscopic enucleation of the prostate(EEP)(n=332,57.2%).Consensus in the knowledge section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,day surgery feasibility,and post-operative *** in the attitudes section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,and day surgery *** on both sections was achieved for EEP as the option with the better symptoms and flow improvement,lower retreatment rate,and better suitable for prostate more than 80 ***:Minimal blood loss,fast post-operative recovery,and short hospital stay were the most important qualities for defining ***®,Rezum®,and EEP were regarded as MIST by most urologists.

关键词： Benignprostate hyperplasia Minimalinvasive surgical therapy surgery Bladderoutlet obstruction

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Oleanolic acid inhibits colon cancer cell stemness and reverses chemoresistance by suppressing JAK2/STAT3 signaling pathway

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BIOCELL 2024年第7期48卷 1037-1046页

作者： RUOYU CHEN YIMAN WU FENG WANG JUNTAO ZHOU HUAZHANG ZHUANG WEI LI Department of Anus and Intestine surgery Shenzhen Longhua District Central HospitalShenzhenChina Department of urology Shenzhen Longhua District Central HospitalShenzhenChina

Background:Oleanolic acid(OA),a pentacyclic triterpenoid exhibiting speciﬁc anti-cancer properties and highly effective antioxidant activity,was isolated from traditional Chinese medicinal ***,the OA that impacts colon cancer(CC)cells and its underlying mechanisms remain poorly ***:The cytotoxic effect of OA alone or OA-5-Fluorouracil(5-FU)combination on normal and CC cells was analyzed by methyl thiazolyl diphenyl-tetrazolium bromide(MTT).Then,the impact of OA on CC cell lines(LoVo and HT-29)proliferation and stemness were measured using colon formation and tumorsphere formation ***-binding transcription factor 4(Oct4),Prominin-1(CD133),Nanog,and transcription factor SOX-2(SOX2)are cell stemness-related indicators whose expression was assessed usingﬂuorescence qPCR assay,Western blotting,and *** effect of OA on the proliferative potency of CC cells was evaluated using an in vivo ***:The stem-like characteristics and clone production of colon cancer cells were markedly reduced by OA alone or in combination with ***,OA increases the susceptibility of CC cells to 5-FU by blocking the cell stemness-related markers(CD133,Nanog,SOX2,and Oct4)expression levels both in vitro and in vivo,as well as by inactivating the activator of transcription 3(STAT3 signaling)and Janus kinase 2/signal transducer(JAK2).Conclusion:Theseﬁndings imply that oleanolic acid,both in vitro and in vivo,suppresses the JAK2/STAT3 pathway,which in turn reverses chemoresistance and decreases colon cancer cell ***,by reducing the recommended amount of 5-FU,this strategy may improve chemotherapeutic effectiveness and minimize undesired side effects.

关键词： Colon cancer,Oleanolic acid,Stemness,5-FU JAK2/STAT3 signaling pathway

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Impact of pre- and peri-operative risk factors on length of stay and hospital readmission following minimally-invasive partial nephrectomy

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Asian Journal of urology 2024年第1期11卷 72-79页

作者： Vanessa A.Lukas Rahul Dutta Ashok K.Hemal Matvey Tsivian Timothy E.Craven Nicholas A.Deebel David D.Thiel Ram Anil Pathak Brigham and Women's Hospital Division of UrologyDepartment of Surgery75 Francis StreetBostonMAUSA Atrium Health Wake Forest Baptist Medical Center Department of Urology1 Medical Center BlvdWinston-SalemNCUSA Mayo Clinic Florida Department of Urology4500 San Pablo RoadJacksonvilleFLUSA

Objective:We conducted an analysis of the American College of Surgeons National Surgical Quality Improvement Program database for minimally-invasive partial nephrectomy cases reported with the goal to identify pre-and peri-operative variables associated with length of stay(LOS)greater than 3 days and readmission within 30 ***:Records from 2008 to 2018 for“laparoscopy,surgical;partial nephrectomy”for prolonged LOS and readmission cohorts were *** analysis with Chi-square,t-tests,and multivariable logistic regression analysis with odds ratios(ORs),p-values,and 95%confidence intervals assessed statistical ***:Totally,20306 records for LOS greater than 3 days and 15854 for readmission within 30 days were *** and multivariable analysis exhibited similar *** LOS greater than 3 days,undergoing non-elective surgery(OR=5.247),transfusion of greater than four units within 72 h prior to surgery(OR=5.072),pre-operative renal failure or dialysis(OR=2.941),and poor pre-operative functional status(OR=2.540)exhibited the strongest statistically significant *** hospital readmission within 30 days,loss in body weight greater than 10%in 6 months prior to surgery(OR=2.227)and bleeding disorders(OR=2.081)exhibited strongest statistically significant ***:Multiple pre-and peri-operative risk factors are independently associated with prolonged LOS and hospital readmission within 30 days of surgery using the American College of Surgeons National Surgical Quality Improvement Program *** the risks factors that can potentially be improved prior to minimally-invasive partial nephrectomy is crucial to informing patient selection,optimization strategies,and patient education.

关键词： Minimally-invasive partial nephrectomy The American College of Surgeons National Surgical Quality Improvement Program Lengthof stay Hospital readmission

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