The majority of patients had no congenital abnormalities. Early diagnosis of urological abnormalities and urinary infection, and appropriate management of neurogenic bladder may have reduced the incidence in those groups. Most stones are calcium based but occur in the absence of metabolic disturbances. More patients presented in the fall, perhaps reflecting the increased concentration of urine in the summer. Half of the patients passed the stones and shock wave lithotripsy was curative in most others. Ureteroscopy, percutaneous nephrostolithotomy and open surgery were rarely required.
Results show that ureteroscopic lithotripsy of large stone burden can be performed with a high success rate. Preureteroscopic stent placement was associated with a decreased operative time and reoperative rates in patients with larger stone burdens of >1 cm.
Over the past decade, computed tomographic (CT) urography has emerged as the primary imaging modality for evaluating the urinary tract in various clinical settings, including the initial workup of hematuria. With the widespread implementation of CT urography, it is critical for radiologists to understand normal ureteral anatomy and the varied appearance of pathologic ureteral conditions at CT urography. Pathologic findings at CT urography include congenital abnormalities, filling defects, dilatation, narrowing, and deviations in course. These abnormalities are reviewed, along with the indications for CT urography, current imaging protocols with specific techniques for optimal evaluation of the ureter, and dose reduction strategies.
prospectively in a standard fashion as part of a quality assurance programme. Nine patients were excluded (three had unresectable disease and six underwent palliative cystectomy) and the remainder were divided into five groups. Data included demographics, operative variables, complications and pathological outcomes. Evidence of the LNY curve was examined using nonlinear regression to compare the number of LNs obtained.
RESULTSThe mean (range) patient age was 67 (36-90) years and the mean body mass index (BMI) was 27 (17-45) kg/m 2 . The mean operative duration for the robot-assisted pelvic LND was 44 (19-85) min. There was one postoperative complication that required exploration for vascular injury. The mean number of LNs retrieved was 18 (6-43). The mean LNY for each of the five groups was 13, 16, 21, 19 and 23, respectively, and neither BMI nor previous major abdominal surgery affected LNY.
CONCLUSIONRobot-assisted RC with pelvic LND was performed safely. LNY was oncologically acceptable and increased with experience.
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