To quantitatively compare the functional renal volume loss, following nephron sparing surgery (NSS) between patients in whom tumor bed closure was done by biological tissue adhesive and those who were managed by standard suture technique. Methods: From our institutional NSS database we retrospectively collected patients who had two sequential quantitative single-photon emission computed tomography of 99mTc-dimercaptosuccinic acid uptake studies, the first study immediately before surgery and the second one 3-6 months following surgery. The study group included 69 patients: 26 (37.7%) patients in the sealant group (BioGlue®) and 43 (62.3%) patients in the standard suture group. Results: No statistically significant differences were noted in the baseline clinical and pathological characteristics of the studied groups. However, there were several statistically significant differences in operative variables: patients in the suture group had larger amount of blood loss (3-fold), longer ischemia time (26.6 vs. 21 minutes,) and slightly longer operation time. Patients in whom tumor bed was closed by sutures had nearly 3-fold higher parenchymal loss compared to patients managed by sealant (26.28 vs. 8.92 ml, p = 0.048). Conclusions: The use of tissue sealant during tumor bed reconstruction is associated with reduced devascularized parenchymal mass loss and should be considered among modifiable surgical factors during NSS.
<b><i>Introduction:</i></b> Ureteral strictures could be a chronic illness that leads to severe side effects and poor quality of life. A treatment with an Allium ureteral stent (URS), a self-expanding, large-caliber URS, was implemented in our department for ureteral stricture. Our study aim was to report the long-term results, including success rate, complications, and adverse effects. <b><i>Methods:</i></b> We retrospectively collected data on all patients who were treated with an Allium URS in our department between January 2017 and January 2021. Demographic, clinical, radiological, and perioperative parameters were retrieved and analyzed. The primary outcome was stricture resolution rates following stent removal. <b><i>Results:</i></b> Our cohort included 17 patients, 9 men and 8 women. The etiology of ureteral strictures was urolithiasis in 76.5% and pelvic procedure injury in 17.6%. The overall success rate was 35.29% in an average follow-up of 10.42 ± 2.39 months after stent removal. A higher failure rate was observed in the urolithiasis etiology group (90% vs. 66.7%, <i>p</i> = 0.38). The mean indwelling time of the Allium stent was 14.29 ± 1.29 months. <b><i>Conclusions:</i></b> Although an Allium URS could be considered as a feasible and attractive treatment of ureteral strictures, due to its minimal invasiveness, the success rate of this treatment is relatively low. Therefore, this option should be carefully considered and should be discouraged in young and fit patients and reserved for older unfit patients who are unwilling to undergo surgical repair of ureteral strictures.
INTRODUCTION AND OBJECTIVES: Trans Urethral Resection ofBladder Tumor (TUR-BT) is one of the most commonly performed procedures by urologists. This procedure is usually accompanied by anxiety of the patients and can result in physiologic response similar to anxiety disorder. Such event can affect the course of anesthesia, surgery and recovery. Standard of care (SOC) treatment for reducing anxiety include anxiolytic agents.In recent years the use of complementary and alternative medicine (CAM) is increasing steadily across the world, particularly in oncologic patients undergoing interventional procedures. Literature search revealed only very few publications concerning CAM in patients with urothelial cell carcinoma. In the current study we evaluated the use CAM (acupuncture) for reducing the preoperative anxiety of patients undergoing TUR-BT.METHODS: We conducted a prospective randomized control trial. Patients referred for TUR-BT based on clinical and imaging findings suggestive of bladder wall lesion were enrolled and divided into two groups: acupuncture þ SOC treatment and SOC treatment. Upon arrival to the induction room patients in both groups completed an anxiety VAS questionnaire. Patients in the intervention group received acupuncture treatment for the duration of 15-30 minutes at the induction room. Patients were asked to fill out the VAS anxiety questionnaire before and 15 minutes after intervention. Patients were also asked regarding their expectations from the treatment.RESULTS: 118 patients were included in the final analysis. Mean VAS anxiety score before treatment for the entire population was 4.25 without difference between the groups (p[0.28). After treatment, significant decrease of anxiety level in acupuncture group, mean difference of 2.64 points, in contrast to the control group in which we observed increase in the vas score of 0.6 points (p<0.001). In subgroup analysis of patients with baseline significant anxiety level (VAS > 4) we observed even more pronounced effect. While the score of anxiety in the SOC group increased from 6.00 to 6.48 points, it significantly decreased in the intervention group from 6.35 to 2.56 (P<0.001). No difference was noted between study groups when patients were asked about their expectations from the treatment (p[0.699). Concerning toxicity, except for occasional mild discomfort at the puncture site no adverse events were recorded CONCLUSIONS: We present a unique study that demonstrate the advantage of acupuncture in reducing anxiety in patients undergoing TUR-BT
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.