scholarly journals The Impact of COVID-19 Disease on Urology Practice

2021 ◽  
Vol 07 (02) ◽  
pp. e83-e91
Author(s):  
Mohamad Moussa ◽  
Mohamed Abou Chakra ◽  
Athanasios G. Papatsoris ◽  
Athanasios Dellis
Keyword(s):  
Kidney Transplantation ◽  
Minimally Invasive ◽  
Intravesical Instillation ◽  
Testicular Tumors ◽  
Telemedicine Application ◽  
Urological Cancers ◽  
The Impact ◽  
Urological Emergencies ◽  
Timely Treatment ◽  
Systemic Therapies

AbstractThe diagnosis and timely treatment of cancer patients should not be compromised during an infectious disease pandemic. The pandemic of coronavirus disease 2019 (COVID-19) has serious implications on urology practice and raises particular questions for urologists about the management of different conditions. It was recommended to cancel most of the elective urological surgeries. Urological cancers surgeries that should be prioritized are radical cystectomy for selective tumors, orchiectomy for suspected testicular tumors, nephrectomy for c T3 + , nephroureterectomy for high-grade disease, and radical adrenalectomy for tumors >6 cm or adrenal carcinoma. Most prostatectomies can be delayed without compromising the survival rate of patients. Urological emergencies should be treated adequately even during this pandemic. There is a potential risk of coronavirus diffusion during minimally invasive procedures performed. It is crucial to use specific precautions when urologists performed those type of surgeries. It was also recommended to suspend the kidney transplantation program during the COVID-19 pandemic except for specific cases. In this review, we discussed the triage of urological surgeries, the risk of minimally invasive urological procedure, the kidney transplantation challenges, the systemic therapies, intravesical instillation of Bacillus Calmette-Guérin (BCG), endourology, teleconferencing, and telemedicine application in urology during the COVID-19 pandemic.

scholarly journals The Impact of Perioperative Factors on Changes in Diastolic Function after Kidney Transplantation: A Retrospective Analysis

2019 ◽  
Vol 60 (3) ◽  
pp. 291
Author(s):  
Eun Jung Kim ◽  
Bon-Nyeo Koo ◽  
So Yeon Kim ◽  
Kyu Ha Huh ◽  
Soojeong Kang ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Diastolic Function ◽  
Retrospective Analysis ◽  
The Impact

One Hundred Thirty Resections for Pancreatic Neuroendocrine Tumor: Evaluating the Impact of Minimally Invasive and Parenchyma-Sparing Techniques

2010 ◽  
Vol 14 (10) ◽  
pp. 1536-1546 ◽  
Author(s):  
Joseph DiNorcia ◽  
Minna K. Lee ◽  
Patrick L. Reavey ◽  
Jeanine M. Genkinger ◽  
James A. Lee ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Neuroendocrine Tumor ◽  
Pancreatic Neuroendocrine Tumor ◽  
Parenchyma Sparing ◽  
The Impact

792 OUTCOMES AFTER TOTALLY MINIMALLY INVASIVE VERSUS HYBRID OR OPEN IVOR LEWIS ESOPHAGECTOMY: RESULTS FROM THE INTERNATIONAL ESODATA STUDY GROUP.

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Berend Van Der Wilk ◽  
Eliza R C Hagens ◽  
Ben M Eyck ◽  
Suzanne S Gisbertz ◽  
Richard Hillegersberg ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Minimally Invasive ◽  
Anastomotic Leakage ◽  
Hospital Length Of Stay ◽  
Mortality Data ◽  
Study Group ◽  
Ivor Lewis ◽  
Open Esophagectomy ◽  
Ivor Lewis Esophagectomy ◽  
The Impact

Abstract   To compare complications following totally minimally invasive (TMIE), laparoscopically assisted (hybrid) and open Ivor Lewis esophagectomy in patients with esophageal cancer. Three randomized trials have reported benefits for minimally invasive esophagectomy. Two studies compared TMIE versus open esophagectomy and another compared hybrid versus open Ivor Lewis esophagectomy. Only small retrospective studies compared TMIE with hybrid Ivor Lewis esophagectomy. Methods Data were used from the International Esodata Study Group assessing patients undergoing TMIE, hybrid or open Ivor Lewis esophagectomy. Primary outcome was pneumonia, secondary outcomes included incidence and severity of anastomotic leakage, (major) complications, length of stay, escalation of care and 90-day mortality. Data were analyzed using multivariate multilevel models. Results In total, 4733 patients were included in this study (TMIE:1472, hybrid:1364 and open:1897). Patients undergoing TMIE had lower incidence of pneumonia compared to hybrid (10.9% vs 16.3%, Odds Ratio (OR):0.56, 95%CI: 0.40–0.80) and open esophagectomy (10.9% vs 17.4%, OR:0.60, 95%CI: 0.42–0.84) and had shorter length of stay (median 10 days (IQR 8–16)) compared to hybrid (14 (11–19), p = 0.041) and open esophagectomy (11 (9–16), p = 0.027). Patients undergoing TMIE had higher rate of anastomotic leakage compared to hybrid (15.1% vs 10.7%, OR:1.47, 95%CI: 1.01–2.13) and open esophagectomy (7.3%, OR:1.73, 95%CI: 1.26–2.38). No differences were reported between hybrid and open esophagectomy. Conclusion Compared to hybrid and open Ivor Lewis esophagectomy, TMIE resulted in a lower pneumonia rate, a shorter hospital length of stay but a higher anastomotic leakage rate. The impact of these individual complications on survival and long-term quality of life should be further investigated.

13 Impact of Catheter Choice on Procedural Success of Minimally Invasive Surfactant Therapy

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e8-e9
Author(s):  
Soume Bhattacharya ◽  
Brooke Read ◽  
Michael Miller ◽  
Orlando daSilva
Keyword(s):  
Adverse Effects ◽  
Minimally Invasive ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Surfactant Therapy ◽  
P Value ◽  
Perinatal Medicine ◽  
Procedural Success ◽  
Multi Access ◽  
The Impact

Abstract Primary Subject area Neonatal-Perinatal Medicine Background Surfactant delivery via a thin endotracheal catheter during spontaneous breathing, a technique called minimally invasive surfactant therapy (MIST), is an alternative to intubation and surfactant administration. Procedural details among different centres vary, with marked differences in the choice of catheter to instill surfactant. Studies report use of feeding catheters, multi-access catheters, vascular catheters and, recently, custom-designed catheters for this purpose. The impact of choice of catheter on procedural success and adverse effects has not been reported. Objectives The objective of the present study was to compare the procedural success and adverse effects of MIST, using a semi-rigid vascular catheter (16G Angiocath-Hobart Method) versus a flexible multi-access catheter (MAC). Design/Methods This was a retrospective review of prospectively collected data at a tertiary care neonatal intensive care unit in southwestern Ontario. All neonates who received surfactant via MIST between May 1, 2016 and September 30, 2020 were included in the study. Relevant baseline characteristics, data on procedural details (premedication, type of catheter) were collected. The procedural success, number of attempts, and adverse effects between neonates who received MIST via MAC and 16G Angiocath were compared using a Chi Square test or Fisher’s test, as appropriate. A P value of less than 0.05 was considered significant. Results A total of 139 neonates received surfactant via MIST method during the study period. 93 neonates received the surfactant via MAC, while 46 received it via Angiocath. The baseline demographic characteristics in the two groups were similar (Table 1). A higher proportion of neonates in the Angiocath group received atropine (100% vs. 76%, P =.002] and fentanyl (98% vs. 36%; p<0.001) than the MAC group. The procedural success was 91% in the Angiocath group and 89% in the MAC group (p >.99). Multiple attempts were needed in 24% of neonates in the Angiocath group, and 37% in the MAC group (p=0.158). More episodes of desaturations were noted in the Angiocath group (89%) than the MAC group (69%) (P=0.012). Other rates of common adverse effects were similar between the two groups (Table 2). Conclusion The overall procedural success of MIST was similar in both catheter groups. The proportion of neonates requiring multiple attempts was lower with Angiocath use, though this difference was not statistically significant. Desaturation episodes were seen more frequently in the Angiocath group, possibly related to higher use of procedural sedation in this group.

Pregnancy After Simultaneous Pancreas-Kidney Transplantation in Treatment of End-Stage Diabetes Mellitus: a Review

2021 ◽  
Author(s):  
Zana Stanic ◽  
Marko Vulic ◽  
Zlatko Hrgovic ◽  
Rajko Fureš ◽  
Milvija Plazibat ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Kidney Transplantation ◽  
Graft Function ◽  
Insulin Dependent Diabetes Mellitus ◽  
Organ Damage ◽  
Multiple Organ ◽  
Dependent Diabetes Mellitus ◽  
Increased Risk ◽  
Simultaneous Pancreas Kidney ◽  
The Impact

AbstractThe majority of patients with simultaneous pancreas and kidney transplant (SPKT) required transplantation owing to a long-standing history of insulin-dependent diabetes mellitus (IDDM). The disease causes multiple organ damage, impairs fertility, and affects quality of life. A successful kidney and pancreas transplant can improve health, ameliorate the consequences of pre-existent diabetes, and restore fertility. Good graft function, without any sign of rejection, and stable doses of immunosuppressant drugs are of utmost importance prior to the planned pregnancy. SPKT recipients who become pregnant may be at an increased risk for an adverse outcome and require meticulous multidisciplinary surveillance. We present experiences with SPKT pregnancies, traditional approaches, and recent considerations. In light of complex interactions between new anatomic relations and the impact of developing pregnancy and immunosuppressive medications, special stress is put on the risk of graft rejection, development of pregnancy complications, and potential harmful effects on fetal development. Recent recommendations in management of SPKT recipients who wish to commence pregnancy are presented as well. Key words: transplantation, pregnancy, pancreas, kidney, simultaneous pancreas and kidney transplantation (SPKT)

scholarly journals The impact of surgeon-based ultrasonography for parathyroid disease on a British endocrine surgical practice

2012 ◽  
Vol 94 (1) ◽  
pp. 17-23 ◽  
Author(s):  
SR Aspinall ◽  
S Nicholson ◽  
RD Bliss ◽  
TWJ Lennard
Keyword(s):  
Minimally Invasive Surgery ◽  
Primary Hyperparathyroidism ◽  
Minimally Invasive ◽  
Negative Predictive Value ◽  
Invasive Surgery ◽  
Predictive Value ◽  
Surgical Practice ◽  
Parathyroid Disease ◽  
Operative Findings ◽  
The Impact

INTRODUCTION Surgeon-based ultrasonography (SUS) for parathyroid disease has not been widely adopted by British endocrine surgeons despite reports worldwide of accuracy in parathyroid localisation equivalent or superior to radiology-based ultrasonography (RUS). The aim of this study was to determine whether SUS might benefit parathyroid surgical practice in a British endocrine unit. METHODS Following an audit to establish the accuracy of RUS and technetium sestamibi (MIBI) in 54 patients, the accuracy of parathyroid localisation by SUS and RUS was compared prospectively with operative findings in 65 patients undergoing surgery for primary hyperparathyroidism (pHPT). RESULTS The sensitivity of RUS (40%) was below and MIBI (57%) was within the range of published results in the audit phase. The sensitivity (64%), negative predictive value (86%) and accuracy (86%) of SUS were significantly greater than RUS (37%, 77% and 78% respectively). SUS significantly increased the concordance of parathyroid localisation with MIBI (58% versus 32% with RUS). CONCLUSIONS SUS improves parathyroid localisation in a British endocrine surgical practice. It is a useful adjunct to parathyroid practice, particularly in centres without a dedicated parathyroid radiologist, and enables more patients with pHPT to benefit from minimally invasive surgery.

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