scholarly journals Percutaneous endoscopic treatment of benign and malignant renal pelvis carcinoma: A single-center experience

2020 ◽  
Author(s):  
Xin Zhang ◽  
Wu Xiu Han ◽  
Sheng Yan Li ◽  
Hao Yuan Chen ◽  
Zhe Yu Tang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Renal Pelvis ◽  
Operation Time ◽  
Laser Evaporation ◽  
Pathological Grade ◽  
Group I ◽  
Grade Ii ◽  
The Mean ◽  
Group Ii

Abstract Background Percutaneous nephrolithotomy (PCNL) is a safe and efficient treatment for intro-renal diseases, most of which are calculus disease. In this study, we carried out percutaneous endoscopic nephron-sparing ablation for renal carcinoma in carefully selected patients. Our aim was to evaluate whether percutaneous endoscopic nephron-sparing operation was feasible for patients with renal cell carcinoma.Methods A total of 15 patients with renal pelvis carcinoma were treated with laser evaporation under percutaneous endoscopy between January 2015 and September 2019 ( group I ). Another 13 patients who received standard radical nephroureterectomy were recruited as the control group (group II). We recorded demographic data of the patients, the indication for surgery, tumor pathological grade, size and side of tumor, and the intraoperative and postoperative outcome, including the duration of surgery, length of hospital stay, and complication rate, as well as progression-free survival (PFS).Results In both groups, all of the patients received flexible ureteroscopy. In group I, 14 patients had transitional renal cell carcinoma (UCC), four had pathological grade I, nine had grade II, and one had hemangiopericytoma. In group II, all patients had UCC, five had pathological grade I, and eight had grade II. In group I, the mean operation time was 118 min (65–236 min), the mean blood loss was 110 ml (55–220 ml), and the mean hospital stay was 9 days (7–12 days). During follow-up, two patients died and two had recurrence; among them, one had systematic bone metastasis. The PFS rate was 66.7% (10/15). In group II, the mean operation time was 265 min (185–436 min), the mean blood loss was 133 ml (85–240 ml), and the mean hospital stay was 13 days (9–16 days). During the follow-up, two patients died and there was no local or systematic metastasis. The PFS rate was 84.6% (11/13). There was no significant difference in blood loss between the groups. However, the operation time and mean hospital stay were significantly shorter in group I compared with that in group II ( P < 0.05). But the PFS rate was significantly higher in group II than in group I (P < 0.05).Conclusions This study shows that laser evaporation under percutaneous endoscopy for renal pelvis carcinoma is a safe, effective, and technically feasible procedure for treating benign and malignant renal pelvis carcinoma.

Preoperative Angiography and Transarterial Embolization in the Management of Carotid Body Tumor: A Single-Center, 10-Year Experience

Neurosurgery ◽  
2010 ◽  
Vol 67 (4) ◽  
pp. 941-948 ◽  
Author(s):  
Jiaping Li ◽  
Shenming Wang ◽  
Chishing Zee ◽  
Jianyong Yang ◽  
Wei Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Carotid Body ◽  
Operation Time ◽  
Class Ii ◽  
Preoperative Embolization ◽  
Intraoperative Blood Loss ◽  
Class Iii ◽  
Group I ◽  
Group Ii

Abstract BACKGROUND: Sixty percent of paragangliomas are located unilaterally at the carotid bifurcation. These are referred to as carotid body tumors (CBTs). OBJECTIVE: To present our 10-year experience in the management of patients with CBTs, and to evaluate the efficacy of angiography and preoperative embolization technique in this retrospective study. METHODS: Sixty-two patients with surgically removed CBTs (Shamblin class II and III), were divided into two groups. Group I, the preoperative embolization group, included 33 patients with 11 class II lesions and 25 class III lesions. Group II, the group that had surgery only, without preoperative embolization, included 29 patients with 9 class II lesions and 21 class III lesions. Comparisons were made between the groups in terms of mean intraoperative blood loss, mean operation time, mean postoperative hospital stay, and clinical complications. RESULTS: In group I, post-embolization angiography demonstrated complete tumor devascularization in 25 (76%) lesions and partial devascularization in 11 (24%) lesions. All but 1 (2%) lesion were completely excised. Mean intraoperative blood loss, mean operation time, and mean hospital stay were 354.8 ± 334.4 mL, 170.3 ± 75.4 min, 8.0 ± 2.1days in group I and 656.4 ± 497.4 mL, 224.6 ± 114.0 min, 9.5 ± 3.5days in group II, respectively. In group II, 27 lesions (91%) were completely removed. The transient ischemic attack (TIA) and cranial nerve injury incidence rates were 10.3% and 13.8% in group II and only 3% for TIA in group I. CONCLUSION: These results suggest angiography is highly valuable for the diagnosis of CBT. Preoperative selective embolization of CBT is an effective and safe adjunct for surgical resection, especially for Shamblin class II and III tumors.

scholarly journals Endoscopic, Single-Session Management of Encrusted, Forgotten Ureteral Stents

Medicina ◽  
2019 ◽  
Vol 55 (3) ◽  
pp. 58 ◽  
Author(s):  
Volkan Ulker ◽  
Orcun Celik
Keyword(s):  
Hospital Stay ◽  
Treatment Options ◽  
Operating Time ◽  
Operation Time ◽  
Ureteral Stents ◽  
Single Session ◽  
Extracorporeal Shock Wave ◽  
Clavien Grade ◽  
Grade Ii ◽  
The Mean

Background and Objectives: Remained or forgotten ureteral double-J stents may cause serious complications. Removing of an encrusted, forgotten stent can be challenging. We present our experience with heavily encrusted ureteral stents and discuss the endourologic treatment options as well as their effectivity. Materials and Methods: Eleven men and six women (mean 48.58 ± 14.48 years of age) with 18 encrusted forgotten stents (mean 16.4 ± 13.25 months of indwelling) were treated at our clinic. All patients underwent the operation after negative urine cultures were obtained. Their medical records were retrospectively reviewed and analyzed in terms of number of interventions required to remove the stent, operation time, complications, hospital stay and stone-free rate. Results: According to the Forgotten-Encrusted-Calcified (FECal) classification, the most common form of stent encrustation was grade III (64.7%) and 17.6% of the stents were fragmented. Four of 17 patients were initially treated with extracorporeal shock-wave lithotripsy. The patients required a mean of two endoscopic interventions for removing the encrusted stent and all stents were removed endoscopically in a single session. The mean operating time was 63.3 ± 41.8 minutes. Cystolithotripsy followed by ureteroscopy was the most common intervention (41.1%). Of the 17 patients, peroperative and postoperative complications were Clavien grade I in two, grade II in two and grade IIIb in one. The mean hospital stay was 1.3 ± 0.99 days. All patients were stone-free after a month of stent removal. Conclusions: The endourological removal of the encrusted forgotten stents in a single session is feasible and effective with a minimal morbidity. The treatment strategy should be to minimize the number of interventions.

scholarly journals Laennec’s approach for laparoscopic anatomical hemihepatectomy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Wei Hu ◽  
Gongming Zhang ◽  
Meng Chen ◽  
Chengcheng Zhong ◽  
Mingxu Li ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Primary Liver Cancer ◽  
Surgical Techniques ◽  
Operation Time ◽  
Bile Leakage ◽  
Hepatic Veins ◽  
Hepatic Hemangioma ◽  
Conversion To Open Surgery ◽  
The Mean

Abstract Background Laennec’s capsule has been found for about 200 years. However, laparoscopic anatomical right and left hemihepatectomy (LARH and LALH) using Laennec’s approach are rarely reported. Methods We retrospectively analyzed the technical details and the surgical outcomes of 15 patients who underwent LAH via Laennec’s approach between May 2017 and July 2020. The operation time, intraoperative blood loss, postoperative complications, and hospital stay were recorded and analyzed. Results Four of 15 patients were diagnosed with hepatic hemangioma, 2 had hepatolithiasis, and 9 patients had primary liver cancer. During the surgery, Laennec’s approach was used for LAH without conversion to open surgery. Four patients were treated with LARH, and 11 patients were cured with LALH. The mean age of the patients was 62.1 ± 6.5 years, and four were male. The mean operative time, blood loss, and length of the postoperative hospital stay were 193 ± 49 min, 247 ± 120 mL, and 8.7 ± 2.0 days, respectively. There was no incidence of postoperative bile leakage and bleeding. No mortality occurred. We also demonstrated that Laennec’s capsule does exist around the peripheral hepatic veins with histological confirmation. Conclusions Laennec’s approach is safe and feasible for LAH. Precise isolation of Laennec’s approach based on Laennec’s capsule helps to standardize the surgical techniques for laparoscopic anatomical hepatectomy.

scholarly journals Comparing endoscopic microdebrider assisted adenoidectomy with curettage procedure

2018 ◽  
Vol 4 (2) ◽  
pp. 559
Author(s):  
C. Ravishakar ◽  
Shambulinga Killera
Keyword(s):  
Blood Loss ◽  
Otitis Media With Effusion ◽  
Randomized Study ◽  
Operating Time ◽  
Waldeyer’S Ring ◽  
Adenoid Tissue ◽  
Group I ◽  
Operative Complications ◽  
The Mean ◽  
Group Ii

<p class="abstract"><strong>Background:</strong> Adenoid is a mass of lymphatic tissue situated posterior to the nasal cavity, in the roof of the nasopharynx, forming a part of the Waldeyer's ring, was initially described in 1868 by Meyer. Adenoidectomy is one of the commonest operations done on children. It is done alone or along with tonsillectomy or with ventilation tube insertion for otitis media with effusion. Objective of the study was to compare the results of endoscopic microdebrider assisted adenoidectomy with that of conventional curettage adenoidectomy.</p><p class="abstract"><strong>Methods:</strong> A prospective randomized study of 60 patients with clinical features of adenoid hypertrophy. These patients were randomly divided into two groups, 30 each using the table of random numbers. Group I, underwent endoscopic microdebrider assisted adenoidectomy and group II underwent adenoidectomy by curettage. All the patients were followed up for a period of 3 months. Parameters such as operating time, blood loss, intra-operative/post-operative complications and residual adenoid tissue were assessed.  </p><p class="abstract"><strong>Results:</strong> In this study mean age of patients in group I (EAA) was 9±0.50 years (range 6–15 years) and group II (CA) was 9.86 ± 2.31 years (range 6-15 years). The mean operating time was 20.79 minutes for the group I (range: 12 to 35 minutes) and 14.42 minutes for group II (range: 10 to 22 minutes, p=0.001). Blood loss was around 31.06 ml (range: 21 to 46 ml) in group I and 22.26 ml (range: 10 to 60 ml) in group II. Adenoidectomy by curette group showed more residual nasopharyngeal adenoid tissue (43.33%) than by endoscopic microdebrider assisted adenoidectomy (20%).</p><p class="abstract"><strong>Conclusions:</strong> Endoscopic microdebrider assisted adenoidectomy is a safe and more effective compared to curettage method, with very minimal chances of injury to the surrounding structures during the procedure.</p>

scholarly journals Outcomes of Open Cystolithotomy and Percutaneous Cystolithotripsy in the Management of Urinary Bladder Stone

2022 ◽  
Vol 19 (1) ◽  
pp. 1-4
Author(s):  
Naresh Man Shrestha
Keyword(s):  
Urinary Bladder ◽  
Hospital Stay ◽  
Operation Time ◽  
Bladder Stone ◽  
Medical College ◽  
Group I ◽  
Stone Free Rate ◽  
Urinary Tract Stone ◽  
Group Ii ◽  
Free Rate

Introduction: Urinary bladder stone occupies only 5% of all urinary tract stone. Various techniques have been used for the management of bladder stone. Open Cystolithotomy is the traditional treatment but a percutaneous approach has been also in practice. Aims: To confirm the best options between open cystolithotomy and percutaneous cystolithotripsy for the treatment of bladder stone. Methods: It is a prospective hospital based study from May 2019 to January 2021 in Nepalgunj Medical College. Total 42 patients with inclusion criteria were divided into two groups.  Group I was allocated to 21 patients who were treated with open cystolithotomy while Group II were allocated to 21 patients who were treated with percutaneous cystolithotripsy. Two groups were compared for stone free rate, mean hospital stay, mean postoperative scar, mean operation time and rate of post-operative complications. Results: The stone free rate in Group I was 100 % and in Group II was 90.47 %. Mean Operation time was in Group I and Group II were 40.09+ 2.48  minutes and 31.38+15.65 days,  respectively with p<0.05. Mean hospital stay was significantly low in Group II (3.71+1.87 days ) when compared to Group I (7.67+ 2.12 days) with p<0.001. Mean scar length of Group I (5.466+2.9 cm) with respect to Group II (1.04+0.09) was significantly long (p<0.01). Rate of complications were not significantly different between two groups (p>0.5). Conclusion: For management of urinary bladder stones sized up to 4 cm, both open cystolithotomy and percutaneous cystolithotripsy are effective, with a low incidence of complications. However, comparing the surgery time, hospital stay, length of scar between two procedures, percutaneous cystolithotripsy procedure is more beneficial for treatment of urinary bladder stone.

Minipercutaneous nephrolithotomy without ureteric catheterization. Comparison with the standard procedure

2021 ◽  
Vol 14 (2) ◽  
pp. 58-63
Author(s):  
I.E. Mamaev ◽  
◽  
K.K. Akhmedov ◽  
K.A. Dolomanov ◽  
G.Sh. Saipulaev ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Standard Procedure ◽  
Operation Time ◽  
Standard Technique ◽  
Medical Personnel ◽  
Complete Elimination ◽  
Ureteral Catheterization ◽  
Group I ◽  
The Mean ◽  
Group Ii

Introduction. Percutaneous nephrolithotomy (PNL) is the method of choice for the treatment of patients with kidney stones larger than 2 cm. Mini-percutaneous nephrolithotomy (mini-PNL) became widespread due to reduction of injury associated with surgical approach. Creation of puncture access to the pelvicalyceal system without ureteral catheterization is also recently described. The main benefits of such technique are reduction of total operative time and the radiation exposure to the patient and medical personnel. The results of using mini-PNL without prior ureteral catheterization remain insufficiently studied, which predetermined the goal of our study. Purpose. Compare the efficacy and duration of mini-PCNL with and without ureteral catheterization. Materials and methods. We analyzed the treatment outcomes of 111 patients with a single kidney stone. Group I included 60 patients who underwent mini-PCNL according to the standard technique. Group II included 51 patients who underwent mini-PCNL without prior catheterization of the ureter. The average stone size was 19.2 0.92 mm and 18.6  0.93 mm in groups I and II, respectively. The puncture of the pyelocaliceal system of the kidney was performed under X-ray control and US guidance using the free-hand technique. Results. In group I, complete elimination of the stone was achieved in 55 (92%) patients and the mean duration of the operation was 108,3 34,85 min (range: 60 to 210). In group II, complete elimination of the stone was achieved in 50 (90%) patients and the mean duration of the operation was 69,7 22 min (range: 25 to 120 min). In all cases, the severity of complications did not exceed grade II according to Clavien classification, and their rate was 6,7% and 5,9% in group I and group II, respectively. Conclusions. According to the results of the study, the compared groups did not differ in their post-operative complication and stone-free rates. Avoidance of routine ureteral catheterization significantly reduces the operation time and hence the anesthetic risk and radiation load.

scholarly journals Impact of Spleen Size on Outcomes in Laparoscopic Splenectomy in Children

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Cetin Ali Karadag ◽  
Basak Erginel ◽  
Ozgur Kuzdan ◽  
Nihat Sever ◽  
Melih Akın ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Laparoscopic Splenectomy ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Time Rate ◽  
Open Procedure ◽  
Group I ◽  
Longitudinal Length ◽  
The Mean ◽  
Group Ii

Background. The aim of our study is to compare the efficacy of laparoscopic splenectomy (LS) between enlarged spleens and normal sized spleens.Methods. From June 2006 to September 2012, 50 patients underwent LS. The patients consisted of 24 girls and 26 boys with the mean age of 8.64 years (1–18). The patients are divided into two groups according to spleen’s longitudinal length on the ultrasonography. Group I consisted of the normal sized spleens; Group II consisted of spleens that are exceeding the upper limit. Groups are compared in terms of number of ports, operative time, rate of conversion to open procedure, and length of hospital stay.Results. The mean number of ports was 3.27 and 3.46, the mean length of the operation was 116.36 min and 132.17 min, rate of conversion to open procedure was 9.09% and 10.25%, and the mean length of hospital stay was 3.36 days and 3.23 days, respectively, in Group I and Group II. Although there is an increase in the number of the ports, the operative time, rate of conversion to open procedure, and the length of hospital stay, the difference was not significant between groups (P>0.05).Conclusion. LS is safe and effective in enlarged spleens as well as normal sized spleens.

scholarly journals Which Criterion for Wound Drain Removal is Better Following Posterior 1-Level or 2-Level Lumbar Fusion With Instrumentation: Time Driven or Output Driven?

2021 ◽  
pp. 219256822110137
Author(s):  
Hang Shi ◽  
Zhi-Hao Huang ◽  
Yong Huang ◽  
Lei Zhu ◽  
Zan-Li Jiang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Lumbar Fusion ◽  
Demographic Characteristics ◽  
Total Blood ◽  
Duration Of Hospital Stay ◽  
Drain Removal ◽  
Group I ◽  
Wound Drain ◽  
Group Ii

Study Design: Case-control study. Objectives: To compare the outcomes of 2 different criteria (time driven and output driven) for wound drain removal and identify which one is better. Methods: 743 patients who underwent posterior lumbar fusion with instrumentation involving 1 or 2 motion segments were enrolled in this study. Based on the different criteria for drain removal, the patients were divided into 2 groups. The drains were discontinued by time driven (postoperative day 2) in group I and output driven (<50 ml per day) in group II. Demographic characteristics, perioperative parameters and clinical outcomes were compared between the 2 groups. Results: The demographic characteristics in both groups were comparable. The postoperative drain output, total blood loss, postoperative timing of ambulation, and postoperative duration of hospital stay in group I were lower than those in group II ( P < 0.001). There was a higher proportion of patients requiring postoperative blood transfusion in group II, but not to a level of statistical significance ( P = 0.054). There was no statistical significant difference in the incidence of surgical site infection (SSI) or symptomatic spinal epidural hematoma (SEH) between the 2 groups ( P > 0.05). Conclusions: This study reveals that there are more benefits of wound drain removal by time driven than that by output driven for patients undergoing posterior 1-level or 2-level lumbar fusion with instrumentation, including less postoperative drain output, less total blood loss, earlier postoperative timing of ambulation and less postoperative duration of hospital stay without increasing the incidence of postoperative SSI or symptomatic SEH.

scholarly journals Laparoscopy versus laparotomy in the treatment of benign ovarian cyst

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Humaira Akram ◽  
Sohail Khurshid Lodhi ◽  
Tabinda Rana
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Ovarian Cyst ◽  
Preoperative Evaluation ◽  
Normal Activity ◽  
Group I ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Laparoscopic Fenestration ◽  
Group Ii

Objective: To compare laparoscopy with laparotomy in the treatment of benign ovarian cyst in women under 40 years of age. Design: Experimental. Place and duration of study: The study was conducted over a period of one and half year from June 2003 to Nov 2004 in Obstetrics & Gynaecology Department, Unit-III, Lady Willingdon Hospital, Lahore. Subjects & Methods: The sixty consecutive patients of benign ovarian cysts who required surgical treatment underwent either Laparoscopy(group I). or laparotomy (group II). The laparoscopic fenestration, aspiration and cystectomies were performed in group I (30 patients). However, ovarian cystectomies, salpingo-oophorectomy and oophorectomy were performed by laparotomy in group II (30 patients). Results: The comparison was done with respect to duration of surgery intra-operative blood loss, time of mobilization, duration of hospital stay and amount of analgesia used, time to return to normal activity. The amount of analgesics used, time of mobilization, duration of hosp ital stay and time to return to normal activity was less (P<0.05) in Laparoscopy as compared to Laparotomy. There was statistically no significant difference in the duration of surgery, blood loss and post operative morbidity (P>0.05). Conclusion: With appropriate preoperative evaluation, laparoscopic surgery is safe and effective in treating benign ovarian cyst in women under 40 years of age where the risk of malignancy is low. It is associated with early mobilization, less use of analgesia, shorter hospital stay.

scholarly journals Outcomes of Percutaneous Nephrolithotripsy With or Without Nephrostomy Tube: A Comparative Study

2020 ◽  
Vol 18 (1) ◽  
pp. 96-99
Author(s):  
Naresh Man Shrestha
Keyword(s):  
Hospital Stay ◽  
Renal Stone ◽  
Standard Procedure ◽  
Operation Time ◽  
P Value ◽  
Nephrostomy Tube ◽  
Group I ◽  
The Mean ◽  
Tubeless Pcnl ◽  
Percutaneous Nephrolithotripsy

Introduction: Percutaneous Nephrolithotripsy (PCNL) is one of the most accepted surgical modality for removal of renal stone. Placement of a nephrostomy tube at the end of PCNL is a standard procedure for PCNL, however many reports have showed the safety and efficacy of tubeless PCNL for the removal of renal stone. Aims: The present study aimed to report the outcomes of PCNL with or without nephrostomy tube. Methods: It is Prospective Hospital Study conducted from June 2017 to April 2020 in the Department of Urology Nepalgunj Medical College. Total 153 patients under inclusion criteria were divided into two groups. Group 1 (75 patients) was allocated to patients who were   being treated under standard PCNL procedure while Group 2 (78 patients) was allocated for patients who were being treated under Tubeless PCNL procedure. The two groups were compared for operation time (minutes), hospital stay (days), post operative dose of analgesic (mg), post operative complications such as, leakage (%), bleeding (%) and infection (%). Data were analyzed from SPSS and p-value less than 0.5 was considered as significant. Results: In Group II the mean hospital stay, analgesic dose and rate of leakage was significantly lesser than Group I (p<0.05) whereas, the mean operation time, rate of infection and bleeding were not significantly different between two groups (p>0.05). Conclusion:  Tubeless PCNL procedure causes more rapid recovery and earlier discharge from the hospital, reduction in postoperative pain and no leakage when compared to standard tubless PCNL.

Sign in / Sign up

Export Citation Format

Share Document