scholarly journals Laparoscopic cystectomy with lymphadenectomy and ileoconduitis creation: А case report

2021 ◽  
Vol 61 (3) ◽  
pp. 31-34
Author(s):  
T. A. Kurmanov ◽  
A. K. Digay ◽  
Sh. V. Mugalbekov ◽  
Zh. D. Zhumagazin ◽  
A. K. Mukazhanov ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Minimally Invasive ◽  
Radical Cystectomy ◽  
Open Surgery ◽  
Locally Advanced ◽  
Surgical Interventions ◽  
Quick Recovery ◽  
Minimally Invasive Surgical ◽  
Laparoscopic Cystectomy ◽  
The Creation

Relevance: Radical cystectomy remains the «gold standard» of muscle-invasive and locally advanced bladder cancer treatment. The article describes the capacity and technique of laparoscopic cystoprostatectomy with lymphadenectomy and the creation of ileoconduitis in bladder cancer since the authors could not find publications on conducting laparoscopic cystoprostatectomy with the creation of an ileoconduitis in oncological and urological clinics in Kazakhstan by domestic specialists. The purpose was to describe an attempt to reproduce the method of open radical cystectomy laparoscopically as accurately as possible. Results: In the described case, the patient diagnosed with bladder cancer T2N0M0 IIst underwent surgery in the form of laparoscopic cystectomy with lymphadenectomy and the creation of ileoconduitis. This method of surgical intervention is minimally invasive, less traumatic, and ensures quick recovery in the postoperative period. Conclusion: Laparoscopic execution of radical cystectomy allows preserving the advantages of minimally invasive interventions without losing the reliability of the well-proven open surgery. Currently, the implementation of such minimally invasive surgical interventions is possible in many clinics in Kazakhstan, equipped with endoscopic video equipment, if there are specialists experienced in open surgery

scholarly journals Laparoscopic cystectomy with lymphadenectomy and ileoconduitis creation: А case report

2021 ◽  
Vol 61 (3) ◽  
pp. 31-34
Author(s):  
T. A. Kurmanov ◽  
A. K. Digay ◽  
Sh. B. Mugalbekov ◽  
Zh. D. Zhumagazin ◽  
A. K. Mukazhanov ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Minimally Invasive ◽  
Radical Cystectomy ◽  
Locally Advanced ◽  
Surgical Interventions ◽  
Quick Recovery ◽  
Minimally Invasive Surgical ◽  
Laparoscopic Cystectomy ◽  
The Creation ◽  
Open Radical Cystectomy

Relevance: Radical cystectomy remains the “gold standard” of treatment for muscle-invasive and locally advanced bladder cancer. The article describes the capacity and technique of laparoscopic cystoprostatectomy with lymphadenectomy and the creation of an ileoconduitis in bladder cancer, since the authors could not find publications on conducting laparoscopic cystoprostatectomy with the creation of an ileoconduitis in oncological and urological clinics in Kazakhstan by domestic specialists. The purpose was to describe an attempt to reproduce laparoscopically the method of open radical cystectomy as accurately as possible. Results: In the described case, the patient diagnosed with the bladder cancer T2N0M0 IIst underwent surgery in the form of laparoscopic cystectomy with lymphadenectomy and the creation of an ileoconduitis. This method of surgical intervention is minimally invasive, less traumatic, and ensures quick recovery in the postoperative period. Conclusion: Laparoscopic execution of radical cystectomy allows preserving the advantages of minimally invasive interventions without losing the reliability of the well-proven open surgery. Currently, the implementation of such minimally invasive surgical interventions is possible in many clinics in Kazakhstan, equipped with endoscopic video equipment, if there are specialists experienced in open surgery.

Combination of AST to ALT and neutrophils to lymphocytes ratios as predictors of locally advanced disease in patients with bladder cancer subjected to radical cystectomy: Results from a single-institutional series

2021 ◽  
pp. 039156032110351
Author(s):  
Alessandro Uleri ◽  
Rodolfo Hurle ◽  
Roberto Contieri ◽  
Pietro Diana ◽  
Nicolòmaria Buffi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Advanced Disease ◽  
Independent Predictor ◽  
Small Sample Size ◽  
Statistical Significance ◽  
Locally Advanced ◽  
Small Sample ◽  
Locally Advanced Disease ◽  
Increased Risk

Background: Bladder cancer (BC) staging is challenging. There is an important need for available and affordable predictors to assess, in combination with imaging, the presence of locally-advanced disease. Objective: To determine the role of the De Ritis ratio (DRR) and neutrophils to lymphocytes ratio (NLR) in the prediction of locally-advanced disease defined as the presence of extravescical extension (pT ⩾ 3) and/or lymph node metastases (LNM) in patients with BC treated with radical cystectomy (RC). Methods: We retrospectively analyzed clinical and pathological data of 139 consecutive patients who underwent RC at our institution. Logistic regression models (LRMs) were fitted to test the above-mentioned outcomes. Results: A total of 139 consecutive patients underwent RC at our institution. Eighty-six (61.9%) patients had a locally-advanced disease. NLR (2.53 and 3.07; p = 0.005) and DRR (1 and 1.17; p = 0.01) were significantly higher in patients with locally-advanced disease as compared to organ-confined disease. In multivariable LRMs, an increasing DRR was an independent predictor of locally-advanced disease (OR = 3.91; 95% CI: 1.282–11.916; p = 0.017). Similarly, an increasing NLR was independently related to presence of locally-advanced disease (OR = 1.28; 95% CI: 1.027–1.591; p = 0.028). In univariate LRMs, patients with DRR > 1.21 had a higher risk of locally advanced disease (OR = 2.83; 95% CI: 1.312–6.128; p = 0.008). Similarly, in patients with NLR > 3.47 there was an increased risk of locally advanced disease (OR = 3.02; 95% CI: 1.374–6.651; p = 0.006). In multivariable LRMs, a DRR > 1.21 was an independent predictor of locally advanced disease (OR = 2.66; 95% CI: 1.12–6.35; p = 0.027). Similarly, an NLR > 3.47 was independently related to presence of locally advanced disease (OR = 2.24; 95% CI: 0.95–5.25; p = 0.065). No other covariates such as gender, BMI, neoadjuvant chemotherapy or diabetes reached statistical significance. The AUC of the multivariate LRM to assess the risk of locally advanced disease was 0.707 (95% CI: 0.623–0.795). Limitations include the retrospective nature of the study and the relatively small sample size.

scholarly journals Preliminary Results of Robotic Lobectomy in Stage IIIA-N2 NSCLC after Induction Treatment: A Case Control Study

2021 ◽  
Vol 10 (16) ◽  
pp. 3465
Author(s):  
Monica Casiraghi ◽  
Francesco Petrella ◽  
Giulia Sedda ◽  
Antonio Mazzella ◽  
Juliana Guarize ◽  
...  
Keyword(s):  
Lymph Node ◽  
Minimally Invasive ◽  
Open Surgery ◽  
Case Control Study ◽  
Locally Advanced ◽  
Case Control ◽  
Induction Treatment ◽  
Stage Iiia ◽  
Robot Assisted ◽  
Control Study

Despite there already being many studies on robotic surgery as a minimally invasive approach for non-small-cell lung cancer (NSCLC) patients, the use of this technique for stage III disease is still poorly described. These are the preliminary results of our prospective study on the safety and effectiveness of robotic approaches in patients with locally advanced NSCLC in terms of postoperative complications and oncological outcomes. Since 2016, we prospectively investigated 19 consecutive patients with NSCLC stage IIIA-pN2 (diagnosed by EBUS-TBNA) who underwent lobectomy and radical lymph node dissection with robotic approaches after induction treatment. Furthermore, we matched a case-control study with 46 patients treated with open surgery during the same period of time, with similar age, comorbidities, clinical stage and tumor size. The individual matched population was composed of 16 robot-assisted thoracic surgeries and 16 patients who underwent open surgery. The median time range of resection was inferior in the open group compared to robotic lobectomy (243 vs. 161 min; p < 0.001). Lymph node resection and positivity were not significantly different (p = 0.96 and p = 0.57, respectively). Moreover, no difference was observed for PFS (p = 0.16) or OS (p = 0.41). In conclusion, we demonstrated that the early outcomes and oncological results of N2-patients after robotic lobectomy were similar to those who had open surgery. Considering the advantages of minimally invasive surgery, robot-assisted lobectomy appears to be a safe approach to patients with locally advanced diseases.

scholarly journals Pathophysiological aspects as the object of the treatment tactics in acute pancreatitis (review)

2021 ◽  
Vol 8 (2) ◽  
pp. 87-94
Author(s):  
Igor Kryvoruchko ◽  
Anastasiya Drozdova ◽  
Nataliya Goncharova
Keyword(s):  
Acute Pancreatitis ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Surgical Trauma ◽  
Fast Track Surgery ◽  
Surgical Interventions ◽  
Minimally Invasive Surgical ◽  
Treatment Measures ◽  
Mechanisms Of Development ◽  
Adequate Management

The review presents a modern view on the features of the course and treatment of acute pancreatitis, based on a cascade of pathophysiological mechanisms of this disease. A number of concepts of development and course of acute pancreatitis on the basis of randomized prospective and retrospective researches devoted to this problem are considered. Attention is paid to the mechanisms of development of organ failure in acute pancreatitis. In accordance with the above, the main positions of treatment measures for acute pancreatitis, which are based on the principles of tactics "step-up approach" were highlighted. Among them, attention is focused on the features of the conservative treatment program, minimally invasive surgical interventions, as well as the management of the postoperative period of patients. Minimally invasive surgical interventions perform the main tasks of surgical treatment in acute pancreatitis, but significantly reduce surgical trauma compared to "open" methods. Adequate management of the postoperative period of patients is carried out through the implementation of protocols "fast-track surgery".

Disease Progression in Bladder Cancer: Which Developments since 1994

2009 ◽  
Vol 76 (2) ◽  
pp. 115-117
Author(s):  
V. Varca ◽  
A. Simonato ◽  
P. Traverso ◽  
A. Romagnoli ◽  
F. Venzano ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bladder Cancer ◽  
Lymph Node ◽  
Radical Prostatectomy ◽  
Lymph Nodes ◽  
Radical Cystectomy ◽  
Public Awareness ◽  
Locally Advanced ◽  
Node Dissection ◽  
Group 2

Objectives The introduction of PSA in clinical practice has resulted in decreasing the death rate form prostate cancer and in a downward shift of the pathological stage in radical prostatectomy specimens. This seems not to be the case for bladder cancer. In order to verify this assumption, we have reviewed the charts of the patients operated on of radical prostatectomy and radical cystectomy between 1994 and 2006. Methods 456 and 491 consecutive patients, respectively, underwent radical cystectomy and radical prostatectomy with bilateral lymph nodes dissection. We excluded all the patients who had received neoadjuvant treatment or did not undergo node dissection. The patients were divided into two consecutive groups according to the year of treatment: group 1 included pts treated from 1994 to 2000, and group 2 pts from 2001 to 2006. The histopathological findings of the two groups of pts were compared. The difference among TNM systems has been balanced evaluating histopathological reports critically and converting them to the 2002 edition. Results For patients with prostate cancer, those in group 2 had a decrease in the incidence of extracapsular extension and lymph nodes invasion. The bladder cancer patients belonging to group 2 had a greater number of T2, but there was an increased number of pN+ in this group. Conclusions Even if there is a decline in locally advanced disease in patients with bladder cancer, our retrospective analysis did not show a comparable success in early diagnosis as it did for prostate cancer. There is undoubtedly an increase in the lymph node dissemination, whether this is due to a more extended lymph node dissection or to a premature dissemination remains questionable. Public awareness regarding bladder cancer and its risk factors is limited, but several studies have reported that a delay in diagnosis of invasive bladder cancer is an adverse prognostic factor. A higher care in the development of new diagnostic markers for bladder tumors and especially in the screening protocols together with an earlier radical therapy could hopefully improve the management of such a pathology, as it happened for prostate cancer.

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