Asian Journal of Urology最新文献

{"title":"Virtual-reality robot-assisted inferior vena cava thrombectomy using virtual vascular endoscopy to identify inferior vena cava invasion","authors":"Qingbo Huang ,&nbsp;Cheng Peng ,&nbsp;Songliang Du ,&nbsp;Xiaohui Ding ,&nbsp;Chenfeng Wang ,&nbsp;Kan Liu ,&nbsp;Jialong Song ,&nbsp;Xinran Chen ,&nbsp;Fei Yan ,&nbsp;Baojun Wang ,&nbsp;Xeng Inn Fam ,&nbsp;David Wei Lee ,&nbsp;Stewart Ping Lee ,&nbsp;Haiyi Wang ,&nbsp;Xu Zhang ,&nbsp;Xin Ma","doi":"10.1016/j.ajur.2024.08.004","DOIUrl":"10.1016/j.ajur.2024.08.004","url":null,"abstract":"<div><h3>Objective</h3><div>Partial or segmental inferior vena cava (IVC) resection is indicated for tumor control in patients with renal tumors invading the IVC. This study aimed to introduce a virtual vascular endoscope to assist surgeons in locating IVC invasion, formulate a surgical plan for robot-assisted IVC thrombectomy (RA-IVCT), and evaluate its potential value.</div></div><div><h3>Methods</h3><div>The reconstruction involves building the construction of deep learning models to predict IVC invasion, which were evaluated via intraoperative findings and pathological analysis. Thirty-six patients with renal tumors and IVC thrombi who underwent RA-IVCT between June 2016 and March 2022 were included in the study. A virtual vascular endoscopy was performed based on preoperative CT findings to identify IVC invasion. Based on the extent of IVC wall invasion and the collateral situation, surgeons could decide whether to perform partial or segmental IVC resection during RA-IVCT.</div></div><div><h3>Results</h3><div>Twenty patients were retrospectively analysed for training in virtual vascular endoscopy (the training cohort), and 16 patients were prospectively analysed to evaluate the accuracy of this technique (the validation cohort). Sixteen patients with IVC invasion underwent cavectomy, whereas six patients underwent partial IVC resection. In the validation cohort, pathological analysis confirmed the exact location of IVC invasion in eight of the nine patients, as indicated by virtual vascular endoscopy. Patients who underwent partial IVC wall resection had less lower extremity edema than those who underwent cavectomy.</div></div><div><h3>Conclusion</h3><div>Our initial experience showed that the virtual vascular endoscopy could assist surgeons in identifying IVC invasion and creating a surgical plan for RA-IVCT.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 375-384"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison between thulium fiber laser enucleation of the prostate and robot-assisted simple prostatectomy in the surgical management of large benign prostatic hyperplasia","authors":"Victor Audige,&nbsp;Davy Benarroche,&nbsp;Louis Lenfant,&nbsp;Christophe Vaessen,&nbsp;Jérôme Parra,&nbsp;Emmanuel Chartier-Kastler,&nbsp;Aurélien Beaugerie,&nbsp;Pierre Mozer,&nbsp;Quentin Dubourg,&nbsp;Margaux Felber,&nbsp;Thomas Seisen,&nbsp;Morgan Roupret,&nbsp;Ugo Pinar","doi":"10.1016/j.ajur.2025.03.016","DOIUrl":"10.1016/j.ajur.2025.03.016","url":null,"abstract":"<div><h3>Objective</h3><div>Thulium fiber laser enucleation of the prostate (ThuFLEP) and robot-assisted simple prostatectomy (RASP) are two options for treating large benign prostatic hyperplasia. The most appropriate technique remains a matter of debate. We evaluated the efficacy and safety of ThuFLEP compared to RASP.</div></div><div><h3>Methods</h3><div>Between January 2020 and December 2023, all patients who underwent either RASP or ThuFLEP for a prostate volume &gt;80 mL were retrospectively included. The surgical procedure choice was left to the surgeon's and patient's discretion. Preoperative patient evaluation included the assessment of functional parameters. The groups were compared.</div></div><div><h3>Results</h3><div>A total of 234 patients were included: 106 (45%) underwent RASP and 128 (55%) underwent ThuFLEP. The mean operative time was shorter in the ThuFLEP group compared to the RASP group (106.4 with standard deviation [SD] 46.1 min <em>vs.</em> 123.2 [SD 32.8] min, <em>p</em>=0.012). The mean lengths of catheterization and stay were significantly longer in the RASP group (5.0 [SD 3.9] days <em>vs.</em> 1.7 [SD 2.0] days, <em>p</em>=0.009 [catheterization] and 4.9 [SD 3.0] days <em>vs.</em> 1.9 [SD 1.8] days, <em>p</em>=0.009 [stay]). The overall complication rate was significantly higher in the ThuFLEP group (12% <em>vs.</em> 2.8% in the RASP group, <em>p</em>=0.022). However, we did not observe significant differences in major complications (Clavien-Dindo ≥3) between the two groups (four [3.1%] in the ThuFLEP group <em>vs.</em> one [0.94%] in the RASP group, <em>p</em>=0.073). At 3 months, the rate of stress urinary incontinence was 4.7% after ThuFLEP and 1.9% after RASP (<em>p</em>=0.2). Finally, the quality of life score and maximum urinary flow were comparable between the ThuFLEP and RASP groups, but the International Prostate Symptom Score at 3 months postoperatively was lower in the RASP group (<em>p</em>=0.012).</div></div><div><h3>Conclusion</h3><div>Both ThuFLEP and RASP are safe techniques with comparable functional outcomes for large benign prostatic hyperplasia. ThuFLEP allows a reduction in catheterization and hospitalization durations but presents more complications compared to RASP.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 320-326"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk analysis of adverse pathological changes in cT2cN0M0 prostate cancer after robot-assisted radical prostatectomy: Results from a population-based study","authors":"Jianhui Qiu ,&nbsp;Ruiyi Deng ,&nbsp;Jiaheng Shang ,&nbsp;Zihou Zhao ,&nbsp;Jingcheng Zhou ,&nbsp;Lin Cai ,&nbsp;Kan Gong ,&nbsp;Yi Liu","doi":"10.1016/j.ajur.2024.09.005","DOIUrl":"10.1016/j.ajur.2024.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>To explore clinicopathological predictors of adverse pathological changes (APCs) (upgrading, upstaging, and positive surgical margin [PSM]) after robot-assisted radical prostatectomy (RARP) in clinical tumor stage 2c (cT2c) prostate cancer (PCa) patients.</div></div><div><h3>Methods</h3><div>From January 2018 to December 2022, cT2cN0M0 PCa patients who underwent prostate biopsies and subsequent RARP at the Peking University First Hospital with an interval between biopsy and RARP of ≤90 days were included. Univariable and stepwise multivariable logistic regression analyses were performed to identify independent risk factors associated with APCs. Nomograms were constructed based on these predictive models. The performance of the nomograms was evaluated by receiver operating characteristic curves, decision curve analyses, and calibration plots.</div></div><div><h3>Results</h3><div>A total of 423 eligible cT2cN0M0 PCa patients were included. The rates of upgrading, upstaging, and PSM in our cohort were 33%, 51%, and 35%, respectively. The stepwise multivariate logistic analysis suggested that PSA density and the percentage of positive cores in systematic biopsy were significantly associated with the occurrence of APCs. The score of the Prostate Imaging Reporting and Data System, PSA density, and the International Society of Urological Pathology grade group (IGG) of needle-biopsy specimens (or clinical IGG [cIGG]) were significantly associated with upgrading. The PSA density, percentage of positive cores in systematic biopsy, and largest tumor percentage in all cores of each patient (LTP) were significantly associated with upstaging. The PSA density and LTP were significantly associated with the PSM. Based on these results, four nomograms were developed. Receiver operating characteristic curves, decision curve analyses, and calibration plots implied that the nomograms exhibited excellent accuracy.</div></div><div><h3>Conclusion</h3><div>The predictive models we developed could help to identify high-risk PCa early, and optimize clinical decisions of cT2cN0M0 PCa patients.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 338-349"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing postoperative functional recovery: Impact of the MAIA™ telerehabilitation platform in robot-assisted radical prostatectomy patients","authors":"Daniele Amparore ,&nbsp;Sabrina De Cillis ,&nbsp;Michele Sica ,&nbsp;Federico Piramide ,&nbsp;Enrico Checcucci ,&nbsp;Alberto Piana ,&nbsp;Alberto Quara ,&nbsp;Edoardo Cisero ,&nbsp;Federica Pini ,&nbsp;Cecilia Gatti ,&nbsp;Matteo Manfredi ,&nbsp;Cristian Fiori ,&nbsp;Francesco Porpiglia","doi":"10.1016/j.ajur.2024.07.005","DOIUrl":"10.1016/j.ajur.2024.07.005","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and user satisfaction of the MAIA™ telemedicine platform for postoperative telemonitoring and telerehabilitation in patients undergoing robot-assisted radical prostatectomy (RARP).</div></div><div><h3>Methods</h3><div>Patients undergoing RARP (from April 2022 to January 2023) were divided into Group A, following the standard rehabilitation protocol, and Group B using the MAIA™ platform for the first 30-day post-intervention period. Perioperative, pathological, and functional variables (continence and potency rates, assessed via validated questionnaires) were collected and telerehabilitation protocol's adherence was monitored. The telerehabilitation system included an online platform for medical providers and a patient application, facilitating data acquisition, management, treatment planning, and monitoring. Patient and provider satisfaction were evaluated using the visual analogue scale score and validated telemedicine satisfaction questionnaire.</div></div><div><h3>Results</h3><div>Totally, 227 patients were enrolled. No differences in perioperative or pathological variables were found. Group B had higher potency recovery rates than Group A (<em>p</em>=0.031); the potency recovery rates at 1 month and 3 months for Group B were 45% and 57%, respectively, and in Group A were 34% and 48%, respectively. At the multivariate analysis, MAIA™ use and the nerve-sparing (NS) were independent predictors of erectile function at both 1 month (MAIA™ use: odd ratio [OR] 2.03, 95% confidence interval [CI] 1.13–3.63, <em>p</em>=0.018; NS: OR 2.08, 95% CI 1.06–4.12, <em>p</em>=0.034) and 3 months (MAIA™ use: OR 1.89, 95% CI 1.07–3.34, <em>p</em>=0.028; NS: OR 1.90; 95% CI 1.02–3.54, <em>p</em>=0.044). Adherence monitoring revealed 4.6% of patients in Group B reported exercise issues due to pelvic pain onset and 10% did not take oral phosphodiesterase 5-inhibitors due to myalgia. All those patients restarted the rehabilitation program after televisit to address the causing problem, allowing restarting of a rehabilitation program. Patients reported high satisfaction with the MAIA™ platform use (mean visual analogue scale score: 88.7).</div></div><div><h3>Conclusion</h3><div>The MAIA™ telemedicine platform seems to have a role in optimizing early potency recovery after RARP. Patient and provider satisfaction levels were high, emphasizing the user-friendliness of the platform.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 366-374"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Aboutaleb H, Sultan M, Zaghloul A, Farahat Y, Gawish M, Zanaty F. Is fluoroscopy-free single-use flexible ureteroscopy a feasible treatment for kidney stones with abnormal renal anatomy? Asian J Urol 2024;11:591–5. Fluoroscopic-free procedures: Is this the future of endourology?","authors":"Guglielmo Mantica,&nbsp;Alessandro Calarco","doi":"10.1016/j.ajur.2025.03.014","DOIUrl":"10.1016/j.ajur.2025.03.014","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 417-418"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation exposure in flexible ureteroscopy with a flexible and navigable suction ureteral access sheath: A European Association of Urology–Endourology multicenter study","authors":"Vineet Gauhar ,&nbsp;Olivier Traxer ,&nbsp;Thomas R.W. Herrmann ,&nbsp;Daniele Castellani ,&nbsp;Hatem Kamkoum ,&nbsp;Wissam Kamal ,&nbsp;Tzevat Tefik ,&nbsp;Heng Chin Tiong ,&nbsp;Mehmet Ilker Gökce ,&nbsp;Michael Y.C. Wong ,&nbsp;Khi Yung Fong ,&nbsp;Ben Hall Chew ,&nbsp;Manoj Monga ,&nbsp;Vincent de Connick ,&nbsp;Bhaskar Kumar Somani ,&nbsp;Steffi Kar Kei Yuen","doi":"10.1016/j.ajur.2025.01.002","DOIUrl":"10.1016/j.ajur.2025.01.002","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to study the effect of flexible ureteroscopy (FURS) for renal stones using a flexible and navigable suction ureteral access sheath (FANS) on intraoperative radiation dose and time.</div></div><div><h3>Methods</h3><div>This was a multicenter study of adults who underwent FURS with FANS. The correlation analysis was done to identify factors affecting radiation dose and time measured by the C-arm fluoroscopy intraoperatively.</div></div><div><h3>Results</h3><div>We analyzed 110 patients, with a median age of 50 years. Of them, 72% were pre-stented prior to the procedure. The median stone volume was 1503 mm³ and the median operative time was 39 min. The median radiation dose was 7.4 mSv and median radiation time was 0.6 min. Totally, 91% of patients achieved stone-free status (Grade A or B) on the non-contrast CT scan within 30 days postoperatively. There were no cases of postoperative sepsis. Body mass index, stone volume, and total operation time were associated with a higher radiation dose. Procedures performed under general anesthesia had a lower radiation dose and time than those performed under spinal anesthesia. Disposable scopes were associated with higher radiation time than reusable scopes but not dose. A low-power holmium laser had longer radiation time than other laser sources, but only the thulium fiber laser was associated with a significantly lower radiation dose.</div></div><div><h3>Conclusion</h3><div>Our study is the first to highlight the multitude of factors affecting radiation exposure in FURS with FANS. Although not a direct measure of surgeons' actual exposure, it has important implications for the As Low As Reasonably Achievable principle which is commonly used to minimize radiation exposure to patients and operating room staff.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 385-392"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erectile function after laparoscopic versus robotic-assisted radical prostatectomy: A systematic review and meta-analysis","authors":"Ana J. Pina ,&nbsp;Vitor C. Melo ,&nbsp;Vinícius W. Carlos ,&nbsp;Luca S. Tristão ,&nbsp;Clara L. Santos ,&nbsp;Wanderley M. Bernardo ,&nbsp;Aguinaldo C. Nardi","doi":"10.1016/j.ajur.2024.10.002","DOIUrl":"10.1016/j.ajur.2024.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>Prostate cancer is a common malignancy in men over 50 years old, and radical prostatectomy, particularly via laparoscopic and robotic-assisted techniques, significantly impacts quality of life, especially in terms of erectile dysfunction. This systematic review and meta-analysis aimed to evaluate the preservation of erectile function following robotic-assisted and laparoscopic radical prostatectomy, with a separate analysis of randomized clinical trials and non-randomized studies.</div></div><div><h3>Methods</h3><div>This review was carried out using randomized and non-randomized studies involving adult patients diagnosed with localized prostate cancer undergoing radical prostatectomy, according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and registered in PROSPERO. Applicable literature from PubMed, Cochrane, Embase, and the Latin American and Caribbean Health Sciences Literature database was analysed. The bias in randomized clinical trials was assessed using the Cochrane Risk of Bias 2.0 tool, and observational studies were evaluated via the Newcastle-Ottawa Scale. The statistical analysis was performed using Review Manager version 5.4.</div></div><div><h3>Results</h3><div>Our analysis included 13 studies involving 6281 patients. Comparative meta-analysis of non-randomized studies demonstrated that robotic techniques were significantly more effective in preserving erectile function at 3 months (risk difference [RD] 0.05, 95% confidence interval [CI] 0.00–0.11; <em>p</em>=0.040), 6 months (RD 0.10, 95% CI 0.03–0.17; <em>p</em>=0.006), and 12 months postoperatively (RD 0.06, 95% CI 0.02–0.10; <em>p</em>=0.002).</div></div><div><h3>Conclusion</h3><div>Robotic-assisted surgery showed greater preservation of erectile function 3 months, 6 months, and 12 months after radical prostatectomy. However, additional studies with meticulous methodological criteria are necessary for future analysis.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 281-289"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the brain weep? Post-hysterectomy vaginal leak may not always be urine!","authors":"Sajal Gupta,&nbsp;Abheesh Varma Hegde,&nbsp;Geover Joslen Lobo","doi":"10.1016/j.ajur.2025.03.007","DOIUrl":"10.1016/j.ajur.2025.03.007","url":null,"abstract":"","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 3","pages":"Pages 412-413"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145050654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of postoperative infectious complications after partial nephrectomy: Analysis at a referral institution","authors":"Riccardo Bertolo ,&nbsp;Francesco Ditonno ,&nbsp;Alessandro Veccia ,&nbsp;Francesca Montanaro ,&nbsp;Francesco Artoni ,&nbsp;Alberto Baielli ,&nbsp;Michele Boldini ,&nbsp;Davide Brusa ,&nbsp;Sonia Costantino ,&nbsp;Marcella Sibani ,&nbsp;Vincenzo De Marco ,&nbsp;Filippo Migliorini ,&nbsp;Antonio Benito Porcaro ,&nbsp;Riccardo Rizzetto ,&nbsp;Maria Angela Cerruto ,&nbsp;Riccardo Autorino ,&nbsp;Alessandro Antonelli","doi":"10.1016/j.ajur.2024.06.002","DOIUrl":"10.1016/j.ajur.2024.06.002","url":null,"abstract":"<div><h3>Objective</h3><div>Infectious complications after partial nephrectomy (PN) remain a significant concern. We aimed to analyze predictive factors of postoperative infectious complications (PICs) occurring after PN.</div></div><div><h3>Methods</h3><div>Data on patients undergoing PN for renal masses between January 2018 and May 2023 were retrieved from prospectively maintained institutional database and retrospectively analyzed. Patients were stratified into two groups based on the occurrence of PICs during admission for PN. A PIC was defined by clinical and/or imaging findings of an infectious process plus microbial isolation upon culture examination. Multivariable logistic regression analysis after adjusting for potential confounders evaluated predictors of a PIC.</div></div><div><h3>Results</h3><div>Six-hundred and twenty-seven patients underwent PN; rough incidence of PICs was 11%, with median time to PIC onset of 1 (interquartile range 0–3) day. Compared to patients without PIC events, the PIC group showed a significantly higher proportion of open surgeries (54% <em>vs.</em> 20%, <em>p</em>&lt;0.001), bleeding events (23% <em>vs.</em> 10%, <em>p</em>&lt;0.01), postoperative transfusion (19% <em>vs.</em> 5.0%, <em>p</em>&lt;0.001), and urinary leakage (4.2% <em>vs.</em> 0.18%, <em>p</em>=0.01), and a statistically significantly higher median hemoglobin drop from baseline (−2.6 g/dL <em>vs</em>. −1.7 g/dL, <em>p</em>=0.001). At multivariable logistic regression, the odds of experiencing a PIC were statistically significantly lower after minimally-invasive surgery compared to open surgery (odds ratio 0.32, 95% confidence interval 0.17–0.59), and higher for patients who received transfusion (odds ratio 1.68, 95% confidence interval 1.10–2.54).</div></div><div><h3>Conclusion</h3><div>We underlined factors that impact the occurrence of PICs and, consequently, duration of hospitalization following PN. By addressing these predictors, clinicians can promote enhanced patient recovery.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 236-243"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic uro-oncology applications of the SSI Mantra™ surgical robotic system","authors":"Sudhir K. Rawal ,&nbsp;Ashish Khanna ,&nbsp;Amitabh Singh ,&nbsp;Sarbartha K. Pratihar ,&nbsp;Ishan Malla ,&nbsp;Mujahid Ali ,&nbsp;Vivek Vasudeo ,&nbsp;Kaushik Jaganthan ,&nbsp;Bhuvan Kumar ,&nbsp;Nikhil Saurabh","doi":"10.1016/j.ajur.2024.04.009","DOIUrl":"10.1016/j.ajur.2024.04.009","url":null,"abstract":"<div><h3>Objective</h3><div>To report our preliminary clinical experience and outcomes of uro-oncology procedures conducted utilizing the SSI Mantra™ surgical robotic system.</div></div><div><h3>Methods</h3><div>Data of consecutive patients who underwent various robot-assisted uro-oncology procedures using the SSI Mantra™ surgical robotic system at our institution between July 2022 and September 2023 were recorded. The specific surgical configurations employed with the SSI Mantra™ for these procedures were duly noted. We assessed the feasibility of these procedures with this novel surgical robotic system and report the outcomes.</div></div><div><h3>Results</h3><div>A total of 156 patients were operated with the SSI Mantra™ surgical robotic system. The spectrum of procedures performed comprised robot-assisted laparoscopic radical prostatectomy with bilateral extended pelvic lymph node dissection (<em>n</em>=77), robot-assisted radical cystectomy with bilateral extended pelvic lymph node dissection with extracorporeal urinary diversion (<em>n</em>=39), robot-assisted radical nephrectomy (<em>n</em>=32), robot-assisted partial nephrectomy (<em>n</em>=6), robot-assisted radical nephroureterectomy with bladder cuff excision (<em>n</em>=1), and bilateral robot-assisted video endoscopic inguinal lymph node dissection (<em>n</em>=1). One robot-assisted laparoscopic radical prostatectomy had to be converted to open in view of system malfunction. However, no system-related intraoperative complications or injuries were encountered.</div></div><div><h3>Conclusion</h3><div>The SSI Mantra™ surgical robotic system demonstrates significant promise as an innovative robotic platform. In this single-center experience, we have demonstrated the feasibility of a diverse array of surgical procedures using this platform. Further research, involving a larger cohort of patients, is imperative to refine the operative techniques and comprehensively understand the perioperative outcomes of the SSI Mantra™ surgical robotic system, particularly in comparison to other robotic surgical platforms.</div></div>","PeriodicalId":46599,"journal":{"name":"Asian Journal of Urology","volume":"12 2","pages":"Pages 143-151"},"PeriodicalIF":2.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143904402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}