Annales D Urologie最新文献_第8页

Practical aspects concerning the use of anticoagulants in urology 泌尿外科抗凝剂应用的实际问题

Annales D Urologie Pub Date : 2006-11-01 DOI: 10.1016/S0003-4401(06)80032-X

P. Coloby , P. Zufferey

引用次数: 0

Antithrombotic drugs in urological surgery. Treatment interfering with haemostasis in urology? 泌尿外科的抗血栓药物。泌尿外科干扰止血的治疗方法?

Annales D Urologie Pub Date : 2006-11-01 DOI: 10.1016/S0003-4401(06)80025-2

Paul Zufferey

引用次数: 0

Metastatic renal cell carcinoma and its treatments 转移性肾细胞癌及其治疗

Annales D Urologie Pub Date : 2006-11-01 DOI: 10.1016/S0003-4401(06)80029-X

B. Escudier

引用次数: 2

How far should partial nephrectomy be extended for renal cell carcinoma? 肾细胞癌的部分切除应扩大到什么程度?

Annales D Urologie Pub Date : 2006-11-01 DOI: 10.1016/S0003-4401(06)80026-4

A. Méjean

{"title":"How far should partial nephrectomy be extended for renal cell carcinoma?","authors":"A. Méjean","doi":"10.1016/S0003-4401(06)80026-4","DOIUrl":"10.1016/S0003-4401(06)80026-4","url":null,"abstract":"<div><p>Conservative renal surgery for cancer has now achieved consensus for imperative, relative, and elective indications (tumor < 4 cm with healthy contralateral kidney). The results show 90%–100% 10-year survival rates and 0%–3% recurrence rates. Surgical techniques are improving and complication rates are decreasing with experience.</p><p>It is now recognized that margin thickness has no real significance provided that it is negative, even if excision is flush with the tumor capsule. Finally, the frequently cited multifocal lesions are no longer an argument against conservative surgery. The usual limitations of conservative surgery are the size and location of the tumor. Nevertheless, there is no statistically significant difference in the survival and recurrence rates between T1 a (<4 cm) and T1 b (4-7 cm) tumors, even if the risk of renal sinus fat tissue involvement increases proportionally with tumor size. Finally, resectiog tumors of the renal sinus is possible without adding to the risk of metastasis but increases the risk of surgical complications.</p><p>The risk of deteriorated renal function with radical nephrectomy is now well documented. Laparoscopy, which has become the reference treatment mode for radical nephrectomy, remains reserved for conservative surgery for exophytic tumors less than 3–4 cm because of the technical difficulties involved in resection and hemostasis.</p><p>Although conservative surgery is now recognized, extending its indications to tumors greater than 4 cm or in cases of parenchymatous location is supported by real arguments that need to be confirmed. The limit remains the surgical feasibility.</p></div>","PeriodicalId":50783,"journal":{"name":"Annales D Urologie","volume":"40 ","pages":"Pages S68-S71"},"PeriodicalIF":0.0,"publicationDate":"2006-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0003-4401(06)80026-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26610868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

Renal cell carcinoma: management of venous thrombus 肾细胞癌:静脉血栓的处理

Annales D Urologie Pub Date : 2006-11-01 DOI: 10.1016/S0003-4401(06)80028-8

C. Coulange , J. Hardwigsen , P. Le^Treut

{"title":"Renal cell carcinoma: management of venous thrombus","authors":"C. Coulange , J. Hardwigsen , P. Le^Treut","doi":"10.1016/S0003-4401(06)80028-8","DOIUrl":"10.1016/S0003-4401(06)80028-8","url":null,"abstract":"<div><p>Radical nephrectomy with vena cava thrombectomy remains the treatment of choice in patients with renal cell carcinoma and inferior vena cava involvement. Surgery is performed with curative intent in patients without evidence of metastases or for cytoreduction, followed by possible immunotherapy in patients with distant metastases.</p><p>The role of magnetic resonance imaging for evaluating the renal vein and/or IVC to detect thrombus and the proximal extent of thrombus is fully established. Surgical removal of these cancers through a transabdominal approach, even in patients with a level 2 thrombus (involving the retrohepatic IVC with close proximity to the main hepatic veins) is possible, avoiding the potential added morbidity of a throacoabdominal approach or median sternotomy. The application of liver transplant techniques and liver mobilization procedures not generally familiar to urological surgeons facilitates wide exposure and proximal control of the IVC for tumors cephalad to the confluence of the hepatic veins. As an initial step' we believe that cephalad retraction of the liver with mobilization of the IVC by securing the lumbar, small hepatic and other unnamed venous collaterals may be tried to gain exposure of the retrohepatic IVC.</p><p>Overall survival in patients with IVC involvement after complete surgical removal in the absence of metastatic disease justifies aggressive surgical management.</p></div>","PeriodicalId":50783,"journal":{"name":"Annales D Urologie","volume":"40 ","pages":"Pages S77-S81"},"PeriodicalIF":0.0,"publicationDate":"2006-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0003-4401(06)80028-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26610870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endoscope disinfection 内窥镜消毒

Annales D Urologie Pub Date : 2006-11-01 DOI: 10.1016/S0003-4401(06)80031-8

J.-P. Mignard

引用次数: 0

Interfaces in urology Biarritz, February 3–5, 2006 泌尿外科接口，2006年2月3-5日，Biarritz

Annales D Urologie Pub Date : 2006-11-01 DOI: 10.1016/S0003-4401(06)80023-9

F. Desgrandchamps, R.-O. Fourcade, J.-P. Mignard

引用次数: 0

Is volume of surgical activity relevant for surgeon's evaluation? 手术活动量是否与外科医生的评估有关?

Annales D Urologie Pub Date : 2006-11-01 DOI: 10.1016/S0003-4401(06)80033-1

R.-O. Fourcade

引用次数: 0

Management of patients with benign prostatic hyperplasia by urologists: the DUO study 泌尿科医师对良性前列腺增生患者的管理:DUO研究

Annales D Urologie Pub Date : 2006-11-01 DOI: 10.1016/S0003-4401(06)80024-0

R.-O. Fourcade , M.-C. Picot , A.-F. Gaudin , N. Texier , A. Slama

{"title":"Management of patients with benign prostatic hyperplasia by urologists: the DUO study","authors":"R.-O. Fourcade , M.-C. Picot , A.-F. Gaudin , N. Texier , A. Slama","doi":"10.1016/S0003-4401(06)80024-0","DOIUrl":"10.1016/S0003-4401(06)80024-0","url":null,"abstract":"<div><p>The DUO study intended to define the factors determining diagnostic and treatment strategies for benign prostatic hyperplasia (BPH) management.</p></div><div><h3><strong>Methods</strong></h3><p>This longitudinal, observational study was conducted in France (June 2004 to March 2005), with a representative sample of private and hospital urologists.</p></div><div><h3><strong>Results</strong></h3><p>1027 BPH patients were included by 202 urologists and 856 were followed-up 6 months later. Mean I-PSS was 14.9 (±6.7) at inclusion and 10.5 (±6.7) at the follow up visit. At inclusion, pharmacologic treatment was prescribed to 84% of the patients, surgery to 13% and no treatment to 3%. Factors in favour of surgery (versus drugs) were BPH severity (OR=2.5 if IPSS=20), patients' choice (0R=2.5), quality of life improvement (OR=2.2), post-void residual (OR=2.1) and dribbling (OR=1.6). Patients' age and prostatic volume have no impact on this choice. Factors in favour of a combination of an a-blocker plus an 5α-reductase inhibitor (versus an α-blocker) were prostate volume (OR=7.8), patient's age (OR-3.0 if âge=74) and post-void residual (OR=2.3) and those in favour of a 5α reductase inhibitor (versus an α-blocker) were prostate volume (OR=7.6), PSA results (OR=5.8), patients' age (OR=5.4 if > 74 years, OR= 2.1 if > 68 years).</p></div><div><h3><strong>Conclusion</strong></h3><p>Medical or surgical treatment of BPH results in IPSS improvement at 6 months. Patients' age and prostatic volume favour 5α-reductase inhibitor initiation and have no impact on surgical treatment decision. Surgery is performed in severe BPH or when patients expecting a quality of life improvement do that choice.</p></div>","PeriodicalId":50783,"journal":{"name":"Annales D Urologie","volume":"40 ","pages":"Pages S58-S63"},"PeriodicalIF":0.0,"publicationDate":"2006-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0003-4401(06)80024-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26610866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Renal cancer: What can we expect from emerging new technologies: Radiofrequency and cryoablatic ? 肾癌:我们能从新兴的新技术中期待什么:射频和冷冻?

Annales D Urologie Pub Date : 2006-11-01 DOI: 10.1016/S0003-4401(06)80027-6

P. Liberati , O. Mathieu , E. Tariel , P. Meria , P. Mongiat-Artus , F. Desgrandchamps , P. Teillac

引用次数: 1