Advances in Urology最新文献

{"title":"A Vaginal Inlay for Reduction of Stress Urinary Incontinence: Outcome of a Randomized Clinical Trial and Four User Acceptance Studies.","authors":"Aino Fianu Jonasson,&nbsp;Karin Bryder,&nbsp;Elisabeth Sthengel","doi":"10.1155/2021/8822186","DOIUrl":"https://doi.org/10.1155/2021/8822186","url":null,"abstract":"<p><p>A multicenter, randomized, controlled clinical trial and four postmarket user acceptance investigations were carried out to document the safety, performance, and user acceptance of Efemia Bladder Support, a novel vaginal inlay for the temporary reduction of stress urinary incontinence (SUI). The clinical investigation enrolled 97 women diagnosed with SUI, randomized 3 : 1 to either treatment or standard care (control). The primary endpoint was reduction of urine leakage, measured as change in pad weight baseline week compared with treatment week. Secondary endpoints were treatment success, calculated as the percentage of subjects with >70% reduction in pad weight, reduction in incontinence episodes, and quality of life (QoL). 75 women (77%) completed the clinical investigation. No serious adverse events occurred. The treatment group reached a 55% (<i>p</i> < 0.001) mean reduction of total leakage compared to the control arm. A subanalysis, involving only leakage during provocation testing (coughing and jumping), showed a 67% (<i>p</i> < 0.001) mean reduction of leakage. No significant effect on QoL could be observed. 51% of the women answered \"yes\" to the question if they would use the device to reduce SUI. The user acceptance of the device was further investigated in four postmarket studies, using an improved device design with a slimmer centerpiece and a thinner handle, while keeping the effect achieving parts of the device unchanged. An average of 74% of the 102 participants in the postmarket studies reported that they were likely to continue using Efemia. The highest user satisfaction was seen in the two studies evaluating the use of Efemia during exercise, where 83% and 88% of the women were likely to continue using Efemia. It can be concluded that Efemia is a safe, well-tolerated, and effective alternative for reducing SUI, both in everyday life and during physical exercise.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2021-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25402432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Obstetric and Iatrogenic Urogenital Fistulas in Burkina Faso: A Cross-Sectional Study.","authors":"Fasnéwindé Aristide Kabore,&nbsp;Stéphanie Dominique Amida Nama,&nbsp;Boureima Ouedraogo,&nbsp;Moussa Kabore,&nbsp;Adama Ouattara,&nbsp;Brahima Kirakoya,&nbsp;Gilles Karsenty","doi":"10.1155/2021/8838146","DOIUrl":"https://doi.org/10.1155/2021/8838146","url":null,"abstract":"<p><strong>Objective: </strong>To compare the sociodemographic, clinical, and therapeutic characteristics of obstetric urogenital fistulas (OF) and iatrogenic urogenital fistulas (IF) treated in seven centers in Burkina Faso. <i>Material and Methods</i>. We carried out a cross-sectional study over a seven years' period (January 1, 2010 to December 31, 2016). We considered as iatrogenic all urogenital fistulas (UGF) occurred after elective caesarean section, gynecologic surgery (hysterectomy, myomectomy, and prolapse repair), or induced abortion. UGF following vaginal delivery after prolonged labor without obstetric maneuvers or caesarean section were considered as obstetric. UGF caused by other mechanisms (emergency caesarian section, congenital, and traumatic) were excluded from this study. The statistical analysis was carried out using version 14 of the STATA software. A logistic regression model was used to compare the two groups.</p><p><strong>Results: </strong>310 cases of UGF were included. IF accounted for 25.8% (<i>n</i> = 80) versus 74.2% (<i>n</i> = 230) for OF. The median age was 35 years for IF and 35.38 years for OF. The vesicovaginal fistulas were predominant (74.5%) in the two groups. All circumferential fistulas were found in the OF group. OF were frequently associated with residence in rural areas (OR = 1.8; CI = [1.05-3.1]), low level of education (OR = 5.4; CI = [2.3-12.9]), and a height under 158 cm (OR = 3.4 CI = [1.7-6.6]). Vaginal sclerosis was less common among IF (OR = 2.2; CI = [1-4.6]). The failure of surgical treatment after 3 months was more associated with OF (OR = 4.7; CI = [1.1-20.5]).</p><p><strong>Conclusion: </strong>OF were the most common, frequently affecting short women living in rural area and with low level of schooling. Fistulas were also more severe in the OF group. IF gave better results after surgical repair.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2021-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25325160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors of Ureteral Stenosis in Kidney Transplant Recipients: A Retrospective Study in National Referral Hospital in Indonesia.","authors":"Gampo A Irdam,&nbsp;Bobby Sutojo,&nbsp;Putu A R Raharja","doi":"10.1155/2021/2410951","DOIUrl":"https://doi.org/10.1155/2021/2410951","url":null,"abstract":"<p><p>Ureteral stenosis is one of the most common urological complications following kidney transplantations. It is occurred in 2-10% of patients and poses a significant problem to the patients as it may lead to permanent damage to renal damage. Identification of risk factors is important to prevent the incidence of ureteral stenosis. Thus, we aim to determine the risk factors of ureteral stenosis in the Indonesian population. This is a retrospective analysis of 487 kidney transplant patients performed in Cipto Mangunkusumo Hospital between 2014 and 2018. We collected and compared donor and recipient demography data in recipients who developed ureteral stenosis and recipients who did not develop ureteral stenosis. Ureteral stenosis was defined as the presence of hydronephrosis from ultrasound and increased number of serum creatinine. The overall incidence of ureteral stenosis post-kidney transplantation in our center is 6.6% (32 from 487 patients) from January 2014 until June 2018. We found that older donor and recipient age more frequent in developing ureteral stenosis post-kidney transplantation (<i>p</i> < 0.001). We also found that donors with number of arteries more than 2 (<i>p</i> < 0.001) and prolonged warm ischemic time (<i>p</i> < 0.05) are more frequently to develop ureteral stenosis post-kidney transplantation. There is no association between type II diabetes mellitus and hypertension with ureteral stenosis in this study. Donor age, recipient age, donor number of arteries more than 2, and prolonged warm ischemia time are associated with ureteral stenosis after kidney transplantation.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2021-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7822702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38873619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Technology-Driven Mobile Phone Applications (Apps) the New Currency for Digital Stent Registries and Patient Communication: Prospective Outcomes Using Urostentz App.","authors":"B M Zeeshan Hameed,&nbsp;Milap J Shah,&nbsp;Nithesh Naik,&nbsp;Mohan Amaresh,&nbsp;Padmaraj Hegde,&nbsp;Rahil Hussein Beary,&nbsp;Suraj Jayadeva,&nbsp;Bhaskar K Somani","doi":"10.1155/2021/6612371","DOIUrl":"https://doi.org/10.1155/2021/6612371","url":null,"abstract":"<p><strong>Background: </strong>Forgotten ureteral stents (FUS) and stent-related symptoms (SRS) lead to increased postprocedural emergency department visits and add to the psychological and financial burden of the patients.</p><p><strong>Purpose: </strong>To review the usage and benefits of ureteral stent tracking and symptom monitoring through a single smartphone-based application (App) platform with 2-way clinician-patient communication. This study also compared the features with other smartphone apps used for stent tracking.</p><p><strong>Materials and methods: </strong>100 patients were included in this single-center prospective study conducted between September 2019 and December 2019. Patients who had metallic or long-term indwelling stents, noncomprehensible patients, and those not willing to share their data were excluded from the study.</p><p><strong>Results: </strong>Of 100 patients, 92 downloaded the Urostentz application, and 72 (78.2%) patients answered the pictorial symptom questionnaire. Symptom score analysis suggested that 62 patients (86.1%) had stent-related symptoms of which 3 required readmission and underwent early stent removal. The mean stent duration was 17.2 + 3.5 days (range: 11-23 days), with 69% of patients having their stent removed on the scheduled date and 25% of patients requesting a change of their appointment via the App.</p><p><strong>Conclusion: </strong>In this study, there was no case of FUS encountered. The \"Urostentz\" App is a freely available patient safety stent tracking application that provides a secure and simplified interface, which can significantly reduce the incidence of FUS and provide digital remote assistance in the management of stent-related symptoms.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2021-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7810523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38868634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CK20 and CK5/6 Immunohistochemical Staining of Urothelial Neoplasms: A Perspective.","authors":"Mohammed Akhtar,&nbsp;Sameera Rashid,&nbsp;Mohamed Ben Gashir,&nbsp;Noheir Mostafa Taha,&nbsp;Issam Al Bozom","doi":"10.1155/2020/4920236","DOIUrl":"https://doi.org/10.1155/2020/4920236","url":null,"abstract":"<p><p>Cytokeratins belong to the family of intermediate filaments. They are expressed in a highly specific manner in epithelial cells where they play a crucial role in the integrity and mechanical stability of the cells. Several types of cytokeratins have been described in normal as well as neoplastic urothelium. In the case of urothelial neoplasms expression of CK20 and CK5/6 has been shown in several studies to have diagnostic and prognostic implications. Thus, low-grade urothelial carcinoma manifests CK expression limited to the umbrella cells, while high-grade tumors usually have an expression in the entire thickness of the urothelium except for the basal layer. CK5/6 expression on the other hand is expressed in the basal cells in all low-grade and some high-grade urothelial carcinomas. Diffuse CK20 staining accompanied by loss of CK5/6-positive basal layer is usually associated with aggressive clinical behavior. Double staining of the slides for these cytokeratins may facilitate proper interpretation and correlation.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/4920236","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38854067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of the Uncommon Bladder Cancers: A Single-Center Experience over 10 Years.","authors":"Youssef Kadouri,&nbsp;Salim Lachkar,&nbsp;Hamza Dergamoun,&nbsp;Hachem El Sayegh,&nbsp;Lounis Benslimane,&nbsp;Yassine Nouini","doi":"10.1155/2020/7563703","DOIUrl":"https://doi.org/10.1155/2020/7563703","url":null,"abstract":"<p><strong>Background: </strong>Under the name of uncommon bladder cancers are gathered rare histological entities which represent less than 5% of bladder tumors. There is not a clear and consensual therapeutic management for these entities.</p><p><strong>Purpose: </strong>To review a single-institution 10-year experience with rare form of bladder cancers detailing the diagnosis, treatment, and patient outcome.</p><p><strong>Materials and methods: </strong>We performed a retrospective review of 27 medical records of rare bladder cancer form treated at our center between February 2006 and February 2015. The clinicopathologic features are reported with emphasis on treatment and survival.</p><p><strong>Results: </strong>Mean patient age was 65.5 ± 20 yr and 70% of patients were males. Smoking background was found in 16 cases, chronic bladder irritation factors were found in 12 cases, and past urinary tract infection was found in 11 cases. The main symptom was total hematuria (93%) causing an anemia in 16 cases. The two mean histological forms were epidermoid carcinoma (37%) and adenocarcinoma (22%). 26% of patients were found to have extended invasive tumors (T4) at diagnosis. Metastatic disease was confirmed in 8 cases. Our patients were managed by a wide range of therapeutic modalities as total cystectomy with bilateral lymph node dissection (63%), palliative chemotherapy (30%), or concomitant radiochemotherapy (7%). 55.6% of patients were alive one year after diagnosis. Epidermoid carcinoma has the best prognosis followed by leiomyosarcoma and sarcomatoid carcinoma. Neuroendocrine carcinoma has the worst outcome. The overall 5-year survival rate is 33.3%.</p><p><strong>Conclusion: </strong>The rarity and small size of these tumors justify the absence of clear and consensual therapeutic management. No role of total cystectomy concerning the conclusions could be drawn but elements suggest this may be the treatment of choice. The highly aggressive nature of those lesions justifies an aggressive and fast therapy when feasible which gives the best outcomes.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7563703","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38510910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital Bladder and Urethral Agenesis: Two Case Reports and Management.","authors":"Salahaddin Delshad,&nbsp;Hadith Rastad,&nbsp;Parham Mardi","doi":"10.1155/2020/2782783","DOIUrl":"https://doi.org/10.1155/2020/2782783","url":null,"abstract":"<p><strong>Background: </strong>Agenesis of the bladder and urethra is a rare congenital anomaly, with a very few living cases reported in the literature so far. <i>Case Presentation</i>. We are reporting two female patients (3 and 6 years old) with bladder and urethral agenesis who presented with urinary incontinence. In both patients, magnetic resonant imaging (MRI) revealed a case of bladder and urethral agenesis with normal ureters draining into the vagina. Patients underwent a neobladder and conduit creation surgery. The neobladder was constructed from the whole cecum and a part of the ascending colon, followed by an anastomose of the ureters into the neobladder in a nonrefluxing fashion; the appendix was used simultaneously as a continent catheterizable conduit. The two patients attained urinary continence postoperatively.</p><p><strong>Conclusion: </strong>We reported two cases of bladder agenesis, and for the first time, we have performed neobladder creation surgery using the cecum and ascending colon. One-year follow-up did not reveal any complications.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2782783","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38561278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of Radiographic Imaging for Infant Hydronephrosis over the First 12 Months of Life.","authors":"Anthony J Schaeffer, Patrick C Cartwright, Glen A Lau, Mark D Ebert, Nora F Fino, Flory L Nkoy, Rachel Hess","doi":"10.1155/2020/2108362","DOIUrl":"10.1155/2020/2108362","url":null,"abstract":"<p><strong>Purpose: </strong>The workup and surveillance strategies for infant hydronephrosis (HN) vary, although this could be due to grade-dependent differences in imaging intensity. We aimed to describe the frequency of imaging studies for HN within the first year of life, stratified by initial HN grade, within a large regional healthcare system. <i>Study Design and Data Source</i>. Retrospective cohort using Intermountain Healthcare Data Warehouse. Inclusion criteria: (1) birth between 1/1/2005 and 12/31/2013, (2) CPT code for HN, and (3) ultrasound (U/S) confirmed HN within four months of birth. <i>Data Collection</i>. Grade of HN on initial postnatal U/S; number of HN-associated radiologic studies (renal U/Ss, voiding cystourethrograms (VCUGs), and diuretic renal scans); demographic and medical variables. <i>Primary Outcome</i>. Sum of radiologic studies within the first year of life or prior to pyeloplasty. <i>Statistical Analysis</i>. Multivariate poisson regression to analyze association between the primary outcome and the initial HN grade.</p><p><strong>Results: </strong>Of 1,380 subjects (993 males and 387 females), 990 (72%), 230 (17%), and 160 (12%) had mild, moderate, and severe HN, respectively. Compared with those with mild HN, patients with moderate (RR: 1.57; 95% CI: 1.42-1.73) and severe (RR: 2.09; 95% CI: 1.88-2.32) HN had a significantly higher rate of imaging use over 12 months (or prior to surgery) after controlling for potential confounders.</p><p><strong>Conclusions: </strong>In a large regional healthcare system, imaging use for HN is proportional to its initial grade. This suggests that within our system, clinicians treating this condition are using a risk-stratified approach to imaging.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/2108362","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10389260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histological Inflammation in Human Ureter either Healthy or Fitted with Double-Pigtail Stent or a Thin 0.3 F Suture Thread: A Preliminary Study.","authors":"Benoît Vogt,&nbsp;Ilham Chokri","doi":"10.1155/2020/1204897","DOIUrl":"https://doi.org/10.1155/2020/1204897","url":null,"abstract":"Background Ureteral stent intolerance reduces patients' quality of life. It has been suggested that changes in the shape of stents could decrease discomfort. In previous studies, the innovative pigtail-suture stent (i.e., JFil® or MiniJFil®) with a thin 0.3 F suture thread significantly decreased stent-related symptoms. Fortuitously, a dilation of the ureter containing the sutures was discovered. In addition, no inflammation was seen on the ureter wall around the suture in endoscopy. In this preliminary study, we assessed ureteral inflammation in the human ureter when it was healthy or when fitted with a double-pigtail stent or a thread. Materials and Methods After consent and inclusion of patients in the protocol, fifteen segments of ureters were collected during cystectomy procedures for bladder tumors. Ureteral inflammation was assessed on the histological section stained with hematoxylin-eosin. Histological grading (cumulative range of 0 to 6) assessing inflammation was performed on the ureter section for mucosa inflammation and inflammation in the muscle layer. Results A marked ureteral inflammatory reaction was observed in all cases of ureters fitted with a double-pigtail stent with a mean inflammation score of 4.8 ± 0.4. The ureter fitted with the thin suture thread showed inflammation in only one case with a mean inflammation score of 1.8 ± 1.3 (p=0.001). Conclusion Although the study was limited by the small number of patients, it confirmed that the double-pigtail stent induced ureteral inflammation in all cases and the thin 0.3 F suture thread caused less ureteral inflammation than the double-pigtail stent. The concept of material reduction within the urinary tract seems necessary in order to decrease mucosal irritation. The JFil® or the MiniJFil® thread could meet this requirement.","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1204897","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38186144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Removal of the Tumor Thrombus from the Right Atrium without Extracorporeal Circulation: Emphasis on the Displacement of the Tumor Apex.","authors":"D V Shchukin,&nbsp;V N Lesovoy,&nbsp;G G Khareba,&nbsp;A I Harahatyi,&nbsp;A V Maltsev,&nbsp;M M Polyakov,&nbsp;R V Stetsyshyn,&nbsp;M P Kopytsya,&nbsp;P V Mozzhakov,&nbsp;O O Makovozov","doi":"10.1155/2020/6063018","DOIUrl":"https://doi.org/10.1155/2020/6063018","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the outcomes of cavoatrial tumor thrombus removal using the liver transplantation technique for thrombectomy, a retrospective study was conducted.</p><p><strong>Materials and methods: </strong>Five patients with atrial tumor thrombi who underwent piggy-back mobilization of the liver, surgical access to the right atrium from the abdominal cavity, and external manual repositioning of the thrombus apex below the diaphragm (milking maneuver) were included into the study. Extracorporeal circulation was used in none of the cases. The average length of the atrial component of the tumor was 20.0 ± 11.7 mm (10 to 35 mm), and the width was 14.8 ± 8.5 mm (10 to 30 mm). In this work, the features of patients and surgical interventions as well as perioperative complications and mortality were analyzed.</p><p><strong>Results: </strong>External manual repositioning of the tumor thrombus apex below the diaphragm was successfully performed in all patients. Tumor thrombi with the length of the atrial part up to 1.5 cm were removed through the extrapericardial approach. For evacuation of the thrombi with the large atrial part (3.0 cm or more), a transpericardial surgical approach was required. Specific complications associated with the access to the right atrium from the abdominal cavity (paresis of the right phrenic nerve, pneumothorax, and mediastinitis) were not detected in any case. The average clamping time of the supradiaphragmatic inferior vena cava (IVC) was 6.3 ± 4.6 min. The volume of intraoperative blood loss varied from 2500 to 5600 ml (an average of 3675 ± 1398.5 ml).</p><p><strong>Conclusion: </strong>Our work represents the initial experience in the liver transplantation technique for thrombectomy in distinct and well-selected patients with atrial tumor thrombi. The effectiveness of this approach needs further study. The video presentation of our research took place in March 2019 at the 34th Annual EAU Congress in Barcelona.</p>","PeriodicalId":7490,"journal":{"name":"Advances in Urology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/6063018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38114047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}