BMC Urology最新文献

{"title":"Valveless and conventional insufflation on pneumoperitoneum-related complications in robotic partial nephrectomy: a systematic review and meta-analysis of prospective studies.","authors":"Lucas Schenk de Almeida, Richard Dobrucki de Lima, Breno Cordeiro Porto, Carlo Camargo Passerotti, Rodrigo Afonso da Silva Sardenberg, José Pinhata Otoch, José Arnaldo Shiomi da Cruz","doi":"10.1186/s12894-024-01632-3","DOIUrl":"10.1186/s12894-024-01632-3","url":null,"abstract":"<p><strong>Introduction: </strong>The use of pneumoperitoneum is an essential step for performing laparoscopic and robotic surgery. Pneumoperitoneum insufflation can cause complications such as pneumothorax, subcutaneous emphysema, and pneumomediastinum. The purpose of this meta-analysis is to compare the safety of using the conventional insufflation system versus a Valveless insufflation system as devices for manufacturing pneumoperitoneum in robotic-assisted nephrectomy.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted on PUBMED, EMBASE, SCOPUS, and Cochrane, from inception until January 2024. Randomized and nonrandomized prospective studies were included in the meta-analysis, performed by the R+ Rstudio.</p><p><strong>Results: </strong>Three publications encompassing 478 patients were included. We observed no difference in SCE (OR 0.60, CI 95% 0.27;1.34, p = 0.134, I² = 0), PNM (OR 0.82, CI 95% 0.24;2.78, p = 0.558, I² = 0), When comparing groups conventional insufflation system (CIS) versus AirSealTM insufflation system (AIS) with pneumoperitoneum pressure of 15 mmHg or 12 mmHg.</p><p><strong>Conclusion: </strong>The presented data showed no difference between the AIS when compared with CIS in Pneumoperitoneum insufflation-related complications.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"239"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic surgery of the urothelial carcinoma of the upper urinary tract single surgeon initial experience, 66 consecutive cases.","authors":"Mahmoud Farzat, Sami-Ramzi Leyh-Bannurah, Florian M Wagenlehner","doi":"10.1186/s12894-024-01629-y","DOIUrl":"10.1186/s12894-024-01629-y","url":null,"abstract":"<p><strong>Purpose: </strong>Robotic surgery is increasingly utilized in the treatment of urothelial carcinoma of the upper urinary tract (UTUC). This study investigates the advantages and burden of robot-assisted surgical treatment of the urothelial carcinoma of the upper urinary tract in a referral urological department, along with their functional and oncological results.</p><p><strong>Methods: </strong>The study included 66 prospectively enrolled patients who were surgically treated by a single, robotically specialized surgeon between July 2019 and December 2023. Patients were divided into three groups. Group 1: 50 patients underwent robot-assisted radical Nephroureterectomy (RANU) with bladder cuff excision, Group 2: 11 patients underwent RANU simultaneously with robot-assisted radical cystectomy (RARC), and Group 3: 5 patients underwent robot-assisted segmental ureterectomy (RASU). Clinical and oncological parameters were compared. Perioperative morbidity according to Clavien-Dindo was the primary endpoint of our study. The secondary endpoint was oncologic outcomes.</p><p><strong>Results: </strong>37.8% of patients had locally advanced carcinomas. The average console time of RANU with bladder cuff excision was 69 min. The rate of positive surgical margins was n = 1/66 (2%). Lymphadenectomy (LAD) was performed on 30% of patients, with a mean of 13.7 lymph nodes removed. Of those who received LAD, 33% had lymph node metastasis. n = 6/66 (9%) patients received blood transfusion. The overall complication rate was 24%. The readmission rate was 7.5%. With a median follow-up of 26 months, the 2-year recurrence-free survival rate was 84.4%, and the 2-year overall survival rate was 94%.</p><p><strong>Conclusion: </strong>Robotic surgery is a feasible option for treating UTUC that can be adapted to meet the surgical needs of each patient. Prospective studies are warranted to confirm its benefits.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"238"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metoclopramide for analgesia in renal colic: a narrative systematic review.","authors":"Andrew Tabner, Adithan Ganesh, Lucy Hobbs, Nikhil Prasanna Ponna, Matthew J Reed, Apostolos Fakis, Suzanne Toft, Graham Johnson","doi":"10.1186/s12894-024-01598-2","DOIUrl":"10.1186/s12894-024-01598-2","url":null,"abstract":"<p><p>Metoclopramide, a prokinetic antiemetic with activity at multiple receptor types, may be a useful treatment for renal colic pain. This review investigated whether metoclopramide is an effective analgesic in the management of adults with renal colic.Eligible studies were randomised, quasi-randomised or case-control trials of metoclopramide for the management renal colic pain. Electronic database searches were performed in November 2022. Screening was performed by two authors independently; disagreement was resolved by discussion or by adjudication by a third author. The Cochrane Collaboration Risk of Bias Tool v2.0 was used to assess bias.Two studies were included, enrolling 279 patients. Heterogeneity of primary outcome measurement and comparators rendered meta-analysis inappropriate; a narrative review is presented. Both studies showed some evidence of analgesic effect. The largest study had a low risk of bias in all assessed domains, whilst the smaller study was at a high risk of bias.There is limited evidence that metoclopramide may be an effective analgesic in the management of renal colic, with the highest quality study demonstrating analgesic properties similar to an intravenous non-steroidal anti-inflammatory medication.Protocol registration Prospero (CRD42022346618).</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"240"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11529211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical efficacy of intracavernous injection of platelet lysate for erectile dysfunction.","authors":"Yi-Kai Chang, I-Ni Chiang, Hong-Chiang Chang, Yi-Hui Chen, Shih-Chieh Jeff Chueh","doi":"10.1186/s12894-024-01633-2","DOIUrl":"10.1186/s12894-024-01633-2","url":null,"abstract":"<p><strong>Background: </strong>Among the emerging treatments for erectile dysfunction (ED), platelet-rich plasma (PRP), known for its ability to enhance tissue repair and regeneration, stands out as a promising therapeutic approach. In this innovative study, we aimed to assess the efficacy of intracavernous injections of platelet lysate (PL), a derivative of PRP, in improving erectile function among ED patients.</p><p><strong>Methods: </strong>We enrolled twenty-six patients, aged between 35 and 70 years (mean age 51.6 ± 11.3 years), who had been experiencing ED for over six months and had an International Index of Erectile Function-5 (IIEF-5) score of 21 or less. Participants received autologous PL injections intracavernously every two weeks for a total of five administrations. We assessed Erection Hardness Score (EHS) and International Index of Erectile Function-5 (IIEF-5) bi-weekly for 16 weeks and conducted penile Doppler ultrasounds pre- and post-treatment to record peak systolic velocity (PSV) and resistance index (RI).</p><p><strong>Results: </strong>Before treatment, the mean EHS was 2.15 ± 0.88 and IIEF-5 was 10.92 ± 5.28. Remarkable improvements were observed post-treatment, with the EHS significantly increasing to 3.15 ± 0.83 (p < 0.05) and IIEF-5 to 17.23 ± 5.26 (p < 0.05). Penile Doppler ultrasound exhibited an increase in both PSV and RI post-treatment, with the rise in RI being statistically significant.</p><p><strong>Conclusions: </strong>Our findings indicate that intracavernous injections of PL substantially enhance erectile function, as evidenced by improvements in EHS, IIEF-5, and the RI of penile Doppler ultrasound, without hemorrhagic events or other adverse reactions apart from temporary pain at the injection site during the 16-week follow-up period. These encouraging results suggest that PL injections are a safe and effective treatment modality for patients with moderate ED, potentially providing a less invasive and more physiologically friendly alternative to current ED management strategies.</p><p><strong>Trial registration: </strong>The study received approval from the Institutional Review Board of National Taiwan University Hospital (IRB Number 202008061RIPC, date of registration 08/28/2020).</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"237"},"PeriodicalIF":1.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraperitoneal laparoscopic technique in trendelenburg position: an effective surgical method for pyelolithotomy, pyeloplasty, and heminephrectomy in patients with horseshoe kidneys.","authors":"Ming Xiong, Zhaohui Chen, Xiaoming Wang, Huiling Jiang, Zhicheng Luo, Guancai Liang, Teng Hou","doi":"10.1186/s12894-024-01631-4","DOIUrl":"10.1186/s12894-024-01631-4","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety and feasibility of intraperitoneal laparoscopic surgery in Trendelenburg position (ILSTP) for pyelolithotomy, pyeloplasty, and heminephrectomy in patients with horseshoe kidneys (HSKs).</p><p><strong>Methods: </strong>Between March 2021 and March 2024, three patients with HSKs underwent ILSSP. Of these three patients, two with pelvi-ureteric junction obstruction with recurrent kidney stones underwent pyelolithotomy and pyeloplasty, one with symptomatic nonfunctioning left moiety of a HSK was managed with heminephrectomy.</p><p><strong>Results: </strong>Mean operating time was 114 ± 64.8 (44-172) min, and estimated blood loss was 63.3 ± 51.3 (20-120) ml. The mean hospital stay was 3.3 ± 1.5 (2-5) days. There were no major intra- or post-operative complications.</p><p><strong>Conclusions: </strong>ILSTP is a feasible and effective technique for performing pyelolithotomy, pyeloplasty, and heminephrectomy in patients with HSKs.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"236"},"PeriodicalIF":1.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transvaginal posterior levatorplasty and perineoplasty for female primary stress urinary incontinence: 12-month follow-up and technical presentation.","authors":"Yansheng Xu, Lan Wei, Meichen Liu, Zhuomin Jia, Yilin Li, Fengyong Li","doi":"10.1186/s12894-024-01604-7","DOIUrl":"10.1186/s12894-024-01604-7","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the feasibility of transvaginal posterior levatorplasty combined with perineoplasty (TPLP) for women with primary stress urinary incontinence and demonstrate the surgical technique with step-by-step procedures.</p><p><strong>Methods: </strong>A prospective, non-randomised study was conducted using technique of TPLP to treat female primary SUI from January 2019 to December 2021. Patient follow-up was performed at 3 and 12 months posteroperatively. A series of validated questionnaires were used to evaluate the improvement of symptom severity, sexual function and quality of life. In addition, 4-D ultrasonography was used to measure the anatomic changes of pelvic structures.</p><p><strong>Results: </strong>A total of 47 patients were enrolled in this study with a mean age of 43.6 years. Mean operative time was 78.7 min. Median estimated intraoperative blood loss was 80.2 ml. Objective cure and subjective cure rates were 87.2% and 91.5%, respectively. Compared with baseline, scores of quality of life, symptom severity and sexual function improved after surgery. Meanwhile, mobility of the urethra and bladder neck and areas of levator hiatus were decreased after surgery. Mild coitus pain was reported in 15.4% (6/39) patients at the initial several times of intercourse after resuming sexual activity.</p><p><strong>Conclusions: </strong>This study shows that transvaginal posterior levatorplasty combined with perineoplasty appears to be an effective surgical method for selected women with primary stress urinary incontinence.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"235"},"PeriodicalIF":1.7,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and safety of flexible ureteroscopy with intelligent control of renal pelvis pressure without urinary catheter: a retrospective study.","authors":"Huang Mei, Yang Baihua, Luo Xiaohua, Song Leming, Deng Xiaolin","doi":"10.1186/s12894-024-01628-z","DOIUrl":"10.1186/s12894-024-01628-z","url":null,"abstract":"<p><strong>Background: </strong>To explore the feasibility and safety of aflexible ureteroscopy with intelligent control of renal pelvic pressure(FUS-ICP) without a post-operative indwelling urinary catheter .</p><p><strong>Methods: </strong>In this retrospective study, we assessed patients with upper urinary tract stones who were treated with FUS-ICP at the Ganzhou People's Hospital from February 2022 to December 2023. Patients were divided into the non-urinary catheter (non-UC) and urinary catheter (UC) groups according to whether an indwelling catheter was used after surgery.</p><p><strong>Results: </strong>In total, 142 patients were included in the study. There was no significant difference in the preoperative general data between the two groups. Patients in the non-UC group performed better than those in the UC group in terms of catheter-related bladder irritation (P = 0.001), the Sedation-Agitation Scale score (P = 0.012), and the numerical rating scale (P = 0.003). The incidences of urinary retention (P = 0.620), urinary tract infection (P = 0.529), and replacement of urethral catheter s (P = 0.438) in the UC group were inferior to those in the non-UC group, but there was no statistical significance.</p><p><strong>Conclusions: </strong>It is feasible and safe to perform FUS-ICP without a post-procedure indwelling urinary catheter.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"234"},"PeriodicalIF":1.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison in prostate cancer diagnosis with PSA 4-10 ng/mL: radiomics-based model VS. PI-RADS v2.1.","authors":"Chunxing Li, Zhicheng Jin, Chaogang Wei, Guangcheng Dai, Jian Tu, Junkang Shen","doi":"10.1186/s12894-024-01625-2","DOIUrl":"10.1186/s12894-024-01625-2","url":null,"abstract":"<p><strong>Background: </strong>To evaluate accuracy of MRI-based radiomics in diagnosing prostate cancer (PCa) in patients with PSA levels between 4 and 10 ng/mL and compare it with the latest Prostate Imaging Reporting and Data System (PI-RADS v2.1) score.</p><p><strong>Methods: </strong>221 patients with prostate lesions and PSA levels in 4-10 ng/mL, including 154 and 67 cases in the training and validation groups. Pathological confirmation of all patients was accomplished by the use of MRI-TRUS fusion targeted biopsy or systematic transrectal ultrasound (TRUS) guided biopsy. 851 radiomic features were extracted from each lesion of ADC and T2WI images. The least absolute shrinkage and selection operator (LASSO) regression algorithm and logistic regression were employed to select features and build the ADC and T2WI model. The combined model was obtained based on the ADC and T2WI features. The clinical benefit and diagnostic accuracy of the three radiomics models and PI-RADS v2.1 score were evaluated.</p><p><strong>Results: </strong>10 radiomic features were ultimately selected from the ADC images, 13 from the T2WI images and 7 from the combined models. The ADC, T2WI and combined models achieved satisfactory diagnostic accuracy in the training [AUC:0.945 (ADC), 0.939 (T2WI), 0.979 (combined)] and validation groups [AUC: 0.942 (ADC), 0.943 (T2WI), 0.959 (combined)], which was significantly higher than those in PI-RADS v2.1 model (0.825 for training cohort and 0.853 for validation cohort). Compared with the PI-RADS v2.1 score, the three radiomics models generated superior PCa diagnostic performance in both the training (p = 0.002, p = 0.005, p < 0.001) and validation groups (p = 0.045, p = 0.035, p = 0.015).</p><p><strong>Conclusion: </strong>Radiomics based on ADC and T2WI images can better identify PCa in patients with PSA 4-10 ng/mL, and MRI-based radiomics significantly outperforms the PI-RADS v2.1 score.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"233"},"PeriodicalIF":1.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11515792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of efficacy and safety of low-intensity pulsed ultrasound in patients with concurrent erectile dysfunction and chronic prostatitis/chronic pelvic pain syndrome: a prospective, randomized controlled study.","authors":"Zhongyi Li, Dongjie Li, Xiongbing Zu, Boyu Xiang, Guilin Wang, Zhengyan Tang","doi":"10.1186/s12894-024-01630-5","DOIUrl":"10.1186/s12894-024-01630-5","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective of this clinical trial is to investigate the effect of low-intensity pulsed ultrasound (LIPUS) on patients suffering from comorbid erectile dysfunction (ED) and chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS).</p><p><strong>Methods: </strong>The clinical trial was conducted in the andrology outpatient treatment room of the Department of Urology, Xiangya Hospital, Central South University from August to November 2022 A total of 60 patients who met the research criteria for comorbid ED combined with CP/CPPS were recruited and randomly assigned to three treatment groups. They were treated with LIPUS (Group A), drug therapy(Group B), and LIPUS combined with drug therapy (Group C), respectively. Each group comprised 20 patients. Statistical analysis was performed on the five-item version of International Index of Erectile Function (IIEF-5), Erection Hardness Score (EHS), National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI), the nine-item Patient Health Questionnaire (PHQ-9), the seven-item Generalized Anxiety Disorder Scale (GAD-7), and the incidence of adverse events to comprehensively evaluate the efficacy and safety of LIPUS.</p><p><strong>Results: </strong>The positive response rate of ED and CP/CPPS treatment in Group A is 40%(8/20) and 45%(9/20), while those in Group B is 55%(11/20) and 60%(12/20), and those in Group C is 85%(17/20) and 85%(17/20). A notable increase in IIEF-5 scores was observed across the three groups post-treatment (10.45 ± 2.50 vs. 13.65 ± 3.03, P = 0.008; 11.80 ± 3.21 vs. 16.40 ± 3.20, P = 0.011; 12.90 ± 3.92 vs. 19.40 ± 2.35, P = 0.042) with a concomitant significant decrease in NIH-CPSI scores (16.75 ± 4.53 vs. 14.65 ± 4.51, P = 0.016; 16.35 ± 4.32 vs. 12.20 ± 4.74, P = 0.007; 16.00 ± 4.40 vs. 8.15 ± 4.28, P = 0.021). Notably, the most pronounced changes were seen in the group receiving LIPUS combined with tadalafil and doxazosin. Additionally, all groups exhibited marked improvements in anxiety and depression symptoms post-treatment. No adverse events were observed during treatment.</p><p><strong>Conclusion: </strong>LIPUS can improve erectile function and CP/CPPS symptoms with good safety, and LIPUS combined with tadalafil and doxazosin is more effective during the treatment. However, its long-term efficacy remains to be seen.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry; approval number: ChiCTR2200063038 ( https://www.chictr.org.cn/ ) on August 29, 2022.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"232"},"PeriodicalIF":1.7,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142495528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open versus mini-invasive partial and radical nephrectomy complications: results from the French national health database.","authors":"Guillaume Pascal, Pascal Eschwège, Julia Salleron, Beverley Balkau, Jacques Hubert, Charles Mazeaud","doi":"10.1186/s12894-024-01620-7","DOIUrl":"10.1186/s12894-024-01620-7","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic surgery is associated with a lower morbidity than open surgery. No recent data compared kidney cancer surgery in the French population using the National Health Insurance database (PMSI-MCO).</p><p><strong>Aims: </strong>We explore and compare the surgical morbidity rates between laparoscopic and open laparotomy for kidney cancer.</p><p><strong>Methods: </strong>The initial length of stay and complications parameters during the three postoperative months were described for renal cancer in every French center in 2018. We compared Relative Risks (RR [95% CI]) between laparoscopic and open surgery for both radical and partial nephrectomy.</p><p><strong>Results: </strong>Among 8,162 patients, 3,525 had a radical nephrectomy, 978 open, 2,547 laparoscopic surgeries; 4,637 patients had partial nephrectomies, 1,778 open 2,859 laparoscopic surgeries. For radical surgery, the most common complications were urinary infections (7.8%), acute renal failure (8.9%), sepsis (8.4%), bleeding (9.3%), and postoperative anemia (5.9%); the RR for laparoscopic versus open surgery were respectively 0.68 [0.54;0.86], 0.71 [0.57;0.88], 0.69 [0.55;0.86], 0.83 [0.66;1.03], 0.56 [0.43;0.73]. For partial nephrectomies, the most common complications were urinary infections (7.7%), bleeding (11.6%), and postoperative anemia (5.8%), with RR of 0.71 [0.58;0.87], 0.61 [0.52;0.71], and 0.64 [0.51;0.81]. The mean length of stay was 7.7 for open radical nephrectomy, 6.3 for laparoscopic radical nephrectomy, 7.5 for open partial nephrectomy, and 5 for laparoscopic partial nephrectomy.</p><p><strong>Conclusions: </strong>The laparoscopic approach had fewer postoperative complications and a shorter length of stay than open surgery for partial and radical nephrectomy. The PMSI analysis provided an exhaustive description of surgical practice for kidney cancer and surgical complications in France.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9285,"journal":{"name":"BMC Urology","volume":"24 1","pages":"229"},"PeriodicalIF":1.7,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11492573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}