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| 1 | 经腹机器人辅助腹腔镜肾部分切除术治疗T2期肾肿瘤的国际多中心临床研究显示文摘目的通过国际多中心研究探讨临床T2期肾肿瘤行经腹机器人辅助腹腔镜肾部分切除术的安全性及有效性。方法回顾性分析2012年1月至2017年12月国际19家泌尿中心378例临床T2期肾肿瘤行经腹机器人肾部分切除术和经腹机器人根治性肾切除术患者的临床资料。根据手术方式不同,分为部分切除组和根治组。部分切除组159例,男118例,女41例;年龄(59.3±13.2)岁,体重指数(28.7±5.4) kg/m^2,术前GFR (77.3±22.1)ml/min;肿瘤位于左侧72例,右侧87例;肿瘤直径(83±16)mm;R.E.N.A.L.评分(8.6±2.2)分。根治组219例,男156例,女63例;年龄(62.0±12.9)岁,体重指数(28.7±6.1) kg/m^2,术前GFR (71.4±20.3)ml/min;肿瘤位于左侧112例,右侧105例,双侧2例;肿瘤直径(92±25)mm;R.E.N.A.L.评分(9.7±1.5)分。两组患者性别、体重指数、肿瘤位置的差异均无统计学意义(P〉0.05)。部分切除组患者年龄、肿瘤直径、R.E.N.A.L.评分均低于根治组(P〈0.05),术前GFR优于根治组(P=0.012)。比较两组围手术期资料、肿瘤病理类型、随访时间、复发时间及术后GFR等。结果378例手术均顺利完成。部分切除组手术时间中位值150 min(65-353 min),短于根治组[180 min(85-361 min),P〈0.001],术中出血量中位值150 ml(40-3 000 ml),多于根治组[100 ml (10-1 100 ml),P〈0.001]。术中并发症发生率部分切除组为5.7%(9/159),根治组为3.2%(7/219),两组差异无统计学意义(P=0.240)。部分切除组术后并发症发生率高于根治组[19.5%(31/159)与10.5%(23/219),P=0.014],但≥3级并发症发生率的差异无统计学意义[4.4%(7/159)与2.3%(5/219),P=0.246]。部分切除组无复发生存率高于根治组[91.4%(117/128)与81.9%(167/204),P=0.013]。部分切除组术后GFR降低值16.9 ml/min(10.4-84.7 ml/min)明显少于根治组29.0 ml/min(14.0-54.0 ml/min),肾部分切除术更利于术后肾功能的保护(P〈0.001)。结论临床T2期肾肿瘤行机器人肾部分切除术可获得有效的肿瘤控制率,同时可以更好地保护肾功能,可作为临床T2期肾肿瘤有效的手术方式。 | 过菲 张超 王富博 王林辉 杨庆 叶华茂 吕晨 肖成武 汪洋 Giuseppe Simone Ithaar Derweesh Andrea Minervini Daniel Eun Francesco Porpiglia Sisto Perdona James Porter Matteo Ferro Alexandre Mottrie Robert Uzzo Luigi Schips Wesley White Ken Jacobsohn Prokar Dasgupta Riccardo Autorino Clayton Lau Chandru Sundaram Umberto Capitanio 孙颖浩 杨波 | 2018 | 中华泌尿外科杂志2018,39,6: | 8 |
| 2 | Laparoendoscopic Single-Site Upper Urinary Tract Surgery: Assessment of Postoperative Complications and Analysis of Risk Factors显示文摘 | Francesco Greco Luca Cindolo Riccardo Autorino Salvatore Micali Robert J. Stein Giampaolo Bianchi Caterina Fanizza Luigi Schips Paolo Fornara Jihad Kaouk | 2011 | European Urology2011,,3: | 1 |
| 3 | Do patients with a higher body mass index have a greater risk of advanced-stage renal cell carcinoma?显示文摘 | Luigi Schips Richard Zigeuner Katja Lipsky Franz Quehenberger Michael Salfellner Susanne Winkler Karl Pummer Gerhart Hubmer | 2003 | Urology2003,,3: | 1 |
| 4 | Potential benefit of lymph node dissection during radical nephrectomy for kidney cancer:A review and critical analysis of current literature显示文摘Objective:The role of lymph node dissection(LND)is still controversial in patients with renal cell carcinoma undergoing surgery.We aimed to provide a comprehensive review of the literature about the effect of LND on survival,prognosis,surgical outcomes,as well as patient selection and available LND templates.Methods:Recent literature(from January 2011 to December 2021)was assessed through PubMed and MEDLINE databases.A narrative review of most relevant articles was provided.Results:The frequencies in which LNDs are being carried out are decreasing due to an increase in minimally invasive and nephron sparing surgery.Moreover,randomized clinical trials and meta-analyses failed to show any survival advantage of LND versus no LND.However,retrospective studies suggest a survival benefit of LND in high-risk patients(bulky tumors,T3-4 stage,and cN1 patients).Moreover,extended LND might provide important staging information,which could be of interest for adjuvant treatment planning.Conclusion:No level 1 evidence of any survival advantage deriving from LND is currently available in literature.Thus,the role of LND is limited to staging purposes.However,low grade evidence suggests a possible role of LND in high-risk patients.Randomized clinical trials are warranted to corroborate these findings. | Michele Marchioni Daniele Amparore Igino Andrea Magli Riccardo Bertolo Umberto Carbonara Selcuk Erdem Alexandre Ingels Constantijn H.J.Muselaers Onder Kara Marco Mascitti Tobias Klatte Maximilian Kriegmair Nicola Pavan Eduard Roussel Angela Pecoraro Laura Marandino Riccardo Campi Luigi Schips | 2022 | Asian Journal of Urology2022,9,3: | 1 |
| 5 | Single-site laparoscopic partial nephrectomy: Where are we going?显示文摘AIM:To review an evolution of laparoscopic surgery,there has been a growing interest in laparoendoscopic single-site surgery(LESS).METHODS:A comprehensive electronic literature search was conducted using PubM ed database to identify all publications relating to LESS-partial nephrectomy(PN).The research includes articles published from April 2008 to January 2014.We focused our attention only on articles in which were cited the single-site surgical technique(laparoscopic and robotic),tumour stage and grade,mean tumour size,intraoperative variables,blood loss and transfusion rate,length of postoperative stay and complication rates,Clavien classification,positive of surgical margins,pain assessment at discharge.RESULTS:A total of 9 studies were collected with 221patients included.The mean patients age was 62 years.The mean tumor size was 2.35 cm with a mean operative time of 181 min(range 111-270 min)and 58.3%were done by robot.The mean ischemia time was 23.6min.The 25.8%of patients underwent an unclamp LESS-PN.Mean estimated blood loss was 296 mL and median length of hospital stay was 4 d.The rate of severe post-operative complications(≥Clavien gradeⅢ)was 5.4%.Not all surgical series of LESS-PN or Robotic-LESS-PN shows conversion in Multiport Laparoscopic or Open Surgery.Regarding oncologic outcomes,surgical margins were positive 4%of patients(9/221),no distant or port-site metastases were recorded.CONCLUSION:LESS-PN and RLESS-PN are feasible and associated with reduced postoperative pain,shorter median hospital stay,shorter recovery time,and better cosmetic satisfaction without compromising surgical and oncological safety. | Roberto Castellucci Luca Cindolo Mario Alvaréz-Maestro Guido Giusti Francesco Berardinelli Fabio Pellegrini Luigi Schips | 2014 | World Journal of Clinical Urology2014,3,3: | 0 |
| 6 | Transurethral prostate surgery in prostate cancer patients: A population-based comparative analysis of complication and mortality rates显示文摘Objective:Prostate cancer(PCa)patients might experience lower urinary tract symptoms as those diagnosed with benign prostatic hyperplasia(BPH).Some of them might be treated for their lower urinary tract symptoms instead of PCa.We aimed to test the effect of PCa versus BPH on surgical outcomes after transurethral prostate surgery,namely complication and mortality rates.Methods:Within the American College of Surgeons National Surgical Quality Improvement Program database(2011-2016),we identified patients who underwent transurethral resection of the prostate,photoselective vaporization,or laser enucleation.Patients were stratified according to postoperative diagnosis(PCa vs.BPH).Univariable and multivariable logistic regression models evaluated the predictors of perioperative morbidity and mortality.A formal test of interaction between diagnosis and surgical technique used was performed.Results:Overall,34542 patients were included.Of all,2008(5.8%)had a diagnosis of PCa.The multivariable logistic regression model failed to show statistically significant higher rates of postoperative complications in PCa patients(odds ratio:0.9,95%confidence interval:0.7-1.1;p=0.252).Moreover,similar rates of perioperative mortality(p=0.255),major acute cardiovascular events(p=0.581),transfusions(p=0.933),and length of stay of more than or equal to 30 days(p=0.174)were found.Additionally,all tests failed to show an interaction between post-operative diagnosis and surgical technique used.Conclusion:Patients diagnosed with PCa do not experience higher perioperative morbidity or mortality after transurethral prostate surgery when compared to their BPH counterparts.Moreover,the diagnosis seems to not influence surgical technique outcomes. | Michele Marchioni Giulia Primiceri Alessandro Veccia Marta Di Nicola Umberto Carbonara Fabio Crocerossa Ugo Falagario Ambra Rizzoli Riccardo Autorino Luigi Schips | 2024 | Asian Journal of Urology2024,11,1: | 0 |