Comparison of Two Different Bipolar Energy Resources in Transurethral Resection of Bladder Tumors

2021 ◽  
pp. 1-5
Author(s):  
Mehmet Kaynar ◽  
Zeliha Esin Celik ◽  
Emre Altintas ◽  
Ali Furkan Batur ◽  
Ozcan Kilic ◽  
...  
Keyword(s):  
Bladder Tumor ◽  
Perioperative Complications ◽  
Tumor Resection ◽  
Muscularis Propria ◽  
Transfusion Rate ◽  
Tissue Samples ◽  
Bipolar Energy ◽  
Significant Difference ◽  
Resected Tissue ◽  
Tissue Characteristics

<b><i>Purpose:</i></b> To determine whether the use of different bipolar resources is associated with different results on tissue and perioperative parameters in patients undergoing bipolar transurethral bladder tumor resection (bTURBT). <b><i>Methods:</i></b> In this single-center prospective study, patients diagnosed with bladder tumor randomized to undergo TURBT either with a Gyrus PlasmaKinetic system (<i>n</i> = 62) or Olympus TUR in saline (TURis) system (<i>n</i> = 51). Primary endpoint was to evaluate the alteration of patients’ perioperative parameters, while secondary aim was to assess the thermal effect of these 2 different bipolar devices on the resected tissue samples by a grading system determined by tissue characteristics. <b><i>Results:</i></b> One hundred thirteen patients were randomized in the study, and 43 were excluded from the analysis due to the exclusion criteria. There were no significant differences between the groups in terms of mean age, tumor site, number of tumors, operative time, alteration in hemoglobin or hematocrit, blood transfusion rate, catheterization time, and postoperative stay. On the other hand, the ratio of obturator jerk was significantly higher in the Olympus TURis group (<i>p</i> = 0.028). The histopathological analyses of both groups determined muscularis propria and cautery artifact presence without a statistically significant difference (χ<sup>2</sup>: 0.476, <i>p</i> = 0.788). <b><i>Conclusion:</i></b> Although the perioperative complications of bTURBT are low in nature, bladder perforation resulted from obturator jerk still poses a risk for extravesical tumor implantation. Urologists should be aware of this risk especially when they are using a TURis system.

Associations between clinical outcome and tractography based on navigated transcranial magnetic stimulation in patients with language-eloquent brain lesions

2020 ◽  
Vol 132 (4) ◽  
pp. 1033-1042 ◽  
Author(s):  
Nico Sollmann ◽  
Alessia Fratini ◽  
Haosu Zhang ◽  
Claus Zimmer ◽  
Bernhard Meyer ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Brain Tumors ◽  
Risk Stratification ◽  
Magnetic Stimulation ◽  
Diffusion Tensor ◽  
Tumor Resection ◽  
Navigated Transcranial Magnetic Stimulation ◽  
Language Mapping ◽  
Significant Difference ◽  
Related Pathway

OBJECTIVENavigated transcranial magnetic stimulation (nTMS) in combination with diffusion tensor imaging fiber tracking (DTI FT) is increasingly used to locate subcortical language-related pathways. The aim of this study was to establish nTMS-based DTI FT for preoperative risk stratification by evaluating associations between lesion-to-tract distances (LTDs) and aphasia and by determining a cut-off LTD value to prevent surgery-related permanent aphasia.METHODSFifty patients with left-hemispheric, language-eloquent brain tumors underwent preoperative nTMS language mapping and nTMS-based DTI FT, followed by tumor resection. nTMS-based DTI FT was performed with a predefined fractional anisotropy (FA) of 0.10, 0.15, 50% of the individual FA threshold (FAT), and 75% FAT (minimum fiber length [FL]: 100 mm). The arcuate fascicle (AF), superior longitudinal fascicle (SLF), inferior longitudinal fascicle (ILF), uncinate fascicle (UC), and frontooccipital fascicle (FoF) were identified in nTMS-based tractography, and minimum LTDs were measured between the lesion and the AF and between the lesion and the closest other subcortical language-related pathway (SLF, ILF, UC, or FoF). LTDs were then associated with the level of aphasia (no/transient or permanent surgery-related aphasia, according to follow-up examinations).RESULTSA significant difference in LTDs was observed between patients with no or only surgery-related transient impairment and those who developed surgery-related permanent aphasia with regard to the AF (FA = 0.10, p = 0.0321; FA = 0.15, p = 0.0143; FA = 50% FAT, p = 0.0106) as well as the closest other subcortical language-related pathway (FA = 0.10, p = 0.0182; FA = 0.15, p = 0.0200; FA = 50% FAT, p = 0.0077). Patients with surgery-related permanent aphasia showed the lowest LTDs in relation to these tracts. Thus, LTDs of ≥ 8 mm (AF) and ≥ 11 mm (SLF, ILF, UC, or FoF) were determined as cut-off values for surgery-related permanent aphasia.CONCLUSIONSnTMS-based DTI FT of subcortical language-related pathways seems suitable for risk stratification and prediction in patients suffering from language-eloquent brain tumors. Thus, the current role of nTMS-based DTI FT might be expanded, going beyond the level of being a mere tool for surgical planning and resection guidance.

scholarly journals The Effect of Zingiber officinale on the Spleen Tissue and Antibody Titer of Broiler Chickens

2019 ◽  
Vol 36 (01) ◽  
pp. 046-050
Author(s):  
Alireza Taghdisi ◽  
Sajjad Hejazi
Keyword(s):  
Broiler Chickens ◽  
Zingiber Officinale ◽  
Control Group ◽  
White Pulp ◽  
Broiler Chicks ◽  
Pulp Tissue ◽  
Tissue Samples ◽  
Serum Factors ◽  
Spleen Tissue ◽  
Significant Difference

Introduction Increasing the immune system's function of fighting infectious diseases is very important in the poultry industry. Ginger, scientifically known as Zingiber officinale, belongs to the Zingiberaceae family. The use of ginger in the diet of poultry increases serum levels of superoxide dismutase enzymes and glutathione peroxidase, which are considered to be important antioxidant enzymes. The main objective of the present study is to evaluate the effect of ginger on the spleen tissue of broiler chickens. Material and Methods The specimens comprised 2 groups of 20 Ross breed broiler chicks, for 42 days and were then, examined and tested. The diet was supplemented with 1 g/kg of ginger powder from the beginning of the rearing period. Blood samples of the chicks were randomly collected to measure the levels of hemagglutination (HI). The removed spleens were fixed with 10% formalin buffer. The specimens were cut in 5-micron diameters and stained with hematoxylin and eosin. Results and Conclusion There was a statistically significant difference in the mean of HI blood titers between the chicks in the growth period and final period groups (p < 0.05). The white-pulp tissue samples were more clearly seen in the treatment group than in the control group, and also, it was observed that the wall of the central artery of the white pulp was thicker in the ginger-treated group as compared with the control group. The nutritional value of ginger may vary. Thus, it is necessary to investigate the effect of this plant final on weight gain; the serum factors associated with the metabolic chart, and the response of the immune system to this plant.

scholarly journals Does Diabetes Affect the Surgical Outcomes in Cases With Cervical Ossification of the Posterior Longitudinal Ligament? A Multicenter Study From Asia Pacific Spine Study Group

2021 ◽  
pp. 219256822199630
Author(s):  
Narihito Nagoshi ◽  
Kota Watanabe ◽  
Masaya Nakamura ◽  
Morio Matsumoto ◽  
Nan Li ◽  
...  
Keyword(s):  
Multicenter Study ◽  
Surgical Outcomes ◽  
Hemoglobin A1c ◽  
Perioperative Complications ◽  
Japanese Orthopaedic Association ◽  
Posterior Longitudinal Ligament ◽  
Asia Pacific ◽  
C5 Palsy ◽  
Significant Difference ◽  
The Impact

Study Design: Retrospective multicenter study. Objectives: To evaluate the surgical outcomes of cervical ossification of the posterior longitudinal ligament (OPLL) in diabetes mellitus (DM) patients. Methods: Approximately 253 cervical OPLL patients who underwent surgical decompression with or without fixation were registered at 4 institutions in 3 Asian countries. They were followed up for at least 2 years. Demographics, imaging, and surgical information were collected, and cervical Japanese Orthopaedic Association (JOA) scores and the visual analog scale (VAS) for the neck were used for evaluation. Results: Forty-seven patients had DM, showing higher hypertension and cardiovascular disease prevalence. Although they presented worse preoperative JOA scores than non-DM patients (10.5 ± 3.1 vs. 11.8 ± 3.2; P = 0.01), the former showed comparable neurologic recovery at the final follow-up (13.9 ± 2.9 vs. 14.2 ± 2.6; P = 0.41). No correlation was noted between the hemoglobin A1c level in the DM group and the pre- and postoperative JOA scores. No significant difference was noted in VAS scores between the groups at pre- and postsurgery. Regarding perioperative complications, DM patients presented a higher C5 palsy frequency (14.9% vs. 5.8%; P = 0.04). A similar trend was observed when surgical procedure was limited to laminoplasty. Conclusions: This is the first multicenter Asian study to evaluate the impact of DM on cervical OPLL patients. Surgical results were favorable even in DM cases, regardless of preoperative hemoglobin A1c levels or operative procedures. However, caution is warranted for the occurrence of C5 palsy after surgery.

scholarly journals Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a multi-institutional comparative study

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Amr A. Faddan ◽  
Mahmoud M. Shalaby ◽  
Mohamed Gadelmoula ◽  
Younis Alshamsi ◽  
Daniar K. Osmonov ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Complication Rate ◽  
Perioperative Complications ◽  
Statistical Significance ◽  
Operating Time ◽  
Perioperative Outcomes ◽  
Academic Institutions ◽  
Robot Assisted ◽  
Surgical Specimen ◽  
Significant Difference

Abstract Background The standard surgical treatment of localized prostate cancer (PCa) has been rapidly changed along the last two decades from open to laparoscopic and finally robot-assisted techniques. Herein, we compare the three procedures for radical prostatectomy (RP), namely radical retropubic (RRP), laparoscopic (LRP), and robot-assisted laparoscopic (RALRP) regarding the perioperative clinical outcome and complication rate in four academic institutions. Methods A total of 394 patients underwent RP between January 2016 and December 2018 in four academic institutions; their records were reviewed. We recorded the patient age, BMI, PSA level, Gleason score and TNM stage, type of surgery, the pathological data from the surgical specimen, the perioperative complications, unplanned reoperating, and readmission rates within 3 months postoperatively. Statistical significance was set at (P < 0.05). All reported P values are two-sided. Results A total of 123 patients underwent RALRP, 220 patients underwent RRP, and 51 underwent LRP. There was no statistically significant difference between the three groups regarding age, BMI, prostatic volume, and preoperative PSA. However, there were statistically significant differences between them regarding the operating time (P < .0001), catheterization period (P < .001), hospital stay (P < .0001), and overall complications rate (P = .023). Conclusions The minimally invasive procedures (RALRP and LRP) are followed by a significantly lower complication rate. However, the patients’ factors and surgical experience likely impact perioperative outcomes and complications.

Transurethral Bladder Tumor Resection (TUR-Bt) in a Patient With Osler-Rendu-Weber Syndrome

Urology ◽  
2010 ◽  
Vol 75 (6) ◽  
pp. 1518
Author(s):  
Takashi Kawahara ◽  
Zenkichi Sekiguchi ◽  
Kaoru Kita ◽  
Kazuhide Makiyama ◽  
Noboru Nakaigawa ◽  
...  
Keyword(s):  
Bladder Tumor ◽  
Tumor Resection ◽  
Weber Syndrome

Comparison of stapler and handsewn anastomosis techniques in creating an ileal conduit following radical cystectomy

2021 ◽  
pp. 1
Keyword(s):  
Postoperative Complications ◽  
Ileal Conduit ◽  
Perioperative Complications ◽  
Movement Time ◽  
Oral Intake ◽  
Total Cost ◽  
Handsewn Anastomosis ◽  
Significant Difference ◽  
The Mean ◽  
Mean Time

Background and objective: Ileal conduit for urinary diversion can be completed using either end-to-end handsewn or stapled anastomosis. This study aimed to compare stepled and handsewn anastomosis methods in terms of complications, hospitalization and cost. Materials and methods: Forty-three patients were included in the hand-sewn and 44 patients in the stapler group. After creating an ileal conduit, continuity of the loop was achieved either with handsewn or stapler method. Patients' demographic data, time to onset of bowel movement, time to transit to oral intake, time to removal of the drain, perioperative and postoperative complications, mortality and total costs were retrospectively recorded and compared between the two groups. Results: There was no statistically significant difference between the groups in terms of the mean to the onset of bowel movements (p = 0.51) and the mean time to transit to oral intake (p = 0.23). The mean time to removal of the drain was significantly lower in the stapler group (p = 0.023). Perioperative complications were seen in eight patients in the handsewn group, while none of the patients in the stapler group developed perioperative complication (p = 0.003). Postoperative complications were similar between both groups (p = 0.75). The duration of hospitalization was statistically significantly lower in the stapler group (p = 0.004) and the mean total cost was statistically significantly more advantageous (p < 0.001). Conclusion: No significant difference was found between stapler and handsewn anastomosis techniques in terms of postoperative complications. On the other hand, hospitalization and total cost were in favour of stapler technique, showing that this technique can be used safely.

A propensity-adjusted comparison of endoscopic endonasal surgery versus transcranial microsurgery for pediatric craniopharyngioma: a single-center study

2021 ◽  
pp. 1-10
Keyword(s):  
Perioperative Complications ◽  
Single Center ◽  
Endoscopic Endonasal Surgery ◽  
Endonasal Surgery ◽  
Endoscopic Endonasal ◽  
Adjusted Analysis ◽  
Significant Difference ◽  
Csf Leakage ◽  
Hypothalamic Function

OBJECTIVE When comparing endoscopic endonasal surgery (EES) and transcranial microsurgery (TCM) for adult and mixed-age population craniopharyngiomas, EES has become an alternative to TCM. To date, studies comparing EES and TCM for pediatric craniopharyngiomas are sparse. In this study, the authors aimed to compare postoperative complications and surgical outcomes between EES and TCM for pediatric craniopharyngiomas. METHODS The data of pediatric patients with craniopharyngiomas who underwent surgery between February 2009 and June 2021 at a single center were retrospectively reviewed. All included cases were divided into EES and TCM groups according to the treatment modality received. The baseline characteristics of patients were compared between the groups, as well as surgical results, perioperative complications, and long-term outcomes. To control for confounding factors, propensity-adjusted analysis was performed. RESULTS Overall, 51 pediatric craniopharyngioma surgeries were identified in 49 patients, among which 35 were treated with EES and 16 were treated with TCM. The proportion of gross-total resection (GTR) was similar between the groups (94.3% for EES vs 75% for TCM, p = 0.130). TCM was associated with a lower rate of hypogonadism (33.3% vs 64.7%, p = 0.042) and a higher rate of growth hormone deficiency (73.3% vs 26.5%, p = 0.002), permanent diabetes insipidus (DI) (60.0% vs 29.4%, p = 0.043), and panhypopituitarism (80.0% vs 47.1%, p = 0.032) at the last follow-up. CSF leakage only occurred in the EES group, with no significant difference observed between the groups (p > 0.99). TCM significantly increased the risk of worsened visual outcomes (25.0% vs 0.0%, p = 0.012). However, TCM was associated with a significantly longer median duration of follow-up (66.0 vs 40.5 months, p = 0.007) and a significantly lower rate of preoperative hypogonadism (18.8% vs 60.0%, p = 0.006). The propensity-adjusted analysis revealed no difference in the rate of recurrence, hypogonadism, or permanent DI. Additionally, EES was associated with a lower median gain in BMI (1.5 kg/m2 vs 7.5 kg/m2, p = 0.046) and better hypothalamic function (58.3% vs 8.3%, p = 0.027) at the last follow-up. CONCLUSIONS Compared with TCM, EES was associated with a superior visual outcome, better endocrinological and hypothalamic function, and less BMI gain, but comparable rates of GTR, recurrence, and perioperative complications. These findings have indicated that EES is a safe and effective surgical modality and can be a viable alternative to TCM for pediatric midline craniopharyngiomas.

The Role of Pathology Review of Transurethral Bladder Tumor Resection Specimens in the Modern Era

2010 ◽  
Vol 183 (3) ◽  
pp. 921-928 ◽  
Author(s):  
Michael C. Lee ◽  
Howard S. Levin ◽  
J. Stephen Jones
Keyword(s):  
Bladder Tumor ◽  
Tumor Resection ◽  
Modern Era ◽  
Pathology Review

scholarly journals Single-Step Renal Dilatation Is a Novel Technique in Percutaneous Nephrolithotomy: A Prospective Randomised Study

2020 ◽  
Vol 20 (2) ◽  
pp. 70-73
Author(s):  
Md Shariful Islam ◽  
Md Shawkat Alam ◽  
AHM Mostofa Kamal ◽  
Md Asaduzzamman ◽  
Md Ruhul Quddus
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Perioperative Complications ◽  
Single Step ◽  
Safety And Efficacy ◽  
X Ray ◽  
Randomised Study ◽  
Operative Duration ◽  
Novel Technique ◽  
Significant Difference ◽  
Prospective Randomised Study

Purpose: To evaluate the feasibility, safety and efficacy of one-shot dilation (OSD) in percutaneous nephrolithotomy (PCNL). Materials and Methods: In a prospective randomised study including 62 patients divided into two groups, the first had RD before PCNL using the standard metallic telescopic dilators (Alken), and the second had RD using the 30-F Amplatz dilator over the central Alken dilator. The operative duration, with X-ray exposure, was calculated. The procedure outcome in terms of complications, stone-free rates and hospital stay was evaluated statistically. Results : The tract was dilated correctly in all cases. The operative duration and X-ray exposure was shorter in patients undergoing single-step RD (P < 0.05). There were perioperative complications, according to the Clavien grading system, in 15 (25%) patients but there was no statistically significant difference between the groups. The stone-free rates were comparable in both groups. Conclusion : A single-step RD during PCNL is feasible, with a shorter operative duration and X-ray exposure. The outcomes were comparable with those of a standard metallic telescopic RD Bangladesh Journal of Urology, Vol. 20, No. 2, July 2017 p.70-73

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