Posts made in May, 2017

Serum tissue factor as a biomarker for renal clear cell carcinoma

Vol. 43 (x): 2017 May 5.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2017.0007


ORIGINAL ARTICLE

Daniel D’Oliveira Silva 1, Jorge A. P. Noronha 1, Bartira E. Pinheiro da Costa 2, Pedro Caetano Edler Zandona 1, Gustavo F. Carvalhal 1
1 Departamentos de Urologia, Pontifícia Universidade Católica, Porto Alegre, RS, Brasil; 2 Instituto de Pesquisas Biomédicas (BEP), Pontifícia Universidade Católica, Porto Alegre, RS, Brasil

 

ABSTRACT

Purpose: to determine the usefulness of serum TF as a potential marker for patients with clear cell RCC.

Materials and Methods: prospective study of 30 patients with clear cell RCC submit­ted to nephrectomy and 16 controls without clear cell RCC treated surgically for other conditions. TF is a endothelium marker that was correlated with worse prognosis in a variety of solid tumors including RCC. Serum TF was collected before surgery at the operating room and in the postoperative setting after at least four weeks. Serum samples were analyzed with a commercial ELISA kit for human TF (R&D Systems®).

Results: Mean preoperative serum TF levels in clear cell RCC patients and in controls were 66.8 pg/dL and 28.4 pg/dL, respectively (p<0.001). Mean postoperative serum TF levels in clear cell RCC patients were 26.3 pg/dL. In all patients with clear cell RCC postoperative serum levels of TF were lower, with a mean reduction of 41.6 pg/dL in the postoperative setting (p<0.001). Linear regression revealed that tumor size was cor­related with the postoperative reduction of serum TF levels (p=0.037).

Conclusions: We have shown a 3-fold reduction in the median preoperative serum levels of TF in patients with clear cell RCC after surgery. We have also...

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Complications after prone PCNL in pediatric, adult and geriatric patients – a single center experience over 7 years

Vol. 43 (x): 2017 May 5.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2016.0563


ORIGINAL ARTICLE

Sumit Kumar 1, Ramaiah Keshavamurthy 1, Vilvapathy Senguttuvan Karthikeyan 1, Ashwin Mallya 1
1 Department of Urology, Institute of Nephrourology, Bangalore, India

ABSTRACT

Introduction: CROES-Clavien system (CCS) for grading complications in percutaneous nephrolithotomy (PCNL) is a step towards standardization of outcomes. We categorized complications based on CCS and predicted risk factors across the entire cohort and individually for pediatric (P: ≤18 years), adult (A: 19-65 years) and geriatric (G: ≥65 years) subgroups to assess the risk factors in each subset. We assessed association of complications with length of hospitalization (LOH) and operation time (OT).

Materials and Methods: Retrospective record review of unilateral PCNL performed be­tween January 2009-September 2015 at a tertiary care center in India, performing around 150 PCNL per year.

Results: Out of 922 (P=61; A=794; G=67) PCNL, 259 (28.09%) complications occurred with CCS I, II, III and IV constituting 152 (16.49%), 72 (7.81%), 31 (3.36%) and 4 (0.43%) respectively and its distribution was similar across the subsets and majority (224; 24.3%) were minor (CCS-1, 2). Placement of a nephrostomy (47.4%; 18/38) in Group P, supracostal access, ≥2 punctures, higher GSS, nephrostomy, staghorn stones, ≥2 stones, stone size in Group A and hydronephrosis and prolonged OT in Group G were significantly associated with complications. On logistic regression, need of neph­rostomy (adj. OR – 4.549), OT (adj. OR – 1.364) and supracostal access (adj. OR – 1.471) significantly contributed to complications in the study population. LOH was found to be significantly...

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Comparison of two different suture techniques in laparoscopic partial nephrectomy

Vol. 43 (x): 2017 May 5.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2016.0550


ORIGINAL ARTICLE

Onur Kaygisiz 1, Sinan Çelen 2, Berna Aytac Vuruşkan 3, Hakan Vuruşkan 1
1 Department of Urology, Uludag University, Faculty of Medicine, Bursa, Turkey; 2 Afyon Sandikli Government Hospital, Afyon, Turkey; 3 Department of Surgical Pathology, Faculty of Medicine, Uludag University, Bursa, Turkey

ABSTRACT

Objective: To comparatively evaluate the traditional interrupted knot-tying and run­ning suture renorrhaphy with Monocryl® in laparoscopic partial nephrectomy (LPN).

Materials and Methods: A retrospective analysis of 62 consecutive patients undergo­ing LPN using traditional interrupted knot-tying suture renorrhaphy (Group 1; n=31) or running suture technique renorrhaphy with 2-0 monofilament polyglecaprone (Monocryl®, Ethicon) (Group 2; n=31) from December 2011 to October 2015 at the University. All patients underwent LPN performed by an experienced laparoscopic sur­geon. The demographic, perioperative and postoperative parameters were compared between the groups, and the effect of both suture techniques on the warm ischemic time (WIT) and trifecta were evaluated.

Results: The running suture renorrhaphy with Monocryl® reduced WIT, estimated blood lost and length of hospitalization stay significantly without increasing postoperative complication rate during LPN in comparison with interrupted knot-tying suture.

Conclusion: The renorrhaphy using the running suture with Monocryl® is an effective and safe technique with the advantage of shortening WIT even in more challenging and larger tumors during LPN.

Keywords: Nephrectomy;...

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Medical ozone therapy reduces oxidative stress and testicular damage in an experimental model of testicular torsion in rats

Vol. 43 (x): 2017 May 5.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2016.0546


ORIGINAL ARTICLE

Mustafa Tusat 1, Ahmet Mentese 2, Selim Demir 3, Ahmet Alver 4,5, Mustafa Imamoglu 6
1 Department of Pediatric Surgery, Kilis State Hospital, Kilis, Turkey; 2 Program of Medical Laboratory Techniques, Vocational School of Health Sciences, Karadeniz Technical, University, Trabzon, Turkey; 3 Department of Nutrition and Dietetics, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey; 4 Department of Medical Biochemistry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey; 5 Department of Medical Biochemistry, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey; 6 Department of Pediatric Surgery, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey

 

ABSTRACT

Objective: Testicular torsion (TT) refers to rotation of the testis and twisting of the spermatic cord. TT results in ischemia-reperfusion (I/R) injury involving increased oxidative stress, inflammation and apoptosis, and can even lead to infertility. The aim of this study was to investigate the effect of ozone therapy on testicular damage due to I/R injury in an experi­mental torsion model.

Materials and Methods: 24 male Sprague-Dawley rats were divided into 3 groups; sham-operated, torsion/detorsion (T/D), and T/D+ozone. Ozone (1mg/kg) was injected intraperi­toneally 120 minutes before detorsion and for the following 24h. Blood and tissue samples were collected at the end of 24h. Johnsen score, ischemia modified albumin (IMA), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) levels were determined.

Results:...

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High cancer detection rate using cognitive fusion – targeted transperineal prostate biopsies

Vol. 43 (x): 2017 May 5.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2016.0511


ORIGINAL ARTICLE

Snir Dekalo 1, Haim Matzkin 1, Nicola J Mabjeesh 1
1 Department of Urology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel

ABSTRACT

Objective MRI of the prostate improves diagnostic accuracy of prostate cancer. Dif­ferent fusion approaches with transrectal ultrasound images are employed. Objective: To determine detection rate of prostate cancer in men undergoing transperineal MRI-based cognitive fusion biopsy.

Materials and Methods: One hundred and sixty-four consecutive men underwent a multiple-core prostate transperineal biopsy. Univariable and multivariable logistic re­gression analyses were used to address the relationship between clinical parameters and prostate cancer detection rate.

Results: One hundred and fourteen patients underwent mpMRI prior to the transperi­neal biopsy, 52 (45%) were diagnosed with prostate cancer, of them, 36 had Gleason score ≥7 (69%). Among these 114 patients, 82 had suspicious lesions on MRI, and 43 of them were diagnosed with cancer (52%). On multivariate analysis, the most significant independent predictive factors were PSA density (P<0.001) and suspicious MRI lesion (P=0.006). Men with a PSA density of more than 0.22 and a suspicious lesion on MRI had a detection rate of 78%. Detection rate among 50 patients with no MRI study prior to this biopsy was 26%.

Conclusions: This study showed that among a group of mostly multi-biopsied patients, the presence of mpMRI lesions and high PSA density values helped to detect clinically significant prostate cancer using cognitive MRI/TRUS fusion...

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