198 results on '"Antonio Celia"'
Search Results
2. Stone-scoring systems for predicting complications in percutaneous nephrolithotomy: A systematic review of the literature
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Giorgio Mazzon, Simon Choong, and Antonio Celia
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Percutaneous nephrolithotomy ,Complications ,Nomogram ,Stone-scoring system ,Clavien-Dindo ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Objective: Percutaneous nephrolithotomy is a treatment of choice for larger stones of the upper urinary tract. Currently, several nephrolithometric nomograms for prediction of post-operative surgical outcomes have been proposed, although uncertainties still exist regarding their roles in the estimation of complications. Methods: We conducted a systematic review on PubMed and Web of Sciences databases including English studies with at least 100 cases and published between January 2010 and December 2021. We identified original articles evaluating correlations between the Guy's stone score, the stone size (S), tract length (T), obstruction (O), number of involved calices (N), and essence or stone density (E) (S.T.O.N.E.), Clinical Research Office of the Endourological Society (CROES), and Seoul National University Renal Stone Complexity (S-ReSC) scores and post-operative complications in adult patients. We also included newly designed nomograms for prediction of specific complications. Results: After an initial search of 549 abstracts, we finally included a total of 18 papers. Of them, 11 investigated traditional nephrolithometric nomograms, while seven newly designed nomograms were used to predict specific complications. Overall, 7316 patients have been involved. In total, 14 out of 18 papers are derived from retrospective single-center studies. Guy's stone score obtained correlation with complications in five, S.T.O.N.E. nephrolithometry score in four, while CROES score and S-ReSC score in three and two, respectively. None of the studies investigated minimally invasive percutaneous nephrolithotomy (PCNL) and all cases have been conducted in prone position. Considering newly designed nomograms, none of them is currently externally validated; five of them predict post-operative infections; the remaining two have been designed for thromboembolic events and urinary leakage. Conclusion: This review presents all nomograms currently available in the PCNL field and highlights a certain number of concerns. Published data have appeared contradictory; more recent tools for prediction of post-operative complications are frequently based on small retrospective cohorts and lack external validations. Heterogeneity among studies has also been noticed. More rigorous validations are advisable in the future, involving larger prospective patients’ series and with the comparison of different tools.
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- 2023
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3. The role of the general practictioner in the management of urinary calculi
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Domenico Prezioso, Gaetano Piccinocchi, Veronica Abate, Michele Ancona, Antonio Celia, Ciro De Luca, Riccardo Ferrari, Pietro Manuel Ferraro, Stefano Mancon, Giorgio Mazzon, Salvatore Micali, Giacomo Puca, Domenico Rendina, Alberto Saita, Andrea Salvetti, Andrea Spasiano, Elisa Tesè, and Alberto Trinchieri
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Urinary calculi ,General practice ,Renal colic ,Diagnosis ,Treatment ,Prevention ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Background: The prevalence of kidney stones tends to increase worldwide due to dietary and climate changes. Disease management involves a high consumption of healthcare system resources which can be reduced with primary prevention measures and prophylaxis of recurrences. In this field, collaboration between general practitioners (GPs) and hospitals is crucial. Methods: a panel composed of general practitioners and academic and hospital clinicians expert in the treatment of urinary stones met with the aim of identifying the activities that require the participation of the GP in the management process of the kidney stone patient. Results: Collaboration between GP and hospital was found crucial in the treatment of renal colic and its infectious complications, expulsive treatment of ureteral stones, chemolysis of uric acid stones, long-term follow-up after active treatment of urinary stones, prevention of recurrence and primary prevention in the general population. Conclusions: The role of the GP is crucial in the management and prevention of urinary stones. Community hospitals which are normally led by GPs in liaison with consultants and other health professional can have a role in assisting multidisciplinary working as extended primary care.
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- 2023
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4. Open versus Robot-Assisted Radical Cystectomy for the Treatment of pT4a Bladder Cancer: Comparison of Perioperative Outcomes
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Davide Perri, Bernardo Rocco, Maria Chiara Sighinolfi, Pierluigi Bove, Antonio L. Pastore, Alessandro Volpe, Andrea Minervini, Alessandro Antonelli, Stefano Zaramella, Antonio Galfano, Giovanni E. Cacciamani, Antonio Celia, Orietta Dalpiaz, Simone Crivellaro, Francesco Greco, Giovannalberto Pini, Angelo Porreca, Andrea Pacchetti, Tommaso Calcagnile, Lorenzo Berti, Carlo Buizza, Federica Mazzoleni, and Giorgio Bozzini
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bladder cancer ,pT4 ,open radical cystectomy ,robot-assisted radical cystectomy ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
We compared the perioperative outcomes of open (ORC) vs. robot-assisted (RARC) radical cystectomy in the treatment of pT4a MIBC. In total, 212 patients underwent ORC (102 patients, Group A) vs. RARC (110 patients, Group B) for pT4a bladder cancer. Patients were prospectively followed and retrospectively reviewed. We assessed operative time, estimated blood loss (EBL), intraoperative and postoperative complications, length of stay, transfusion rate, and oncological outcomes. Preoperative features were comparable. The mean operative time was 232.8 vs. 189.2 min (p = 0.04), and mean EBL was 832.8 vs. 523.7 mL in Group A vs. B (p = 0.04). An intraoperative transfusion was performed in 32 (31.4%) vs. 11 (10.0%) cases during ORC vs. RARC (p = 0.03). The intraoperative complications rate was comparable. The mean length of stay was shorter after RARC (12.6 vs. 7.2 days, p = 0.02). Postoperative transfusions were performed in 36 (35.3%) vs. 13 (11.8%) cases (p = 0.03), and postoperative complications occurred in 37 (36.3%) vs. 29 (26.4%) patients in Groups A vs. B (p = 0.05). The positive surgical margin (PSM) rate was lower after RARC. No differences were recorded according to the oncological outcomes. ORC and RARC are feasible treatments for the management of pT4a bladder tumors. Minimally invasive surgery provides shorter operative time, bleeding, transfusion rate, postoperative complications, length of stay, and PSM rate.
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- 2024
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5. Reliability of nephrolithometric nomograms in patients treated with minimally invasive percutaneous nephrolithotomy: A precision study
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Giorgio Mazzon, Francesco Claps, Nicola Pavan, Simon Choong, Guohua Zeng, Wenqi Wu, Jiehui Zhong, Maida Bada, Marco Pirozzi, Raffaele Vitale, and Antonio Celia
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Urolithiasis ,Nomogram ,Percutaneous nephrolithotomy ,Renal stone ,Clavien-Dindo ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Objectives: The study aimed to evaluate quality of nephrolithometric nomograms to predict stone-free rates (SFRs) and complication rates (CRs) in case of minimally invasive percutaneous nephrolithotomy (PNL). In the last decade, nomograms have been introduced to estimate the SFRs and CRs of PNL. However, no data are available regarding their reliability in case of utilization of miniaturized devices. Herein we present a prospective multicentric study to evaluate reliability of Guy’s stone score (GSS), the stone size, tract length, obstruction, number of involved calyces, and essence of stone (S.T.O.N.E.) nephrolithometry score and Clinical Research Office of the Endourological Society (CROES) score in patients treated with minimally invasive PNL. Methods: We evaluated SFRs and CRs of 222 adult patients treated with miniaturized PNL. Patients were considered stone-free if no residual fragments of any size at post-operative unenhanced computed tomography scan. Patients demographics, SFRs, and CRs were reported and analyzed. Performances of nomograms were evaluated with the area under the curve (AUC). Results: We included 222 patients, the AUCs of GSS, CROES score, and S.T.O.N.E. nephrolithometry score were 0.69 (95% confidence interval [CI] 0.61–0.78), 0.64 (95% CI 0.56–0.73), and 0.62 (95% CI 0.52–0.71), respectively. Regarding SFRs, at multivariate binomial logistic regression, only the GSS had significance with an odds ratio of 0.53 (95% CI 0.31–0.95, p=0.04). We did not find significant correlation with complications, with only a trend for GSS. Conclusion: This is the first study evaluating nomograms in miniaturized PNL. They still show good reliability; however, our data showed lower performances compared to standard PNL. We emphasize the need of further studies to confirm this trend. A dedicated nomogram for minimally invasive PNL may be necessary.
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- 2023
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6. Randomized Clinical Trial Comparing On-clamp Versus Off-clamp Laparoscopic Partial Nephrectomy for Small Renal Masses (CLOCK II Laparoscopic Study): A Intention-to-treat Analysis of Perioperative Outcomes
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Riccardo Bertolo, Pierluigi Bove, Marco Sandri, Antonio Celia, Luca Cindolo, Chiara Cipriani, Mario Falsaperla, Costantino Leonardo, Andrea Mari, Paolo Parma, Alessandro Veccia, Domenico Veneziano, Andrea Minervini, and Alessandro Antonelli
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Partial nephrectomy ,Renal neoplasm ,Laparoscopy ,Off-clamp ,Clampless ,Ischemia ,Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Recent randomized trials (RCTs) in the field of robotic partial nephrectomy (PN) showed no significant differences in perioperative outcomes between the off- and on-clamp approaches. Objective: To compare the perioperative outcomes of on- versus off-clamp pure laparoscopic PN (LPN). Design, setting, and participants: A multi-institutional analysis of the on- versus off-clamp approach during LPN in the setting of an RCT (CLOCK II trial; ClinicalTrials.gov NCT02287987) was performed. Intervention: Off- versus on-clamp LPN. Outcome measurements and statistical analysis: Baseline patient and tumor variables, and peri- and postoperative data were collected. Randomized allocation with a 1:1 ratio was assigned. Surgical strategy for managing the renal pedicle was dictated by the study protocol. In the off-clamp arm, the renal artery had to remain unclamped for the duration of the whole procedure. Reporting the intention-to-treat analysis is the purpose of the study. Results and limitations: The study recruited 249 patients. Of them, 123 and 126 were randomized and allocated into the on- and off-clamp treatment groups, respectively. Treatment groups were comparable at baseline after randomization with respect to patients’ demographics, comorbidities, renal function, and tumor size and complexity. A univariable analysis found no differences in the perioperative outcomes between the groups, including median (interquartile range) estimated blood loss (150 [100–200] vs 150 [100–250] ml, p = 0.2), grade ≥2 complication rate as classified according to the Clavien-Dindo system (5.7% vs 4.8%, p = 0.6), and positive surgical margin rate (8.2% vs 3.5% for the on- vs off-clamp group, p = 0.1). No differences were found in terms of the 1st (81.3 [66.7–94.3] vs 85.3 [71.0–97.7] ml/min, p = 0.2) and 5th postoperative days estimated glomerular filtration rate (83.3 [70.5–93.7] vs 83.4 [68.6–139.3] ml/min, p = 0.2). A multivariable analysis found each +1 increase in RENAL score corresponded to an increase in the protection from the occurrence of complications (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.54–0.97, p = 0.034), while each +1 cm increase in tumor size corresponded to an increase in the risk of blood transfusion (OR 1.39, 95% CI 1.14–1.70, p = 0.001). Conclusions: In the setting of an RCT, no differences were found in the perioperative and early functional outcomes between on- and off-clamp LPN. Patient summary: In this study, we investigated, by means of a randomized trial, whether avoiding the clamping of renal artery during laparoscopic resection of renal mass is able to translate into benefits. We found no differences in terms of safety, efficacy, and renal function from the standard approach, which includes arterial clamping.
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- 2022
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7. Rectal Perforation During Pelvic Surgery
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Bernardo Rocco, Gaia Giorgia, Assumma Simone, Calcagnile Tommaso, Sangalli Mattia, Terzoni Stefano, Eissa Ahmed, Bozzini Giorgio, Bernardino De Concilio, Antonio Celia, Micali Salvatore, and Maria Chiara Sighinolfi
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Rectal perforation ,Complication ,Iatrogenic ,Pelvic surgery ,Minimally invasive surgery ,Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Rectal perforations during pelvic surgery are rare but serious complications. The occurrence of rectal involvement is generally lower than that of the involvement of other portions of the bowel. The urologic field is responsible for the majority of iatrogenic rectal injuries from pelvic surgery; general and gynecologic surgeries are prone to the occurrence as well, the latter especially in the case of rectal shaving for deep infiltrating endometriosis. Attention should be posed to the prevention of rectal injuries, especially in case of challenging or salvage procedures; some tricks may be recommended to avoid thermal and mechanical damages and to realize a safe dissection. Intraoperative detection of rectal injuries is of paramount importance; once confirmed, immediate management with the closure of the defect is recommended. In general, rectal injuries diagnosed after surgery are liable to significantly worse outcomes than those detected and managed intraoperatively. Patient summary: Rectal perforation is a rare but possible complication of pelvic surgeries. The more challenging the procedure (ie, surgery for locally advanced tumors or after radiation therapy), the higher the risk of rectal lesion. Intraoperative management of the injury should be attempted, with direct repair of the defect with or without fecal diversion.
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- 2022
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8. Corrigendum to 'Rectal Perforation During Pelvic Surgery' [Eur Urol Open Sci 44 (2022) 54–59]
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Bernardo Rocco, Giorgia Gaia, Simone Assumma, Tommaso Calcagnile, Mattia Sangalli, Stefano Terzoni, Ahmed Eissa, Giorgio Bozzini, Bernardino De Concilio, Antonio Celia, Salvatore Micali, and Maria Chiara Sighinolfi
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Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2023
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9. Percutaneous Ablation of T1 Renal Masses: Comparative Local Control and Complications after Radiofrequency and Cryoablation
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Lorenzo Bertolotti, Federica Segato, Francesco Pagnini, Sebastiano Buti, Andrea Casarin, Antonio Celia, Francesco Ziglioli, Umberto Maestroni, Giuseppe Pedrazzi, Velio Ascenti, Chiara Martini, Calogero Cicero, and Massimo De Filippo
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radiofrequency ablation ,cryoablation ,renal mass ,kidney cancer ,thermal ablation ,percutaneous ablation ,Medicine (General) ,R5-920 - Abstract
The efficacy and complication rates of percutaneous radiofrequency ablation (RFA) and cryoablation (CA) in the treatment of T1 renal masses in two Northern Italy hospitals were retrospectively investigated. Eighty-two patients with 80 T1a tumors and 10 T1b tumors treated with thermal ablation from 2015 through 2020 were included. A total of 43 tumors in 38 patients were treated with RFA (2.3 ± 0.9 cm), and 47 tumors in 44 patients were treated with CA (2.1 ± 0.8 cm). The mean follow-up observation period was 26 ± 19 months. The major complications and efficacy, as measured using the technical success and local tumor recurrence rates, were recorded. There were three (6.9%) technical failures with RFA and one (2.1%) with cryoablation (p = 0.30). Among the 40 tumors that were successfully treated with RFA, 1 tumor (2.5%) developed local tumor recurrence; 5/46 tumors that were treated with cryoablation (10.8%) developed local tumor recurrence (p = 0.17). T1b lesions (4.0 ± 0.7 cm) resulted in 1/6 technically unsuccessful cases with RFA and 0/4 with CA. No recurrent disease was detected in the T1b lesions. Major complications occurred after 2.3% (1/43) of RFAs and 0/47 of cryoablation procedures. RFA and cryoablation are both effective in the treatment of renal masses. Major complications with either procedure are uncommon.
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- 2023
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10. Protocol of the Italian Radical Cystectomy Registry (RIC): a non-randomized, 24-month, multicenter study comparing robotic-assisted, laparoscopic, and open surgery for radical cystectomy in bladder cancer
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Angelo Porreca, Katie Palmer, Walter Artibani, Alessandro Antonelli, Lorenzo Bianchi, Eugenio Brunocilla, Aldo Massimo Bocciardi, Maurizio Brausi, Gian Maria Busetto, Marco Carini, Giuseppe Carrieri, Antonio Celia, Luca Cindolo, Giovanni Cochetti, Renzo Colombo, Ettore De Berardinis, Ottavio De Cobelli, Fabrizio Di Maida, Amelio Ercolino, Franco Gaboardi, Antonio Galfano, Andrea Gallina, Michele Gallucci, Carlo Introini, Ettore Mearini, Andrea Minervini, Francesco Montorsi, Gennaro Musi, Giovannalberto Pini, Riccardo Schiavina, Silvia Secco, Sergio Serni, Claudio Simeone, Giovanni Tasso, and Daniele D’Agostino
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Cancer ,Neoplasm ,bladder ,Urinary ,Robotic ,Surgery ,Bladder reconstruction ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Background Bladder cancer is the ninth most common type of cancer worldwide. In the past, radical cystectomy via open surgery has been considered the gold-standard treatment for muscle invasive bladder cancer. However, in recent years there has been a progressive increase in the use of robot-assisted laparoscopic radical cystectomy. The aim of the current project is to investigate the surgical, oncological, and functional outcomes of patients with bladder cancer who undergo radical cystectomy comparing three different surgical techniques (robotic-assisted, laparoscopic, and open surgery). Pre-, peri- and post-operative factors will be examined, and participants will be followed for a period of up to 24 months to identify risks of mortality, oncological outcomes, hospital readmission, sexual performance, and continence. Methods We describe a protocol for an observational, prospective, multicenter, cohort study to assess patients affected by bladder neoplasms undergoing radical cystectomy and urinary diversion. The Italian Radical Cystectomy Registry is an electronic registry to prospectively collect the data of patients undergoing radical cystectomy conducted with any technique (open, laparoscopic, robotic-assisted). Twenty-eight urology departments across Italy will provide data for the study, with the recruitment phase between 1st January 2017-31st October 2020. Information is collected from the patients at the moment of surgical intervention and during follow-up (3, 6, 12, and 24 months after radical cystectomy). Peri-operative variables include surgery time, type of urinary diversion, conversion to open surgery, bleeding, nerve sparing and lymphadenectomy. Follow-up data collection includes histological information (e.g., post-op staging, grading, and tumor histology), short- and long-term outcomes (e.g., mortality, post-op complications, hospital readmission, sexual potency, continence etc). Discussion The current protocol aims to contribute additional data to the field concerning the short- and long-term outcomes of three different radical cystectomy surgical techniques for patients with bladder cancer, including open, laparoscopic, and robot-assisted. This is a comparative-effectiveness trial that takes into account a complex range of factors and decision making by both physicians and patients that affect their choice of surgical technique. Trial registration ClinicalTrials.gov , NCT04228198 . Registered 14th January 2020- Retrospectively registered.
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- 2021
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11. Minimally invasive simple prostatectomy: Robotic-assisted versus laparoscopy. A comparative study
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Michele Amenta, Francesco Oliva, Biagio Barone, Alfio Corsaro, Davide Arcaniolo, Antonio Scarpato, Gennaro Mattiello, Lorenzo Romano, Carmine Sciorio, Tommaso Silvestri, Giovanni Costa, Felice Crocetto, and Antonio Celia
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minimally invasive simple prostatectomy ,benign prostatic hyperplasia ,laparoscopy ,robotic-assisted surgey ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Purpose: Robotic-assisted simple prostatectomy (RASP) is a novel surgical procedure for the management of obstructive symptoms caused by enlarged prostate glands. Before the introduction of minimally invasive techniques, the standard approach was the open simple prostatectomy (OSP). The aim of our study was to compare intraoperative and perioperative outcomes of robotic (RASP) and laparoscopic (LSP) simple prostatectomy. Methods: We retrospectively analyzed data from patients who underwent minimally invasive simple prostatectomy at the Urological Department of Portogruaro Hospital, Portogruaro, and at the Urological Department of “San Bassiano” Hospital, in Bassano del Grappa, from March 2015 to December 2020. Data collected from medical records included age, body mass index, prostate volume, operative time, preoperative International Prostatic Symptoms Score (IPSS), postoperative IPSS, time with drainage, blood transfusion, intraoperative complications, perioperative complications and length of hospital stay. Results: Robotic-assisted (n = 25) and laparoscopic simple prostatectomy (n = 25) were performed with a transvesical approach. No significant differences were observed regarding baseline characteristics, body mass index, prostate volume and IPSS. Operative time was lower in the laparoscopic group (122 min vs 139 min) (p = 0.024), while hospital stay was lower in the robotic group (4 days vs 6 days) (p = 0.047). Conclusions: Robotic-assisted simple prostatectomy is a safe technique with results comparable to laparoscopic simple prostatectomy, encompassing the advantage of a shorter hospitalization. Considering the costs and the limited availability of robotic-assisted simple prostatectomy, laparoscopic simple prostatectomy is a valid and safe alternative for experienced surgeons.
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- 2022
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12. The Therapeutic Intensity Score as Predictor of Clinical Outcomes after Total and Partial Adrenalectomy for Unilateral Primary Aldosteronism: Results of a Multicentric Series
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Umberto Anceschi, Marilda Mormando, Rocco Simone Flammia, Cristian Fiori, Orazio Zappalà, Bernardino De Concilio, Aldo Brassetti, Alessandro Carrara, Maria Consiglia Ferriero, Gabriele Tuderti, Leonardo Misuraca, Francesco Prata, Antonio Tufano, Alfredo Maria Bove, Riccardo Mastroianni, Marialuisa Appetecchia, Giuseppe Tirone, Francesco Porpiglia, Antonio Celia, and Giuseppe Simone
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Conn’s syndrome ,primary aldosteronism ,partial adrenalectomy ,outcomes ,PASO ,hypertension ,Medicine - Abstract
Background: To evaluate the ability of therapeutic intensity score (TIS) in predicting the clinical outcomes of partial (PA) and total adrenalectomy (TA) for UPA. Methods: Between 2011 and 2022, a four-center adrenalectomy dataset was queried for “unilateral adrenal mass” and “UPA” (n = 90). Preoperative TIS of each antihypertensive medication were individually calculated and merged to create a single, cumulative variable. Probability of complete clinical, partial, and absent pooled success rates according to TIS were assessed for the overall cohort by Kaplan–Meier. Cox analyses were used to identify predictors of complete clinical and partial/absent success, respectively. For all analyses, a two-sided p < 0.05 was considered significant. Results: At a median follow-up of 42 months (IQR 27–54) complete partial, and absent clinical success were observed in 60%, 17.7%, and 22.3%, respectively. On Kaplan–Meier analysis, TIS < 1 predicted higher complete success rates (p < 0.001), while TIS ≥ 1 was predictor of either partial and absent clinical success (p = 0.008). On multivariable analysis, TIS < 1 (HR 0.25; 95% CI 0.11–0.57; p = 0.001) and adenoma size (HR 1.11; 95% CI 1–1.23; p = 0.0049) were independent predictors of complete clinical success, while TIS ≥ 1 (HR 2.84; 95% CI 1.32–6.1; p = 0.007) was the only independent predictor of absent clinical success. Conclusions: TIS score and adenoma size may help to identify patients who are likely to be at risk of persistent hypertension after surgery.
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- 2023
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13. Assessing Trifecta Achievement after Percutaneous Cryoablation of Small Renal Masses: Results from a Multi-Institutional Collaboration
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Andrea Piasentin, Francesco Claps, Tommaso Silvestri, Giacomo Rebez, Fabio Traunero, Maria Carmen Mir, Michele Rizzo, Antonio Celia, Calogero Cicero, Martina Urbani, Luca Balestreri, Lisa Pola, Fulvio Laganà, Stefano Cernic, Maria Assunta Cova, Michele Bertolotto, Carlo Trombetta, Giovanni Liguori, and Nicola Pavan
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cryoablation ,renal cancer ,small renal masses ,Medicine (General) ,R5-920 - Abstract
Background and Objectives: To assess efficacy and safety of Percutaneous Cryoablation (PCA) of small renal masses (SRMs) using Trifecta outcomes in a large cohort of patients who were not eligible for surgery. Materials and methods: All PCAs performed in four different centers between September 2009 and September 2019 were retrospectively evaluated. Patients were divided in two different groups depending on masses dimensional criteria: Group-A: diameter ≤ 25 mm and Group-B: diameter > 25 mm. Complications rates were reported and classified according to the Clavien–Dindo system. The estimate glomerular filtration rate (eGFR) was calculated before PCA and during follow-up schedule. Every patient received a Contrast Enhanced Ultrasound (CEUS) evaluation on the first postoperative day. Radiological follow-up was taken at 3, 6, and 12 months for the first year, then yearly. Radiological recurrence was defined as a contrast enhancement persistence and was reported in the study. Finally, Trifecta outcome, which included complications, RFS, and preservation of eGFR class, was calculated for every procedure at a median follow-up of 32 months. Results: The median age of the patients was 74 years. Group-A included 200 procedures while Group-B included 140. Seventy-eight patients were eligible for Trifecta evaluation. Trifecta was achieved in 69.6% of procedures in Group-A, 40.6% in Group-B (p = 0.02). We observed an increased rate of complication in Group-B (13.0% vs. 28.6; p < 0.001). However, 97.5% were p = 0.08). Conclusions: PCA seems to be a safe and effective treatment for SRM but in the need of more strict dimensional criteria to achieve a higher possible success rate.
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- 2022
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14. Reliable Prediction of Post-Operative Complications’ Rate Using the G8 Screening Tool: A Prospective Study on Elderly Patients Undergoing Surgery for Kidney Cancer
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Fabio Traunero, Francesco Claps, Tommaso Silvestri, Maria Carmen Mir, Luca Ongaro, Michele Rizzo, Andrea Piasentin, Giovanni Liguori, Francesca Vedovo, Antonio Celia, Carlo Trombetta, and Nicola Pavan
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G8 ,elderly ,preoperative assessment ,frailty ,geriatric assessment ,urological surgery ,Medicine - Abstract
In the last years the incidence of renal neoplasms has been steadily increasing, along with the average age of patients at the time of diagnosis. Surgical management for localized disease is becoming more challenging because of patients’ frailty. We conducted a multi-center prospective study to evaluate the role of the G8 as a screening tool in the assessment of intra and post-operative complications of elderly patients (≥70 y.o.) undergoing surgery for kidney cancer. A total of 162 patients were prospectively enrolled between January 2015 to January 2019 and divided into two study groups (frail vs. not-frail) according to their geriatric risk profile based on G8 score. Several factors (i.e., age, CCI, ASA score, preoperative anemia, RENAL score, surgical procedures, and techniques) were analyzed to identify whether any of them would configure as a statistically significant predictor of surgical complications. According to the G8 Score, 90 patients were included in the frail group. A total of 52 frail patients vs. 4 non-frail patients developed a postoperative complication of any kind (p < 0.001). Of these, 11 were major complications and all occurred in the frail group. Our results suggest that the G8 screening tool is an effective and useful instrument to predict the risk of overall complications in elderly patients prior to renal surgery.
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- 2022
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15. Surgical Quality, Antihypertensive Therapy, and Electrolyte Balance: A Novel Trifecta to Assess Long-Term Outcomes of Adrenal Surgery for Unilateral Primary Aldosteronism
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Umberto Anceschi, Marilda Mormando, Cristian Fiori, Orazio Zappalà, Bernardino De Concilio, Aldo Brassetti, Alessandro Carrara, Maria Consiglia Ferriero, Gabriele Tuderti, Leonardo Misuraca, Alfredo Maria Bove, Riccardo Mastroianni, Alfonsina Chiefari, Marialuisa Appetecchia, Giuseppe Tirone, Francesco Porpiglia, Antonio Celia, Michele Gallucci, and Giuseppe Simone
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trifecta ,primary aldosteronism ,adrenalectomy ,PASO ,Conn’s syndrome ,Medicine - Abstract
Background: To propose a trifecta that summarizes endpoints and predicts their maintenance after adrenalectomy (n = 90) for unilateral primary aldosteronism (UPA). Methods: Trifecta was defined as coexistence of: ≥50% antihypertensive therapeutic intensity score reduction (∆TIS), no hypokalemia at 3 months, and no Clavien grade 2–5. Logistic regression was used to identify predictors of trifecta. Probability of clinical, biochemical, and simultaneous success according to trifecta were assessed by Kaplan–Meier. Cox regression was used to identify predictors of long-term clinical, biochemical, and simultaneous success. For all analyses, a two-sided p < 0.05 was considered significant. Results: Simultaneous success rate was 50%. On multivariable analysis, TIS was an independent predictor of trifecta achievement (HR 3.28; 95% CI 1.07–10.9; p = 0.03). At Kaplan–Meier, trifecta predicted higher success for all endpoints (each p < 0.03). On multivariable Cox analysis, adenoma size (AS) ≥6 cm and trifecta were independent predictors of biochemical (AS: HR 2.87; 95% CI 1.53–5.36; trifecta: HR 2.1; 95% CI 1.13–3.90; each p < 0.02) and simultaneous success (AS: HR 3.81; 95% CI 1.68–8.65; trifecta: HR 4.29; 95% CI 2.08–8.86; each p < 0.01), while trifecta was an independent predictor of complete clinical success (HR 2.84; 95% CI 1.45–5.58; p < 0.01). Conclusions: Trifecta and AS are independent predictors of either long-term complete clinical, biochemical, or combined success after adrenalectomy for UPA.
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- 2022
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16. Gelatin sponge (Spongostan®) and N-butyl-2-cyanoacrylate: Utility on percutaneous treatment of persistent urinary leakage after partial nephrectomy. Case report and review of the literature
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Bernardino de Concilio, Francesca Vedovo, Maria Carmen Mir, Tommaso Silvestri, Andrea Casarin, and Antonio Celia
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Cyanoacrylates ,Fibrin foam ,Gelatin sponge ,Urinary fistula ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Introduction: Percutaneous treatment of persistent urinary fistula after partial nephrectomy using N-butyl-2-cyanoacrylate and gelatin sponge (Spongostan®) is an effective and relatively non-invasive procedure that should be considered when a conservative approach fails. Three successful cases of percutaneous embolization by using N-butyl-2-cyanoacrylate have been reported in the literature. To our knowledge, the use of Spongostan for the treatment of urinary fistula after partial nephrectomy has not been previously described. Case report: We present the case of an 82-year old man who underwent percutaneous closure of a urinary fistula following partial nephrectomy by using gelatin sponge (Spongostan®) and N-butyl-2-cyanoacrylate. Conclusions: We encourage the use of this technique in selected cases. Collaboration amongst urologists and skilled interventional radiologist is strongly recommended.
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- 2020
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17. COMMENT ON: Hospital care in Departments defined as COVID-free: A proposal for a safe hospitalization protecting healthcare professionals and patients not affected by COVID-19
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Alessandro Tafuri, Andrea Minervini, Antonio Celia, Luca Cindolo, Riccardo Schiavina, Bernardo Rocco, Angelo Porreca, and Alessandro Antonelli
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Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
The COVID-19 outbreak dramatically changed hospital everyday life, impairing the course of previous routine activity, also in urology. In the next months, together with keeping the focus on the prevention of contagion recrudescence, the health care system will face another stringent issue, i.e. to restore all the services not COVID-related. Leonardi et al. in their paper report an equilibrate overview on the incoming “Phase 2”, in order to set up so-called COVID-free hospitals and departments. The authors offer an insight from a practical point of view, detailing protocols for any of the steps of the path of care, from the outpatient visit to surgery
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- 2020
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18. Efficacy and safety of Finasteride (5 alpha-reductase inhibitor) monotherapy in patients with benign prostatic hyperplasia: A critical review of the literature
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Gian Maria Busetto, Francesco Del Giudice, Daniele D'Agostino, Daniele Romagnoli, Andrea Minervini, Bernardo Rocco, Alessandro Antonelli, Antonio Celia, Riccardo Schiavina, Luca Cindolo, Benjamin I. Chung, Jae Heon Kim, Martina Maggi, Alessandro Sciarra, Ettore De Berardinis, and Angelo Porreca
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Benign prostatic hyperplasia ,5 alpha-reductase inhibitor ,Finasteride ,Side effects ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Background: Combination therapy with 5 alpha-reductase inhibitor (5-ARI) and alpha-blocker can be considered as a gold standard intervention for medical management of lower urinary tract symptoms related to benign prostatic hyperplasia (LUTS/BPH). On the other hand, 5-ARI monotherapy and in particular Finasteride alone is currently getting focus of attention especially due to lack of systematic reviews investigating efficacy outcomes and/or adverse events associated. Objectives: Aim of the present critical review was to analyze current knowledge of clinical efficacy and incidence of adverse events associated with 5-ARI treatment for LUTS/BPH. Materials and methods: A systematic review of clinical trials of the literature of the past 20 years was performed using database from PubMed, Cochrane Collaboration and Embase. A total of 8821 patients were included in this study and inclusion criteria for studies selection were: data from randomized clinical trials (RCTs) focusing their attention on the clinical role of Finasteride monotherapy for symptomatic BPH. Parameters of research included prostate specific antigen (PSA), prostate volume (PV), International Prostate Symptom Score (IPPS), postvoid residual urine (PVR), voiding symptoms of IPSS (voiding IPSS), maximum urinary flow rate (Qmax), and adverse events (AEs). Results: Overall 12 original articles were included and critically evaluated. Sample sizes of patient actively treated with finasteride varied from 13 to 1524 cases analyzed in a single study. Follow-up after treatments ranged from 3 to 54 months. The effect of finasteride in reducing prostate volume (PV) was moderate (standardized mean difference (SMD) effect between 0.5 to 0.8 for all trials evaluable) while the effect on IPSS score and Qmax was considered significant (SMD in the 0.2 to 0.5 variation range). No severe AEs and/or psychiatric disorders were retrieved among the studies. Sexual health dysfunctions were significantly influenced by finasteride therapy when compared with placebo treated patients. Conclusions: Although significant clinical benefits of finasteride monotherapy were demonstrated, the effective size of the available reports included in the analysis is limited. Additional head-to-head studies would be needed to re-evaluate clinical efficacy and safety of 5-ARI in combination or not with alpha blockers.
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- 2020
19. Evaluation of laparoscopic vs robotic partial nephrectomy using the margin, ischemia and complications score system: a retrospective single center analysis
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Stefano Ricciardulli, Qiang Ding, Xu Zhang, Hongzhao Li, Yuzhe Tang, Guoqiang Yang, Xiyou Wang, Xin Ma, Alberto Breda, and Antonio Celia
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Complications ,Laparoscopic partial nephrectomy ,Positive margins ,Robot-assisted partial nephrectomy ,Warm ischemia time ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Objective: To evaluate differences between Laparoscopic Partial Nephrectomy (LPN) and Robot-Assisted Partial Nephrectomy (RAPN) using the Margin, Ischemia and Complications (MIC) score system and to evaluate factors related with MIC success. Materials and Methods: Single centre retrospective study on 258 LPN and 58 RAPN performed between January 2012 and January 2014. Success was defined when surgical margins was negative, Warm Ischemia Time (WIT) was ≤ 20 minutes and no major complications occurred. Mann-Whitney-U and Pearson χ2 correlation were used to compare LPN and RAPN. A matched pair comparison was also performed. Spearman correlation (Rho) was used to evaluate the relationship between clinical, intra and post-operative and pathological patients characteristics with MIC score. A binary regression analysis was also performed to evaluate independent factors associated with MIC success. Results: The MIC rate in LPN and RAPN was 55% and 65.5% respectively. No differences in clinical, intra and post-operative outcomes between groups were found. Clinical tumor size (p-value: < 0.001; OR: 0.829; 95% CI: 0.697-0.987), PADUA score (p-value: < 0.001; OR: 0.843; 95% CI: 0.740-0.960), PADUA risk groups (intermediate; p-value: < 0.001; OR: 0.416; 95% CI: 0.238- 0.792; high: p-value: < 0.001; OR: 0.356; 95% CI: 0.199- 0.636), WIT (p-value: < 0.001; OR: 0.598; 95% CI: 0.530- 0.675) were independently associated with MIC. eGFR (< 60 vs ≥ 60 ml/min per 1.73 m2: p-value: < 0.001; OR: 3.356; 95% CI: 1.701-6.621) and Fuhrman nuclear grade (p-value: 0.014; OR: 1.798; 95% CI:1.129-2.865) were also independently associated with MIC. Conclusions: MIC score system is a simple and useful tool to report and to compare different surgical approach.
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- 2015
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20. Renal angiomyolipoma with renal vein invasion
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Francesca Di Cristofano, Federico Petrucci, Guglielmo Zeccolini, Genesio Leo, Calogero Cicero, Dario Del Biondo, and Antonio Celia
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Angiomyolipoma ,Kidney ,Renal vein invasion ,Radical nephrectomy ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Renal angiomyolipoma is a uncommon benign tumor, considered an hamartoma. The lesion, usually benign, can be single or multiple and well-circumscribed. In letterature only few cases of infiltrating angiomyolipomas have been described. The aim of the paper is to describe a paradigmatic case of a giant kidney angiomyolipoma, not associ- ated with tuberous sclerosis, invading the pelvis and the renal vein. The lesion have been discovered incidentally during abdominal ultrasound for other pathology. Owing to the extent of the lesion and the appreciable risk of bleeding, we opted for surgical treatment.
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- 2013
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21. Percutaneous Ablation vs Robot-Assisted Partial Nephrectomy for Completely Endophytic Renal Masses: A Multicenter Trifecta Analysis with a Minimum 3-Year Follow-Up
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Savio Domenico Pandolfo, Alp T. Beksac, Ithaar Derweesh, Antonio Celia, Riccardo Schiavina, Lorenzo Bianchi, Giovanni Costa, Umberto Carbonara, Davide Loizzo, Giuseppe Lucarelli, Clara Cerrato, Ciro Imbimbo, Vicenzo Mirone, Jeffrey Elbich, Giuseppe Basile, Lance J. Hampton, Fernando J. Kim, Umberto Capitanio, Jihad Kaouk, and Riccardo Autorino
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Urology - Published
- 2023
22. Percutaneous thermal ablation for cT1 renal mass in solitary kidney: A multicenter trifecta comparative analysis versus robot-assisted partial nephrectomy
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Savio Domenico Pandolfo, Davide Loizzo, Alp T. Beksac, Ithaar Derweesh, Antonio Celia, Lorenzo Bianchi, Jeffrey Elbich, Giovanni Costa, Umberto Carbonara, Giuseppe Lucarelli, Clara Cerrato, Margaret Meagher, Pasquale Ditonno, Lance J. Hampton, Giuseppe Basile, Fernando J. Kim, Riccardo Schiavina, Umberto Capitanio, Jihad Kaouk, and Riccardo Autorino
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Oncology ,Surgery ,General Medicine - Abstract
Renal cell carcinoma (RCC) in solitary kidney (SK) represents a challenging scenario. We sought to compare outcomes of robot-assisted partial nephrectomy (RAPN) versus percutaneous thermal ablation (PTA) in SK patients with renal tumors cT1.We performed a multicenter retrospective analysis of SK patients treated for RCC. The PTA group included cryoablation or radiofrequency ablation. We collected baseline characteristics, intraoperative, pathological, and post-operative data. We applied an arbitrary composite "trifecta" to assess surgical, functional, and oncological outcomes, only for malignant histology. RFS analysis was performed using the Kaplan-Meier method. Multivariable regression analysis was performed to determine independent predictors of "trifecta" achievement.We included 198 SK patients (RAPN, n = 50; PTA n = 119). Mean clinical tumor size was not significantly different while R.E.N.A.L. score was higher for RAPN (p 0.001). No differences in intra and major post-procedural complications. Recurrence rate was higher in PTA group but not statistically significant (p 0.328). No difference in metastasis rate was found (p = 0.435). RFS was 96.1% in RAPN and 86.8% in PTA cohort (p = 0.003) while no difference in PFS was detected (p = 0.1). Trifecta was achieved in 72.5% of RAPN vs 77.3% of PTA (p = 0.481). Multivariable analysis has not detected predictors for Trifecta achievement.PTA offers good outcomes in the management of SK patients with RCC. Compared with RAPN, it might carry a higher risk of recurrence; on the other hand, re-treatment is possible. Overall, PTA can be safely offered to treat SK patients presenting RCC. In general, it should be preferred in more frail patients to minimize the risk of complications.
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- 2023
23. Saphenous-sparing laparoscopic inguinal lymphadenectomy
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Gaetano Chiapparrone, Sebastiano Rapisarda, Bernardino de Concilio, Guglielmo Zeccolini, Michele Antoniutti, and Antonio Celia
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Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
ABSTRACT Introduction: Inguinal lymphadenectomy is an integral part in the management of penile cancer. Video endoscopic inguinal lymphadenectomy (VEIL) is emerging as a minimally invasive treatment to reduce postoperative complications. Materials and Methods: 62 years old man underwent glansectomy for a squamous cell carcinoma (pT1b). At the physical examination one left inguinal lymph node was detectable (cN1). The chest-abdomen-pelvis CT was negative for metastasis. A 10-mm optical trocar and two 5mm operating trocar were placed. The optical trocar was placed in the apex of Scarpa's triangle after a skin incision and after the creation of a subcutaneous space by blunt finger dissection. The pCO2 was 8-10mmHg. The surgical technique involved the removal of superficial lymph nodes according to the scheme described by Deseler and of the deep lymph nodes. Sparing main venous structures and closing lymphatic vessels is important to reduce post operative complications. At the end of the procedure, a suction drain was placed per side. Results: Operative time was 90 minutes per side. Drains were removed on the seventh postoperative day. Hospital stay was 8 days and no postoperative complications occurred. The total number of nodes removed was 16 (8 per side) with 2 superficial positive nodes on the left side. Conclusion: ILND is burned by a high complication rate. VEIL provides a less invasive approach and a saphenous-sparing technique ensures a lower complication rate, reducing lymphorrhea, skin necrosis and wound complications (1–3). In experienced laparoscopic hands, VEIL is a safe and effective treatment.
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24. Prediction of significant renal function decline after open, laparoscopic, and robotic partial nephrectomy: External validation of the Martini’s nomogram on the RECORD2 project cohort
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Alessandro Antonelli, Andrea Mari, Alessandro Tafuri, Riccardo Tellini, Umberto Capitanio, Paolo Gontero, Antonio Andrea Grosso, Vincenzo Li Marzi, Nicola Longo, Francesco Porpiglia, Angelo Porreca, Bernardo Rocco, Claudio Simeone, Riccardo Schiavina, Luigi Schips, Salvatore Siracusano, Carlo Terrone, Vincenzo Ficarra, Marco Carini, Andrea Minervini, Vincenzo Altieri, Daniele Amparore, Walter Artibani, Fabrizio Di Maida, Francesco Berardinelli, Pierluigi Bove, Carlo Andrea Bravi, Eugenio Brunocilla, Anna Cadenar, Antonio Celia, Elisabetta Costantini, Luigi Da Pozzo, Alberto Diminutto, Mario Falsaperla, Gaetano Grosso, Luca Lambertini, Alessandro Larcher, Francesco Maiorino, Giancarlo Marra, Francesco Montorsi, Andrea Polara, Riccardo Rizzetto, Marco Roscigno, Alchiede Simonato, Carlo Trombetta, Antonelli, Alessandro, Mari, Andrea, Tafuri, Alessandro, Tellini, Riccardo, Capitanio, Umberto, Gontero, Paolo, Andrea Grosso, Antonio, Li Marzi, Vincenzo, Longo, Nicola, Porpiglia, Francesco, Porreca, Angelo, Rocco, Bernardo, Simeone, Claudio, Schiavina, Riccardo, Schips, Luigi, Siracusano, Salvatore, Terrone, Carlo, Ficarra, Vincenzo, Carini, Marco, Minervini, Andrea, Berardinelli, Francesco, Bove, Pierluigi, Andrea Bravi, Carlo, Brunocilla, Eugenio, Cadenar, Anna, Celia, Antonio, Costantini, Elisabetta, Da Pozzo, Luigi, Diminutto, Alberto, Falsaperla, Mario, Grosso, Gaetano, Lambertini, Luca, Larcher, Alessandro, Maiorino, Francesco, Marra, Giancarlo, Montorsi, Francesco, Polara, Andrea, Rizzetto, Riccardo, Roscigno, Marco, Simonato, Alchiede, Trombetta, Carlo, and Alessandro Antonelli, Andrea Mari, Alessandro Tafuri, Riccardo Tellini, Umberto Capitanio, Paolo Gontero, Antonio Andrea Grosso, Vincenzo Li Marzi, Nicola Longo, Francesco Porpiglia, Angelo Porreca, Bernardo Rocco, Claudio Simeone, Riccardo Schiavina, Luigi Schips, Salvatore Siracusano, Carlo Terrone, Vincenzo Ficarra, Marco Carini, Andrea Minervini, Vincenzo Altieri, Daniele Amparore, Walter Artibani, Fabrizio Di Maida, Francesco Berardinelli, Pierluigi Bove, Carlo Andrea Bravi, Eugenio Brunocilla, Anna Cadenar, Antonio Celia, Elisabetta Costantini, Luigi Da Pozzo, Alberto Diminutto, Mario Falsaperla, Gaetano Grosso, Luca Lambertini, Alessandro Larcher, Francesco Maiorino, Giancarlo Marra, Francesco Montorsi, Andrea Polara, Riccardo Rizzetto, Marco Roscigno, Luigi Schips, Alchiede Simonato, Carlo Trombetta
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laparoscopy ,nephron-sparing surgery ,renal cell carcinoma ,renal function ,robotics ,Humans ,Kidney ,Nephrectomy ,Nomograms ,Kidney Neoplasms ,Laparoscopy ,Robotic Surgical Procedures ,Robotics ,Urology - Abstract
Objectives: Martini et al. developed a nomogram to predict significant (>25%) renal function loss after robot-assisted partial nephrectomy and identified four risk categories. We aimed to externally validate Martini’s nomogram on a large, national, multi-institutional data set including open, laparoscopic, and robot-assisted partial nephrectomy. Methods: Data of 2584 patients treated with partial nephrectomy for renal masses at 26 urological Italian centers (RECORD2 project) were collected. Renal function was assessed at baseline, on third postoperative day, and then at 6, 12, 24, and 48 months postoperatively. Multivariable models accounting for variables included in the Martini’s nomogram were applied to each approach predicting renal function loss at all the specific timeframes. Results: Multivariable models showed high area under the curve for robot-assisted partial nephrectomy at 6- and 12-month (87.3% and 83.6%) and for laparoscopic partial nephrectomy (83.2% and 75.4%), whereas area under the curves were lower in open partial nephrectomy (78.4% and 75.2%). The predictive ability of the model decreased in all the surgical approaches at 48 months from surgery. Each Martini risk group showed an increasing percentage of patients developing a significant renal function reduction in the open, laparoscopic and robot-assisted partial nephrectomy group, as well as an increased probability to develop a significant estimated glomerular filtration rate reduction in the considered time cutoffs, although the predictive ability of the classes was
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- 2022
25. MP58-04 PROPOSAL AND INTERNAL VALIDATION OF A NOMOGRAM FOR THE PREDICTION OF LOCAL RECURRENCE FREE-SURVIVAL AFTER PERCUTANEOUS ABLATION FOR CT1 RENAL MASSES
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Angelo Mottaran, Luigi Nocera, Lorenzo Bianchi, Stefano Luzzago, Marco Bandini, Pietro Piazza, Antonio Celia, Carla Serra, Francesco Modestino, Antonio De Cinque, Rita Golfieri, Gennaro Musi, Andrea Gallina, Francesco De Cobelli, Giovanni Mauri, Franco Orsi, Umberto Capitanio, null Milan, null Italy, Riccardo Schiavina, Ottavio De Cobelli, Francesco Montorsi, and Eugenio Brunocilla
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Urology - Published
- 2023
26. MP58-05 THE IMPACT OF HISTOLOGY AND TYPE OF ENERGY USED ON ONCOLOGICAL OUTCOMES AFTER LOCAL TUMOR ABLATION OF SMALL RENAL MASSES
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Pietro Piazza, Lorenzo Bianchi, Stefano Luzzago, Marco Bandini, Angelo Mottaran, Sasan Amirhassankhani, Stefano Puliatti, Bernardino De Concilio, Antonio Celia, Carla Serra, Alberta Cappelli, Francesco Modestino, Antonio De Cinque, Rita Golfieri, Gennaro Musi, Andrea Gallina, null Lugano, null Switzerland, Francesco De Cobelli, Giovanni Mauri, Franco Orsi, Umberto Capitanio, Riccardo Schiavina, Ottavio De Cobelli, Francesco Montorsi, and Eugenio Brunocilla
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Urology - Published
- 2023
27. External validation of yonsei nomogram predicting chronic kidney disease development after partial nephrectomy: An international, multicenter study
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Ali Abdel Raheem, Isotta Landi, Ibrahim Alowidah, Umberto Capitanio, Francesco Montorsi, Alessandro Larcher, Ithaar Derweesh, Fady Ghali, Alexander Mottrie, Elio Mazzone, Geert De Naeyer, Riccardo Campi, Francesco Sessa, Marco Carini, Andrea Minervini, Jay D. Raman, Chris J. Rjepaj, Maximilian C. Kriegmair, Riccardo Autorino, Alessandro Veccia, Maria Carmen Mir, Francesco Claps, Young Deuk Choi, Won Sik Ham, Glen Denmer Santok, John Paul Tadifa, Justin Syling, Maria Furlan, Claudio Simeone, Maida Bada, Antonio Celia, Diego M. Carrión, Alfredo Aguilera Bazan, Cristina Ballesteros Ruiz, Manar Malki, Neil Barber, Muddassar Hussain, Salvatore Micali, Stefano Puliatti, Ahmed Ghaith, Ayman Hagras, Ayman M. Ghoneem, Ahmed Eissa, Abdulrahman Alqahtani, Abdullah Rumaih, Abdelaziz Alwahabi, Mohammed Jayed Alenzi, Nicola Pavan, Fabio Traunero, Alessandro Antonelli, Antonio Benito Porcaro, Ester Illiano, Elisabetta Costantini, Koon Ho Rha, Abdel Raheem, Ali, Landi, Isotta, Alowidah, Ibrahim, Capitanio, Umberto, Montorsi, Francesco, Larcher, Alessandro, Derweesh, Ithaar, Ghali, Fady, Mottrie, Alexander, Mazzone, Elio, De Naeyer, Geert, Campi, Riccardo, Sessa, Francesco, Carini, Marco, Minervini, Andrea, Raman, Jay D, Rjepaj, Chris J, Kriegmair, Maximilian C, Autorino, Riccardo, Veccia, Alessandro, Mir, Maria Carmen, Claps, Francesco, Choi, Young Deuk, Ham, Won Sik, Santok, Glen Denmer, Tadifa, John Paul, Syling, Justin, Furlan, Maria, Simeone, Claudio, Bada, Maida, Celia, Antonio, Carrión, Diego M, Aguilera Bazan, Alfredo, Ruiz, Cristina Ballestero, Malki, Manar, Barber, Neil, Hussain, Muddassar, Micali, Salvatore, Puliatti, Stefano, Ghaith, Ahmed, Hagras, Ayman, Ghoneem, Ayman M, Eissa, Ahmed, Alqahtani, Abdulrahman, Rumaih, Abdullah, Alwahabi, Abdelaziz, Alenzi, Mohammed Jayed, Pavan, Nicola, Traunero, Fabio, Antonelli, Alessandro, Porcaro, Antonio Benito, Illiano, Ester, Costantini, Elisabetta, and Rha, Koon Ho
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functional outcomes ,external validation ,Yonsei nomogram ,partial nephrectomy ,Urology ,chronic kidney disease ,functional outcome - Abstract
ObjectiveTo externally validate Yonsei nomogram. MethodsFrom 2000 through 2018, 3526 consecutive patients underwent on-clamp PN for cT1 renal masses at 23 centers were included. All patients had two kidneys, preoperative eGFR >= 60 ml/min/1.73 m2, and a minimum follow-up of 12 months. New-onset CKD was defined as upgrading from CKD stage I or II into CKD stage >= III. We obtained the CKD-free progression probabilities at 1, 3, 5, and 10 years for all patients by applying the nomogram found at . Thereafter, external validation of Yonsei nomogram for estimating new-onset CKD stage >= III was assessed by calibration and discrimination analysis. Results and limitationMedian values of patients' age, tumor size, eGFR and follow-up period were 47 years (IQR: 47-62), 3.3 cm (IQR: 2.5-4.2), 90.5 ml/min/1.73 m2 (IQR: 82.8-98), and 47 months (IQR: 27-65), respectively. A total of 683 patients (19.4%) developed new-onset CKD. The 5-year CKD-free progression rate was 77.9%. Yonsei nomogram demonstrated an AUC of 0.69, 0.72, 0.77, and 0.78 for the prediction of CKD stage >= III at 1, 3, 5, and 10 years, respectively. The calibration plots at 1, 3, 5, and 10 years showed that the model was well calibrated with calibration slope values of 0.77, 0.83, 0.76, and 0.75, respectively. Retrospective database collection is a limitation of our study. ConclusionsThe largest external validation of Yonsei nomogram showed good calibration properties. The nomogram can provide an accurate estimate of the individual risk of CKD-free progression on long-term follow-up.
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- 2023
28. ProACT in the management of stress urinary incontinence after radical prostatectomy. What happens after 8 years of follow up? monocentric analysis in 42 patients
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Maida Bada, Felice Crocetto, Biagio Barone, Davide Arcaniolo, Sebastiano Rapisarda, Antonio Aliberti, Guglielmo Zeccolini, Antonio Celia, Bada, M., Crocetto, F., Barone, B., Arcaniolo, D., Rapisarda, S., Aliberti, A., Zeccolini, G., Celia, A., Bada, Maida, Crocetto, Felice, Barone, Biagio, Arcaniolo, Davide, Rapisarda, Sebastiano, Aliberti, Antonio, Zeccolini, Guglielmo, and Celia, Antonio
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Pharmacology ,quality of life ,Physiology ,Drug Discovery ,General Medicine ,ProACT ,stress urinary incontinence ,daily pad use - Abstract
Objectives Stress urinary incontinence is defined by a complaint of any involuntary loss of urine on effort or physical exertion or on sneezing or coughing and represents a major complication after radical prostatectomy. According to surgical technique, incidence of post-prostatectomy incontinence varies from open (7–39.5%), laparoscopic (5–33.3%) or robotic-assisted (4–31%) approaches. The ProACT® device (Uromedica, Inc., MN) is a possible surgical option for the treatment of this condition. Methods We retrospectively analyzed surgical records of consecutive patients underwent ProACT® implantation in our department between January 2006 to November 2010. We collected data at 6 and 12 months after surgical approach about the daily pad use, International Prostatic Symptoms Score and its quality of life domain. Results 42 patients were included in the final analysis. Most patients (92.9%) received minimally invasive surgery for treating prostate cancer. During the follow up after 6 and 12 months, the daily pad, International Prostatic Symptom Score and its quality of life domain significantly improved compared to preoperative outcomes. The logistic regression analysis found that presence of comorbidities was the only predictive factor of low satisfaction rate (PGE-I > 2) in patients who underwent ProACT® implant. Conclusions ProACT® implant represents an effective and safe treatment for post-prostatectomy stress urinary incontinence with a high satisfaction degree and a low rate of complications.
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- 2023
29. Inguinal lymphadenectomy in penile cancer patients: a comparison between open and video endoscopic approach in a multicenter setting
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Maida Bada, Felice Crocetto, Peter Nyirady, Vincenzo Pagliarulo, Sebastiano Rapisarda, Antonio Aliberti, Stefano Boccasile, Matteo Ferro, Biagio Barone, Antonio Celia, Bada, Maida, Crocetto, Felice, Nyirady, Peter, Pagliarulo, Vincenzo, Rapisarda, Sebastiano, Aliberti, Antonio, Boccasile, Stefano, Ferro, Matteo, Barone, Biagio, and Celia, Antonio
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Pharmacology ,inguinal lymphadenectomy ,Physiology ,Drug Discovery ,complication ,General Medicine ,laparoscopic approach ,penile cancer - Abstract
Objectives To compare differences of operative outcomes, post-operative complications and survival outcomes between open and laparoscopic cases in a multicenter study. Methods This was a retrospective cohort study performed at three European centers from September 2011 to January 2019. The surgeon decision to perform open inguinal lymphadenectomy (OIL) or video endoscopic inguinal lymphadenectomy (VEIL) was done in each hospital after patient counselling. Inclusion criteria regarded a minimum follow-up of 9 months since the inguinal lymphadenectomy. Results A total of 55 patients with proven squamous cell penile cancer underwent inguinal lymphadenectomy. 26 of them underwent OIL, while 29 patients underwent VEIL. For the OIL and VEIL groups, the mean operative time was 2.5 vs. 3.4 h (p=0.129), respectively. Hospital stays were lower in the VEIL group with 4 vs. 8 days in OIL patients (p=0.053) while number of days requiring drains to remain in situ was 3 vs. 6 days (p=0.024). The VEIL group reported a lower incidence of major complications compared to the OIL group (2 vs. 17%, p=0.0067) while minor complications were comparable in both groups. In a median follow-up period of 60 months, the overall survival was 65.5 and 84.6% in OIL and VEIL groups, respectively (p=0.105). Conclusions VEIL is comparable to OIL regarding safety, overall survival and post-operative outcomes.
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- 2023
30. Learning Curve for Endoscopic Combined Intra-Renal Surgery Using Vacuum-Assisted Device
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Giorgio Mazzon, Francesco Claps, Federico Germinale, Davide Brusa, Simon Choong, Adara Caruso, Marco Pirozzi, Alessandro Antonelli, Maria Angela Cerruto, Antonio Celia, Mazzon, Giorgio, Claps, Francesco, Germinale, Federico, Brusa, Davide, Choong, Simon, Caruso, Adara, Pirozzi, Marco, Antonelli, Alessandro, Cerruto, Maria Angela, and Celia, Antonio
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Renal stone ,Super-mini PCNL ,Urology ,Endoscopic combined intra-renal surgery ,Learning curve ,Training - Abstract
Introduction: The aim of the study was to provide data related to endoscopic combined intra-renal surgery learning curve using minimally invasive techniques with vacuum-assisted devices. Minimal data exist on the learning curve for these techniques. Methods: We conducted a prospective study monitoring the training of a mentored surgeon learning ECIRS with vacuum assistance. We use varied parameters for improvements. After collection of peri-operative data, tendency lines and CUSUM analysis were used to investigate the learning curves. Results: 111 patients have been included. Guy’s Stone Score 3 and 4 stones 51.3% of all cases. The mostly used percutaneous sheath was 16 Fr (87.3%). SFR was 78.4%. 52.3% patients were tubeless, and 38.7% achieved trifecta. High-degree complication rate was 3.6%. Operative time improved after 72 cases. We observed a decrease of complications throughout the case series, with improvement after 17 cases. In terms of trifecta, proficiency was reached after 53 cases. Proficiency seems achievable in a limited number of procedures, but results did not plateau. Higher number of cases might be necessary for excellence. Discussion: A surgeon learning ECIRS with vacuum assistance can obtain proficiency in 17–50 cases. The number of procedures required for excellence remains unclear. Exclusion of more complex cases might positively affect the training, reducing unnecessary complications.
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- 2023
31. Percutaneous Ablation
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Savio Domenico, Pandolfo, Alp T, Beksac, Ithaar, Derweesh, Antonio, Celia, Riccardo, Schiavina, Lorenzo, Bianchi, Giovanni, Costa, Umberto, Carbonara, Davide, Loizzo, Giuseppe, Lucarelli, Clara, Cerrato, Ciro, Imbimbo, Vicenzo, Mirone, Jeffrey, Elbich, Giuseppe, Basile, Lance J, Hampton, Fernando J, Kim, Umberto, Capitanio, Jihad, Kaouk, and Riccardo, Autorino
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- 2022
32. Rotterdam mobile phone app including MRI data for the prediction of prostate cancer
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Alessandro Antonelli, Cosimo De Nunzio, Yazan Al Salhi, Luca Cindolo, Giovannalberto Pini, Andrea Tubaro, Filippo Mugavero, Riccardo Rizzetto, Riccardo Lombardo, Guglielmo Mantica, Riccardo Bertolo, Matteo Vittori, Valeria Baldassarri, Pierluigi Bove, Giovanni Novella, Francesco Sessa, Sebastiaan Remmers, Andrea Minervini, Giorgio Bozzini, Gianluca Muto, Antonio Luigi Pastore, Mario Falsaperla, Antonio Celia, Marco Giampaoli, Pietro Castellan, Luigi Schips, Maida Bada, Nicolò Trabacchin, Angelo Porreca, and Urology
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Oncology ,Male ,medicine.medical_specialty ,Prostate biopsy ,Biopsy ,030232 urology & nephrology ,urologic and male genital diseases ,Nomogram ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Prostate ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,Multiparametric Magnetic Resonance Imaging ,Aged ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Medical app ,Cancer ,Prostatic Neoplasms ,Magnetic resonance imaging ,General Medicine ,Middle Aged ,medicine.disease ,Mobile Applications ,Prostate-specific antigen ,Settore MED/24 ,medicine.anatomical_structure ,ROC Curve ,Magnetic resonance ,030220 oncology & carcinogenesis ,Area Under Curve ,Calibration ,Surgery ,magnetic resonance ,medical app ,nomogram ,prostate cancer ,Neoplasm Grading ,business - Abstract
Objectives The Rotterdam Prostate Cancer Risk calculator (RPCRC) has been validated in the past years. Recently a new version including multiparametric magnetic resonance imaging (mpMRI) data has been released. The aim of our study was to analyze the performance of the mpMRI RPCRC app. Methods A series of men undergoing prostate biopsies were enrolled in eleven Italian centers. Indications for prostate biopsy included: abnormal Prostate specific antigen levels (PSA>4 ng/ml), abnormal DRE and abnormal mpMRI. Patients’ characteristics were recorded. Prostate cancer (PCa) risk and high-grade PCa risk were assessed using the RPCRC app. The performance of the mpMRI RPCRC in the prediction of cancer and high-grade PCa was evaluated using receiver operator characteristics, calibration plots and decision curve analysis. Results Overall, 580 patients were enrolled: 404/580 (70%) presented PCa and out of them 224/404 (55%) presented high-grade PCa. In the prediction of cancer, the RC presented good discrimination (AUC = 0.74), poor calibration (p = 0.01) and a clinical net benefit in the range of probabilities between 50 and 90% for the prediction of PCa (Fig. 1). In the prediction of high-grade PCa, the RC presented good discrimination (AUC = 0.79), good calibration (p = 0.48) and a clinical net benefit in the range of probabilities between 20 and 80% (Fig. 1). Conclusions The Rotterdam prostate cancer risk App accurately predicts the risk of PCa and particularly high-grade cancer. The clinical net benefit is wide for high-grade cancer and therefore its implementation in clinical practice should be encouraged. Further studies should assess its definitive role in clinical practice.
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- 2021
33. Microwave versus cryoablation and radiofrequency ablation for small renal mass: a multicenter comparative analysis
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Savio D. PANDOLFO, Umberto CARBONARA, Alp T. BEKSAC, Ithaar DERWEESH, Antonio CELIA, Riccardo SCHIAVINA, Jeffrey ELBICH, Giuseppe BASILE, Lance J. HAMPTON, Clara CERRATO, Giovanni COSTA, Lorenzo BIANCHI, Giuseppe LUCARELLI, Vincenzo MIRONE, Ciro IMBIMBO, Fernando J. KIM, Francesco DEL GIUDICE, Umberto CAPITANIO, Jihad KAOUK, and Riccardo AUTORINO
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Nephrology ,Urology - Abstract
Ablative techniques emerged as effective alternative to nephron-sparing surgery for treatment of small renal masses. Radiofrequency ablation (RFA) and cryoablation (CRYO) are the two guidelines-recommended techniques. Microwave ablation (MWA) represents a newer technology, less described. Aim of the study was to compare outcomes of MWA to those of CRYO and RFA.Retrospective investigation of patients who underwent MWA, CRYO, or RFA from seven high-volume US and European centers was performed. The first group included patients who underwent CRYO or RFA; the second MWA. We collected baseline characteristics, clinical, intraoperative and post-operative data. Oncological data included technical success, local recurrence, and progression to metastasis. Multivariate analysis was performed to find predictors for postoperative complications. A composite outcome of "trifecta" was used to assess surgical, functional, and oncological outcomes.739 patients underwent CRYO or RFA and 50 MWA. CRYO/RFA group had significantly longer operative time (p.001), but no difference in LOS, post-procedural Hb mean, intra-procedural complications (p=0.180), overall post-procedural complication rates (p=0.126), and in the 30-day re-admission rate (p=0.853) were detected. No predictive parameter of postprocedural complications was found. Concerning functional outcome no differences were detected in terms of eGFR at 1yr (p=0.182), ΔeGFR at 1-yr (p= 0.825) and eGFR at latest follow-up (p=0.070). "Technical success" was achieved in 98.6% of the cases (MWA= 100%, CRYO/RFA= 98.5%; p=0.775), and there was no significant difference in terms of 2-yr recurrence rate (p= 0.114) and metastatic progression (p= 0.203). Trifecta was achieved in 73.0% of CRYO/RFA vs 69.6% of MWA cases (p = 0.719).MWA is a safe and effective treatment option for small renal masses. Compared with CRYO/RFA, it seems to offer low complication rates, shorter operation time, and equivalent surgical and functional outcomes.
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- 2022
34. The relationship between obstructive sleep apnoea and erectile dysfunction: An underdiagnosed link? A prospective cross-sectional study
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Elena Cantone, Matteo Massanova, Felice Crocetto, Biagio Barone, Fabio Esposito, Davide Arcaniolo, Fabrizio Corlianò, Luigi Romano, Gaetano Motta, Antonio Celia, Cantone, E., Massanova, M., Crocetto, F., Barone, B., Esposito, F., Arcaniolo, D., Corliano, F., Romano, L., Motta, G., Celia, A., Cantone, Elena, Massanova, Matteo, Crocetto, Felice, Barone, Biagio, Esposito, Fabio, Arcaniolo, Davide, Corlianò, Fabrizio, Romano, Luigi, Motta, Gaetano, and Celia, Antonio
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Male ,Sleep Apnea, Obstructive ,Sleepiness ,Urology ,General Medicine ,ED ,SatO2 ,OSA ,Oxygen ,Endocrinology ,Cross-Sectional Studies ,Erectile Dysfunction ,Obstructive sleep apnoea ,Risk Factors ,Humans ,Prospective Studies - Abstract
This cross-sectional study aimed to investigate the prevalence and clinical characteristics of erectile dysfunction in patients with obstructive sleep apnoea. We enrolled 133 male patients with suspected obstructive sleep apnoea. Ear, nose and throat evaluation, laboratory tests, body mass index, Epworth sleepiness scale, 5-international index of erectile function, overnight ambulatory polygraphy and drug-induced sleep endoscopy patterns were assessed. Eighty patients reported obstructive sleep apnoea. 60% (n=48) reported erectile dysfunction. Statistically significant correlations were found between 5-International Index of Erectile Function and age, hypertension, diabetes, Epworth sleepiness scale, apnoea-hypopnea index score, O2 saturation-nadir, and oxygen desaturation index. Age, diabetes and O2 saturation-nadir were independent predictors of erectile function. Epworth sleepiness scale, apnoea-hypopnea index score, O2 saturation-nadir, oxygen desaturation index and albumin were higher compared to patients without erectile dysfunction. No statistically significant differences were reported for drug-induced sleep endoscopy patterns and erectile dysfunction. Patients with obstructive sleep apnoea were at significant risk of having erectile dysfunction. Males with obstructive sleep apnoea should be investigated for erectile dysfunction.
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- 2022
35. Introducing trifecta for percutaneous nephrolithotomies: a proposal for standard reporting outcomes after treatment for renal stones
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Guohua Zeng, Simon Choong, Nicola Pavan, Giorgio Mazzon, Maida Bada, Antonio Celia, Marco Pirozzi, Wenqi Wu, Otas Durutovic, and Jiehui Zhong
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Univariate analysis ,medicine.medical_specialty ,business.industry ,Urology ,Stone free ,Nephrostomy tube ,External validation ,Nephrolithotomy, Percutaneous ,Middle Aged ,Surgery ,Kidney Calculi ,Treatment Outcome ,Quality of life ,Nephrology ,Quality of Life ,medicine ,Humans ,Prospective Studies ,Percutaneous Nephrolithotomies ,Data reporting ,business ,After treatment ,Retrospective Studies - Abstract
Background In literature, the reports of outcomes after percutaneous nephrolithotomies are rather heterogeneous. This may influence studies comparison, it may also render difficult to evaluate surgical adequacy, peri-operative morbidity and patient's quality of life between studies. For this reason, we propose to introduce PNL-Trifecta as composite measure to standardize data reporting outcomes after percutaneous nephrolithotomies. Methods We performed a prospective multicentric study on consecutive patients undergone PNL to treat renal stones between 2018 and 2020. Successful PNL-trifecta was considered achieved when procedures obtained the three following results: no residual fragments > 2mm at unenhanced CT scan at 3 months post-op, no complications (defined as Clavien-Dindo Score 0) and operation carried out without placing a nephrostomy tube (tubeless or totally tubeless). We compared results of standard versus mini-PNL and between stones of different complexity (evaluated with Guy's Stone Score and S.T.O.N.E. nephrolithometry Score). Univariate analysis was utilized to identify other factors influencing achievement of PNL-Trifecta. Results 245 patients fulfilled inclusion/exclusion criteria and have been enrolled in the study (median age: 56, IQR 48-57). The overall PNL-Trifecta achievement rate was 22.85% (28.66% in the mini-PNL group and 13.68% in the standard-PNL group, p=0.010). The stone free rate, CD 0 rate and tubeless/totally tubeless rate in the mini-PNL group were 60.66%, 89.33% and 51.33% respectively. In the standard-PNL group they were 44.21%, 40.00% and 15.78% respectively. At the univariate analysis, differences between Guy's Stone Score groups in achieving PNL-Trifecta were significant (p=0.001). Also, the level of upper puncture (p=0.010) and utilization of device with active suction (p=0.002) showed statistically significant differences. Furthermore, the length of stay in the patient's group achieving Trifecta was 2.28 versus a mean length of stay of 4.64 days in the group of patients not achieving Trifecta (p=0.046). Conclusions We present Trifecta for PNLs as a potential tool to evaluate quality of percutaneous nephrolithotomies and to provide an instrument for an adequate standard data reporting. It can represent a valid way to assess and monitor surgeon's learning curves. It will require further external validation and studies to evaluate its correlation with mid- and long-term results and patient's health related quality of life outcomes.
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- 2022
36. Double Loop Ureteral Stent Encrustation According to Indwelling Time: Results of a European Multicentric Study
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Alain Ruffion, Fouad Djouhri, Sebastien Kalakech, Antonio Celia, F. Legrand, Gennaro Musi, Isabelle Desriac, Thierry Roumeguere, Thibaud Saussez, and UCL - (SLuc) Service d'urologie
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medicine.medical_specialty ,Time Factors ,stone ,Urology ,medicine.medical_treatment ,Population ,030232 urology & nephrology ,03 medical and health sciences ,0302 clinical medicine ,Daily practice ,indwelling time ,medicine ,Humans ,education ,Retrospective Studies ,Double loop ,education.field_of_study ,encrustation ,business.industry ,Stent ,Retrospective cohort study ,Ureteral stents ,Surgery ,030220 oncology & carcinogenesis ,Stents ,Ureter ,ureteral stent ,business - Abstract
Introduction: Double-J ureteral stents are subject to encrustation. Studies have shown that the encrustation onset is linked with indwelling time. In prevention, it is admitted that the Double-J stent indwelt for medium or long term should be replaced periodically. However, in the absence of guidelines, indwelling durations vary with centers' habits, stent indication, and stent materials. Our target was to evaluate the actual ureteral stent medium-/long-term indwelling times and related encrustation rates perceived by urologists in daily practice. Methods: An observational retrospective study was performed over six European centers. All data of all consecutive removed stents of the same material implanted for more than 2 months within a same 2-year referred period were collected. Three stent types of various materials, with/without coating, were evaluated. Encrustation rates were analyzed according to indwelling times and stent indication. Results: Four hundred seventy-three stents were recorded with indwelling times between 60 and 679 days. An unexpected number of long-term indwelling times were noticed: globally one-third more than 6 months, and 9% more than 1 year. In case of malignant indication, these rates were, respectively, 44% and 17%. For nonstone indication, clinically significant encrustation rates stayed extremely low before 4 months (1.3%) and quite low before 6 months (5.2%), increasing with time to reach around 10% in the long term. However, as expected, the rate was higher for stone indication with a marked increase after 4 months (8% before 4 months, nearly 17% after). Conclusion: Our data confirm a higher encrustation risk for stone patients. Long indwelling times in nonstone patients beyond 6 months or even 12 months appear to be still requested and relatively well supported in usual practice by this population.
- Published
- 2021
37. Cross-analysis of two randomized controlled trials to compare pure versus robot-assisted laparoscopic approach during off-clamp partial nephrectomy
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Riccardo, Bertolo, Pierluigi, Bove, Marco, Sandri, Luca, Cindolo, Filippo, Annino, Costantino, Leonardo, Paolo, Parma, Roberto, Nucciotti, Angelo, Porreca, Mario, Falsaperla, Domenico, Veneziano, Antonio, Celia, Luigi, Schips, Claudio, Simeone, Marco, Carini, Andrea, Minervini, Alessandro, Antonelli, and Alessandro, Veccia
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Nephrology ,Urology ,Humans ,Laparoscopy ,Robotics ,Nephrectomy ,Kidney Neoplasms ,Randomized Controlled Trials as Topic - Published
- 2022
38. Comment on 'Comparison of safety and efficacy between single-tract and multiple-tract percutaneous nephrolithotomy treatment of complex renal calculi: a systematic review and meta-analysis'
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Giorgio MAZZON, Simon CHOONG, and Antonio CELIA
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Nephrology ,Urology - Published
- 2022
39. Active surveillance for small renal masses in elderly patients does not increase overall mortality rates compared to primary intervention: a propensity score weighted analysis
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Michele MARCHIONI, Joseph G. CHEAIB, Toshio TAKAGI, Nicola PAVAN, Alessandro ANTONELLI, Wourter EVERAERTS, Matthias HECK, Koon H. RHA, Alexandre MOTTRIE, Jihad KAOUK, Umberto CAPITANIO, Estevão Lima, Alessandro VECCIA, Simone CRIVELLARO, Estefania LINARES, Antonio CELIA, Francesco PORPIGLIA, Riccardo AUTORINO, Marta DI NICOLA, Luigi SCHIPS, Phillip M. PIERORAZIO, and Maria Carmen MIR
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Nephrology ,Urology ,Humans ,Propensity Score ,Watchful Waiting ,Nephrectomy ,Kidney Neoplasms ,Aged ,Proportional Hazards Models - Abstract
BACKGROUND: The aim of the study was to test the effect of active surveillance (AS) versus primary intervention (PI) on overall mortality (OM) in elderly patients diagnosed with SRM. METHODS: Elderly patients (75 years or older) diagnosed with SRMs (
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- 2022
40. Rectal Perforation During Pelvic Surgery
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Bernardo, Rocco, Gaia, Giorgia, Assumma, Simone, Calcagnile, Tommaso, Sangalli, Mattia, Terzoni, Stefano, Eissa, Ahmed, Bozzini, Giorgio, Bernardino, De Concilio, Antonio, Celia, Micali, Salvatore, and Maria Chiara, Sighinolfi
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Pelvic surgery ,Iatrogenic ,Minimally invasive surgery ,Urology ,Complication ,Rectal perforation - Abstract
Rectal perforations during pelvic surgery are rare but serious complications. The occurrence of rectal involvement is generally lower than that of the involvement of other portions of the bowel. The urologic field is responsible for the majority of iatrogenic rectal injuries from pelvic surgery; general and gynecologic surgeries are prone to the occurrence as well, the latter especially in the case of rectal shaving for deep infiltrating endometriosis. Attention should be posed to the prevention of rectal injuries, especially in case of challenging or salvage procedures; some tricks may be recommended to avoid thermal and mechanical damages and to realize a safe dissection. Intraoperative detection of rectal injuries is of paramount importance; once confirmed, immediate management with the closure of the defect is recommended. In general, rectal injuries diagnosed after surgery are liable to significantly worse outcomes than those detected and managed intraoperatively.Rectal perforation is a rare but possible complication of pelvic surgeries. The more challenging the procedure (ie, surgery for locally advanced tumors or after radiation therapy), the higher the risk of rectal lesion. Intraoperative management of the injury should be attempted, with direct repair of the defect with or without fecal diversion.
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- 2022
41. Warm ischemia time length during on-clamp partial nephrectomy: does it really matter?
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Maida Bada, Manar Malki, Antonio Celia, Stefano Puliatti, Francesco Claps, Antonio Benito Porcaro, Ayman Hagras, Elio Mazzone, Glen D. Santok, Ali Abdel Raheem, Ester Illiano, Cristina Ballesteros Ruiz, Alexader Mottrie, Andrea Minervini, Alessandro Veccia, Won Sik Ham, Abdelaziz Alwahabi, Mohammed Jayed S Alenzi, Diego M Carrion, Chris Rjepaj, Umberto Capitanio, Geert De Naeyer, Ibrahim Alowidah, Salvatore Micali, Claudio Simeone, Maria Carmen Mir, Marco Carini, Young Deuk Choi, Alessandro Larcher, Ithaar Derweesh, Alessandro Antonelli, Francesco Sessa, Ayman M. Ghoneem, Elisabetta Costantini, Fady Ghali, Fabio Traunero, Riccardo Autorino, John P. Tadifa, Ahmed Ghaith, Alfredo Aguilera Bazán, Jay D. Raman, Maria Furlan, Riccardo Campi, Francesco Montorsi, Ahmed Eissa, Muddassar Hussain, Koon Ho Rha, Neil Barber, Abdullah Rumaih, Maximilian C. Kriegmair, Nicola Pavan, Abdulrahman Alqahtani, Abdel Raheem, Ali, Alowidah, Ibrahim, Capitanio, Umberto, Montorsi, Francesco, Larcher, Alessandro, Derweesh, Ithaar, Ghali, Fady, Mottrie, Alexader, Mazzone, Elio, DE Naeyer, Geert, Campi, Riccardo, Sessa, Francesco, Carini, Marco, Minervini, Andrea, Raman, Jay D, Rjepaj, Chris J, Kriegmair, Maximilian C, Autorino, Riccardo, Veccia, Alessandro, Mir, Maria Carmen, Claps, Francesco, Choi, Young Deuk, Ham, Won S, Tadifa, John P, Santok, Glen D, Furlan, Maria, Simeone, Claudio, Bada, Maida, Celia, Antonio, Carrion, Diego M, Aguilera Bazan, Alfredo, Ruiz, Cristina B, Malki, Manar, Barber, Neil, Hussain, Muddassar, Micali, Salvatore, Puliatti, Stefano, Alwahabi, Abdelaziz, Alqahtani, Abdulrahman, Rumaih, Abdullah, Ghaith, Ahmed, Ghoneem, Ayman M, Hagras, Ayman, Eissa, Ahmed, Alenzi, Mohammed J, Pavan, Nicola, Traunero, Fabio, Antonelli, Alessandro, Porcaro, Antonio B, Illiano, Ester, Costantini, Elisabetta, and Rha, Koon H
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medicine.medical_specialty ,Nephrectomy ,Warm Ischemia ,Delayed graft function ,Urology ,medicine.medical_treatment ,Renal function ,Cohort Studies ,delayed graft function ,medicine ,nephrectomy ,Humans ,Stage (cooking) ,Retrospective Studies ,Warm ischemia ,business.industry ,Proportional hazards model ,Confounding ,medicine.disease ,Kidney Neoplasms ,Nephrology ,Cohort ,business ,Glomerular Filtration Rate ,Cohort study ,Kidney disease - Abstract
Background: The impact of warm ischemia time (WIT) on renal functional recovery remains controversial. We examined the length of WIT >30 min. on the long-term renal function following on-clamp partial nephrectomy (PN). Methods: Data from 23 centers for patients undergoing on-clamp PN between 2000 and 2018 were analyzed. We included patients with two kidneys, single tumor, cT1, minimum 1-year followup, and preoperative eGFR ≥60 ml/min/1.73m2. Patients were divided into two groups according to WIT length: group Ⅰ "WIT ≤30 min." and group Ⅱ "WIT >30 min.". A propensity-score matched analysis (1:1 match) was performed to eliminate potential confounding factors between groups. We compared eGFR values, eGFR (%) preservation, eGFR decline, events of chronic kidney disease (CKD) upgrading, and CKD-free progression rates between both groups. Cox regression analysis evaluated WIT impact on upgrading of CKD stages. Results: The primary cohort consisted of 3526 patients: group Ⅰ (n=2868) and group Ⅱ (n=658). After matching the final cohort consisted of 344 patients in each group. At last followup, there were no significant differences in median eGFR values at 1, 3, 5, and 10 years (P>0.05) between the matched groups. In addition, the median eGFR (%) preservation and absolute eGFR change were similar (89% in group Ⅰ vs. 87% in group Ⅱ, p=0.638) and (-10 in group Ⅰ vs. -11 in group Ⅱ, p=0.577), respectively. The 5 years new-onset CKD-free progression rates were comparable in the non-matched groups (79% in group Ⅰ vs. 81% in group Ⅱ, log-rank, p=0.763) and the matched groups (78.8% in group Ⅰ vs. 76.3% in group Ⅱ, log-rank, p=0.905). Univariable Cox regression analysis showed that WIT >30 min. was not a predictor of overall CKD upgrading (HR:0.953, 95%CI 0.829-1.094, p=0.764) nor upgrading into CKD stage ≥Ⅲ (HR:0.972, 95%CI 0.805-1.173, p=0.764). Retrospective design is a limitation of our study. Conclusions: Our analysis based on a large multicenter international cohort study suggests that WIT length during PN has no effect on the long-term renal function outcomes in patients having two kidneys and preoperative eGFR ≥60 ml/min/1.73m2.
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- 2022
42. Validation of the Italian version of wisconsin stone quality of life (WISQOL): a prospective Italian multicenter study
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Giorgio Mazzon, Emanuele Serafin, Stefania Ferretti, Francesco Claps, Wen Zhong, Cristian Fiori, Giuseppe Celentano, Giulio Gaetano Guarino, Davide Zamengo, Andrea Piasentin, Massimiliano Creta, Nicola Longo, Roberta Dordoni, Nicola Pavan, Claudio Brancelli, Maria Angela Cerruto, Alessandro Antonelli, Antonio Celia, Mazzon, Giorgio, Serafin, Emanuele, Ferretti, Stefania, Claps, Francesco, Zhong, Wen, Fiori, Cristian, Celentano, Giuseppe, Guarino, Giulio Gaetano, Zamengo, Davide, Piasentin, Andrea, Creta, Massimiliano, Longo, Nicola, Dordoni, Roberta, Pavan, Nicola, Brancelli, Claudio, Cerruto, Maria Angela, Antonelli, Alessandro, and Celia, Antonio
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Health-related quality of life ,Kidney stones ,Questionnaire ,SF-36v2 ,Urolithiasis ,WISQOL ,Urology ,Reproducibility of Results ,Kidney Calculi ,Wisconsin ,Quality of Life ,Humans ,Urolithiasi ,Prospective Studies ,Kidney stone ,Language - Abstract
Urolithiasis is a worldwide spread condition that affects patients' Health-Related Quality of Life (HRQOL), which measurement is an important tool for routine clinical and research practice. Disease-specific HRQOL measures demonstrated to perform better in assessing the effects of specific conditions. A disease-specific questionnaire for kidney stones, the WISQOL, has been validated in different languages, but an Italian version is still missing. Our aim is to produce and validate the Italian version of WISQOL (IT-WISQOL). Patients undergoing any elective treatment for upper urinary tract stones were enrolled. A multi-step process with forward- and back-translation was used to translate WISQOL into Italian. Patients were evaluated within 15 days pre-operatively and then at 30-, 90 days post-operatively and administered both IT-WISQOL and SF-36v2. Post-operative data such as 30 days postoperative complications, late stone-related events, successful status, and stone complexity were collected. Cronbach's α was used to evaluate the internal consistency of IT-WISQOL, while Spearman's rho was used for item and inter-domain correlations and IT-WISQOL with SF-36v2 correlation. We found excellent internal consistency across all domains (α ≥ 0.88), particularly when the total score is considered (α = 0.960). Test-retest reliability showed excellent results for the total questionnaire (Pearson correlation value: 0.85). The Inter-domain association ranged from 0.497 to 0.786. Convergent validity was confirmed by a good correlation with subdomains of the SF-36v2 measures. IT-WISQOL is a reliable tool to measure HRQOL in stone patients. It shows analog characteristics if compared to English WISQOL.
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- 2022
43. Impact of the controlling nutritional status (CONUT) score on perioperative morbidity and oncological outcomes in patients with bladder cancer treated with radical cystectomy
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Francesco Claps, Maria Carmen Mir, Bas W.G. van Rhijn, Giorgio Mazzon, Francesco Soria, David D'Andrea, Giancarlo Marra, Matteo Boltri, Fabio Traunero, Matteo Massanova, Giovanni Liguori, Jose L. Dominguez-Escrig, Antonio Celia, Paolo Gontero, Shahrokh F. Shariat, Carlo Trombetta, Nicola Pavan, Claps, Francesco, Mir, Maria Carmen, van Rhijn, Bas W G, Mazzon, Giorgio, Soria, Francesco, D'Andrea, David, Marra, Giancarlo, Boltri, Matteo, Traunero, Fabio, Massanova, Matteo, Liguori, Giovanni, Dominguez-Escrig, Jose L, Celia, Antonio, Gontero, Paolo, Shariat, Shahrokh F, Trombetta, Carlo, and Pavan, Nicola
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Survival ,Urology ,Urinary bladder neoplasms ,Nutritional Status ,Biomarker ,Biomarkers ,Morbidity ,Nutrition assessment ,Postoperative complications ,Radical cystectomy ,Humans ,Retrospective Studies ,Prognosis ,Cystectomy ,Urinary Bladder Neoplasms ,Postoperative complication ,Oncology - Abstract
Introduction and objectives: To evaluate the impact of the Controlling Nutritional Status (CONUT) score on perioperative morbidity and oncological outcomes of bladder cancer (BC) patients treated with radical cystectomy (RC). Materials and methods: We retrospectively analyzed a multi-institutional cohort of 347 patients treated with RC for clinical-localized BC between 2005 and 2019. The CONUT-score was defined as an algorithm including serum albumin, total lymphocyte count, and cholesterol. Multivariable logistic regression analyses were performed to evaluate the ability of the CONUT-score to predict any-grade complications, major complications and 30 days readmission. Multivariable Cox' regression models were performed to evaluate the prognostic effect of the CONUT-score on recurrence-free survival (RFS), overall survival (OS), and cancer-specific survival (CSS). Results: A cut-off value to discriminate between low and high CONUT-score was determined by calculating the receiver operating characteristic (ROC) curve. The area under the curve was 0.72 hence high CONUT-score was defined as ≥3 points. Overall, 112 (32.3%) patients had a high CONUT. At multivariable logistic regression analyses, high CONUT was associated with any-grade complications (OR 3.58, P = 0.001), major complications (OR 2.56, P = 0.003) and 30 days readmission (OR 2.39, P = 0.01). On multivariable Cox' regression analyses, high CONUT remained associated with worse RFS (HR 2.57, P < 0.001), OS (HR 2.37, P < 0.001) and CSS (HR 3.52, P < 0.001). Conclusions: Poor nutritional status measured by the CONUT-score is independently associated with a poorer postoperative course after RC and is predictive of worse RFS, OS, and CSS. This simple index could serve as a comprehensive personalized risk-stratification tool identifying patients who may benefit from an intensified regimen of supportive cares.
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- 2022
44. Robotic-assisted, laparoscopic, and open radical cystectomy: surgical data of 1400 patients from The Italian Radical Cystectomy Registry on intraoperative outcomes
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Angelo, Porreca, Luca, Di Gianfrancesco, Walter, Artibani, Gian Maria, Busetto, Giuseppe, Carrieri, Alessandro, Antonelli, Lorenzo, Bianchi, Eugenio, Brunocilla, Aldo Massimo, Bocciardi, Marco, Carini, Antonio, Celia, Giovanni, Cochetti, Andrea, Gallina, Ettore, Mearini, Andrea, Minervini, Riccardo, Schiavina, Sergio, Serni, Daniele, D'Agostino, Erica, Debbi, Paolo, Corsi, and Alessandro, Crestani
- Subjects
multicenter registry ,robotic-assisted ,bladder cancer ,General Medicine ,intraoperative outcomes ,radical cystectomy ,bladder cancer, intraoperative outcomes - Abstract
The Italian Radical Cystectomy Registry (Registro Italiano Cistectomie - RIC) aimed to analyse outcomes of a multicenter series of patients treated with radical cystectomy (RC) for bladder cancer.An observational, prospective, multicenter, cohort study was performed to collect data from RC and urinary diversion via open (ORC), laparoscopic (LRC), or robotic-assisted (RARC) techniques performed in 28 Italian Urological Departments. The enrolment was planned from January 2017 to June 2020 (goal: 1000 patients), with a total of 1425 patients included. Chi-square and t-tests were used for categorical and continuous variables. All tests were 2-sided, with a significance level set at p0.05.Overall median operative-time was longer in RARCs (390 minutes, IQR 335-465) than ORCs (250, 217-309) and LRCs (292, 228-350) (p0.001). Lymph node dissection (LND) was performed more frequently in RARCs (97.1%) and LRCs (93.5%) than ORCs (85.6%) (p0.001), with extended-LND performed 2-fold more frequently in RARCs (61.6%) (p0.001). The neobladder rate was significantly higher (more than one-half) in RARCs. The median estimated blood loss (EBL) rate was lower in RARCs (250 ml, 165-400) than LRCs (330, 200-600) and ORCs (400, 250-600) (p0.001), with intraoperative blood transfusion rates of 11.4%, 21.7% and 35.6%, respectively (p0.001). The conversion to open rate was slightly higher in RARCs (6.8%) than LRCs (4.3%). Intraoperative complications occurred in 1.3% of cases without statistically significant differences among the approaches.Data from the RIC confirmed the need to collect as much data as possible in a multicenter manner. RARCs proves to be feasible with perioperative complication rates that do not differ from the other approaches.
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- 2021
45. The Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration Project: Development of Criteria for Reporting Adverse Events During Surgical Procedures and Evaluating Their Impact on the Postoperative Course
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Giovanni E. Cacciamani, Tamir Sholklapper, Paolo Dell'Oglio, Bernardo Rocco, Filippo Annino, Alessandro Antonelli, Michele Amenta, Marco Borghesi, Pierluigi Bove, Giorgio Bozzini, Angelo Cafarelli, Antonio Celia, Costantino Leonardo, Carlo Ceruti, Luca Cindolo, Simone Crivellaro, Orietta Dalpiaz, Roberto Falabella, Mario Falsaperla, Antonio Galfano, Farizio Gallo, Francesco Greco, Andrea Minervini, Paolo Parma, Maria Chiara Sighinolfi, Antonio L. Pastore, Giovannalberto Pini, Angelo Porreca, Luigi Pucci, Carmine Sciorio, Riccardo Schiavina, Paolo Umari, Virginia Varca, Domenico Veneziano, Paolo Verze, Alessandro Volpe, Stefano Zaramella, Amir Lebastchi, Andre Abreu, Dionysios Mitropoulos, Chandra Shekhar Biyani, Rene Sotelo, Mihir Desai, Walter Artibani, and Inderbir Gill
- Subjects
Settore MED/24 ,ICARUS ,ICARUS criteria ,intraoperative adverse event ,intraoperative complications ,surgical complications ,Urology - Abstract
Intraoperative adverse events (iAEs) are surgical and anesthesiologic complications. Despite the availability of grading criteria, iAEs are infrequently reported in the surgical literature and in cases for which iAEs are reported, these events are described with significant heterogeneity.To develop Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration criteria to standardize the assessment, reporting, and grading of iAEs. The ultimate aim is to improve our understanding of the nature and frequency of iAEs and our ability to counsel patients regarding surgical procedures.The present study involved the following steps: (1) collecting criteria for assessing, reporting, and grading of iAEs via a comprehensive umbrella review; (2) collecting additional criteria via a survey of a panel of experienced surgeons (first round of a modified Delphi survey); (3) creating a comprehensive list of reporting criteria; (4) combining criteria acquired in the first two steps; and (5) establishing a consensus on clinical and quality assessment utility as determined in the second round of the Delphi survey.Panel inter-rater agreement and consistency were assessed as the overall percentage agreement and Cronbach's α.The umbrella review led to nine common criteria for assessing, grading, and reporting iAEs, and review of iAE grading systems led to two additional criteria. In the first Delphi round, 35 surgeons responded and two criteria were added. In the second Delphi round, 13 common criteria met the threshold for final guideline inclusion. All 13 criteria achieved the consensus minimum of 70%, with agreement on the usefulness of the criteria for clinical and quality improvement ranging from 74% to 100%. The mean inter-rater agreement was 89.0% for clinical improvement and 88.6% for quality improvement.The ICARUS Global Collaboration criteria might aid in identifying important criteria when reporting iAEs, which will support all those involved in patient care and scientific publishing.We consulted a panel of experienced surgeons to develop a set of guidelines for academic surgeons to follow when publishing surgical studies. The surgeon panel proposed a list of 13 criteria that may improve global understanding of complications during specific procedures and thus improve the ability to counsel patients on surgical risk.
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- 2021
46. PD16-05 PERC-SCORE: A NEPHROMETRY SCORE FOR PERCUTANEOUS TUMOR ABLATION OF SMALL RENAL MASS
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Angelo Porreca, Bernardino De Concilio, Stefano Puliatti, Marco Salvador, Francesco Chessa, Lorenzo Bianchi, Antonio Celia, Carla Serra, Riccardo Schiavina, Caterina Gaudiano, A. Mottaran, Rita Golfieri, C. Roveroni, Eugenio Brunocilla, Alberta Cappelli, Pietro Piazza, Francesco V. Costa, Emanuela Marcelli, Carlo Casablanca, Alessandro Bertaccini, and Matteo Droghetti
- Subjects
medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,medicine ,Renal mass ,business ,Nephrectomy ,Percutaneous tumor ablation - Abstract
INTRODUCTION AND OBJECTIVE:Many nephrometry scores have been developed to quantify the complexity of renal tumours and to predict complications after partial nephrectomy. However, no specific nephr...
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- 2021
47. MP59-16 SHIFTING FROM PLANNED OFF-CLAMP TO ON-CLAMP APPROACH DURING PARTIAL NEPHRECTOMY: CROSS-ANALYSIS OF TWO RANDOMIZED TRIALS
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Marco Sandri, Alessandro Veccia, Francesco Sessa, Filippo Annino, Mario Falsaperla, Antonio Celia, Domenico Veneziano, Angelo Porreca, Paolo Parma, Chiara Cipriani, Andrea Mari, Andrea Minervini, Riccardo Bertolo, Luca Cindolo, Alessandro Antonelli, R. Nucciotti, Pierluigi Bove, and Costantino Leonardo
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medicine.medical_specialty ,Clamp ,Randomized controlled trial ,business.industry ,law ,Urology ,medicine.medical_treatment ,Medicine ,business ,Nephrectomy ,Surgery ,law.invention - Abstract
INTRODUCTION AND OBJECTIVE:Outcomes of 2 dedicated randomized controlled trials (RCTs) comparing on-clamp versus off-clamp robot-assisted (RPN) or pure laparoscopic partial nephrectomy (LPN) (CLOCK...
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- 2021
48. Percutaneous cryoablation for high-complexity renal masses: complications, functional and oncological outcomes
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Giorgio Artuso, Nicola Pavan, Antonio Celia, Luca Balestrieri, Giacomo Rebez, Paolo Umari, G. Giannarini, Carlo Trombetta, Michele Rizzo, Michele Bertolotto, Giovanni Liguori, Camilla Sachs, Andrea Piasentin, Rizzo, Michele, Piasentin, Andrea, Rebez, Giacomo, Giannarini, Gianluca, Umari, Paolo, Sachs, Camilla, Celia, Antonio, Pavan, Nicola, Balestrieri, Luca, Artuso, Giorgio, Bertolotto, Michele, Trombetta, Carlo, and Liguori, Giovanni
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Cryoablation ,medicine.medical_specialty ,Percutaneous ,Local neoplasm recurrence ,Urology ,medicine.medical_treatment ,Renal function ,Cryosurgery ,High complexity ,medicine ,Overall survival ,Humans ,Renal neoplasm ,Renal cell carcinoma ,Carcinoma, Renal Cell ,Aged ,Retrospective Studies ,Percutaneous cryoablation ,business.industry ,Kidney Neoplasms ,Surgery ,Treatment Outcome ,Nephrology ,Median time ,Charlson comorbidity index ,Percutaneou ,business - Abstract
Background During the past two decades cryoablation (CA) has become a therapeutic option for the management of localized cT1 renal masses in comorbid patients. We analyzed the midterm functional and oncological outcomes of CA in the treatment of cT1 renal masses which were classified as high-complexity masses according to the PADUA system. Methods A total of 299 patients underwent percutaneous CA between November 2007 and December 2018 in 4 institutions for cT1N0M0 renal masses. All patients with highcomplexity (PADUA ≥ 10) renal tumors were included. Technical failure of CA was considered an exclusion criterion. Results Inclusion criteria were met by 45 patients. Median Charlson Comorbidity Index (CCI) was 6.0 (IQR: 5.0-7.0), median age was 74 years (IQR: 64.5-79.5). Seven Clavien 1 and 1 Clavien 2 procedure-related complications were reported. Median eGFR at baseline was 64.3ml/min (IQR: 52.0 - 82.3) while at the 1-year follow-up was 61.4 ml/min (IQR: 44.0-74.5). The median follow-up was 32 months (IQR: 13.25-47.5). Local recurrences were detected in 6 patients; 3 of them underwent re-cryoablation while the others started active surveillance. Median time to recurrence was 17.5 months (IQR: 7.8-27.3). Cancer-Specific Survival and Metastasis-Free Survival were 100%. Overall survival was 86.7%. Conclusions CA proved to be a valuable therapeutic option for the management of patients with cT1 high-complexity PADUA ≥ 10 renal tumors as it provides a low rate of procedural morbidity and good preservation of renal function. However, these results are counterbalanced by a recurrence rate that appears to be higher than those reported on surgically treated patients.
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- 2021
49. PD12-05 PER-PROTOCOL ANALYSIS FROM THE CLOCK II RANDOMIZED CLINICAL TRIAL COMPARING OFF-CLAMP VERSUS ON-CLAMP PURE LAPAROSCOPIC PARTIAL NEPHRECTOMY
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Alessandro Antonelli, Domenico Veneziano, Luca Cindolo, Andrea Minervini, Costantino Leonardo, Paolo Parma, Pierluigi Bove, Riccardo Bertolo, Mario Falsaperla, Antonio Celia, Marco Sandri, and Chiara Cipriani
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medicine.medical_specialty ,Intention-to-treat analysis ,Clamp ,Randomized controlled trial ,law ,business.industry ,Urology ,medicine.medical_treatment ,medicine ,business ,Nephrectomy ,Surgery ,law.invention - Abstract
INTRODUCTION AND OBJECTIVE:Comprehensive systematic literature reviews including pure laparoscopic partial nephrectomy (LPN) showed no impact on either surgical or oncological outcomes by the off-c...
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- 2021
50. V13-08 ROBOTIC INTRACORPOREAL ORTHOTOPIC ILEAL NEOBLADDER: REPLICATING OPEN SURGICAL PRINCIPLES OF Y-SHAPED TECHNIQUE
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Antonio Celia, Giorgio Mazzon, Bernardino De Concilio, Tommaso Silvestri, Guglielmo Zeccolini, Giovanni Costa, and Federico Germinale
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Cystectomy ,medicine.medical_specialty ,Bladder cancer ,business.industry ,Urology ,medicine.medical_treatment ,medicine ,Cancer ,In patient ,medicine.disease ,business ,Surgery - Abstract
INTRODUCTION AND OBJECTIVE:Bladder cancer is the fourth most common cancer diagnosed in men in the Europe and currently radical cystectomy is yet the gold-standard treatment in patient fit for surg...
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- 2021
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