33 results on '"I. Meneghetti"'
Search Results
2. Epidemiological description and management outcomes of benign ureteroenteric stricture after radical cystectomy: A single-center experience
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C. Martinez, J.M. Gaya, I. Meneghetti, A. Caillabet, D. Vanacore, M. Talle, L. Mosquera, J. Huguet, A. Rosales, J. Palou, and A. Breda
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Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2020
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3. Dual thulium-holmium laser ablation by percutaneous approach of upper tract urinary carcinoma in a solitary kidney: An imperative case
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C. Martinez, O. Angerri, A. Territo, D. Vanacore, G. Saitta, M. Talle, A. Caillabet, I. Meneghetti, G. Bevilacqua, B. Montaño, I. Giron, J. Palou, and A. Breda
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Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Published
- 2020
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4. Manejo del carcinoma in situ de tramo urinario superior diagnosticado por biopsia ureteroscópica: ¿es el bacilo de Calmette-Guérin una alternativa a la nefroureterectomía?
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A. Territo, S. Fontanet, I. Meneghetti, A. Gallioli, F. Sanguedolce, Ó. Rodriguez-Faba, J.M. Gaya, J. Palou, J. Huguet, and A. Breda
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Urology - Published
- 2023
5. Evaluación de la dinámica de la temperatura intrarrenal con el uso de láseres holmio y tulio YAG en un modelo ex vivo de riñón porcino
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E. Emiliani, A. Territo, J.F. Calderón Cortez, I. Meneghetti, J.D. Subiela, G. Basile, O. Angerri, J. Palou J, and A. Breda
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Urology - Published
- 2023
6. Assessment of intrarenal temperature dynamics when using holmium and thulium: YAG lasers in an ex vivo porcine kidney model
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E. Emiliani, A. Territo, J.F. Calderón Cortez, I. Meneghetti, J.D. Subiela, G. Basile, O. Angerri, J. Palou J, and A. Breda
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General Medicine - Published
- 2023
7. Management of primary upper urinary tract carcinoma in situ diagnosed by ureteroscopic biopsy: Is bacillus Calmette-Guerin an alternative to nephroureterectomy?
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A. Territo, S. Fontanet, I. Meneghetti, A. Gallioli, F. Sanguedolce, Ó. Rodriguez-Faba, J.M Gaya, J. Palou, J. Huguet, and A. Breda
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General Medicine - Abstract
Radical nephroureterectomy (RNU) represents the gold standard treatment for upper tract urothelial carcinoma (UTUC); however, attempts have been made to treat upper urinary tract CIS (UT-CIS) conservatively. The aim of this study was to compare the outcome of patients with primary UT-CIS treated in our center by means of RNU vs. bacillus Calmette-Guérin (BCG) instillations.This retrospective study included patients with diagnosis of primary UT-CIS between 1990 and 2018. All patients had histological confirmation of UT-CIS in the absence of other concomitant UTUC. Histological confirmation was obtained by ureteroscopy with multiple biopsies. Patients were treated with BCG instillations, RNU or distal ureterectomy. Clinicopathological features and outcomes were compared between RNU and BCG groups.A total of 28 patients and 29 renal units (RUs) were included. Sixteen (57.1%) patients (17 RUs) received BCG. BCG was administered via nephrostomy tube in 4 patients, with a single-J ureteral stent in 5, and using a Double-J stent in 7. Complete response and persistence or recurrence were detected in ten (58.8%) and seven (41.2%) RUs treated with BCG, respectively. Eight (27.6%) RUs underwent RNU, and 4 (13.8%) Rus distal ureterectomy. No differences were found in recurrence-free survival (p=0.841) and cancer-specific survival (p=0.77) between the RNU and BCG groups.Although RNU remains the gold standard treatment for UT-CIS, our results confirm that BCG instillations are also effective. Histological confirmation of UT-CIS is mandatory before any treatment.
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- 2022
8. Prostatic artery embolization versus transurethral resection of the prostate: assessment of safety and efficacy
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T. Di Vico, I. Meneghetti, L. Mosillo, A. Piccirilli, C. Catalano, L. Lorenzi, and V. Vocaturo
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Urology - Published
- 2021
9. Feasability of the Epicheck test in upper urinary tract tumor: Interim analysis of a prospective trial
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Angelo Territo, D. Vanacore, J. Palou, M. Talle, J.M. Gaya, I. Meneghetti, G. Bevilacqua, A. Breda, B.E. Montaño Roca, G. Saitta, Claudio Martínez, Andrea Gallioli, and Romain Boissier
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medicine.medical_specialty ,business.industry ,Urology ,lcsh:Diseases of the genitourinary system. Urology ,lcsh:RC870-923 ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Interim analysis ,lcsh:RC254-282 ,Test (assessment) ,Prospective trial ,medicine ,business ,Upper urinary tract - Published
- 2020
10. Epidemiological description and management outcomes of benign ureteroenteric stricture after radical cystectomy: A single-center experience
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Jorge Huguet, A. Breda, M. Talle, J.M. Gaya, I. Meneghetti, A. Caillabet, D. Vanacore, Antonio Rosales, L. Mosquera, Claudio Martínez, and J. Palou
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medicine.medical_specialty ,business.industry ,Urology ,General surgery ,medicine.medical_treatment ,lcsh:Diseases of the genitourinary system. Urology ,lcsh:RC870-923 ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Single Center ,lcsh:RC254-282 ,Cystectomy ,Epidemiology ,Medicine ,business - Published
- 2020
11. Randomized controlled study assessing the effect of the Airseal system during robotic assisted radical cystectomy with intracorporeal ileal conduit
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T. Di Vico, I. Meneghetti, D. Bracchitta, J. Durante, M. Santarsieri, L. Tesi, Aldo Paolicchi, C. Cariello, F. Francesca, and G. Pomara
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Cystectomy ,medicine.medical_specialty ,Electrical conduit ,Randomized controlled trial ,business.industry ,Robotic assisted ,law ,Urology ,medicine.medical_treatment ,Medicine ,business ,Surgery ,law.invention - Published
- 2019
12. Impact of Re-usable surgical drapes on perioperative wound and systemic infections
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T. Di Vico, I. Meneghetti, L. Tesi, J. Durante, D. Bracchitta, A. Perotti, Alessio Tognarelli, S. Malloggi, M. Lencioni, L. Brizzi, Riccardo Bartoletti, and Chiara Polito
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medicine.medical_specialty ,business.industry ,Urology ,General surgery ,medicine ,Perioperative ,Surgical Drape ,USable ,business - Published
- 2019
13. Prostate cancer diagnosis report to the patient may induce subjective urinary and sexual symptoms worsening
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I. Meneghetti, Riccardo Bartoletti, L. Brizzi, L. Mosillo, J. Durante, Chiara Polito, G. Neri, M. Lencioni, L. Tesi, Alessio Tognarelli, R. Baldesi, and T. Di Vico
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medicine.medical_specialty ,Prostate cancer ,business.industry ,Urology ,Internal medicine ,Urinary system ,medicine ,medicine.disease ,business ,Sexual symptoms - Published
- 2018
14. BCR and BCR-ABL regulation during myeloid differentiation in healthy donors and in chronic phase/blast crisis CML patients
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Rocco Piazza, I Meneghetti, Angela Mogavero, Ilaria Iacobucci, Matteo Parma, Carlo Gambacorti-Passerini, Sara Redaelli, M Marega, Enrico Maria Pogliani, Alessandra Pirola, Marega, M, Piazza, R, Pirola, A, Redaelli, S, Mogavero, A, Iacobucci, I, Meneghetti, I, Parma, M, Pogliani, E, and GAMBACORTI PASSERINI, C
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Cancer Research ,Myeloid ,DNA Primer ,Fusion Proteins, bcr-abl ,Biology ,Philadelphia chromosome ,Polymerase Chain Reaction ,Blast Crisi ,MED/15 - MALATTIE DEL SANGUE ,Leukemia, Myelogenous, Chronic, BCR-ABL Positive ,hemic and lymphatic diseases ,K562 Cell ,medicine ,Transcriptional regulation ,Humans ,neoplasms ,DNA Primers ,ABL ,Base Sequence ,breakpoint cluster region ,Myeloid leukemia ,Cell Differentiation ,Hematology ,medicine.disease ,medicine.anatomical_structure ,Oncology ,Proto-Oncogene Proteins c-bcr ,Immunology ,Cancer research ,Blast Crisis ,K562 Cells ,K562 cells ,Chronic myelogenous leukemia - Abstract
Chronic myeloid leukemia (CML) is caused by the BCR-ABL hybrid gene. The molecular mechanisms leading from chronic phase (CP) to blast crisis (BC) are not understood. However, both the presence and the levels of BCR-ABL seem to be important for CML progression. BCR-ABL is under the transcriptional control of BCR promoter. Here we focused on the gene expression control of BCR and BCR-ABL upon myeloid differentiation in healthy donors (HDs), CP and BC patients. As previously reported, BCR-ABL is downregulated during myeloid maturation in CP patients. A similar pattern was detected for BCR (but not for ABL) in CP-CML and in HD, thus suggesting that the two genes may be under a similar transcriptional control. In BC this mechanism is similarly impaired for both BCR-ABL and BCR. These data indicate the presence of an 'in trans' deregulated transcription of both BCR and BCR-ABL promoters, associated with CML progression.
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- 2010
15. BCR and BCR/ABL Regulation during Myeloid Differentiation in Healthy Donors and in Chronic Phase/Blast Crisis CML Patients
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Angela Mogavero, Carlo Gambacorti, Sara Redaelli, Rocco Piazza, M Marega, I Meneghetti, Marega, M, Piazza, R, Meneghetti, I, Redaelli, S, Mogavero, A, and GAMBACORTI PASSERINI, C
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Myeloid ,ABL ,Chemistry ,Immunology ,breakpoint cluster region ,Cell Biology ,Hematology ,CD38 ,Biochemistry ,Fusion gene ,Haematopoiesis ,medicine.anatomical_structure ,Real-time polymerase chain reaction ,MED/15 - MALATTIE DEL SANGUE ,hemic and lymphatic diseases ,medicine ,Cancer research ,BCR BCR-ABL1 Chronic Myeloid Leukemia, Blast Crisis, Differentiation ,K562 cells - Abstract
The fusion protein BCR/ABL leads to chronic myeloid leukaemia (CML). The corresponding fusion gene is under the transcriptional control of BCR promoter. It is known that in CML progenitors the ability to block myeloid differentiation is directly related to BCR/ABL levels. These observations open new questions about BCR/ABL and BCR expression control. However, up to date only few studies have been focused on the characterization of the BCR promoter, so little is known about the transcriptional regulation of this gene. We studied BCR expression in sorted myeloid precursors in healthy donors (HD) and in CML patients in Chronic Phase (CP) and Blast Crisis (BC). CML samples were also analyzed for BCR/ABL . The expression level was analyzed by Real Time PCR normalized against GUS as housekeeping gene, in haematopoietic stem cells (HSCs defined as CD34 + /CD38 − /Thy + / −), common myeloid and granulocyte-monocyte progenitors (CMPs and GMPs, respectively defined as CD34 + /CD38 + /IL − 3Ralo/CD45RA − and CD34 + /CD38 + /IL − 3Ralo/CD45RA +,) sorted by Fluorescence Activated Cell Sorting (FACS). Preliminarly, we analyzed the BCR and BCR/ABL mRNA halflife. We performed a RNA stability assay using Actinomycin D in the K562 cell line and in CP and BC samples: the halflife of both genes were comparable thus excluding major differences in RNA stability. Then, we analyzed BCR levels in healthy donors. A statistically significant BCR downregulation was noted during myeloid maturation in HD (HSCs [0.815±0.27SD] vs CMPs [0.176±0.1] and vs GMPs [0.167±0.17], p=0.0079 in both cases). The same analysis performed in CP patients showed that both BCR and BCR/ABL were downregulated upon committement to differentiation ( BCR : HSCs [0.326±0.24] vs CMPs [0.0899±0.054], p=0.0078, and vs GMPs [0.0277±0.07], p=0.0008; BCR/ABL : HSCs [2.99±1.76] vs CMPs [0.781±0.41], p=0.0005 and vs GMPs [0.304±0.46], p=0.028). However, while BCR levels were lower in CML samples compared to HD (HSC samples [0.815±0.27 vs 0.326±0.24]: p=0.0120), probably due to haploinsufficiency, BCR/ABL values were higher than BCR ones, when compared to CML (HSCs: p=0.0020) and even to HD samples (HSCs: p=0.0074). These data indicate that in CML a potent upregulation of BCR/ABL compared to BCR is present, probably caused by a selective mechanism acting on BCR/ABL . In a limited set of BC samples (4 patients), the decrease of BCR and BCR/ABL was less evident and did not reach statistical significance ( BCR : HSCs 0.339±0.235; CMPs: 0.135±0.12; GMPs: 0.126±0.06; BCR/ABL : HSCs: 8.58±5.78; CMPs: 5.55±7.39; GMPs: 3.36±2.61); thus as already indicated by Jamieson and colleagues (NEJM, 351:657, 2004), in BC the downregulation of BCR/ABL during maturation is impaired. Moreover, we detected a tendency for higher expression of BCR/ABL in BC than CP in all the subpopulations under study, which reached statistical significance only in GMPs (HSCs [8.58±5.78 BC vs 2.99±1.76 CP]: p=0.1483; CMPs [5.55±7.39 BC vs 0.781±0.41 CP]: p=0.1483; GMPs [3.36±2.61 BC vs 0.304±0.46 CP]: p=0.028); BCR was upregulated only in GMPs (HSCs [BC 0.339±0.235 vs 0.326±0.24 CP]: p=0.9399; CMPs [0.135±0.12 vs 0.0899±0.054]: p=0.4818; GMPs [0.126±0.06 vs 0.0277±0.07]: p=0.0755). In conclusion, BCR is physiologically downregulated during myeloid maturation, and this regulation is conserved in CP-CML, not only for BCR but also for BCR/ABL . In BC-CML, this mechanism of regulation seems to be impaired for BCR/ABL and possibly for BCR too. In addition, a potent upregulation of BCR/ABL compared to BCR is present in all stages of CML, probably caused by a selective mechanism acting on BCR/ABL .
- Published
- 2008
16. Synergistic Activity of the Novel Src/Abl Inhibitor Bosutinib in Combination with Imatinib
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Frank Boschelli, Michela Viltadi, I Meneghetti, Sara Redaelli, and Carlo Gambacorti
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ABL ,business.industry ,Immunology ,Imatinib ,Cell Biology ,Hematology ,Pharmacology ,medicine.disease ,Biochemistry ,Leukemia ,Imatinib mesylate ,hemic and lymphatic diseases ,Acute lymphocytic leukemia ,medicine ,business ,neoplasms ,Bosutinib ,K562 cells ,Proto-oncogene tyrosine-protein kinase Src ,medicine.drug - Abstract
The oncogenic fusion protein Bcr-Abl is the underlying cause of Chronic Myeloid Leukemia (CML), and it is present in up to 35% of Acute Lymphoblastic Leukemia (ALL). The discovery of a selective Abl inhibitor, Imatinib mesylate, has revolutionized the treatment of CML. Recently, several new inhibitors have been developed with the aim of increasing both potency and selectivity against Abl. Bosutinib (SKI-606, Wyeth) is a dual Src/Abl inhibitor that showed an in vitro activity in the low nanomolar range on several BCR-ABL positive cells and it is, at present, in phase II clinical trials. Bosutinib is devoid of activity against some known “off-target” kinases blocked by imatinib, such as PDGFR and c-Kit. In addition structural and modelling data attribute to Bosutinib the ability to bind Bcr-Abl in the intermediate/active conformation, while Imatinib is able to bind only the inactive conformation of Bcr-Abl. In this study we analyzed in vitro the combination of Imatinib and Bosutinib in Bcr-Abl expressing cell lines to evaluate the possibility to decrease dosage of both drugs, increasing or maintaining the same efficacy but avoiding toxic effects. Combination effects were evaluated according to the method of Chou and Talalay, in which the combination index (CI) value is calculated for a combination of two drugs and allows the quantification of synergism: CI 1 indicate synergistic, additive or antagonistic interactions, respectively. Proliferation assays on a panel of Imatinib-sensitive and Imatinib-resistant BCR-ABL positive cell lines were performed. Cells were treated with Imatinib and Bosutinib as single agents or in three ratio combinations (1:3, 1:10, 1:33 in favour to Imatinib) across a wide range of concentrations. Combination indexes (CI) calculated at IC50, IC75 and IC90 for K562 cells (Imatinib-sensitive), suggest a synergistic to very strong synergistic effect (CI= 0.01-0.53). Similarly, in KCl22, KU812 and Lama84 cells (Imatinib-sensitive) moderate to strong synergistic effects were observed. A slight to moderate synergism was also obtained in three Imatinib-resistant cell lines tested: Lama84R (CI=0.63-0.88), K562R (CI=0.63-0.82) and KCL22R (CI=0.62-0.92). Western blot analysis of the tyrosine phosphorylation status of K562S cells treated with a mixture of 100nM Imatinib and 10nM Bosutinib revealed a substantially more pronounced inhibition compared with either 100nM Imatinib or 10nM Bosutinib alone. The effect of the combination was also assessed in murine Ba/F3 cells transfected with either wild type (WT) or mutated forms of BCR-ABL. Parental Ba/F3 cells were not affected by the presence of both drugs, while in Ba/F3 BCR-ABL WT the CI ranged from 0.49 to 0.85, indicating moderate synergism. The combination of Imatinib and Bosutinib inhibited the growth of Ba/F3 BCR-ABL Y253F with a slight synergism (CI 0.77-0.87). No synergistic effect was observed on Ba/F3 BCR-ABL E255K and on the highly resistant T315I mutant. Fresh leukemic cells obtained from three CML patients were also studied. In these samples synergistic effects between Bosutinib and Imatinib were confirmed (CI=0.52, 0.73, 0.62). The different binding modes of Imatinib and Bosutinib may justify the synergistic effect observed in the CML lines. This results support a possible therapeutic advantage for the combination of Bosutinib and Imatinib against Philadelphia positive leukemias.
- Published
- 2007
17. Management of an elderly patient with retention of a steel nail in the scrotum: a case report.
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Meneghetti I, Cesta N, Mosillo L, Belli S, Bianchi D, and De Maria M
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- Humans, Male, Aged, Stainless Steel, Nails, Tomography, X-Ray Computed, Foreign Bodies surgery, Scrotum
- Abstract
Background: The retention of foreign bodies inside the body during ludic/sexual procedures or for traumatism represents one of the causes of visits to accident and emergency departments that often requires surgical removal of the foreign body. However, there are cases where the discovery of such foreign bodies takes place after many years, as in patients that are slightly compromised from a neuro-sociological point of view., Case Presentation: A 76-year-old male presented to an outpatient urological examination due to an increase in scrotal volume. At the ultrasound check, an acoustic interference from a solid object was detected, for which computed tomography was requested. The computed tomography scan revealed the presence of an elongated metal body in the perineum. The removal of the foreign body in the operating theatre was then scheduled. A 10 cm long stainless-steel nail located within an abscessed foreign body granuloma was identified and removed via a scrotal access. Four days later, a new surgical toilet was performed due to minimal necrosis of the skin flaps. The patient then performed three more dressings in the operating theatre during the following week. Healing took place by secondary intention until a perfect healing of the surgical wound was obtained., Conclusions: Removal of foreign bodies from the perineum in case of infection can be challenging. Careful attention and postoperative dressings are crucial for the success of the case.
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- 2024
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18. Correction: The use of Versius CMR for pelvic surgery: a multicentric analysis of surgical setup and early outcomes.
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Sighinolfi MC, De Maria M, Meneghetti I, Felline M, Ceretti AP, Mosillo L, Catalano C, Morandi A, Calcagnile T, Panio E, Sangalli M, Turri F, Terzoni S, Assumma S, Sarchi L, Afonina M, Marconi A, Bianchi PP, Micali S, Rocco B, and Gaia G
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- 2024
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19. Partial nephrectomy series using Versius robotic surgical system: technique and outcomes of an initial experience.
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Meneghetti I, Sighinolfi MC, Dibitetto F, Collins JW, Mosillo L, Catalano C, Rocco B, De Dominicis M, and De Maria M
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- Humans, Intraoperative Complications, Nephrectomy, Operative Time, Robotic Surgical Procedures methods, Surgeons
- Abstract
Partial nephrectomy (PN) represents a procedure where the use of a robot has further enabled successful completion of this complex surgery. The results of this procedure using Versius Robotic Surgical System (VRSS) still need to be evaluated. Our working group described the technique and reported the initial results of a series of PN using VRSS. We presented our setting, surgical technique and outcomes for PN, using VRSS. Between 2022 and 2023, 15 patients underwent PN performed by two surgeons in two different centers. Fifteen patients underwent PN. The median lesion size identified on preoperative imaging was 4 (IQR 2.3-5) cm. Median PADUA score was 8 (IQR 7-9). Two procedures were converted to radical nephrectomy for enhanced oncological disease control. Of the 13 nephrectomies that were completed as partial, 7 were performed clampless and 6 with warm ischemia clamping. Median clamping time was 10 (IQR 9-11) minutes. No procedure was converted to open. Median blood loss was 200 (IQR 100-250) mL. Median total operative time was 105 (IQR 100-110) minutes. Median console time was 75 (IQR 66-80) minutes. Median set-up time was 13 (IQR 12-14) minutes. No intraoperative complications were reported. The median hospitalization time was 4 (IQR 3.5-4) days. None of the patients were transfused and none of the patients required readmission. In a pathology report, one patient had a positive surgical margin. Our initial experience suggests that performing PN using VRSS is feasible with good short-term outcomes., (© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)
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- 2024
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20. Versius robotic surgical system: case series of 18 robot-assisted radical prostatectomies.
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De Maria M, Meneghetti I, Mosillo L, Collins JW, and Catalano C
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- Male, Humans, Prostate surgery, Prostatectomy methods, Treatment Outcome, Robotic Surgical Procedures methods, Robotics, Prostatic Neoplasms surgery, Prostatic Neoplasms etiology
- Abstract
Objective: To present the results of the first series of patients treated with robot-assisted radical prostatectomy (RARP) with the use of the Versius® Surgical System (CMR Surgical Ltd., Cambridge, UK). RARP has demonstrated better perioperative outcomes compared to open RP. However, RARP remains limited by platform availability and cost-effectiveness issues. The increasing competition from new robotic surgical platforms may further drive utilisation of the robotic approach., Patients and Methods: Data were collected prospectively for our first 18 consecutive patients with localised prostate cancer who underwent RARP at our centre over a 3-month period. We recorded parameters, including patient demographics and perioperative outcomes. We also report our optimised set-up with regard to trocar placement, bedside unit placement, and overall composition of the operating room for this procedure. Describing the incremental modifications carried out to achieve reductions in set-up and operating times to optimise utilisation of the Versius system., Results: The median (interquartile range [IQR]) set-up time was 8.5 (7-10) min. The median (IQR) console time was 201 (170-242) min. The median (IQR) operative time was 213 (186-266) min. The median (IQR) total surgery time was 226 (201-277) min. Bilateral pelvic lymphadenectomy median (IQR) time was 19 (17-20) min. There were no complications and/or limitations related to the use of the Versius system including need for conversion. There were no relevant intra- or postoperative complications at the 1-month follow-up related to the use of the Versius system. Patients were discharged after a median (IQR) of 4 (3.75-5) days, and the transurethral catheter was removed after a mean (range) of 8 (7-14) days. Continence at 2 months was achieved in 72.2% of the patients., Conclusions: Performing RARP using the Versius system is feasible, safe, and easily reproducible. Our set-up enables a rapid docking approach and efficient completion of the surgery., (© 2023 BJU International.)
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- 2024
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21. The use of Versius CMR for pelvic surgery: a multicentric analysis of surgical setup and early outcomes.
- Author
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Sighinolfi MC, De Maria M, Meneghetti I, Felline M, Ceretti AP, Mosillo L, Catalano C, Morandi A, Calcagnile T, Panio E, Sangalli M, Turri F, Terzoni S, Assumma S, Sarchi L, Afonina M, Marconi A, Bianchi PP, Micali S, Rocco B, and Gaia G
- Subjects
- Male, Humans, Prostatectomy methods, Preoperative Care, Plastic Surgery Procedures, Prostatic Neoplasms surgery, Robotic Surgical Procedures
- Abstract
Introduction: Versius CMR is a novel robotic system characterized by an open surgical console and independent bedside units. The system has potentials of flexibility and versatility, and has been used in urological, gynecological, and general surgical procedure. The aim is to depict a comprehensive analysis of the Versius system for pelvic surgery., Methods: This is a study involving two Institutions, ASST Santi Paolo and Carlo, Milan, and Apuane Hospital, Massa, Italy. All interventions performed in the pelvic area with the Versius were included. Data about indications, intra-, and post-operative course were prospectively collected and analyzed., Results: A total of 171 interventions were performed with the Versius. Forty-two of them involved pelvic procedures. Twenty-two had an oncological indication (localized prostate cancer), the remaining had a non-oncological or functional purpose. The mostly performed pelvic procedure was radical prostatectomy (22) followed by annexectomy (9). No intra-operative complication nor conversion to other approaches occurred. A Clavien II complication and one Clavien IIIb were reported. Malfunctioning/alarms requiring a power cycle of the system occurred in 2 different cases. An adjustment in trocar placement according to patients' height was required in 2 patients undergoing prostatectomy, in which the trocar was moved caudally. In two cases, a pelvic prolapse was repaired concomitant with other gynecological procedures., Conclusions: Pelvic surgery with the Versius is feasible without major complications; either dissection and reconstructive steps could be accomplished, provided a proper OR setup and trocar placement are pursued. Versius can be easily adopted by surgeons of different disciplines and backgrounds; a further multi-specialty implementation is presumed and long-term oncological and functional outcomes are awaited., (© 2024. The Author(s).)
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- 2024
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22. Evaluation of the effectiveness of the FOCUS ADHD App in monitoring adults with attention-deficit/hyperactivity disorder.
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Carvalho LR, Haas LM, Zeni G, Victor MM, Techele SP, Marrone Castanho J, Meneghetti Coimbra I, de Freitas de Sousa A, Ceretta N, Garrudo A, Grevet EH, and Rohde LA
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- Humans, Adult, Attention Deficit Disorder with Hyperactivity drug therapy, Mobile Applications, Telemedicine, Central Nervous System Stimulants therapeutic use
- Abstract
Background: The current investigation assessed a) the performance of the FOCUS ADHD mobile health application (App) in increasing pharmacological treatment adherence and improving patients' knowledge of attention-deficit/hyperactivity disorder (ADHD) and b) the impact of implementing a financial incentive for using the App (i.e., a discount on medication)., Methods: In a randomized, blind, parallel-group clinical trial, 73 adults diagnosed with ADHD were allocated into three groups for 3 months: a) Pharmacological treatment as usual (TAU); b) TAU and the App (App Group); and c) TAU and the App + a commercial discount on the purchase of medication prescribed for ADHD treatment (App + Discount Group)., Results: There was no significant difference in mean treatment adherence between groups, assessed as a medication possession ratio (MPR). However, the App + Discount Group exhibited greater medication intake registrations compared with the App Group during the initial phase of the trial. The financial discount also produced a 100% App adoption rate. App use did not increase ADHD knowledge, though knowledge scores were high at baseline. The usability and quality of the App were rated favorably., Conclusions: The FOCUS ADHD App achieved a high adoption rate and positive evaluations by users. Use of the App did not increase adherence to treatment as measured by MPR, but, for App users, the addition of a financial incentive to use the App produced an increase in treatment adherence in terms of medication intake registrations. The present results offer encouraging data for combining incentives with mobile digital health solutions to positively impact treatment adherence in ADHD.
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- 2023
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23. Management of primary upper urinary tract carcinoma in situ diagnosed by ureteroscopic biopsy: Is bacillus Calmette-Guerin an alternative to nephroureterectomy?
- Author
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Territo A, Fontanet S, Meneghetti I, Gallioli A, Sanguedolce F, Rodriguez-Faba Ó, Gaya JM, Palou J, Huguet J, and Breda A
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- Humans, Nephroureterectomy methods, Ureteroscopy methods, BCG Vaccine therapeutic use, Retrospective Studies, Biopsy, Carcinoma, Transitional Cell drug therapy, Carcinoma, Transitional Cell surgery, Urinary Bladder Neoplasms pathology, Urologic Neoplasms surgery, Carcinoma in Situ pathology
- Abstract
Background: Radical nephroureterectomy (RNU) represents the gold standard treatment for upper tract urothelial carcinoma (UTUC); however, attempts have been made to treat upper urinary tract CIS (UT-CIS) conservatively. The aim of this study was to compare the outcome of patients with primary UT-CIS treated in our center by means of RNU vs. bacillus Calmette-Guérin (BCG) instillations., Methods: This retrospective study included patients with diagnosis of primary UT-CIS between 1990 and 2018. All patients had histological confirmation of UT-CIS in the absence of other concomitant UTUC. Histological confirmation was obtained by ureteroscopy with multiple biopsies. Patients were treated with BCG instillations, RNU or distal ureterectomy. Clinicopathological features and outcomes were compared between RNU and BCG groups., Results: A total of 28 patients and 29 renal units (RUs) were included. Sixteen (57.1%) patients (17 RUs) received BCG. BCG was administered via nephrostomy tube in 4 patients, with a single-J ureteral stent in 5, and using a Double-J stent in 7. Complete response and persistence or recurrence were detected in ten (58.8%) and seven (41.2%) RUs treated with BCG, respectively. Eight (27.6%) RUs underwent RNU, and 4 (13.8%) Rus distal ureterectomy. No differences were found in recurrence-free survival (p=0.841) and cancer-specific survival (p=0.77) between the RNU and BCG groups., Conclusions: Although RNU remains the gold standard treatment for UT-CIS, our results confirm that BCG instillations are also effective. Histological confirmation of UT-CIS is mandatory before any treatment., (Copyright © 2022. Published by Elsevier España, S.L.U.)
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- 2023
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24. Assessment of intrarenal temperature dynamics when using holmium and thulium: YAG lasers in an ex vivo porcine kidney model.
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Emiliani E, Territo A, Calderón Cortez JF, Meneghetti I, Subiela JD, Basile G, Angerri O, Palou J J, and Breda A
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- Swine, Animals, Temperature, Thulium, Holmium, Kidney surgery, Lasers, Solid-State therapeutic use
- Abstract
Aim: To measure the temperature dynamics at the renal surface and within the urinary tract when using Ho:YAG and Tm:YAG lasers for tissue ablation., Materials and Methods: Porcine kidneys were used. Both types of lasers with different configurations and fiber sizes were used through a flexible ureteroscope. The temperature at the renal surface was recorded using a thermal camera while the intrarenal temperature was measured using two thermal probes, the first one at the ureteropelvic junction and the second one at the calyx used for lasering. Temperature was determined at 0.5-1-3-5 and 10 min., Results: Recordings at the ureteropelvic junction and calyx revealed significant increases when using Tm:YAG with the 273 μm (10 W to 50 W) (p ≤ 0.02) and 550 μm (10 W) fiber (p = 0.04). With Ho:YAG there was a significant increase when using 273 μm (at 10 W and 20 W) (p ≤ 0.03) and 365 μm (10 W) fibers (p = 0.04). Regarding fiber size there was a significant difference when using Tm:YAG (at 20 W and 40 W) (p < 0.05). The thermal camera recorded a mean increase of 8 °C in the UPJ while the remaining areas of the kidney did not undergo significant changes., Conclusions: Temperature changes were greater when using the Ho:YAG laser with respect to Tm:YAG at similar power settings for tissue ablation. The greatest temperature increase was recorded at the UPJ from where the heat dissipated throughout the kidney., (Copyright © 2022. Published by Elsevier España, S.L.U.)
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- 2023
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25. Treatment of a hemorrhage secondary to nephrostomy tube placement for derivation of monstrous hydronephrosis in upper tract urothelial carcinoma.
- Author
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Meneghetti I, Tarantino FP, Mosillo L, and Catalano C
- Abstract
A 85-year-old female patient underwent nephrostomy tube insertion for a huge hydronephrosis due to a papillary mass involving the right ureteral ostium diagnosed by at computed tomography scan. As soon as the nephrostomy tube was inserted, a pulsatile bleeding was found and a renal angiography was done. A massive bleeding from the main and unique right renal artery was found such as to require prompt endovascular embolization. A transurethral resection of the bladder was performed and the pathology report confirmed high-grade pTa transitional cell carcinoma. An open drainage was then placed to empty the contents of the pyelocalyceal system of the kidney. Once obtained the volumetric reduction of the abdominal mass the patient underwent the right nephroureterectomy., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Urology Annals.)
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- 2023
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26. Optimizing decision-making process of benign uretero-enteric anastomotic stricture treatment after radical cystectomy.
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Gaya JM, Territo A, Basile G, Gallioli A, Martínez C, Turco M, Baboudjian M, Verri P, Tedde A, Uleri A, Meneghetti I, Huguet J, Rosales A, Sanguedolce F, Rodriguez-Faba O, Palou J, and Breda A
- Subjects
- Humans, Cystectomy adverse effects, Constriction, Pathologic etiology, Constriction, Pathologic surgery, Retrospective Studies, Postoperative Complications surgery, Postoperative Complications etiology, Anastomosis, Surgical adverse effects, Urinary Diversion adverse effects, Ureter surgery, Urinary Bladder Neoplasms surgery, Urinary Bladder Neoplasms complications
- Abstract
Purpose: To identify preoperative predictors of endo-urological treatment (EUT) failure while promoting a new diagnostic and therapeutic pathway for benign uretero-enteric anastomosis stricture (UES) management after radical cystectomy (RC)., Materials and Methods: We relied on a prospectively maintained database including 96 individuals (122 renal units) who developed a benign UES at our institution between 1990 and 2018. UES was classified into two different types according to morphology: FP1 (i.e., sharp or duckbill) and FP2 (i.e., flat or concave). EUT feasibility, success rate, as well as intra and postoperative complications were recorded. Uni- and multivariable logistic regression analysis (MVA) assessed for predictors of EUT failure., Results: Overall, 78 (63.9%) and 32 (26.3%) cases were defined as FP1 and FP2, respectively. EUT was not feasible in 33 (27.1%) cases. After a median follow-up of 50 (IQR 5-240) months, successful treatment was reached only in 15/122 (12.3%) cases. EUT success rates raised when considering short (< 1 cm) (16.8%), FP1 morphology (16.7%) strictures, or the combination of these characteristics (22.4%). Overall, 5 (5.2%) cases had CD ≥ III complications. FP2 (OR: 1.91, 95%CI 1.21-5.31, p = 0.03) and stricture length ≥ 1 cm (OR: 9.08, 95%CI 2.09-65.71, p = 0.009) were associated with treatment failure at MVA., Conclusions: Endoscopic treatment for benign UES after RC is feasible but harbors a low success rate. Stricture length and radiological morphology of the stricture are related to endoscopic treatment failure. Surgeons should be aware of the stricture features during the preoperative decision-making process to choose the optimal candidate for endoscopic treatment., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2023
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27. A single-operator experience using EchoLaser SoracteLiteTM for focal laser ablation of prostate cancer: One more arrow in the quiver for the conservative management of the disease.
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Meneghetti I, Giardino D, Morganti R, Marino V, Menchini Fabris F, Bartoletti R, and Pinzi N
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- Male, Humans, Conservative Treatment, Treatment Outcome, Prospective Studies, Prostatic Neoplasms radiotherapy, Prostatic Neoplasms surgery, Laser Therapy methods
- Abstract
Background: The aim of this study was to evaluate the outcomes of patients suffering prostate cancer (PCa) treated conservatively using 1064 nm laser energy for focal laser ablation (FLA). The patients included in the study were unsuitable for surgery or unwilling to receive external beam radiotherapy because they were afraid of the possible side effects of whole-gland therapies., Methods: This study included patients with a diagnosis of nonmetastatic PCa who underwent FLA using SoracteLiteTM system. Tissue ablation was performed at a fixed power of 5 W by the diode multichannel laser system EchoLaser X4 that uses laser light transmitted through optical fibres causing the target tissue to undergo irreversible thermal damage. Functional outcomes were evaluated with the International Prostatic Symptoms Score (IPSS) and 5-item version of the International Index of Erectile Function (IIEF-5) before the treatment and one year later., Results: Ten patients suffering non-metastatic PCa were included. Four decided upon a conservative treatment because of reduced performance status and for six patients the procedure was chosen electively. All patients underwent multiparametric magnetic resonance imaging at 3 and 12 months and eight out of ten patients underwent prostate biopsy at 6 months. Persistent disease was detected in 3 patients who underwent a second ablation. In these patients at the biopsy following the second ablation none harbored residual disease. At follow-up, no patient suffered urinary incontinence requiring the use of pads. No significant worsening in sexual potency measured with IIEF-5 (p = 0.356) or prostatic symptoms measured at IPSS (p = 0.462) were recorded comparing pre-treatment condition vs one-year follow-up. Compared with baseline, prostate-specific antigen was significantly reduced at one-year follow-up (3.7 ± 1.1 vs 7.9 ± 4.1 ng/mL; p = 0.008)., Conclusions: Although whole gland therapies remain the gold standard treatment for PCa, our results indicate that the SoracteLiteTM system for focal laser ablation, as a very preliminary step, appears to offer a short-term oncologic control of PCa with negligible side effects.
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- 2022
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28. Prospective comparative study of postoperative systemic inflammatory syndrome in robot-assisted vs. open kidney transplantation.
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Territo A, Boissier R, Subiela JD, Gallioli A, Meneghetti I, Theil G, Regis F, Mohammed N, Fornara P, Gausa L, Guirado L, and Breda A
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- Humans, Interleukin-6, Lipocalin-2, Prospective Studies, Systemic Inflammatory Response Syndrome epidemiology, Treatment Outcome, Kidney Transplantation methods, Robotic Surgical Procedures methods, Robotics
- Abstract
Purpose: Robot-assisted kidney transplant (RAKT) recently proved to provide functional results similar to the preferred open kidney transplant (OKT), but with inferior wound morbidity. In a comparative prospective study, we explored the systemic inflammatory response syndrome (SIRS) after KT and compared OKT with RAKT., Methods: Forty-nine patients underwent pre-emptive ABO-compatible kidney transplantations (KT) between January 2017 and December 2018 in 2 centers: 25 RAKT, 24 OKT. Postoperative SIRS was biologically assessed by serum markers (NGAL, CRP and IL-6) measured at: T0 (preoperative/baseline), T1(H1), T2(H6), T3(H12), T4(H24), T5(D2), T6(D3) and T7(D5) after KT., Results: Inflammatory markers + eGFR were assessed in OKT vs. RAKT. IL-6 peak value occurred at H6 and reached ×9 from baseline. CRP peak occurred at H24 and reached ×28 from baseline (All P < 0.05). NGAL decreased after surgery with a plateau (divided by 2 from baseline) from H12 to D5. There was no significant difference in IL-6, CRP and NGAL kinetics and peak values between RAKT and OKT (All P > 0.05). Serum creatinine and eGFR on postoperative days 1, 3 and 7 were similar in RAKT and OKT (All P > 0.05). Delayed graft function was not observed., Conclusion: In this exploratory study, the biological evaluation of postoperative SIRS after living-donor kidney transplant revealed no significant difference between OKT and RAKT and similar functional outcomes in the short term. These results highlight the safety of RAKT as an alternative to OKT in this setting., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2022
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29. Intravesical instillation with glycosaminoglycan replacement treatment in patients suffering radiation-induced haemorrhagic cystitis: When and which patients can benefit most from it?
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Sanguedolce F, Meneghetti I, Bevilacqua G, Montaño B, Martínez C, Territo A, Balaña J, Palou J, and Breda A
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- Administration, Intravesical, Female, Glycosaminoglycans adverse effects, Hematuria complications, Humans, Male, Quality of Life, Cystitis chemically induced, Cystitis etiology, Radiation Injuries drug therapy, Radiation Injuries etiology, Urinary Bladder Neoplasms drug therapy
- Abstract
Introduction & Objectives: Radiation-induced haemorrhagic cystitis (RHC) is a frightening complication occurring after pelvic radiotherapy (PRT) which may significantly affect patients' quality of life. Bladder instillation with glycosaminoglycan replacement therapy (GRT) including hyaluronic acid +/- chondroitin sulphate has been proposed as an emerging alternative to prevent relapses of haematuria. Strong points in favour of using GRT for RHC are the ease of administration, cost, almost absence of side effects and possibility of administration to outpatients. We investigated the effectiveness of GRT in a cohort, single-centre, of patients with past-medical history of PRT attending the outpatient clinic and/or the accident & emergency department (A&E) for RHC., Materials & Methods: Patients with diagnosis of RHC, either with toxicity grade of 2 or 3, were deemed candidate for GRT as long as no active bleeding was occurring; in the case of non-self-limiting haematuria and/or anaemia for active bleeding, admission in the urology department was prompted for bleeding control prior to GRT instillation. An induction course of 6 weekly instillations was scheduled; if tolerated, patients were given a maintenance course with at least 6 monthly instillations. The primary end-point consisted in assessing the rate of haematuria remission (either partial or complete) defined as no need to readmission in the A&E and/or in the hospital. Secondary end-points included factors related to GRT failure. Univariate and multivariate analysis were undertaken to identify clinical independent variables associated to the events., Results: Fifty-one patients with at least 1-year follow-up from the first GRT were included in the analysis. 88.2, 9.8 and 2% of patients had undergone PRT because affected by prostate, uterus and colorectal cancer, respectively. Median time-to-RHC was 31 months (IQR 21-90). Access to A&E and hospital admission were needed in 47 (92.1%) and 35 (68.6%) of the patients, respectively. Twenty-two (n = 22/35, 62.9%) patients required transurethral fulguration of the bladder, while the remainders could be managed with bladder wash-out. Median number of GRT instillations was 6 (IQR 3-7). Twenty-three (45.1%) patients needed to be readmitted to hospital a second time, receiving bladder wash-out (n = 7/23, 30.4%), transurethral fulguration of the bladder (n = 10/23, 43.5%) and/or cystectomy (n = 6/23, 26.1%). Ten (19.6%) patients received a second induction course of GRT. At the last follow-up, 36 (70.6%) patients did not required further hospital admission. Type of PRT and number of hospital admissions pre-GRT were the only variables statistically associated to the events at both univariate (P = 0.032 and P = 0.045) and multivariate analysis (P = 0.048 and P = 0.049)., Conclusions: GRT should be prompted as soon as possible after diagnosis of the haematuria and settling of active bleeding. Patients who had undergone adjuvant PRT after radical prostatectomy are those at higher risk of GRT failure., Competing Interests: Conflict of interests The authors certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript., (Copyright © 2022 Elsevier Inc. All rights reserved.)
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- 2022
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30. Endoscopic Management of Upper Urinary Tract Urothelial Carcinoma: Oncologic Outcomes and Prognostic Factors in a Contemporary Cohort.
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Sanguedolce F, Fontana M, Turco M, Territo A, Lucena JB, Cortez JC, Vanacore D, Meneghetti I, Gallioli A, Gaya JM, Redorta JP, and Breda A
- Subjects
- Humans, Kidney Pelvis, Neoplasm Recurrence, Local surgery, Prognosis, Retrospective Studies, Ureteroscopy, Carcinoma, Transitional Cell, Urinary Bladder Neoplasms
- Abstract
Introduction: Appropriate risk stratification and complete tumor ablation are the key factors to optimize the oncologic outcomes of patients undertaking endoscopic management for upper urinary tract urothelial carcinoma (UTUC). We aimed to identify risk factors associated to tumor recurrence and progression in a contemporary cohort of patients diagnosed and treated with the latest endourologic technologies. Patients and Methods: Forty-seven patients were selected between January-2015 and March-2019 for an endoscopic management of UTUC. Last generation of digital ureteroscopes with image-enhancing technologies were used for the detection of the lesions. The retrograde approach was the most frequent access ( n = 45/47). The confocal laser endomicroscopy and multiple biopsy devices were variably used according to site and tumor presentation for their characterization. Holmium and Thulium lasers were variably used, with their combination being the preferred approach in case of larger lesions. Primary endpoints included the identification of factors associated with UTUC recurrence and progression, and bladder tumor recurrence. Results: Median follow-up (FU) was 24 months (interquartile range 17-44). On multivariate analysis, bladder cancer (BC) recurrence was associated to previous contralateral UTUC (hazard ratios: 5.08 confidence interval [95% CI: 1.35-18.94], p < 0.05) and tumor size (hazard ratios: 1.07 [95% CI: 1.00-1.14], p < 0.05). UTUC recurrence was associated to incomplete clearance after primary treatment (hazard ratios: 4.99 [95% CI: 1.15-21.62], p < 0.05), while UTUC progression was significantly related to the number of UTUC recurrences (hazard ratios: 3.10 [95% CI: 1.27-7.53], p < 0.05). No significant survival differences in BC/UTUC recurrence, as well as in UTUC progression, were detected between risk groups. No Clavien-Dindo grade >2 were detected; one patient developed ureteric stricture at 7-month FU. Limitations involve retrospective nature of the study and relatively small number of patients. Conclusions: The appropriate use of latest technology may enhance the oncologic outcomes of the endoscopic management of UTUC without compromising the safety of the approach. Among the prognostic factors identified in our series, UTUC recurrence seems to be associated to disease progression.
- Published
- 2021
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31. Diagnostic ureteroscopy for upper tract urothelial carcinoma: friend or foe?
- Author
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Territo A, Gallioli A, Meneghetti I, Fontana M, Huguet J, Palou J, and Breda A
- Abstract
Introduction: The European Association of Urology guidelines recommend offering kidney-sparing surgery (KSS) as a primary treatment option to patients with low-risk tumours. Cystoscopy, urinary cytology, and computed tomography urography (CTU) do not always allow correct disease staging and grading, and sometimes there is even a lack of certainty regarding the diagnosis of UTUC. Diagnostic ureteroscopy (d-URS) may therefore be of crucial importance within the diagnostic framework and fundamental in establishing the appropriate therapeutic approach., Evidence Acquisition and Synthesis: A systematic review of the literature was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Risk of bias was assessed using Risk of Bias in Non-randomized Studies of interventions (ROBINS-I). Overall, from 3791 identified records, 186 full-text articles were assessed for eligibility. Finally, after a quantitative review of the selected literature, with the full agreement of all authors, 62 studies were considered relevant for this review., Results: CTU has a sensitivity and specificity for UTUC of 92% and 95% respectively, but is not able to detect small or flat lesions with adequate accuracy. The sensitivity of voided urinary cytology for UTUC is around 67-76% and ranges from 43% to 78% for selective ureteric urine collection. As no technique offers a diagnosis of certainty, d-URS can allow an increase in diagnostic accuracy. In the present review the pros and cons of d-URS were analysed. This technique may provide additional information in the selection of patients suitable for neoadjuvant chemotherapy or KSS, distinguishing between normal tissue and low- and high-grade UTUC thanks to the emerging technologies., Conclusions: Information obtainable from d-URS and ureteroscopic-guided biopsy can prove extremely valuable when the diagnosis of UTUC is doubtful or KSS is being considered. Notwithstanding concerns remain regarding the potential risk of bladder recurrence, cancer dissemination, and/or delay in radical treatment. Abbreviations: CLE: confocal laser endomicroscopy; CSS: cancer-specific survival; CTU: CT urography; d-URS: diagnostic ureteroscopy; EAU: European Association of Urology; HR: hazard ratio; IMAGE1S: Storz professional imaging enhancement system; IVR: intravesical recurrence; KSS: kidney-sparing surgery; MFS: Metastasis-free survival; NAC: neoadjuvant chemotherapy; NBI: narrow-band imaging; OCT: optical coherence tomography; RFS: Recurrence-free survival; RNU: radical nephroureterectomy; ROBINS-I: Risk of Bias in Non-randomized Studies of interventions; URS(-GB): Ureteroscopy(-guided biopsy); UTUC: upper tract urothelial carcinoma; UUT: upper urinary tract., Competing Interests: No potential conflict of interest was reported by the authors., (© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)
- Published
- 2021
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32. En bloc resection of bladder tumors: indications, techniques, and future directions.
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Territo A, Bevilacqua G, Meneghetti I, Mercadé A, and Breda A
- Subjects
- Cystectomy methods, Humans, Urinary Bladder Neoplasms pathology, Urologic Surgical Procedures methods, Urologic Surgical Procedures trends, Cystectomy trends, Urinary Bladder Neoplasms surgery
- Abstract
Purpose of Review: En bloc resection of bladder tumor (ERBT) is an innovative new surgical technique, the use of which is becoming increasingly widespread. In this review, we analyze the recent literature and explore new developments, which may impact the future role of en bloc bladder surgery., Recent Findings: ERBT increases the frequency with which detrusor muscle is present in the specimen (to 95%) and offers a significant improvement in the quality of the resection specimen, thereby helping with T1 substaging. Furthermore, the laser treatment reduces the rate of obturator nerve-related bladder perforation., Summary: ERBT represents a considerable advancement in the surgical management of nonmuscle-invasive bladder cancer. It delivers excellent oncological results and is a well tolerated procedure., Video: In the accompanying video, we shortly report the different modalities and energy sources used for bladder cancer resection. The three strategies are currently employed at the Fundació Puigvert (Barcelona). VIDEO ABSTRACT:.
- Published
- 2020
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33. BCR and BCR-ABL regulation during myeloid differentiation in healthy donors and in chronic phase/blast crisis CML patients.
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Marega M, Piazza RG, Pirola A, Redaelli S, Mogavero A, Iacobucci I, Meneghetti I, Parma M, Pogliani EM, and Gambacorti-Passerini C
- Subjects
- Base Sequence, DNA Primers, Fusion Proteins, bcr-abl genetics, Humans, K562 Cells, Leukemia, Myelogenous, Chronic, BCR-ABL Positive genetics, Leukemia, Myelogenous, Chronic, BCR-ABL Positive metabolism, Polymerase Chain Reaction, Proto-Oncogene Proteins c-bcr genetics, Blast Crisis, Cell Differentiation, Fusion Proteins, bcr-abl metabolism, Leukemia, Myelogenous, Chronic, BCR-ABL Positive pathology, Proto-Oncogene Proteins c-bcr metabolism
- Abstract
Chronic myeloid leukemia (CML) is caused by the BCR-ABL hybrid gene. The molecular mechanisms leading from chronic phase (CP) to blast crisis (BC) are not understood. However, both the presence and the levels of BCR-ABL seem to be important for CML progression. BCR-ABL is under the transcriptional control of BCR promoter. Here we focused on the gene expression control of BCR and BCR-ABL upon myeloid differentiation in healthy donors (HDs), CP and BC patients. As previously reported, BCR-ABL is downregulated during myeloid maturation in CP patients. A similar pattern was detected for BCR (but not for ABL) in CP-CML and in HD, thus suggesting that the two genes may be under a similar transcriptional control. In BC this mechanism is similarly impaired for both BCR-ABL and BCR. These data indicate the presence of an 'in trans' deregulated transcription of both BCR and BCR-ABL promoters, associated with CML progression.
- Published
- 2010
- Full Text
- View/download PDF
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