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2. Critical Assessment of Single-Use Ureteroscopes in an In Vivo Porcine Model.

Author

Ceballos, Brian, Nottingham, Charles, Bechis, Seth, Sur, Roger, Matlaga, Brian, and Krambeck, Amy

Abstract

METHODS: A female pig was placed under general anesthesia and positioned supine, and retrograde access to the renal collecting system was obtained. The LithoVue (Boston Scientific) and Uscope (Pusen Medical) were evaluated by three experienced surgeons, and each surgeon started with a new scope. The following parameters were compared between each ureteroscope: time for navigation to upper and lower pole calyces with and without implements (1.9 F basket, 200 μm laser fiber, and 365 μm laser fiber for upper only) in the working channel and subjective evaluations of maneuverability, irrigant flow through the scope, lever force, ergonomics, and scope optics. RESULTS: Navigation to the lower pole calyx was significantly faster with LithoVue compared to Uscope when the working channel was empty (24.3 vs. 49.4 seconds, p < 0.01) and with a 200 μm fiber (63.6 vs. 94.4 seconds, p=0.04), but not with the 1.9 F basket. Navigation to the upper pole calyx was similar for all categories except faster with LithoVue containing the 365 μm fiber (67.1 vs. 99.7 seconds, p=0.02). Subjective assessments of scope maneuverability to upper and lower pole calyces when the scope was empty and with implements favored LithoVue in all categories, as did assessments of irrigant flow, illumination, image quality, and field of view. Both scopes had similar scores of lever force and ergonomics. CONCLUSIONS: In an in vivo porcine model, the type of single-use ureteroscope employed affected the navigation times and subjective assessments of maneuverability and visualization. In all cases, LithoVue provided either equivalent or superior metrics than Uscope. Further clinical studies are necessary to determine the implications of these findings.

Published
2020

5. European Association of Urology Section of Urolithiasis and International Alliance of Urolithiasis Joint Consensus on Retrograde Intrarenal Surgery for the Management of Renal Stones

Author

Zeng, Guohua, Zhao, Zhijian, Mazzon, Giorgio, Pearle, Margaret, Choong, Simon, Skolarikos, Andreas, Denstedt, John, Seitz, Christian, Olvera Pasada, Daniel, Fiori, Cristian, Bosio, Andrea, Papatsoris, Athanasios, Méndez Probst, Carlos Enrique, Perez Fentes, Daniel, Ann Git, Kah, Wu, Qinghui, Wiseman, Oliver, Emiliani, Esteban, Farahat, Yasser, Ilker Gökce, Mehmet, Giannakopoulos, Stilianos, Goumas Kartalas, Ioannis, Somani, Bhaskar, Knoll, Thomas, de la Rosette, Jean, Zhong, Jiehui, Vinicius Maroccolo, Marcus, Saltirov, lliya, Chew, Ben, Wang, Kunjie, Lahme, Sven, Giusti, Guido, Ferretti, Stefania, Yong Cho, Sung, Geavlete, Petrisor, Cansino, Ramon, Kamphuis, Guido M., Smith, Daron, Matlaga, Brian R., Ghani, Khurshid D., Bernardo, Norberto, Silva, Andres D., Ng, Anthony C.F., Yang, Sixing, Gao, Xiaofeng, Traxer, Olivier, Miernik, Arkadiusz, Liatsikos, Evangelos, Priyakant Parikh, Kandarp, Duvdevani, Mordechai, Celia, Antonio, Yasui, Takahiro, Aquino, Albert, Alomar, Mohammad, Choonhaklai, Vorapot, Erkurt, Bulent, Glass, Jonathan, Sriprasad, Seshadri, Osther, Palle J., Keeley, Francis X., Jr., Preminger, Glenn M., Cepeda Delgado, Marcos, Beltran Suarez, Edgar, Ye, Zhangqun, and Sarica, Kemal

Published
2022
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15. Editorial Comment

Author

Matlaga, Brian R

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Female, Humans, Kidney Calculi, Male, Nephrostomy, Percutaneous, Patient Positioning, Oncology and Carcinogenesis, Cancer, Patient Safety, Clinical Research, Prevention, Evaluation of treatments and therapeutic interventions, 6.4 Surgery, Good Health and Well Being, Carcinoma, Renal Cell, Cardiopulmonary Bypass, Kidney Neoplasms, Middle Aged, Neoplastic Cells, Circulating, Nephrectomy, Retrospective Studies, Survival Rate, Thrombectomy, United States, Vena Cava, Inferior, Venous Thrombosis, Urology & Nephrology, Clinical sciences
Abstract

© 2015 American Urological Association Education and Research, Inc. Purpose: The impact of cardiopulmonary bypass in level III-IV tumor thrombectomy on surgical and oncologic outcomes is unknown. We determine the impact of cardiopulmonary bypass on overall and cancer specific survival, as well as surgical complication rates and immediate outcomes in patients undergoing nephrectomy and level III-IV tumor thrombectomy with or without cardiopulmonary bypass. Materials and Methods: We retrospectively analyzed 362 patients with renal cell cancer and with level III or IV tumor thrombus from 1992 to 2012 at 22 U.S. and European centers. Cox proportional hazards models were used to compare overall and cancer specific survival between patients with and without cardiopulmonary bypass. Perioperative mortality and complication rates were assessed using logistic regression analyses. Results: Median overall survival was 24.6 months in noncardiopulmonary bypass cases and 26.6 months in cardiopulmonary bypass cases. Overall survival and cancer specific survival did not differ significantly in both groups on univariate analysis or when adjusting for known risk factors. On multivariate analysis no significant differences were seen in hospital length of stay, Clavien 1-4 complication rate, intraoperative or 30-day mortality and cancer specific survival. Limitations include the retrospective nature of the study. Conclusions: In our multi-institutional analysis the use of cardiopulmonary bypass did not significantly impact cancer specific survival or overall survival in patients undergoing nephrectomy and level III or IV tumor thrombectomy. Neither approach was independently associated with increased mortality on multivariate analysis. Greater surgical complications were not independently associated with the use of cardiopulmonary bypass.

Published
2015

19. Opioid-Prescribing Guidelines for Common Surgical Procedures: An Expert Panel Consensus

Author

Matlaga, Brian, Johnson, Clark, Sheffield, Jeanne, Shechter, Ronen, Nguyen, Hien, Osgood, Greg, Walsh, Christi, Burkhart, Richard, Blair, Alex, Ludwig, Wes, Nesbit, Suzanne, Wang, Peiqi, Morgan, Suzette, Jones, Christian, Kodadek, Lisa, Taylor, James, Enumah, Zachary, Gilmore, Richard, Habibi, Mehran, Williams, Kayode, Russell, Jon, Wang, Karen, Etra, Joanna, Broderick, Stephen, Zavadsky, Tiffany, Overton, Heidi N., Hanna, Marie N., Bruhn, William E., Hutfless, Susan, Bicket, Mark C., and Makary, Martin A.

Published
2018
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25. A Decision Analysis of Observation vs Immediate Re-Intervention for Asymptomatic Residual Fragments Less than 4 mm Following Ureteroscopic Lithotripsy

Author

Ursiny, Michal, Yaghoubian, Alan, Humphreys, Mitchell R., Brotherhood, Hilary, Chew, Benjamin H., Monga, Manoj, Krambeck, Amy E., Charchenko, Cameron, Wang, An Qi, Sur, Roger L., Miller, Nicole L., Marien, Tracy, Chang, Yui-Hui H., Knudsen, Bodo E., Lange, Dirk, Yong, Courtney, Matlaga, Brian, Shah, Ojas, Pais, Vernon, Lipkin, Michael, and Eisner, Brian H.

Published
2019
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32. A Decision Analysis of Observation vs Immediate Reintervention for Asymptomatic Residual Fragments Less than 4 mm Following Ureteroscopic Lithotripsy

Author

Ursiny, Michal, Yaghoubian, Alan, Humphreys, Mitchell R., Brotherhood, Hilary, Chew, Benjamin H., Monga, Manoj, Krambeck, Amy E., Charchenko, Cameron, Wang, An Qi, Sur, Roger L., Miller, Nicole L., Marien, Tracy, Chang, Yui-Hui H., Knudsen, Bodo E., Lange, Dirk, Yong, Courtney, Matlaga, Brian, Shah, Ojas, Pais, Vernon, Lipkin, Michael, and Eisner, Brian H.

Published
2019
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