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Andras I, Pecoraro A, Telecan T, Piana A, Boissier R, Hevia V, Prudhomme T, Amparore D, Bertolo R, Carbonara U, Erdem S, Diana P, Ingels A, Kara O, Marandino L, Marchioni M, Muselaers S, Pavan N, Pecoraro A, Roussel E, Crisan N, Territo A, Campi R. How to manage renal masses in kidney transplant recipients? A collaborative review by the EAU-YAU kidney transplantation and renal cancer working groups. Actas Urol Esp 2023; 47:621-630. [PMID: 37100223 DOI: 10.1016/j.acuroe.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION Kidney transplant (KT) recipients have a four-times higher risk of renal malignancies compared to general population. As these patients frequently harbor bilateral or multifocal tumors, the management of renal masses is still under debate. OBJECTIVE To explore the current management of the native kidney masses in KT patients. ACQUISITION OF EVIDENCE We performed a literature search on MEDLINE/PubMed database. A number of 34 studies were included in the present review. SYNTHESIS OF EVIDENCE In frail patients with renal masses below 3 cm, active surveillance is a feasible alternative. Nephron-sparing surgery is not justified for masses in the native kidney. Radical nephrectomy is the standard treatment for post-transplant renal tumors of the native kidneys in KT recipients, with laparoscopic techniques leading to significantly less perioperative complication rates as compared to the open approach. Concurrent bilateral native nephrectomy at the time of transplantation can be considered in patients with renal mass and polycystic kidney disease, especially if no residual urinary output is present. Patients with localized disease and successful radical nephrectomy do not require immunosuppression adjustment. In metastatic cases, mTOR agents can ensure efficient antitumoral response, while maintaining proper immunosuppression in order to protect the graft. CONCLUSIONS Post-transplant renal cancer of the native kidneys is a frequent occurrence. Radical nephrectomy is most frequently performed for localized renal masses. A standardized and widely-approved screening strategy for malignancies of native renal units is yet to be implemented.
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Affiliation(s)
- I Andras
- Servicio de Urología, Universidad de Medicina y Farmacia «Iuliu Hatieganu», Hospital Municipal Cluj-Napoca, Cluj-Napoca, Romania.
| | - A Pecoraro
- Unidad de Cirugía Robótica Urológica y Trasplante Renal, Universidad de Florencia, Hospital de Careggi, Florencia, Italy; Grupo de Trasplante Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands
| | - T Telecan
- Servicio de Urología, Universidad de Medicina y Farmacia «Iuliu Hatieganu», Hospital Municipal Cluj-Napoca, Cluj-Napoca, Romania
| | - A Piana
- Grupo de Trasplante Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Sección de Urología, Servicio de Oncología, Facultad de Medicina, Hospital San Luigi, Universidad de Turín, Orbassano, Turín, Italy
| | - R Boissier
- Grupo de Trasplante Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Urología y Trasplante Renal, Hospital Universitario La Concepción, Marsella, France
| | - V Hevia
- Grupo de Trasplante Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Urología, Hospital Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - T Prudhomme
- Grupo de Trasplante Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Urología, Trasplante Renal y Andrología, Hospital Universitario de Rangueil, Toulouse, France
| | - D Amparore
- Sección de Urología, Servicio de Oncología, Facultad de Medicina, Hospital San Luigi, Universidad de Turín, Orbassano, Turín, Italy; Grupo de trabajo de Cáncer Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands
| | - R Bertolo
- Grupo de trabajo de Cáncer Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Urología, Hospital San Carlo Di Nancy, Roma, Italy
| | - U Carbonara
- Grupo de trabajo de Cáncer Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Emergencias y Trasplante de Órganos, Unidad de Urología, Andrología y Trasplante Renal, Universidad de Bari, Bari, Italy
| | - S Erdem
- Grupo de trabajo de Cáncer Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Sección de Oncología Urológica, Servicio de Urología, Facultad de Medicina de la Universidad de Estambul, Estambul, Turkey
| | - P Diana
- Grupo de trabajo de Cáncer Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Urología, Instituto Clínico y de Investigación Humanitas ICCRS, Rozzano, Italy; Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - A Ingels
- Grupo de trabajo de Cáncer Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Urología, APHP, Hospital Universitario Henri Mondor, Créteil, France
| | - O Kara
- Grupo de trabajo de Cáncer Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Urología, Hospital Universitario Henri Mondor, APHP, Créteil, France
| | - L Marandino
- Grupo de trabajo de Cáncer Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Oncología Médica, Hospital ICCRS San Raffaele, Universidad Vita-Salute San Raffaele, Milán, Italy
| | - M Marchioni
- Grupo de trabajo de Cáncer Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Departamento de Ciencias Médicas, Orales y Biotecnológicas, Laboratorio de Biostadística, Universidad «G. D'Annunzio» Chieti-Pescara, Chieti, Italy; Servicio de Urología, Hospital SS Annunziata, Universidad «G. D'Annunzio» de Chieti, Chieti, Italy
| | - S Muselaers
- Grupo de trabajo de Cáncer Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Urología, Centro Médico de la Universidad de Radboud, Nimega, The Netherlands
| | - N Pavan
- Grupo de trabajo de Cáncer Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Clínica de Urología, Departamento de Ciencias Médicas, Quirúrgicas y de la Salud, Universidad de Trieste, Trieste, Italy
| | - A Pecoraro
- Sección de Urología, Servicio de Oncología, Facultad de Medicina, Hospital San Luigi, Universidad de Turín, Orbassano, Turín, Italy; Grupo de trabajo de Cáncer Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands
| | - E Roussel
- Grupo de trabajo de Cáncer Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Urología, Hospital Universitario de Lovaina, Lovaina, Belgium
| | - N Crisan
- Servicio de Urología, Universidad de Medicina y Farmacia «Iuliu Hatieganu», Hospital Municipal Cluj-Napoca, Cluj-Napoca, Romania
| | - A Territo
- Grupo de Trasplante Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - R Campi
- Unidad de Cirugía Robótica Urológica y Trasplante Renal, Universidad de Florencia, Hospital de Careggi, Florencia, Italy; Grupo de trabajo de Cáncer Renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU), Arnhem, The Netherlands; Departamento de Medicina Experimental y Clínica, Universidad de Florencia, Florencia, Italy
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Andras I, Pecoraro A, Telecan T, Piana A, Boissier R, Hevia V, Prudhomme T, Amparore D, Bertolo R, Carbonara U, Erdem S, Diana P, Ingels A, Kara O, Marandino L, Marchioni M, Muselaers S, Pavan N, Pecoraro A, Roussel E, Crisan N, Territo A, Campi R. Manejo de masas renales en receptores de trasplante renal. Revisión colaborativa de los grupos de trabajo de trasplante renal y cancer renal de la sección de jóvenes urológos (yau) de la asociación europea de urología (EAU). Actas Urol Esp 2023. [DOI: 10.1016/j.acuro.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Campi R, Amparore D, Marandino L, Bertolo R, Erdem S, Ingels A, Muselaers S, Pavan N, Roussel E, Carbonara U, Pecoraro A, Diana P, Pecoraro A, Marchioni M. Is adjuvant immunotherapy worth for all patients with clear-cell renal cell carcinoma at high risk of recurrence? Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00520-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Proye P, Gondran-Tellier B, Baboudjian M, Bernhard J, Bensalah K, Bigot P, Mejean A, Doumerc N, Ingels A, Paparel P, Bruyere F, Vaessen C, Olivier J, Nouhaud F, Lebacle C, Tillou X, Durand X, Pignot G, Boissier R. Diagnostic performance of tumor biopsy for the diagnosis of renal tumors in the UroCCR network. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01316-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Margue G, Ferrer L, Etchepare G, Bensalah K, Mejean A, Roupret M, Doumerc N, Ingels A, Boissier R, Pignot G, Parier B, Paparel P, Waeckel T, Bigot P, Colin T, Bernhard JC. Development of an individual postoperative prediction model for kidney cancer recurrence using machine learning (UroCCR study 120). Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00519-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Proye P, Gondran-Tellier B, Baboudjian M, Bernhard J, Bensalah K, Bigot P, Mejean A, Doumerc N, Ingels A, Paparel P, Bruyere F, Vaessen C, Olivier J, Nouhaud F, Lebacle C, Tillou X, Durand X, Pignot G, Boissier R. Practice and impact of tumor biopsy on the management of kidney tumors in the UroCCR registry (Ancillary Study n°118). Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01317-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Miro-Padovani M, Batista da Costa J, Salomon L, Ingels A, De la Taille A. [High risk localized and locally advanced prostate cancer: Long-term oncological outcomes after prostatectomy]. Prog Urol 2022; 32:702-710. [PMID: 35773175 DOI: 10.1016/j.purol.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 03/21/2022] [Accepted: 04/28/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION High risk localized and locally advanced forms are responsible for the vast majority of specific deaths from prostate cancer among non-metastatic diseases at diagnosis. No randomized study has yet been published to establish the best local treatment in terms of survival. AIM Conduct a large-volume cohort study with long-term follow-up to analyze specific and overall survival outcomes after surgery. METHOD A single-center retrospective study of all patients operated on for localized high-risk and locally advanced prostate cancer was performed. Actuarial survival analyses and multivariate analyses were performed to discern predictive risk factors. RESULTS Five hundred patients were included. MRI stage was≥iT3a in 40.7% of cases and 50.2% of patients had a Gleason score≥8 on biopsy. The mean follow-up was 63.1 months. The overall, specific and biological recurrence-free survival were respectively 77.6%, 93.9% and 26.8% at 10 years. A PSA level≥20, a Gleason score on biopsy≥9 and a MRI stage≥iT3a were significantly associated with the 10-years biological recurrence risk. CONCLUSION This study shows very good long-term oncological results. In the absence of a randomized controlled trial, these results suggest the primary role of surgery in this indication and support the evolution of current practices. We pointed out very pejorative features that might help selection of the best candidates for surgical treatment. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- M Miro-Padovani
- Service d'urologie et de transplantation rénale, faculté de médecine Paris 12, CHU d'Henri-Mondor, 51, avenue Marechal-de-Lattre-de-Tassigny, 94000 Créteil, France.
| | - J Batista da Costa
- Service d'urologie et de transplantation rénale, faculté de médecine Paris 12, CHU d'Henri-Mondor, 51, avenue Marechal-de-Lattre-de-Tassigny, 94000 Créteil, France.
| | - L Salomon
- Service d'urologie, centre hospitalier Mont-de-Marsan, 417, avenue Pierre-de-Coubertin, 40024 Mont-de-Marsan, France.
| | - A Ingels
- Service d'urologie et de transplantation rénale, faculté de médecine Paris 12, CHU d'Henri-Mondor, 51, avenue Marechal-de-Lattre-de-Tassigny, 94000 Créteil, France.
| | - A De la Taille
- Service d'urologie et de transplantation rénale, faculté de médecine Paris 12, CHU d'Henri-Mondor, 51, avenue Marechal-de-Lattre-de-Tassigny, 94000 Créteil, France.
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Pelegrin T, Champy CM, Gerbaud F, Miro-Padovani M, Grimbert P, Matignon MB, Durrbach A, De La Taille A, Ingels A. Robotic-assisted laparoscopy living donor nephrectomy: Technique and results of a monocentric retrospective series. Prog Urol 2022; 32:567-576. [PMID: 35623941 DOI: 10.1016/j.purol.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/09/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Robot-assisted nephrectomy for living kidney donation (LKD) has been described in the literature as a safe and reproducible technique in high volume centers with extensive robotic surgery experience. Any surgical procedure in a healthy individual ought to be safe in regards to complications. The objective of this study was to evaluate the Robotic-assisted Living Donor Nephrectomy (RLDN) experience in a robotic surgery expert center. METHODS This is a retrospective study from 11/2011 and 12/2019. In total, 118 consecutive Living Donor (LD) kidney transplants were performed at our institution. All the procedures were performed by robotic-assisted laparoscopic approach. Extraction was performed by iliac (IE), vaginal (VE) or umbilical extraction (UE). The left kidney was preferred even if the vascular anatomy was not modal. RESULTS For donors: the median operative time was 120min with 50mL of blood loss. The median warm ischemia time was 4min, with a non-significant shorter duration with the UE (4min) in comparison with IE or VE (5min). Nine patients had postoperative complications including 1 grade II (blood transfusion) and 1 grade IIIb (vaginal bleeding after VE). None of our procedures were converted to open surgeries and no deaths were reported. For the recipients: 1.7% presented delayed graft function; their median GFR at 1 year was 61mL/min/1.73m2. CONCLUSION RLDN in an expert center appears to be a safe technique. The advantages of the robot device in terms of ergonomy don't hamper the surgical outcomes. Donor, recipient and graft survivals seem comparable to the reported laparoscopic outcomes in the literature. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- T Pelegrin
- Service d'urologie, UPEC, hôpital Henri-Mondor, Créteil, France.
| | - C M Champy
- Service d'urologie, UPEC, hôpital Henri-Mondor, Créteil, France
| | - F Gerbaud
- Service d'urologie, UPEC, hôpital Henri-Mondor, Créteil, France
| | - M Miro-Padovani
- Service d'urologie, UPEC, hôpital Henri-Mondor, Créteil, France
| | - P Grimbert
- Service de néphrologie, UPEC, hôpital Henri-Mondor, Créteil, France
| | - M-B Matignon
- Service de néphrologie, UPEC, hôpital Henri-Mondor, Créteil, France
| | - A Durrbach
- Service de néphrologie, UPEC, hôpital Henri-Mondor, Créteil, France
| | - A De La Taille
- Service d'urologie, UPEC, hôpital Henri-Mondor, Créteil, France
| | - A Ingels
- Service d'urologie, UPEC, hôpital Henri-Mondor, Créteil, France
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Campi R, Pecoraro A, Mir M, Amparore D, Bertolo R, Erdem S, Kara O, Ingels A, Kriegmair M, Ouzaid I, Pavan N, Pecoraro A, Russel E, Minervini A, Serni S, Klatte T, Capitanio U. Decision-making and management strategies for patients with bilateral synchronous non-metastatic renal masses: Insights from a multi-centre European dataset. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00309-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pignot G, Thiery-vuillemin A, Walz J, Lang H, Balssa L, Leblanc L, Borchiellini D, Parier B, Albiges L, Bensalah K, Schlurmann F, Mourey E, Bigot P, Ingels A, Bernhard J, Piechaud T, Roubaud G, Klifa D, Gravis G, Barthelemy P. Résultats oncologiques de la néphrectomie différée après réponse complète à l’immunothérapie pour cancer du rein métastatique au diagnostic. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Morel A, Ouamri Y, Canoui-Poitrine F, Ingels A, Audard V, Luciani A, Grimbert P, Pigneur F, Stehle T. La myostéatose comme facteur de risque indépendant de mortalité après transplantation rénale: une étude de cohorte rétrospective. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pignot G, Thiery-Vuillemin A, Walz J, Lang H, Balssa L, Geoffrois L, Leblanc L, Albiges L, Bensalah K, Ladoire S, Bigot P, Ingels A, Saldana C, Roubaud G, Piechaud T, Cassuto O, Klifa D, Parier B, Bernhard J, Malouf G, Gravis G, Barthelemy P. Nephrectomy after complete response to immune checkpoint inhibitors for Metastatic Renal Cell Carcinoma (mRCC): A surgical challenge allowing favorable oncological outcomes. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01024-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Diamant E, De la Taille A, Ingels A. Réfection d’anastomose urétro-vésicale par voie extra-péritonéale laparoscopique robot-assistée pour sténose anastomotique post-prostatectomie radicale. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Diamant E, Ingels A, Bajeot A, Champy C, Vordos D, Seisen T, Roumiguié M, De La Taille A, Rouprêt M, Batista Da Costa J. Résultats comparés de la survie après cystectomie pour les tumeurs de la vessie n’infiltrant pas le muscle de haut risque : expérience multicentrique. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Belkacemi Y, Jouhaud A, Ingels A, Brunel A, Coraggio G, Joly C, Hadhri A, Hassani W, Nourieh M, Vega Salazar B, de la Taille A, Salomon L. Impact Of Cytoterm On Vasomotor Symptoms (VMS) And Quality Of Life (Qol) Impairments In Patients Receiving Hormone Therapy (HT) And Radiotherapy (RT) For Prostate Cancer (Pca). Results Of The ESCULAPE Phase II Study. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ingels A, Bibas S, Da Costa JB, Attias A, Brunetti F, De Angelis N, Desgranges P, Flouzat-Lachaniette CH, Folliguet T, Ivanov T, Langeron O, Lelde L, Levesque E, Corvoisier PL, Marmorat C, Melendugno F, Meningaud JP, Mesli F, Paillusson W, Palfi S, Pedre L, Somacale D, Champy CM, de la Taille A. Surgery and COVID-19: Balancing the nosocomial risk a french academic center experience during the epidemic peak. Br J Surg 2020; 107:e395-e397. [PMID: 32725815 PMCID: PMC7929147 DOI: 10.1002/bjs.11841] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 01/12/2023]
Affiliation(s)
- A Ingels
- Department of Urology, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - S Bibas
- Department of Urology, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - J B Da Costa
- Department of Urology, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - A Attias
- Department of Anesthesiology and Intensive Care, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - F Brunetti
- Department of Visceral surgery, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - N De Angelis
- Department of Visceral surgery, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - P Desgranges
- Department of Vascular surgery, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | | | - T Folliguet
- Department of Cardiac surgery, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - T Ivanov
- Department of Visceral surgery, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - O Langeron
- Department of Anesthesiology and Intensive Care, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - L Lelde
- Department of Visceral surgery, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - E Levesque
- Department of Anesthesiology and Intensive Care, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - P L Corvoisier
- INSERM, CIC 1430 - Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - C Marmorat
- Department of Urology, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - F Melendugno
- Department of Urology, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - J-P Meningaud
- Department of Reconstructive surgery, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - F Mesli
- Department of Gastroenterology, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - W Paillusson
- Department of Urology, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - S Palfi
- Department of Neurosurgery, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - L Pedre
- Department of Urology, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - D Somacale
- Department of Visceral surgery, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - C M Champy
- Department of Urology, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
| | - A de la Taille
- Department of Urology, Hôpital Henri Mondor - APHP, UPEC, Créteil, France
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Affiliation(s)
- T Hassan
- Department of Urology, Hôpital Henri-Mondor, France
| | | | - A Ingels
- Department of Urology, Hôpital Henri-Mondor, France.
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Boullenois H, Verrier C, Ingels A, Parier B, Serey-Eiffel S, Kozal S, Pinar U, Hammoudi Y, Irani J, Bessede T. [Indocyanine green fluorescence to visualize the ureteric vascularization of kidney transplants: An exploratory study]. Prog Urol 2020; 30:155-161. [PMID: 32122748 DOI: 10.1016/j.purol.2020.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 12/19/2019] [Accepted: 01/10/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Urinary complications after kidney transplantation are common and can compromise renal function. While they are mainly attributed to ischemic lesions of the ureter, there is no existing method to evaluate its vascularization during surgery. The aim of the study was to evaluate if indocyanine green, revealed by infra-red light andused to visualize tissue perfusion, could provide an appreciation of the ureter's vascularization during kidney transplantation. METHODS This feasibility study was conducted over one month, on eleven consecutive kidney transplants. During transplantation, an injection of indocyanine green enabled the surgeon to visualize in real time with an infra-red camera the ureter fluorescence. Its intensity was reported on a qualitative and semi-quantitative scale. Occurrence of urinary complications such as stenosis or ureteral fistula were collected during 6 months. RESULTS In all of the 11 cases (100%), the last centimeters of the ureters were not fluorescent. Three (27%) ureters were poorly or partiallly fluorescent. Out of these three cases, only one case of urinary fistula occurred, followed by ureteric stenosis. In the series, two fistulas (18%) and two ureteric stenoses (18%) occurred. No side effects were observed. The low number of events did not allow statistical analysis. CONCLUSION Infra-red fluorescence of indocyanine green could be a simple and innovative way to appreciate the transplant's ureteric vascularization during kidney transplantation. It could help surgeons to identify the level of ureter section and to decide the anastomosis technique, in order to limit urinary complications. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- H Boullenois
- Service d'urologie, hôpital de Bicêtre, université Pari-Saclay, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
| | - C Verrier
- Service d'urologie, hôpital de Bicêtre, université Pari-Saclay, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - A Ingels
- Service d'urologie, hôpital de Bicêtre, université Pari-Saclay, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - B Parier
- Service d'urologie, hôpital de Bicêtre, université Pari-Saclay, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - S Serey-Eiffel
- Service d'urologie, hôpital de Bicêtre, université Pari-Saclay, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - S Kozal
- Service d'urologie, hôpital de Bicêtre, université Pari-Saclay, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - U Pinar
- Service d'urologie, hôpital de Bicêtre, université Pari-Saclay, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Y Hammoudi
- Service d'urologie, hôpital de Bicêtre, université Pari-Saclay, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - J Irani
- Service d'urologie, hôpital de Bicêtre, université Pari-Saclay, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - T Bessede
- Service d'urologie, hôpital de Bicêtre, université Pari-Saclay, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Inserm, U1195, université Paris-Saclay, Le Kremlin-Bicêtre, France
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Pelegrin T, Champy C, Ingels A, Matignon M, Grimbert P, Salomon L, De la Taille A. Retour d’expérience sur 100 prélèvements de rein de donneur vivant par cœlioscopie robot-assistée : mise à jour d’une série monocentrique. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lavollé A, Ingels A, De la taille A. Réfection de l’anastomose vésico-urétrale par voie extra-péritoneale robot-assistée pour traiter les sténoses anastomotiques post-prostatectomie radicale. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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de'Angelis N, Ingels A, de La Taille A, Brunetti F. Simultaneous robotic total mesorectal excision and radical prostatectomy and enlarged iliac lymphadenectomy for synchronous adenocarcinomas - a video vignette. Colorectal Dis 2019; 21:249-250. [PMID: 30548952 DOI: 10.1111/codi.14534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 12/05/2018] [Indexed: 02/08/2023]
Affiliation(s)
- N de'Angelis
- Unit of Digestive Surgery, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France
| | - A Ingels
- Unit of Urology, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France
| | - A de La Taille
- Unit of Urology, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France
| | - F Brunetti
- Unit of Digestive Surgery, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France
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Bergerat S, Rozet F, Barret E, Batista da Costa J, Galiano M, Ingels A, Sanchez Salas R, Cathelineau X. Technique modifiée de York Mason pour la cure de fistule urétro rectale iatrogène. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Renard-Penna R, Sanchez-Salas R, Barret E, Cosset JM, de Vergie S, Sapetti J, Ingels A, Gangi A, Lang H, Cathelineau X. [Evaluation and results of ablative therapies in prostate cancer]. Prog Urol 2017; 27:887-908. [PMID: 28939336 DOI: 10.1016/j.purol.2017.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 08/04/2017] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To perform a state of the art about methods of evaluation and present results in ablative therapies for localized prostate cancer. METHODS A review of the scientific literature was performed in Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of keywords. Publications obtained were selected based on methodology, language and relevance. After selection, 102 articles were analysed. RESULTS Analyse the results of ablative therapies is presently difficult considering the heterogeneity of indications, techniques and follow-up. However, results from the most recent and homogeneous studies are encouraging. Oncologically, postoperative biopsies (the most important criteria) are negative (without any tumor cells in the treated area) in 75 to 95%. Functionally, urinary and sexual pre-operative status is spared (or recovered early) in more than 90% of the patients treated. More and more studies underline also the correlation between the results and the technique used considering the volume of the gland and, moreover, the "index lesion" localization. CONCLUSION The post-treatment pathological evaluation by biopsies (targeted with MRI or, perhaps in a near future, with innovative ultrasonography) is the corner stone of oncological evaluation of ablative therapies. Ongoing trials will allow to standardize the follow-up and determine the best indication and the best techniques in order to optimize oncological and functional results for each patient treated.
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Affiliation(s)
- R Renard-Penna
- Service d'imagerie, hôpitaux Tenon-Pitié Salpêtrière, AP-HP, UPMC université Paris VI, 75013 Paris, France
| | - R Sanchez-Salas
- Département d'urologie, institut mutualiste Montsouris, 75014 Paris, France; Université Paris Descartes, 75006 Paris, France
| | - E Barret
- Département d'urologie, institut mutualiste Montsouris, 75014 Paris, France; Université Paris Descartes, 75006 Paris, France
| | - J M Cosset
- Département d'urologie, institut mutualiste Montsouris, 75014 Paris, France
| | - S de Vergie
- Département d'urologie, institut mutualiste Montsouris, 75014 Paris, France
| | - J Sapetti
- Département d'urologie, institut mutualiste Montsouris, 75014 Paris, France
| | - A Ingels
- Département d'urologie, institut mutualiste Montsouris, 75014 Paris, France; Université Paris Descartes, 75006 Paris, France
| | - A Gangi
- Service de radiologie interventionnelle, CHU de Strasbourg, 67000 Strasbourg, France
| | - H Lang
- Service de chirurgie urologique, CHU de Strasbourg, 67000 Strasbourg, France
| | - X Cathelineau
- Département d'urologie, institut mutualiste Montsouris, 75014 Paris, France; Université Paris Descartes, 75006 Paris, France.
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Ingels A, Hew M, Algaba F, de Boer OJ, van Moorselaar RJA, Horenblas S, Zondervan P, de la Rosette JJMCH, Pilar Laguna Pes M. Vimentin over-expression and carbonic anhydrase IX under-expression are independent predictors of recurrence, specific and overall survival in non-metastatic clear-cell renal carcinoma: a validation study. World J Urol 2016; 35:81-87. [PMID: 27207480 DOI: 10.1007/s00345-016-1854-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 05/11/2016] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Clinical outcomes prognostic markers are awaited in clear-cell renal carcinoma (ccRCC) to improve patient-tailored management and to assess six different markers' influence on clinical outcomes from ccRCC specimen and their incremental value combined with TNM staging. MATERIALS AND METHODS This is a retrospective, multicenter study. One hundred and forty-three patients with pT1b-pT3N0M0 ccRCC were included. Pathology specimens from surgeries were centrally reviewed, mounted on a tissue micro-array and stained with six markers: CAIX, c-MYC, Ki67, p53, vimentin and PTEN. Images were captured through an Ultra Fast Scanner. Tumor expression was measured with Image Pro Plus. Cytoplasmic markers (PTEN, CAIX, vimentin, c-MYC) were expressed as surface percentage of expression. Nuclear markers (Ki67, p53) were expressed as number of cells/mm2. Clinical data and markers expression were compared with clinical outcomes. Each variable was included in the Cox proportional multivariate analyses if p < 0.10 on univariate analyses. Discrimination of the new marker was calculated with Harrell's concordance index. RESULTS At median follow-up of 63 months (IQR 35.0-91.8), on multivariate analysis, CAIX under-expression and vimentin over-expression were associated with worse survival (recurrence, specific and overall survival). A categorical marker CAIX-/Vimentin+ with cutoff points for CAIX and vimentin of 30 and 50 %, respectively, was designed. The new CAIX-/Vimentin+ marker presented a good concordance and comparable calibration to the reference model. Limitations are the retrospective design, the need for external validation and the large study period. CONCLUSION Using an automated technique of measurement, CAIX and vimentin are independent predictors of clinical outcomes in ccRCC.
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Affiliation(s)
- A Ingels
- Department of Urology, Academisch Medisch Centrum, Postbus 22660, 1100DD, Amsterdam, Netherlands. .,IR4M, CNRS, Univ. Paris Sud, Université Paris-Saclay, 94805, Villejuif, France. .,Service d'urologie Hôpital Bicêtre, 78, rue du Général Leclerc, 94271, Le Kremlin-Bicêtre, France.
| | - M Hew
- Department of Urology, Academisch Medisch Centrum, Postbus 22660, 1100DD, Amsterdam, Netherlands
| | - F Algaba
- Department of Pathology, Fundació Puigvert, Universitat Autonoma de Barcelona, c/Cartagena 340-350, 08025, Barcelona, Spain
| | - O J de Boer
- Department of Pathology, AMC University of Amsterdam, Postbus 22660, 1100DD, Amsterdam, Netherlands
| | - R J A van Moorselaar
- Department of Urology, VU University Medical Center, de Boelelaan 1117, 1081 HV, Amsterdam, Netherlands
| | - S Horenblas
- Department of Urology, Antoni Van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, Netherlands
| | - P Zondervan
- Department of Urology, Academisch Medisch Centrum, Postbus 22660, 1100DD, Amsterdam, Netherlands
| | - J J M C H de la Rosette
- Department of Urology, Academisch Medisch Centrum, Postbus 22660, 1100DD, Amsterdam, Netherlands
| | - M Pilar Laguna Pes
- Department of Urology, Academisch Medisch Centrum, Postbus 22660, 1100DD, Amsterdam, Netherlands
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Daudin M, Lelong B, Flecher E, Lavoué S, Piau C, Ingels A, Revest M. F-08 Profil évolutif des endocardites à pneumocoque : une série de 28 cas. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70165-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Sanchez-Salas R, Prapotnich D, Ingels A, Olivier F, Fhima M, Descamps P, David S, Secin F, Barret E, Galiano M, Rozet F, Cathelineau X. Modélisation du PSA en période d’arrêt de traitement chez les patients sous traitement hormonal intermittent. Est-ce que le temps de doublement du PSA est un outil de mesure fiable ? Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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27
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Flecher E, Rouault P, Desriac V, Ingels A, Le Tulzo Y, Malledant Y, Leguerrier A. 032 * OVERALL FIVE-YEAR RESULTS OF AN EXTRACORPOREAL MEMBRANE OXYGENATION PROGRAMME IN A UNIVERSITY HOSPITAL. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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28
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Ingels A, Giovanni Ruggieri V, Roudmane Lenglet N, Verhoye JP, Leguerrier A. Réopération de la valve aortique après un remplacement par une bioprothèse, patients à haut risque. Rev Epidemiol Sante Publique 2012. [DOI: 10.1016/j.respe.2012.06.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Bégué T, Adam P, Fessy MH, Veillard D, Ingels A, Andrieux M, Thomazeau H. [Periprosthetic fractures around total hip and knee arthroplasty. Introduction and study objectives]. Rev Chir Orthop Reparatrice Appar Mot 2006; 92:2S34-2S36. [PMID: 17088779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- T Bégué
- Service d'Orthopédie-Traumatologie, Hôpital Avicenne, 125, rue Stalingrad 93000 Bobigny
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Thomazeau H, Ingels A, Andrieux M, Veillard D. [Periprosthetic fractures around total hip and knee arthroplasty. Methodology]. Rev Chir Orthop Reparatrice Appar Mot 2006; 92:2S37-2S39. [PMID: 17802653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
- H Thomazeau
- Féderation de Chirurgie Orthopédique et Traumatologique, CHU de Rennes, Hôpital Sud, Rennes.
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Mabit C, Gougam T, Thomazeau H, Ingels A, Andrieux M, Veillard D, Coste C, Oksman A, Proust J, Rochwerger A, Villalba M, Madougou S. Méthodologie et étude épidémiologique. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s0035-1040(06)75856-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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32
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Bégué T, Tricoire JL, Veillard D, Ingels A, Thomazeau H. [Periprosthetic fractures around total hip and knee arthroplasty. Therapeutic algorithm for periprosthetic fractures after total knee arthroplasties]. Rev Chir Orthop Reparatrice Appar Mot 2006; 92:2S90-2S96. [PMID: 17821813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
- T Bégué
- Service d'Orthopédie-Traumatologie, Hôpital Avicenne, 125, rue Stalingrad 93000 Bobigny ; Université Paris XIII, 74, rue Marcel-Cachin, 93000 Bobigny
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Mabit C, Gougam T, Thomazeau H, Ingels A, Andrieux M, Veillard D, Coste C, Oksman A, Proust J, Rochwerger A, Villalba M, Madougou S. [Periprosthetic fractures around total hip and knee arthroplasty. Methodology and epidemiologic study]. Rev Chir Orthop Reparatrice Appar Mot 2006; 92:2S40-2S43. [PMID: 17802654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
- C Mabit
- Département de Chirurgie Orthopédique et Traumatologique, CHU Dupuytren, 2, avenue, Martin-Luther-King, 87042 Limoges
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Ingels A, Veillard D, Thomazeau H, Begue T, Mahieu G, Delhelle M, Chaperon J. P3-4 - Étude prospective multicentrique des fractures péri-prothètiques. Rev Epidemiol Sante Publique 2006. [DOI: 10.1016/s0398-7620(06)76900-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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