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Cocci A, Pezzoli M, Lo Re M, Russo GI, Asmundo MG, Fode M, Cacciamani G, Cimino S, Minervini A, Durukan E. Quality of information and appropriateness of ChatGPT outputs for urology patients. Prostate Cancer Prostatic Dis 2024; 27:103-108. [PMID: 37516804 DOI: 10.1038/s41391-023-00705-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/22/2023] [Accepted: 07/17/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND The proportion of health-related searches on the internet is continuously growing. ChatGPT, a natural language processing (NLP) tool created by OpenAI, has been gaining increasing user attention and can potentially be used as a source for obtaining information related to health concerns. This study aims to analyze the quality and appropriateness of ChatGPT's responses to Urology case studies compared to those of a urologist. METHODS Data from 100 patient case studies, comprising patient demographics, medical history, and urologic complaints, were sequentially inputted into ChatGPT, one by one. A question was posed to determine the most likely diagnosis, suggested examinations, and treatment options. The responses generated by ChatGPT were then compared to those provided by a board-certified urologist who was blinded to ChatGPT's responses and graded on a 5-point Likert scale based on accuracy, comprehensiveness, and clarity as criterias for appropriateness. The quality of information was graded based on the section 2 of the DISCERN tool and readability assessments were performed using the Flesch Reading Ease (FRE) and Flesch-Kincaid Reading Grade Level (FKGL) formulas. RESULTS 52% of all responses were deemed appropriate. ChatGPT provided more appropriate responses for non-oncology conditions (58.5%) compared to oncology (52.6%) and emergency urology cases (11.1%) (p = 0.03). The median score of the DISCERN tool was 15 (IQR = 5.3) corresponding to a quality score of poor. The ChatGPT responses demonstrated a college graduate reading level, as indicated by the median FRE score of 18 (IQR = 21) and the median FKGL score of 15.8 (IQR = 3). CONCLUSIONS ChatGPT serves as an interactive tool for providing medical information online, offering the possibility of enhancing health outcomes and patient satisfaction. Nevertheless, the insufficient appropriateness and poor quality of the responses on Urology cases emphasizes the importance of thorough evaluation and use of NLP-generated outputs when addressing health-related concerns.
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Affiliation(s)
- Andrea Cocci
- Urology Section, University of Florence, Florence, Italy.
| | - Marta Pezzoli
- Urology Section, University of Florence, Florence, Italy
| | - Mattia Lo Re
- Urology Section, University of Florence, Florence, Italy
| | | | | | - Mikkel Fode
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Urology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Copenhagen, Denmark
| | - Giovanni Cacciamani
- Institute of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | | | | | - Emil Durukan
- Department of Urology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Copenhagen, Denmark
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Cocci A, Pezzoli M, Lo Re M, Russo GI, Asmundo MG, Fode M, Cacciamani G, Cimino S, Minervini A, Durukan E. Quality of information and appropriateness of ChatGPT outputs for urology patients. Prostate Cancer Prostatic Dis 2024; 27:159-160. [PMID: 37923807 DOI: 10.1038/s41391-023-00754-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/14/2023] [Accepted: 10/19/2023] [Indexed: 11/06/2023]
Affiliation(s)
- Andrea Cocci
- Urology Section, University of Florence, Florence, Italy.
| | - Marta Pezzoli
- Urology Section, University of Florence, Florence, Italy
| | - Mattia Lo Re
- Urology Section, University of Florence, Florence, Italy
| | | | | | - Mikkel Fode
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Urology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Copenhagen, Denmark
| | - Giovanni Cacciamani
- Institute of Urology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | | | | | - Emil Durukan
- Department of Urology, Copenhagen University Hospital, Herlev and Gentofte Hospital, Copenhagen, Denmark
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Egen L, Demmel GS, Grilli M, Studier-Fischer A, Nickel F, Haney CM, Mühlbauer J, Hartung FO, Menold HS, Piazza P, Rivas JG, Checcucci E, Puliatti S, Belenchon IR, Taratkin M, Rodler S, Cacciamani G, Michel MS, Kowalewski KF. Biophotonics-Intraoperative Guidance During Partial Nephrectomy: A Systematic Review and Meta-analysis. Eur Urol Focus 2024:S2405-4569(24)00008-7. [PMID: 38278713 DOI: 10.1016/j.euf.2024.01.005] [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: 11/02/2023] [Revised: 12/11/2023] [Accepted: 01/15/2024] [Indexed: 01/28/2024]
Abstract
CONTEXT Partial nephrectomy (PN) with intraoperative guidance by biophotonics has the potential to improve surgical outcomes due to higher precision. However, its value remains unclear since high-level evidence is lacking. OBJECTIVE To provide a comprehensive analysis of biophotonic techniques used for intraoperative real-time assistance during PN. EVIDENCE ACQUISITION We performed a comprehensive database search based on the PICO criteria, including studies published before October 2022. Two independent reviewers screened the titles and abstracts followed by full-text screening of eligible studies. For a quantitative analysis, a meta-analysis was conducted. EVIDENCE SYNTHESIS In total, 35 studies were identified for the qualitative analysis, including 27 studies on near-infrared fluorescence (NIRF) imaging using indocyanine green, four studies on hyperspectral imaging, two studies on folate-targeted molecular imaging, and one study each on optical coherence tomography and 5-aminolevulinic acid. The meta-analysis investigated seven studies on selective arterial clamping using NIRF. There was a significantly shorter warm ischemia time in the NIRF-PN group (mean difference [MD]: -2.9; 95% confidence interval [CI]: -5.6, -0.1; p = 0.04). No differences were noted regarding transfusions (odds ratio [OR]: 0.5; 95% CI: 0.2, 1.7; p = 0.27), positive surgical margins (OR: 0.7; 95% CI: 0.2, 2.0; p = 0.46), or major complications (OR: 0.4; 95% CI: 0.1, 1.2; p = 0.08). In the NIRF-PN group, functional results were favorable at short-term follow-up (MD of glomerular filtration rate decline: 7.6; 95% CI: 4.6, 10.5; p < 0.01), but leveled off at long-term follow-up (MD: 7.0; 95% CI: -2.8, 16.9; p = 0.16). Remarkably, these findings were not confirmed by the included randomized controlled trial. CONCLUSIONS Biophotonics comprises a heterogeneous group of imaging modalities that serve intraoperative decision-making and guidance. Implementation into clinical practice and cost effectiveness are the limitations that should be addressed by future research. PATIENT SUMMARY We reviewed the application of biophotonics during partial removal of the kidney in patients with kidney cancer. Our results suggest that these techniques support the surgeon in successfully performing the challenging steps of the procedure.
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Affiliation(s)
- Luisa Egen
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany.
| | - Greta S Demmel
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany
| | - Maurizio Grilli
- Library of the Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany
| | - Alexander Studier-Fischer
- Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix Nickel
- Department of General, Visceral, and Thoracic Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Caelan M Haney
- Department of Urology, University Hospital Leipzig, Leipzig, Germany
| | - Julia Mühlbauer
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany
| | - Friedrich O Hartung
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany
| | - Hanna S Menold
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany
| | - Pietro Piazza
- Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands; Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Juan Gomez Rivas
- Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands; Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
| | - Enrico Checcucci
- Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands; Department of Surgery, FPO-IRCCS Candiolo Cancer Institute, Turin, Italy
| | - Stefano Puliatti
- Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands; Department of Urology, University of Modena, and Reggio Emilia, Modena, Italy
| | - Ines Rivero Belenchon
- Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands; Urology and Nephrology Department, Virgen del Rocío University Hospital, Seville, Spain
| | - Mark Taratkin
- Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands
| | - Severin Rodler
- Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands; Department of Urology, University Hospital LMU Munich, Munich, Germany
| | - Giovanni Cacciamani
- Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands; USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Maurice S Michel
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany
| | - Karl-Friedrich Kowalewski
- Department of Urology and Urosurgery, University Medical Center Mannheim, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany; Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands
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Nassiri N, Cacciamani G, Gill IS. Robotic Bladder Auto-transplantation in a Heart-beating Brain-dead Human Research Donor. Eur Urol 2023; 84:517-518. [PMID: 37393116 DOI: 10.1016/j.eururo.2023.06.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 05/22/2023] [Accepted: 06/10/2023] [Indexed: 07/03/2023]
Affiliation(s)
- Nima Nassiri
- Catherine & Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Giovanni Cacciamani
- Catherine & Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Inderbir S Gill
- Catherine & Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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5
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Cacciamani G. Evaluating the Effectiveness of Artificial Intelligence-powered Large Language Models Application in Disseminating Appropriate and Readable Health Information in Urology. Reply. J Urol 2023; 210:736-737. [PMID: 37624687 DOI: 10.1097/ju.0000000000003656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Affiliation(s)
- Giovanni Cacciamani
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California
- AI Center at USC Urology, USC Institute of Urology, University of Southern California, Los Angeles, California
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California
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6
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Preisser F, Incesu RB, Rajwa P, Chlosta M, Nohe F, Ahmed M, Abreu AL, Cacciamani G, Ribeiro L, Kretschmer A, Westhofen T, Smith JA, Steuber T, Calleris G, Raskin Y, Gontero P, Joniau S, Sanchez-Salas R, Shariat SF, Gill I, Karnes RJ, Cathcart P, Van Der Poel H, Marra G, Tilki D. Impact of persistent PSA after salvage radical prostatectomy: a multicenter study. Prostate Cancer Prostatic Dis 2023:10.1038/s41391-023-00728-5. [PMID: 37803241 DOI: 10.1038/s41391-023-00728-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/16/2023] [Accepted: 09/21/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Persistent prostatic specific antigen (PSA) represents a poor prognostic factor for recurrence after radical prostatectomy (RP). However, the impact of persistent PSA on oncologic outcomes in patients undergoing salvage RP is unknown. To investigate the impact of persistent PSA after salvage RP on long-term oncologic outcomes. MATERIAL AND METHODS Patients who underwent salvage RP for recurrent prostate cancer between 2000 and 2021 were identified from twelve high-volume centers. Only patients with available PSA after salvage RP were included. Kaplan-Meier analyses and multivariable Cox regression models were used to test the effect of persistent PSA on biochemical recurrence (BCR), metastasis and any death after salvage RP. Persistent PSA was defined as a PSA-value ≥ 0.1 ng/ml, at first PSA-measurement after salvage RP. RESULTS Overall, 580 patients were identified. Of those, 42% (n = 242) harbored persistent PSA. Median follow-up after salvage RP was 38 months, median time to salvage RP was 64 months and median time to first PSA after salvage RP was 2.2 months. At 84 months after salvage RP, BCR-free, metastasis-free, and overall survival was 6.6 vs. 59%, 71 vs. 88% and 77 vs. 94% for patients with persistent vs. undetectable PSA after salvage RP (all p < 0.01). In multivariable Cox models persistent PSA was an independent predictor for BCR (HR: 5.47, p < 0.001) and death (HR: 3.07, p < 0.01). CONCLUSION Persistent PSA is common after salvage RP and represents an independent predictor for worse oncologic outcomes. Patients undergoing salvage RP should be closely monitored after surgery to identify those with persistent PSA.
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Affiliation(s)
- Felix Preisser
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg Eppendorf, Hamburg, Germany
- Department of Urology, University Hospital Frankfurt, Frankfurt, Germany
| | - Reha-Baris Incesu
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Pawel Rajwa
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Marcin Chlosta
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Florian Nohe
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Mohamed Ahmed
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - Andre Luis Abreu
- Keck Medical Center of USC, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Giovanni Cacciamani
- Keck Medical Center of USC, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | | | | | - Thilo Westhofen
- Department of Urology, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Joseph A Smith
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Thomas Steuber
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Giorgio Calleris
- Department of Surgical Sciences, San Giovanni Battista Hospital and University of Turin, Turin, Italy
| | - Yannic Raskin
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Paolo Gontero
- Department of Surgical Sciences, San Giovanni Battista Hospital and University of Turin, Turin, Italy
| | - Steven Joniau
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Rafael Sanchez-Salas
- Department of Urology, Institut Mutualiste Montsouris and Université Paris Descartes, Paris, France
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan
- Department of Urology, Weill Cornell Medical College, New York, NY, USA
- Department of Urology, University of Texas Southwestern, Dallas, TX, USA
| | - Inderbir Gill
- Keck Medical Center of USC, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | | | | | - Henk Van Der Poel
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Giancarlo Marra
- Department of Surgical Sciences, San Giovanni Battista Hospital and University of Turin, Turin, Italy
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg Eppendorf, Hamburg, Germany.
- Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
- Department of Urology, Koc University Hospital, Istanbul, Turkey.
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7
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Douglawi A, Ghoreifi A, Carbonara U, Yip W, Uzzo RG, Margulis V, Ferro M, Cobelli OD, Wu Z, Simone G, Mastroianni R, Rha KH, Eun DD, Reese AC, Porter JR, Derweesh I, Mehrazin R, Rosiello G, Tellini R, Jamil M, Kenigsberg A, Farrow JM, Schrock WP, Cacciamani G, Srivastava A, Bhattu AS, Mottrie A, Gonzalgo ML, Sundaram CP, Abdollah F, Minervini A, Autorino R, Djaladat H. Impact of Variant Histology on Oncological Outcomes in Upper Tract Urothelial Carcinoma: Results From the ROBUUST Collaborative Group. Clin Genitourin Cancer 2023; 21:563-568. [PMID: 37301663 DOI: 10.1016/j.clgc.2023.05.011] [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: 08/29/2022] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Oncologic implications of variant histology (VH) have been extensively studied in bladder cancer; however, further investigation is needed in upper tract urothelial carcinoma (UTUC). Our study aims to evaluate the impact of VH on oncological outcomes in UTUC patients treated with radical nephroureterectomy (RNU). METHODS A retrospective analysis was performed on patients who underwent a robotic or laparoscopic RNU for UTUC using the ROBUUST database, a multi-institutional collaborative including 17 centers worldwide. Logistic regression was used to assess the effect of VH on urothelial recurrence (bladder, contralateral upper tract), metastasis, and survival following RNU. RESULTS A total of 687 patients were included in this study. Median (IQR) age was 71 (64-78) years and 470 (68%) had organ confined disease. VH was present in 70 (10.2%) patients. In a median follow-up of 16 months, the incidence of urothelial recurrence, metastasis, and mortality was 26.8%, 15.3%, and 11.8%, respectively. VH was associated with increased risk of metastasis (HR 4.3, P <.0001) and death (HR 2.0, P =.046). In multivariable analysis, VH was noted to be an independent risk factor for metastasis (HR 1.8, P =.03) but not for urothelial recurrence (HR 0.99, P =.97) or death (HR 1.4, P =.2). CONCLUSION Variant histology can be found in 10% of patients with UTUC and is an independent risk factor for metastasis following RNU. Overall survival rates and the risk of urothelial recurrence in the bladder or contralateral kidney are not affected by the presence of VH.
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Affiliation(s)
- Antoin Douglawi
- Institute of Urology, University of Southern California, Los Angeles, CA
| | - Alireza Ghoreifi
- Institute of Urology, University of Southern California, Los Angeles, CA
| | - Umberto Carbonara
- Division of Urology, Virginia Commonwealth University, Richmond, Virginia
| | - Wesley Yip
- Institute of Urology, University of Southern California, Los Angeles, CA
| | - Robert G Uzzo
- Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Matteo Ferro
- Department of Urology, Istituto Europeo di Oncologia (IEO), Milan, Italy
| | - Ottavio De Cobelli
- Department of Urology, Istituto Europeo di Oncologia (IEO), Milan, Italy
| | - Zhenjie Wu
- Department of Urology, Shanghai Hospital, Naval Medical University Shanghai, China
| | - Giuseppe Simone
- Istituto Regina Elena (IRE), Department of Urology, Rome, Italy
| | | | - Koon H Rha
- Department of Urology, Yonsei University, Seoul, Republic of Korea
| | - Daniel D Eun
- Department of Urology, Temple University, Philadelphia, PA
| | - Adam C Reese
- Department of Urology, Temple University, Philadelphia, PA
| | | | - Ithaar Derweesh
- Department of Urology, University of California San Diego, San Diego, CA
| | - Reza Mehrazin
- Icahn School of Medicine at Mount Sinai, Department of Urology, New York, NY
| | - Giuseppe Rosiello
- Onze Lieve Vrouwziekenhuis (OLV), Aalst, Belgium; ORSI Academy, Melle, Belgium
| | - Riccardo Tellini
- Department of Experimental and Clinical Medicine, University of Florence, Careggi Hospital, Florence, Italy
| | - Marcus Jamil
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI
| | - Alexander Kenigsberg
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Jason M Farrow
- Department of Urology, Indiana University, Indianapolis, IN
| | | | | | | | - Amit S Bhattu
- Department of Urology, University of Miami, Miami, FL
| | - Alexandre Mottrie
- Onze Lieve Vrouwziekenhuis (OLV), Aalst, Belgium; ORSI Academy, Melle, Belgium
| | | | | | - Firas Abdollah
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence, Careggi Hospital, Florence, Italy
| | | | - Hooman Djaladat
- Institute of Urology, University of Southern California, Los Angeles, CA.
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Nassiri N, Cacciamani G, Gill IS. Robotic Bladder Autotransplantation: Preclinical Studies in Preparation for First-in-human Bladder Transplant. J Urol 2023; 210:600-610. [PMID: 37681535 DOI: 10.1097/ju.0000000000003620] [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: 06/03/2023] [Accepted: 07/06/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE Human urinary bladder transplantation has never been performed. From a technical standpoint, challenges include the complex deep pelvic vascular anatomy, limited intraoperative visualization, and high procedural complexity. In preparation for a first-in-human clinical trial, we report preclinical studies to develop the technique of robotic retrieval and autotransplantation of vascularized composite bladder allograft. MATERIALS AND METHODS Institutional Animal Care and Use Committee, Institutional Review Board, and UNOS (United Network for Organ Sharing) approvals were obtained, and IDEAL (Idea, Development, Exploration, Assessment, Long-term Study) Reporting Guidelines were followed. Robotic vascularized composite bladder allograft recovery, back-table graft preparation, and robotic autotransplantation were performed in 3 vascularized model settings: living porcine (n=3), pulsatile human cadavers (n=2), and heart-beating brain-dead deceased research human donors (n=5). Our primary objective was to develop a reproducible technique for robotic vascularized composite bladder allograft transplantation. Technical success was defined by adequate, sustained vascularized composite bladder allograft reperfusion. Secondary objectives were intraoperative parameters, including operative time, graft ischemia time, and blood loss. RESULTS Successful robotic vascularized composite bladder allograft autotransplantation was achieved in 2 porcine, 1 cadaver, and 3 brain-dead research donors. In the heart-beating research donors, console time decreased with successive surgeries, and visual inspection revealed healthy revascularized autografts with prompt, global indocyanine green immunofluorescence uptake. In 1 heart-beating donor who was hemodynamically maintained for 12 hours postoperatively, reinspection confirmed excellent maintained global vascularized composite bladder allograft vascularity and bladder mucosal integrity. CONCLUSIONS To our knowledge, the first preclinical experience of bladder autotransplantation in vascularized models is reported, including robotic vascularized composite bladder allograft recovery, back-table reconstruction, and autotransplantation. This experience represents the essential preclinical work required to build toward the first-in-human trial of bladder transplantation, performed under a UNOS-approved genitourinary vascularized composite bladder allograft program (NCT No. 05462561).
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Affiliation(s)
- Nima Nassiri
- Catherine & Joseph Aresty Department of Urology, USC Urology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Giovanni Cacciamani
- Catherine & Joseph Aresty Department of Urology, USC Urology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Inderbir S Gill
- Catherine & Joseph Aresty Department of Urology, USC Urology, Keck School of Medicine, University of Southern California, Los Angeles, California
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9
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Sighinolfi MC, Menezes AD, Patel V, Moschovas M, Assumma S, Calcagnile T, Panio E, Sangalli M, Turri F, Sarchi L, Micali S, Varca V, Annino F, Leonardo C, Bozzini G, Cacciamani G, Gregori A, Morini E, Terzoni S, Eissa A, Rocco B. Three-Dimensional Customized Imaging Reconstruction for Urological Surgery: Diffusion and Role in Real-Life Practice from an International Survey. J Pers Med 2023; 13:1435. [PMID: 37888045 PMCID: PMC10607910 DOI: 10.3390/jpm13101435] [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: 08/29/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023] Open
Abstract
Despite the arising interest in three-dimensional (3D) reconstruction models from 2D imaging, their diffusion and perception among urologists have been scarcely explored. The aim of the study is to report the results of an international survey investigating the use of such tools among urologists of different backgrounds and origins. Beyond demographics, the survey explored the degree to which 3D models are perceived to improve surgical outcomes, the procedures mostly making use of them, the settings in which those tools are mostly applied, the surgical steps benefiting from 3D reconstructions and future perspectives of improvement. One hundred responders fully completed the survey. All levels of expertise were allowed; more than half (53%) were first surgeons, and 59% had already completed their training. Their main application was partial nephrectomy (85%), followed by radical nephrectomy and radical prostatectomy. Three-dimensional models are mostly used for preoperative planning (75%), intraoperative consultation and tailoring. More than half recognized that 3D models may highly improve surgical outcomes. Despite their recognized usefulness, 77% of responders use 3D models in less than 25% of their major operations due to costs or the extra time taken to perform the reconstruction. Technical improvements and a higher availability of the 3D models will further increase their role in surgical and clinical daily practice.
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Affiliation(s)
| | | | - Vipul Patel
- Global Robotic Institute, AdventHealth, Orlando, FL 34747, USA
| | | | - Simone Assumma
- Urologic Unit, ASST Santi Paolo e Carlo, La Statale University, 20122 Milan, Italy
| | - Tommaso Calcagnile
- Urologic Unit, ASST Santi Paolo e Carlo, La Statale University, 20122 Milan, Italy
| | - Enrico Panio
- Urologic Unit, ASST Santi Paolo e Carlo, La Statale University, 20122 Milan, Italy
| | - Mattia Sangalli
- Urologic Unit, ASST Santi Paolo e Carlo, La Statale University, 20122 Milan, Italy
| | - Filippo Turri
- Urologic Unit, ASST Santi Paolo e Carlo, La Statale University, 20122 Milan, Italy
| | - Luca Sarchi
- Urologic Unit, ASST Santi Paolo e Carlo, La Statale University, 20122 Milan, Italy
| | - Salvatore Micali
- Urologic Unit, Azienda Ospedaliera Universitaria di Modena, 41124 Modena, Italy
| | - Virginia Varca
- Urologic Unit, ASST Rhodense—Presidio di Garbagnate Milanese, 20024 Milan, Italy
| | | | | | | | - Giovanni Cacciamani
- USC Institute of Urology, University of Southern California, Los Angeles, CA 90089, USA
| | - Andrea Gregori
- Urologic Unit, Fatebenefratelli-Sacco Hospital, 20157 Milan, Italy
| | | | - Stefano Terzoni
- Urologic Unit, ASST Santi Paolo e Carlo, La Statale University, 20122 Milan, Italy
| | - Ahmed Eissa
- Urologic Department, Faculty of Medicine, Tanta University, Tanta 31527, Egypt
| | - Bernardo Rocco
- Urologic Unit, ASST Santi Paolo e Carlo, La Statale University, 20122 Milan, Italy
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10
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Marra G, Calleris G, Conte F, Benfant N, Rajwa P, Ahmed M, Abreu A, Cacciamani G, Smith JA, Joniau S, Rodriguez-Sanchez L, Sanchez-Salas R, Cathcart P, Gill I, Karnes RJ, Tilki D, Shariat SF, Touijer K, Gontero P. Recurrent Gleason Score 6 Prostate Cancer After Radiotherapy or Ablation: Should We Observe Them All? Results from a Large Multicenter Salvage Radical Prostatectomy Consortium. Eur Urol Focus 2023:S2405-4569(23)00194-3. [PMID: 37704503 DOI: 10.1016/j.euf.2023.08.007] [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: 05/14/2023] [Revised: 08/10/2023] [Accepted: 08/31/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Salvage radical prostatectomy (sRP) yields poor functional outcomes and relatively high complication rates. Gleason score (GS) 6 prostate cancer (PCa) has genetic and clinical features showing little, if not absent, metastatic potential. However, the behavior of GS 6 PCa recurring after previous PCa treatment including radiotherapy and/or ablation has not been investigated. OBJECTIVE To evaluate the oncological outcomes of sRP for radio- and/or ablation-recurrent GS 6 PCa. DESIGN, SETTING, AND PARTICIPANTS Retrospective data of sRP for recurrent PCa after local nonsurgical treatment were collected from 14 tertiary referral centers from 2000 to 2021. INTERVENTION Prostate biopsy before sRP and sRP. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS A survival analysis was performed for pre-sRP biopsy and sRP-proven GS 6. Concordance between PCa at pre-sRP biopsy and sRP histology was assessed. RESULTS AND LIMITATIONS We included GS 6 recurrent PCa at pre-sRP biopsy (n = 142) and at sRP (n = 50), as two cohorts. The majority had primary radiotherapy and/or brachytherapy (83.8% of GS 6 patients at pre-sRP biopsy; 78% of GS 6 patients at sRP) and whole-gland treatments (91% biopsy; 85.1% sRP). Biopsy GS 6 10-yr metastasis, cancer-specific survival (CSS), and overall survival (OS) were 79% (95% confidence interval [CI] 61-89%), 98% (95-99%), and 89% (78-95%), respectively. Upgrading at sRP was 69%, 35.5% had a pT3 stage, and 13.4% had positive nodes. The sRP GS 6 10-yr metastasis-free survival, CSS, and OS were 100%, 100%, and 90% (95% CI 58-98%) respectively; pT3 and pN1 disease were found in 12% and 0%, respectively. Overall complications, high-grade complications, and severe incontinence were experienced by >50%, >10%, and >15% of men, respectively (in both the biopsy and the sRP cohorts). Limitations include the retrospective nature of the study and absence of a centralized pathological review. CONCLUSIONS GS 6 sRP-proven PCa recurring after nonsurgical primary treatment has almost no metastatic potential, while patients experience relevant morbidity of the procedure. However, a significant proportion of GS 6 cases at pre-sRP biopsy are upgraded at sRP. In the idea not to overtreat, efforts should be made to improve the diagnostic accuracy of pre-sRP biopsy. PATIENT SUMMARY We investigated the oncological results of salvage radical prostatectomy for recurrent prostate cancer of Gleason score (GS) 6 category. We found a very low malignant potential of GS 6 confirmed at salvage radical prostatectomy despite surgical complications being relatively high. Nonetheless, biopsy GS 6 was frequently upgraded and had less optimal oncological control. Overtreatment for recurrent GS 6 after nonsurgical first-line treatment should be avoided, and efforts should be made to increase the diagnostic accuracy of biopsies for recurrent disease.
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Affiliation(s)
- Giancarlo Marra
- Department of Surgical Sciences and Urology Clinic, University of Turin and Città della Salute e della Scienza, Turin, Italy
| | - Giorgio Calleris
- Department of Surgical Sciences and Urology Clinic, University of Turin and Città della Salute e della Scienza, Turin, Italy.
| | - Francesca Conte
- Department of Surgical Sciences and Urology Clinic, University of Turin and Città della Salute e della Scienza, Turin, Italy
| | - Nicole Benfant
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Pawel Rajwa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Mohamed Ahmed
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - Andre Abreu
- USC Institute of Urology & The Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Giovanni Cacciamani
- USC Institute of Urology & The Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Joseph A Smith
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Steven Joniau
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Lara Rodriguez-Sanchez
- Department of Urology, Institut Mutualiste Montsouris and Université Paris Descartes, Paris, France
| | - Rafael Sanchez-Salas
- Department of Urology, Institut Mutualiste Montsouris and Université Paris Descartes, Paris, France
| | | | - Inderbir Gill
- USC Institute of Urology & The Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Koc University Hospital, Istanbul, Turkey
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Departments of Urology, Weill Cornell Medical College, New York, New York, USA; Department of Urology, University of Texas Southwestern, Dallas, Texas, USA; Research Center for Evidence-Based Medicine, Iranian EBM Center: A Joanna Briggs Institute Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran; Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
| | - Karim Touijer
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Paolo Gontero
- Department of Surgical Sciences and Urology Clinic, University of Turin and Città della Salute e della Scienza, Turin, Italy
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11
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Sobhani S, Alsyouf M, Ahmadi H, Ghoreifi A, Yu W, Cacciamani G, Miranda G, Cai J, Bhanvadia S, Schuckman A, Aron M, Gill I, Daneshmand S, Desai M, Djaladat H. Association between early postradical cystectomy kidney injury and perioperative outcome in enhanced recovery era. Urol Oncol 2023; 41:389.e15-389.e20. [PMID: 36967251 DOI: 10.1016/j.urolonc.2023.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/08/2022] [Revised: 01/26/2023] [Accepted: 02/18/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To evaluate the incidence and predictors of early postoperative acute kidney injury (EP-AKI) during index hospitalization following radical cystectomy and its association with postoperative outcomes. METHODS All patients with bladder cancer who underwent radical cystectomy with intent-to-cure at our center between 2012 and 2020 were reviewed. EP-AKI during index hospitalization was evaluated using the Acute Kidney Injury Network criteria. The association between EP-AKI and demographics, clinicopathologic features, and perioperative outcomes, including length of hospital stay, complication rate, and readmission rate, were examined. A logistic regression analysis was performed to evaluate the predictors of EP-AKI. RESULTS Overall, 435 patients met eligibility, of whom 112 (26%) experienced EP-AKI during index hospitalization (90 [21%] stage 1, 17 [4%] stage 2, and 5 [1%] stage 3). EP-AKI was associated with a longer mean operative time (6.8 vs. 6.1 hours; P < 0.001), higher mean length of hospital stay (6.3 vs. 5.6; P = 0.02), 30-day complication rate (71% vs. 51%; P < 0.001), 90-day complication rate (81% vs. 69%; P = 0.01) and 90-day readmission rate (37% vs. 33%; P = 0.04). The rate of complications increased at higher stages of AKI. On multivariable analysis, perioperative blood transfusion (OR: 1.84, P = 0.02) and continent diversion (OR: 3.29, P < 0.001) were independent predictors of EP-AKI. CONCLUSION A quarter of cystectomy patients experience acute kidney injury during index hospitalization, which is associated with higher length of stay, postoperative complication, and readmission rates. Perioperative blood transfusion and continent diversion are independent predictors of such injury.
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Affiliation(s)
- Sina Sobhani
- Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Muhannad Alsyouf
- Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Hamed Ahmadi
- Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Department of Urology, University of Minnesota, Minneapolis, MN
| | - Alireza Ghoreifi
- Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Wenhao Yu
- Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Giovanni Cacciamani
- Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Gus Miranda
- Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Jie Cai
- Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Sumeet Bhanvadia
- Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Anne Schuckman
- Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Monish Aron
- Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Inderbir Gill
- Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Siamak Daneshmand
- Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Mihir Desai
- Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Hooman Djaladat
- Institute of Urology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA.
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12
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Rodler S, Kowalewski KF, Scheibert H, Bensel M, Stadelmeier LF, Styn A, Belenchon IR, Taratkin M, Puliatti S, Gomez Rivas J, Veccia A, Piazza P, Checcucci E, Michel MS, Stief CG, Cacciamani G. Digital Therapeutics in Urology: An Innovative Approach to Patient Care and Management. EUR UROL SUPPL 2023; 55:23-27. [PMID: 37593208 PMCID: PMC10432164 DOI: 10.1016/j.euros.2023.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2023] [Indexed: 08/19/2023] Open
Abstract
Digital therapeutics (DTx) are a new class of intervention involving evidence-based software applications and have been used in neurology and psychiatry. To assess the potential of DTx in urology, we conducted a survey to assess the current prevalence of the digital infrastructure required for DTx, areas of support expected by patients, and requirements for uptake. Between November 2022 and January 2023, we conducted an anonymized survey at two German academic centers among patients with urologic conditions. We found that among patients aged <65 yr versus ≥65 yr, digital devices including smartphones (93.6% vs 77.3%; p < 0.001), computers (80.4% vs 70.1%; p < 0.001), tablets (51.7% vs 38.1%; p < 0.001), and smartwatches (24.7% vs 7.7%; p < 0.001) are already widely used, especially in the younger age group. Apps (95.6% vs 74.4%; p < 0.001) and health apps (57.6% vs 30.4%; p < 0.001) are already frequently used, but certified DTx apps are not (7.3% vs 5.4%; p = 0.25). Patients favor solutions that provide access to validated information (49.6%), give medical advice based on data or symptoms captured by the app (43.0%), or replace a physiotherapist (41.7%). Patients feel that optimization of therapy (78.4%), significant positive health outcomes (76.9%), and better patient autonomy (73.4%) are important requirements for DTx in urology. Regulatory and reimbursement changes mean that DTx might play an increasing role in urology. Patient summary Patients can use digital therapeutics (DTx), which are mainly smartphone apps, to improve their health status or treat medical conditions. We assessed the current and future use of DTx in urology. Patients are already widely using smartphones and frequently use uncertified health apps, but do not use DTx. Patients would like to use DTx to optimize therapy that provides a significant health improvement.
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Affiliation(s)
- Severin Rodler
- Depatment of Urology, LMU University Hospital, Munich, Germany
| | | | | | - Moritz Bensel
- Depatment of Urology, LMU University Hospital, Munich, Germany
| | | | - Amelie Styn
- Depatment of Urology, LMU University Hospital, Munich, Germany
| | - Ines Rivero Belenchon
- Urology and Nephrology Department, Virgen del Rocío University Hospital, Seville, Spain
| | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Stefano Puliatti
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Juan Gomez Rivas
- Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
| | - Alessandro Veccia
- Urology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Pietro Piazza
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Enrico Checcucci
- Department of Surgery, Candiolo Cancer Institute FPO-IRCCS, Candiolo, Turin, Italy
| | - Maurice S. Michel
- Department of Urology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Giovanni Cacciamani
- USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - the Young Academic Urologists Urotechnology Group of the European Association of Urology
- Depatment of Urology, LMU University Hospital, Munich, Germany
- Department of Urology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
- Urology and Nephrology Department, Virgen del Rocío University Hospital, Seville, Spain
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
- Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
- Urology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Surgery, Candiolo Cancer Institute FPO-IRCCS, Candiolo, Turin, Italy
- USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
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13
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Rivas JG, Belenchón IR, Li N, Somani B, Esteban EA, Cacciamani G, Checcucci E, Puliatti S, Taratkin M, Kowalewski KF, Rodler S, Veccia A, Palou J, Liatsikos E. A new era and future of education: the impact of pandemic on online learning - a study from the European School of Urology. Cent European J Urol 2023; 76:256-262. [PMID: 38045782 PMCID: PMC10690391 DOI: 10.5173/ceju.2023.059] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 04/05/2023] [Accepted: 04/29/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction In contemporary times, the online learning process has become indispensable for healthcare education. In this direction, the European School of Urology (ESU) has taken the challenge to implement new technologies to bring down knowledge barriers. Web-based seminars (webinars) are one of the tools that help us move towards such inclusivity, and in front-facing COVID-19 pandemic, when face-to-face meetings were forbidden. Material and methods Data from ESU webinars was collected from 2016 to 2022. We described the trends through years of: a) number of webinars per year; b) number of oncological versus non-oncological webinars per year; c) number of registrations per year; d) attendance rate; e) YouTube visualisations. We also analysed audience demographics and COVID-19 impact. Results We found a 60% increase in webinars launched per year with a trend towards more non-oncological webinars. A 94% rise in the number of registrations and an 85% increase in the attendance ratio from 2016 to 2022 was observed. The mean YouTube visualisations per webinar decreased over 200%. Among registrations, we had a 3:1 male: female ratio, 53% were older than 40, and a 51% were of European precedence. COVID-19 positively impacted webinars with a remarkable increase on the amount of webinars launched, number of registrations and attendance ratio. Conclusions Webinars are a powerful tool to spread healthcare knowledge, bridging the gap in medical educational access. COVID-19 was a determinant that reinforced its implantation, but our data show that this new learning tool had a positive uptake, and has come to stay.
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Affiliation(s)
- Juan Gómez Rivas
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands
- Department of Urology, San Carlos Hospital, Madrid, Spain
| | - Inés Rivero Belenchón
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands
- Department of Urology and Nephrology, Biomedical Institute of Seville (IBiS), Virgen del Rocío University Hospital, University of Seville, Seville, Spain
| | - Nan Li
- European Association of Urology, Arnhem, the Neatherlands
| | - Bhaskar Somani
- University Hospital Southampton NHS Trust, Southampton, United Kingdom
| | | | - Giovanni Cacciamani
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands
- Catherine and Joseph Aresty Department of Urology, US Institute of Urology, University of Southern California, Los Angeles, United States of America
| | - Enrico Checcucci
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands
- Division of Urology, Department of Surgery, IRCC Candiolo Cancer Institute, Candiolo, Turin, Italy
| | - Stefano Puliatti
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Mark Taratkin
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Karl-Friedrich Kowalewski
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands
- Department of Urology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Severin Rodler
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands
- Department of Urology, Klinikum der Univertität München, Munich, Germany
| | - Alessandro Veccia
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands
- Urology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Joan Palou
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
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14
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Preisser F, Incesu RB, Rajwa P, Chlosta M, Ahmed M, Abreu AL, Cacciamani G, Ribeiro L, Kretschmer A, Westhofen T, Smith JA, Graefen M, Calleris G, Raskin Y, Gontero P, Joniau S, Sanchez-Salas R, Shariat SF, Gill I, Karnes RJ, Cathcart P, Van Der Poel H, Marra G, Tilki D. Oncologic Outcomes of Lymph Node Dissection at Salvage Radical Prostatectomy. Cancers (Basel) 2023; 15:3123. [PMID: 37370733 DOI: 10.3390/cancers15123123] [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: 05/04/2023] [Revised: 06/03/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Lymph node invasion (LNI) represents a poor prognostic factor after primary radical prostatectomy (RP) for prostate cancer (PCa). However, the impact of LNI on oncologic outcomes in salvage radical prostatectomy (SRP) patients is unknown. OBJECTIVE To investigate the impact of lymph node dissection (LND) and pathological lymph node status (pNX vs. pN0 vs. pN1) on long-term oncologic outcomes of SRP patients. PATIENTS AND METHODS Patients who underwent SRP for recurrent PCa between 2000 and 2021 were identified from 12 high-volume centers. Kaplan-Meier analyses and multivariable Cox regression models were used. Endpoints were biochemical recurrence (BCR), overall survival (OS), and cancer-specific survival (CSS). RESULTS Of 853 SRP patients, 87% (n = 727) underwent LND, and 21% (n = 151) harbored LNI. The median follow-up was 27 months. The mean number of removed lymph nodes was 13 in the LND cohort. At 72 months after SRP, BCR-free survival was 54% vs. 47% vs. 7.2% for patients with pNX vs. pN0 vs. pN1 (p < 0.001), respectively. At 120 months after SRP, OS rates were 89% vs. 81% vs. 41% (p < 0.001), and CSS rates were 94% vs. 96% vs. 82% (p = 0.02) for patients with pNX vs. pN0 vs. pN1, respectively. In multivariable Cox regression analyses, pN1 status was independently associated with BCR (HR: 1.77, p < 0.001) and death (HR: 2.89, p < 0.001). CONCLUSIONS In SRP patients, LNI represents an independent poor prognostic factor. However, the oncologic benefit of LND in SRP remains debatable. These findings underline the need for a cautious LND indication in SRP patients as well as strict postoperative monitoring of SRP patients with LNI.
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Affiliation(s)
- Felix Preisser
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg Eppendorf, 20251 Hamburg, Germany
| | - Reha-Baris Incesu
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg Eppendorf, 20251 Hamburg, Germany
| | - Pawel Rajwa
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria
- Department of Urology, Medical University of Silesia, 40-055 Zabrze, Poland
| | - Marcin Chlosta
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria
| | - Mohamed Ahmed
- Department of Urology, Mayo Clinic, Rochester, MN 55902, USA
| | - Andre Luis Abreu
- Keck Medical Center of USC, USC Institute of Urology, University of Southern California, Los Angeles, CA 90033, USA
| | - Giovanni Cacciamani
- Keck Medical Center of USC, USC Institute of Urology, University of Southern California, Los Angeles, CA 90033, USA
| | - Luis Ribeiro
- Urology Centre, Guy's Hospital, London SE1 9RT, UK
| | - Alexander Kretschmer
- Department of Urology, Ludwig-Maximilians University of Munich, 80539 Munich, Germany
| | - Thilo Westhofen
- Department of Urology, Ludwig-Maximilians University of Munich, 80539 Munich, Germany
| | - Joseph A Smith
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Markus Graefen
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg Eppendorf, 20251 Hamburg, Germany
| | - Giorgio Calleris
- Department of Surgical Sciences, San Giovanni Battista Hospital, University of Turin, 10124 Turin, Italy
| | - Yannic Raskin
- Department of Urology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Paolo Gontero
- Department of Surgical Sciences, San Giovanni Battista Hospital, University of Turin, 10124 Turin, Italy
| | - Steven Joniau
- Department of Urology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Rafael Sanchez-Salas
- Department of Urology, Institut Mutualiste Montsouris, Université Paris Descartes, 75270 Paris, France
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria
- Department of Urology, Second Faculty of Medicine, Charles University, 116 36 Prague, Czech Republic
- Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman 19628, Jordan
- Department of Urology, Weill Cornell Medical College, New York, NY 10075, USA
- Department of Urology, University of Texas Southwestern, Dallas, TX 75390, USA
| | - Inderbir Gill
- Keck Medical Center of USC, USC Institute of Urology, University of Southern California, Los Angeles, CA 90033, USA
| | | | | | - Henk Van Der Poel
- Department of Urology, Netherlands Cancer Institute, 1066 Amsterdam, The Netherlands
| | - Giancarlo Marra
- Department of Surgical Sciences, San Giovanni Battista Hospital, University of Turin, 10124 Turin, Italy
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg Eppendorf, 20251 Hamburg, Germany
- Department of Urology, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany
- Department of Urology, Koc University Hospital, 34010 Istanbul, Turkey
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15
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Ghoreifi A, Kaneko M, Peretsman S, Iwata A, Brooks J, Shakir A, Sugano D, Cai J, Cacciamani G, Park D, Lebastchi AH, Ukimura O, Bahn D, Gill I, Abreu AL. Patient-reported Satisfaction and Regret Following Focal Therapy for Prostate Cancer: A Prospective Multicenter Evaluation. EUR UROL SUPPL 2023; 50:10-16. [PMID: 37101771 PMCID: PMC10123415 DOI: 10.1016/j.euros.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 02/22/2023] Open
Abstract
Background Several reports are available regarding the treatment decision regret of patients receiving conventional treatments for localized prostate cancer (PCa); yet data on patients undergoing focal therapy (FT) are sparse. Objective To evaluate the treatment decision satisfaction and regret among patients who underwent FT for PCa with high-intensity focused ultrasound (HIFU) or cryoablation (CRYO). Design setting and participants We identified consecutive patients who underwent HIFU or CRYO FT as the primary treatment for localized PCa at three US institutions. A survey with validated questionnaires, including the five-question Decision Regret Scale (DRS), International Prostate Symptom Score (IPSS), and International Index of Erectile Function (IIEF-5), was mailed to the patients. The regret score was calculated based on the five items of the DRS, and regret was defined as a DRS score of >25. Outcome measurements and statistical analysis Multivariable logistic regression models were applied to assess the predictors of treatment decision regret. Results and limitations Of 236 patients, 143 (61%) responded to the survey. Baseline characteristics were similar between responders and nonresponders. During a median (interquartile range) follow-up of 43 (26-68) mo, the treatment decision regret rate was 19.6%. On a multivariable analysis, higher prostate-specific antigen (PSA) at nadir after FT (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.1-2, p = 0.009), presence of PCa on follow-up biopsy (OR 3.98, 95% CI 1.5-10.6, p = 0.006), higher post-FT IPSS (OR 1.18, 95% CI 1.01-1.37, p = 0.03), and newly diagnosed impotence (OR 6.67, 95% CI 1.57-27, p = 0.03) were independent predictors of treatment regret. The type of energy treatment (HIFU/CRYO) was not a predictor of regret/satisfaction. Limitations include retrospective abstraction. Conclusions FT for localized PCa is well accepted by the patients, with a low regret rate. Higher PSA at nadir, presence of cancer on follow-up biopsy, bothersome postoperative urinary symptoms, and impotence after FT were independent predictors of treatment decision regret. Patient summary In this report, we looked at the factors affecting satisfaction and regret in patients with prostate cancer undergoing focal therapy. We found that focal therapy is well accepted by the patients, while presence of cancer on follow-up biopsy as well as bothersome urinary symptoms and sexual dysfunction can predict treatment decision regret.
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Cacciamani G, Kaneko M, Magouliantis V, Yang Y, Duddalwar V, Kuo CC, Gill I, Abreu A, Nikias C. Assessment of a novel bpMRI-based machine learning framework to automate the detection of clinically significant prostate cancer using the PI-CAI (Prostate Imaging: Cancer AI) challenge dataset. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01017-5] [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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Veneziano D, Basile G, Cignoli D, Cozzupoli P, Sgrò E, Gomez Rivas J, Dourado A, Okhunov Z, Somani B, Territo A, Cacciamani G, Breda A. Preliminary evaluation of infrared imaging for real-time graft reperfusion assessment during kidney transplant: an ESUT-YAUWP project. Minerva Urol Nephrol 2023; 75:126-129. [PMID: 36282547 DOI: 10.23736/s2724-6051.22.05119-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
| | - Giuseppe Basile
- Department of Urology, IRCCS San Raffaele Hospital, Milan, Italy -
| | - Daniele Cignoli
- Department of Urology, IRCCS San Raffaele Hospital, Milan, Italy
| | - Pietro Cozzupoli
- Department of Urology and Kidney Transplant, Grande Ospedale Metropolitano, Reggio Calabria, Italy
| | - Edoardo Sgrò
- Department of Urology and Kidney Transplant, Grande Ospedale Metropolitano, Reggio Calabria, Italy
| | - Juan Gomez Rivas
- Department of Urology, San Carlos Clinical Hospital, Madrid, Spain
| | - Aurus Dourado
- Department of Urology, Camargo Cancer Center, São Paulo, Brasil
| | - Zhamshid Okhunov
- Department of Urology, University of California, Irvine, CA, USA
| | - Bhaskar Somani
- University Hospital Southampton NHS Trust, Southampton, UK
| | - Angelo Territo
- Department of Urology, Puigvert Foundation, Barcelona, Spain
| | - Giovanni Cacciamani
- Department of Urology, USC Institute of Urology & Catherine and Joseph Aresty, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alberto Breda
- Department of Urology, Puigvert Foundation, Barcelona, Spain
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Calleris G, Marra G, Massari E, Benfant N, Rajwa P, Ahmed M, Abreu A, Cacciamani G, Ribeiro L, Westhofen T, Tourinho-Barbosa R, Raskin Y, Smith J, Van Der Poel H, Joniau S, Sanchez-Salas R, Kretschmer A, Cathcart P, Gill I, Karnes R, Tilki D, Shariat S, Touijer K, Gontero P. EAU patient selection criteria are predictors of metastasis-free survival in a large contemporary salvage radical prostatectomy patients cohort. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01157-0] [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: 02/12/2023]
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19
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Calleris G, Marra G, Benfant N, Rajwa P, Ahmed M, Abreu A, Cacciamani G, Ghoreifi A, Ribeiro L, Westhofen T, Tourinho-Barbosa R, Raskin Y, Veerman H, Albisinni S, Smith JA, Rouprêt M, Oderda M, Massari E, Persad R, Van Der Poel H, Joniau S, Sanchez-Salas R, Kretschmer A, Cathcart P, Gill I, Karnes RJ, Tilki D, Shariat SF, Touijer K, Gontero P. Salvage Radical Prostatectomy for Recurrent Prostate Cancer Following First-line Nonsurgical Treatment: Validation of the European Association of Urology Criteria in a Large, Multicenter, Contemporary Cohort. Eur Urol Focus 2023:S2405-4569(23)00006-8. [PMID: 36682962 DOI: 10.1016/j.euf.2023.01.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/17/2022] [Accepted: 01/06/2023] [Indexed: 01/22/2023]
Abstract
Salvage radical prostatectomy (sRP) is a potentially curative option for locally radiorecurrent prostate cancer (PCa) but is associated with significant morbidity. Therefore, the European Association of Urology (EAU) guidelines recommend restricting sRP to a favorable-prognosis group according to the EAU criteria, but these have been validated considering only biochemical recurrence (BCR). Our aim was to test these criteria in a large, multicenter, contemporary cohort. We retrospectively reviewed 1265 patients who underwent sRP at 14 referral centers (2000-2021), stratified by compliance with the EAU criteria. Our primary outcome was metastasis-free survival (MFS). We included 1030 men, of whom 221 (21.5%) fully met the EAU recommended criteria for sRP and 809 (78.5%) did not. The EAU-compliant group experienced more favorable pathological and functional outcomes (79% vs 63% wearing no pads at 1 yr; p < 0.001) and had significantly better MFS (90% vs 76% at 5 yr; p < 0.001), prostate-specific antigen-free survival (55% vs 38% at 5 yr; p < 0.001), and overall survival (89% vs 84% at 5 yr; p = 0.01). This was verified by Cox regression analysis for MFS (hazard ratio 1.84, 95% confidence interval 1.13-2.99; p = 0.01). We found that adherence to the EAU criteria is associated with a lower risk of BCR and, more importantly, of metastasis after surgery. PATIENT SUMMARY: We looked at outcomes of surgical removal of the prostate for prostate cancer recurrence after radiotherapy or other nonsurgical treatments according to whether or not patients met the European Association of Urology (EAU) criteria for this surgery. We found that men who did not meet the criteria had a higher risk of metastasis and their benefit from surgery might be significantly less than for patients who do meet the EUA criteria.
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Affiliation(s)
- Giorgio Calleris
- Urology Clinic, Department of Surgical Sciences, University of Turin and Città della Salute e della Scienza, Turin, Italy
| | - Giancarlo Marra
- Urology Clinic, Department of Surgical Sciences, University of Turin and Città della Salute e della Scienza, Turin, Italy.
| | - Nicole Benfant
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Pawel Rajwa
- Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria; Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Mohamed Ahmed
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - Andre Abreu
- USC Institute of Urology & The Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Giovanni Cacciamani
- USC Institute of Urology & The Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alireza Ghoreifi
- USC Institute of Urology & The Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Thilo Westhofen
- Department of Urology, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Rafael Tourinho-Barbosa
- Department of Urology, Institut Mutualiste Montsouris and Université Paris Descartes, Paris, France
| | - Yannic Raskin
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Hans Veerman
- Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Simone Albisinni
- Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Joseph A Smith
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Morgan Rouprêt
- Sorbonne University, GRC 5 Predictive Onco-Uro, Department of Urology, Pitie-Salpetriere Hospital, AP-HP, Paris, France
| | - Marco Oderda
- Urology Clinic, Department of Surgical Sciences, University of Turin and Città della Salute e della Scienza, Turin, Italy
| | - Emilia Massari
- Urology Clinic, Department of Surgical Sciences, University of Turin and Città della Salute e della Scienza, Turin, Italy
| | | | | | - Steven Joniau
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Rafael Sanchez-Salas
- Department of Urology, Institut Mutualiste Montsouris and Université Paris Descartes, Paris, France
| | | | | | - Inderbir Gill
- USC Institute of Urology & The Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany; Department of Urology, Koc University Hospital, Istanbul, Turkey
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | - Karim Touijer
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Paolo Gontero
- Urology Clinic, Department of Surgical Sciences, University of Turin and Città della Salute e della Scienza, Turin, Italy
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Wu Z, Chen Q, Djaladat H, Minervini A, Uzzo RG, Sundaram C, Rha KH, Gonzalgo ML, Mehrazin R, Mazzone E, Marcus J, Danno A, Porter J, Asghar A, Ghali F, Guruli G, Douglawi A, Cacciamani G, Ghoreifi A, Simone G, Margulis V, Ferro M, Tellini R, Mari A, Srivastava A, Steward J, Al-Qathani A, Al-Mujalhem A, Satish Bhattu A, Mottrie A, Abdollah F, Eun DD, Derweesh I, Veccia A, Autorino R, Wang L. Corrigendum re "A Preoperative Nomogram to Predict Renal Function Insufficiency for Cisplatin-based Adjuvant Chemotherapy Following Minimally Invasive Radical Nephroureterectomy (ROBUUST Collaborative Group)" [Eur Urol Focus 2022;8:173-81]. Eur Urol Focus 2022:S2405-4569(22)00294-2. [PMID: 36588010 DOI: 10.1016/j.euf.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Zhenjie Wu
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Qi Chen
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Hooman Djaladat
- Institute of Urology & Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence - Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Robert G Uzzo
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | | | - Koon H Rha
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Mark L Gonzalgo
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Reza Mehrazin
- Icahn School of Medicine at Mount Sinai, Department of Urology, New York, NY, USA
| | - Elio Mazzone
- OLV Hospital, Aalst, Belgium; ORSI Academy, Melle, Belgium
| | - Jamil Marcus
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA
| | - Alyssa Danno
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA
| | | | - Aeen Asghar
- Department of Urology, Temple University, Philadelphia, PA, USA
| | - Fady Ghali
- Department of Urology, UCSD, San Diego, CA, USA
| | | | - Antoin Douglawi
- Institute of Urology & Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Giovanni Cacciamani
- Institute of Urology & Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alireza Ghoreifi
- Institute of Urology & Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Giuseppe Simone
- IRCCS "Regina Elena" National Cancer Institute, Department of Urology, Rome, Italy
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Matteo Ferro
- Division of Urology - European Institute of Oncology, IRCCS, Milan, Italy
| | - Riccardo Tellini
- Department of Experimental and Clinical Medicine, University of Florence - Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Andrea Mari
- Department of Experimental and Clinical Medicine, University of Florence - Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Abhishek Srivastava
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - James Steward
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ali Al-Qathani
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ahmad Al-Mujalhem
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Amit Satish Bhattu
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Firas Abdollah
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA
| | - Daniel D Eun
- Department of Urology, Temple University, Philadelphia, PA, USA
| | | | | | | | - Linhui Wang
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, China.
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Rivero Belenchón I, Checcucci E, Gómez Rivas J, Puliatti S, Taratkin M, Kowalewski KF, Rodler S, Veccia A, Medina Lopez RA, Cacciamani G. Comment on "Artificial intelligence to predict oncological outcome directly from hematoxylin and eosin-stained slides in urology: a systematic review". Minerva Urol Nephrol 2022; 74:810-812. [PMID: 36629813 DOI: 10.23736/s2724-6051.22.05180-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Inés Rivero Belenchón
- Department of Urology and Nephrology, Biomedical Institute of Seville (IBiS), Virgen del Rocío University Hospital, University of Seville, Seville, Spain - .,Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands -
| | - Enrico Checcucci
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands.,Division of Urology, Department of Surgery, IRCC Candiolo Cancer Institute, Candiolo, Turin, Italy
| | - Juan Gómez Rivas
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands.,Department of Urology, San Carlos Hospital, Madrid, Spain
| | - Stefano Puliatti
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands.,Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Mark Taratkin
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands.,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Karl-Friedrich Kowalewski
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands.,Department of Urology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Severin Rodler
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands.,Department of Urology, Klinikum der Univertität München, Munich, Germany
| | - Alessandro Veccia
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands.,Unit of Urology, AOUI Verona, Verona, Italy
| | - Rafael A Medina Lopez
- Department of Urology and Nephrology, Biomedical Institute of Seville (IBiS), Virgen del Rocío University Hospital, University of Seville, Seville, Spain
| | - Giovanni Cacciamani
- Young Academic Urologist-Urotechnology Working Party (ESUT-YAU), European Association of Urology, Arnhem, the Neatherlands.,Catherine and Joseph Aresty Department of Urology, US Institute of Urology, University of Southern California, Los Angeles, CA, USA
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22
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Piramide F, Kowalewski KF, Cacciamani G, Rivero Belenchon I, Taratkin M, Carbonara U, Marchioni M, De Groote R, Knipper S, Pecoraro A, Turri F, Dell'Oglio P, Puliatti S, Amparore D, Volpi G, Campi R, Larcher A, Mottrie A, Breda A, Minervini A, Ghazi A, Dasgupta P, Gozen A, Autorino R, Fiori C, Di Dio M, Gomez Rivas J, Porpiglia F, Checcucci E. Three-dimensional Model-assisted Minimally Invasive Partial Nephrectomy: A Systematic Review with Meta-analysis of Comparative Studies. Eur Urol Oncol 2022; 5:640-650. [PMID: 36216739 DOI: 10.1016/j.euo.2022.09.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [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: 06/12/2022] [Revised: 08/16/2022] [Accepted: 09/21/2022] [Indexed: 01/26/2023]
Abstract
CONTEXT Use of three-dimensional (3D) guidance for nephron-sparing surgery (NSS) has increased in popularity, especially for laparoscopic and robotic approaches. Different 3D visualization modalities have been developed as promising new tools for surgical planning and intraoperative navigation. OBJECTIVES To summarize and evaluate the impact of 3D models on minimally invasive NSS in terms of perioperative, functional, and oncological outcomes. EVIDENCE ACQUISITION A systematic literature search was conducted in December 2021 using the Medline (PubMed), Embase (Ovid), Scopus, and Web of Science databases. The protocol was registered on PROSPERO (CRD42022300948). The search strategy used the PICOS (Population, Intervention, Comparison, Outcome, Study design) criteria and article selection was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias and the quality of the articles included were assessed. A dedicated data extraction form was used to collect the data of interest. Meta-analysis was performed using the Mantel-Haenszel method for binary outcomes, with results summarized as the odds ratio (OR), and the inverse variance method for continuous data, with results reported as the mean difference (MD). All effect estimates are reported with the 95% confidence interval (CI) and p ≤ 0.05 was considered statistically significant. All analyses were performed using R software and the meta package. EVIDENCE SYNTHESIS The initial electronic search identified 450 papers, of which 17 met the inclusion criteria and were included in the analysis. Use of 3D technology led to a significant reduction in the global ischemia rate (OR 0.22, 95% CI 0.07-0.76; p = 0.02) and facilitated more frequent enucleation (OR 2.54, 95% CI 1.36-4.74; p < 0.01) and less frequent opening of the collecting system (OR 0.36, 95% CI 0.15-0.89; p = 0.03) and was associated with less blood loss (MD 23.1 ml, 95% CI 31.8-14.4; p < 0.01). 3D guidance for NSS was associated with a significant reduction in the transfusion rate (OR 0.20, 95% CI 0.07-0.56; p < 0.01). There were no significant differences in rates of conversion to radical nephrectomy, minor and major complications, change in glomerular filtration rate, or surgical margins (all p > 0.05). CONCLUSIONS 3D guidance for NSS is associated with lower rates of detriment and surgical injury to the kidney. Specifically, a lower amount of nontumor renal parenchyma is exposed to ischemia or sacrificed during resection, and opening of the collecting system is less frequent. However, use of 3D technology does not lead to significant improvements in oncological or functional outcomes. PATIENT SUMMARY We reviewed the use of three-dimensional tools for minimally invasive surgery for partial removal of the kidney in patients with kidney cancer. The evidence suggests that these tools have benefits during surgery, but do not lead to significant improvements in cancer control or functional outcomes for patients.
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Affiliation(s)
- Federico Piramide
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy; European Association of Urology Young Academic Urologists Robotic Surgery Working Group, Arnhem, The Netherlands.
| | - Karl-Friedrich Kowalewski
- Department of Urology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany; Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands
| | - Giovanni Cacciamani
- Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands; USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Ines Rivero Belenchon
- Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands; Urology and Nephrology Department, Virgen del Rocío University Hospital, Seville, Spain
| | - Mark Taratkin
- Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands; Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Umberto Carbonara
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Michele Marchioni
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, SS Annunziata Hospital, G. D'Annunzio University of Chieti, Chieti, Italy
| | - Ruben De Groote
- European Association of Urology Young Academic Urologists Robotic Surgery Working Group, Arnhem, The Netherlands; Department of Urology, OLV Hospital, Aalst, Belgium; ORSI Academy, Melle, Belgium
| | - Sophie Knipper
- European Association of Urology Young Academic Urologists Robotic Surgery Working Group, Arnhem, The Netherlands; Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Angela Pecoraro
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Department of Urology, Hospital Pederzoli, Peschiera del Garda, Italy
| | - Filippo Turri
- European Association of Urology Young Academic Urologists Robotic Surgery Working Group, Arnhem, The Netherlands; Department of Urology, Nuovo Ospedale Civile S. Agostino Estense, University of Modena and Reggio Emilia, Modena, Italy
| | - Paolo Dell'Oglio
- European Association of Urology Young Academic Urologists Robotic Surgery Working Group, Arnhem, The Netherlands; Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Stefano Puliatti
- Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands; Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Amparore
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy; European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands
| | - Gabriele Volpi
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy
| | - Riccardo Campi
- European Association of Urology Young Academic Urologists Renal Cancer Working Group, Arnhem, The Netherlands; Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Larcher
- European Association of Urology Young Academic Urologists Robotic Surgery Working Group, Arnhem, The Netherlands; Unit of Urology, Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Alex Mottrie
- Department of Urology, OLV Hospital, Aalst, Belgium; ORSI Academy, Melle, Belgium
| | - Alberto Breda
- Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - Andrea Minervini
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Ahmed Ghazi
- Department of Urology, University of Rochester Medical Center, Rochester, NY, USA
| | - Prokar Dasgupta
- Medical Research Council Centre for Transplantation, Guy's Hospital Campus, King's Health Partners, King's College London, London, UK
| | - Ali Gozen
- Trakya Tip Fak Hospital, Edirne, Turkey
| | | | - Cristian Fiori
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy
| | - Michele Di Dio
- Department of Surgery, Division of Urology, SS Annunziata Hospital, Cosenza, Italy
| | - Juan Gomez Rivas
- Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands; Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
| | - Francesco Porpiglia
- Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Turin, Italy
| | - Enrico Checcucci
- Association of Urology Young Academic Urologist-Urotechnology Working Party, Arnhem, The Netherlands; Department of Surgery, FPO-IRCCS Candiolo Cancer Institute, Turin, Italy
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Crocerossa F, Carbonara U, Veccia A, Rosiello G, Tellini R, Mari A, Mastroianni R, Ferro M, De Cobelli O, Cacciamani G, Minervini A, Simone G, Cantiello F, Damiano R, Autorino R. Preoperative predictors of postoperative complications after robot-assisted and laparoscopic radical nephroureterectomy for upper tract urothelial carcinoma. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01121-1] [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: 11/07/2022] Open
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Artibani W, Cacciamani G. Is the Choice Between Clips and No Clips or Cautery and No Cautery Still a Dilemma in Robot-assisted Radical Prostatectomy? EUR UROL SUPPL 2022; 44:76-77. [PMID: 36060859 PMCID: PMC9437800 DOI: 10.1016/j.euros.2022.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Walter Artibani
- Department of Urology, Policlinico Abano Terme, Abano Terme, Italy
- University of Verona, Verona, Italy
- Corresponding author. Department of Urology, Abano Terme Hospital, Piazza Cristoforo Colombo, 1, 35031 Abano Terme, Italy.
| | - Giovanni Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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25
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Puliatti S, Eissa A, Checcucci E, Piazza P, Amato M, Scarcella S, Rivas JG, Taratkin M, Marenco J, Rivero IB, Kowalewski KF, Cacciamani G, El-Sherbiny A, Zoeir A, El-Bahnasy AM, De Groote R, Mottrie A, Micali S. New imaging technologies for robotic kidney cancer surgery. Asian J Urol 2022; 9:253-262. [PMID: 36035346 PMCID: PMC9399539 DOI: 10.1016/j.ajur.2022.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/19/2022] [Accepted: 03/16/2022] [Indexed: 11/21/2022] Open
Abstract
Objective Kidney cancers account for approximately 2% of all newly diagnosed cancer in 2020. Among the primary treatment options for kidney cancer, urologist may choose between radical or partial nephrectomy, or ablative therapies. Nowadays, robotic-assisted partial nephrectomy (RAPN) for the management of renal cancers has gained popularity, up to being considered the gold standard. However, RAPN is a challenging procedure with a steep learning curve. Methods In this narrative review, different imaging technologies used to guide and aid RAPN are discussed. Results Three-dimensional visualization technology has been extensively discussed in RAPN, showing its value in enhancing robotic-surgery training, patient counseling, surgical planning, and intraoperative guidance. Intraoperative imaging technologies such as intracorporeal ultrasound, near-infrared fluorescent imaging, and intraoperative pathological examination can also be used to improve the outcomes following RAPN. Finally, artificial intelligence may play a role in the field of RAPN soon. Conclusion RAPN is a complex surgery; however, many imaging technologies may play an important role in facilitating it.
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26
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Hakimi K, Carbonara U, Djaladat H, Mehrazin R, Eun D, Reese A, Gonzalgo M, Margulis V, Uzzo R, Porter J, Sundaram C, Abdollah F, Mottrie A, Tellini R, Ferro M, Meagher M, Saidian A, Walia A, Veccia A, Ghoriefi A, Cacciamani G, Bhattu A, Minervini A, Autorino R, Derweesh I. Impact of node count on survival outcomes of lymph node dissection in non-metastatic upper tract urothelial carcinoma: Analysis of the robuust registry. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00393-1] [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: 11/30/2022]
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27
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Sholklapper T, Goldenberg M, Lebastchi A, Abreu A, Desai M, Sotelo R, Gill I, Cacciamani G. Intraoperative adverse event reporting in urology: Global ICARUS survey results. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01136-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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28
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Sighinolfi M, Dourado A, Assumma S, Cassani A, Annino F, Patel V, Annino F, Patel V, Moschovas M, Cacciamani G, Bozzini G, Gregori A, Morini E, Simoes J, Eissa A, Puliatti S, Sarchi L, Micali S, Rocco B. The role of 3-D imaging reconstruction in real-life urologic practice: Results from a global survey. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00099-9] [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: 11/04/2022]
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29
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Veccia A, Carbonara U, Djaladat H, Mehrazin R, Eun D, Reese AC, Meng X, Uzzo R, Srivastava A, Porter JR, Farrow J, Jamil M, Rosiello G, Tellini R, Mari A, Al-Qathani A, Rha KH, Wang L, Mastroianni R, Ferro M, De Cobelli O, Hakimi K, Crocerossa F, Ghoreifi A, Cacciamani G, Amit S Bhattu A, Mottrie A, Abdollah F, Minervini A, Wu Z, Simone G, Derweesh IH, Gonzalgo ML, Margulis V, Sundaram CP, Autorino R. Robotic vs laparoscopic nephroureterectomy for upper tract urothelial carcinoma: a multicenter propensity-score matched pair "tetrafecta" analysis (ROBUUST collaborative group). J Endourol 2022; 36:752-759. [PMID: 35019760 DOI: 10.1089/end.2021.0587] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To compare the outcomes of robotic radical nephroureterectomy (RRNU) and laparoscopic radical nephroureterectomy (LRNU) within a large multi-institutional worldwide dataset. MATERIAL AND METHODS The ROBotic surgery for Upper tract Urothelial cancer STudy (ROBUUST) includes data from 17 centers worldwide regarding 877 RRNU and LRNU performed between 2015 and 2019. Baseline features, perioperative and oncological outcomes, were included. A 2:1 nearest-neighbor propensity-score matching with a 0.001 caliper was performed. An univariable and a multivariable logistic regression model were built to evaluate the predictors of a composite "tetrafecta" outcome defined as occurrence of bladder cuff excision + LND + no complications + negative surgical margins. RESULTS After matching, 185 RRNU and 91 LRNU were assessed. Patients in the RRNU group were more likely to undergo bladder cuff excision (81.9% vs 63.7%; p<0.001) compared to the LRNU group. A statistically significant difference was found in terms of overall postoperative complications (p=0.003) and length of stay (p<0.001) in favor of RRNU. Multivariable analysis demonstrated that LRNU was an independent predictor negatively associated with achievement of "tetrafecta" (OR: 0.09; p=0.003). CONCLUSIONS In general, RRNU and LRNU offer comparable outcomes. While the rate of overall complications is higher for LRNU in this study population, this is mostly related to low grade complications, and therefore with more limited clinical relevance. RRNU seems to offer shorter hospital stay but this might also be related to the different geographical location of participating centers. Overall, the implementation of robotics might facilitate achievement of a "tetrafecta" outcome as defined in the present study.
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Affiliation(s)
- Alessandro Veccia
- Spedali Civili Hospital, University of Brescia, Department of Urology, Piazzale Spedali Civili 1, Brescia, Italy, 25123;
| | - Umberto Carbonara
- Virginia Commonwealth University Health System, 6887, Department of Urology, 11200 E BROAD ST, RICHMOND, Richmond, Virginia, United States, 23233.,Università degli Studi di Bari Aldo Moro, 9295, Department of Urology, Bari, Puglia, Italy;
| | | | - Reza Mehrazin
- Mount Sinai Health System, 5944, Urology, 5 East 98th St, 6th floor, New York, New York, United States, 10029;
| | - Daniel Eun
- Temple University, Urology, 255 South 17th street, 7th Floor Urology Suite, Philadelphia, Pennsylvania, United States, 19103;
| | - Adam C Reese
- Lewis Katz School of Medicine at Temple University, Urology, 3401 N Broad St., Suite 340, Philadelphia, Pennsylvania, United States, 19140;
| | - Xiaosong Meng
- University of Texas Southwestern Medical Center, Urology, Dallas, Texas, United States;
| | - Robert Uzzo
- Fox Chase Cancer Center, 6565, 333 Cottman Ave, Philadelphia, Pennsylvania, United States, 19111;
| | | | - James Robert Porter
- Swedish Medical Center, Urology, 1101 Madison, Suite 1400, Seattle, Washington, United States, 98104;
| | - Jason Farrow
- Indiana University Health, 22529, Urology, 535 N Barnhill, Suite 150, Indianapolis, Indiana, United States, 46206-1367;
| | | | - Giuseppe Rosiello
- San Raffaele Hospital, 9372, Urology, Via Olgettina, 52, Milano, Italy, 20132;
| | - Riccardo Tellini
- University Hospital Careggi, 18561, Department of Oncologic, Minimally-Invasive Urology and Andrology, Largo Brambilla 3, Florence, Toscana, Italy, 50134;
| | - Andrea Mari
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy., Urology, Largo Brambilla 3, Firenze, Italy, 50100.,University of Florence, Careggi Hospital, Florence, Italy.;
| | | | - Koon Ho Rha
- Severance Hospital, Yonsei University, Urology, Yonseiro 50-1, Seodaemun-gu, Seoul, Korea, Seoul, Korea (the Republic of);
| | - Linhui Wang
- Changzheng Hospital, 56652, Shanghai, Shanghai, China;
| | | | - Matteo Ferro
- Istituto Europeo di Oncologia, 9290, Urology , via ripamonti 435, Milano, Italy, 90020.,Italy;
| | | | | | - Fabio Crocerossa
- Virginia Commonwealth University, 6889, 1200 E Broad St, Richmond, Virginia, United States, 23284-2512;
| | | | - Giovanni Cacciamani
- AOUI Azienda Ospedaliera Universitaria Integrata, Urology, Piazzale Stefani 1, Verona, Italy, 37100;
| | | | - Alexandre Mottrie
- Onze Lieve Vrouwziekenhuis, 37467, Dep. of Urology, Aalst, Belgium, 9300;
| | - Firas Abdollah
- Henry Ford Health System, Vattikuti Urology Institute, Center for Outcomes Research Analytics and Evaluation, 2799 West Grand Boulevard, Detroit, Michigan, United States, 48202;
| | - Andrea Minervini
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy., Urology, Clinica Urologica I, Azienda Ospedaliera Careggi, Università di Firenze., Largo Brambilla 3 - San Luca Nuovo Padiglione 16/Settore C/Piano II, Florence, Italy, 50134;
| | - Zhenjie Wu
- Changhai hospital, the second military medical university, the department of Urology, Changhai Road NO. 163, Shanghai, Shanghai, China, 200433;
| | - Giuseppe Simone
- Regina Elena, urology, via elio chianesi 53, Roma, Italy, 00144.,Italy;
| | - Ithaar H Derweesh
- University of California - San Diego, Urology, La Jolla, California, United States;
| | - Mark L Gonzalgo
- university of Miami, Miller School of Medicine, urology, Miami, Florida, United States;
| | - Vitaly Margulis
- UT Southwestern Medical, Urology, 5339 harry hines blvd, Dallas, Texas, United States, 75390;
| | - Chandru P Sundaram
- Indiana University School of Medicine, Urology, 535 N Barnhill Dr, Suite 420, Indianapolis, Indiana, United States, 46202;
| | - Riccardo Autorino
- Virginia Commonwealth University Health System, 6887, Surgery (Urology), 1200 East Broad st, Richmond, Virginia, United States, 23298;
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Wu Z, Chen Q, Djaladat H, Minervini A, Uzzo RG, Sundaram CP, Rha KH, Gonzalgo ML, Mehrazin R, Mazzone E, Marcus J, Danno A, Porter J, Asghar A, Ghali F, Guruli G, Douglawi A, Cacciamani G, Ghoreifi A, Simone G, Margulis V, Ferro M, Tellini R, Mari A, Srivastava A, Steward J, Al-Qathani A, Al-Mujalhem A, Bhattu AS, Mottrie A, Abdollah F, Eun DD, Derweesh I, Veccia A, Autorino R, Wang L. A Preoperative Nomogram to Predict Renal Function Insufficiency for Cisplatin-based Adjuvant Chemotherapy Following Minimally Invasive Radical Nephroureterectomy (ROBUUST Collaborative Group). Eur Urol Focus 2022; 8:173-181. [PMID: 33549537 DOI: 10.1016/j.euf.2021.01.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 10/26/2020] [Revised: 12/16/2020] [Accepted: 01/13/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Postoperative renal function impairment represents a main limitation for delivering adjuvant chemotherapy after radical nephroureterectomy (RNU). OBJECTIVE To create a model predicting renal function decline after minimally invasive RNU. DESIGN, SETTING, AND PARTICIPANTS A total of 490 patients with nonmetastatic UTUC who underwent minimally invasive RNU were identified from a collaborative database including 17 institutions worldwide (February 2006 to March 2020). Renal function insufficiency for cisplatin-based regimen was defined as estimated glomerular filtration rate (eGFR) <50 ml/min/1.73 m2 at 3 mo after RNU. Patients with baseline eGFR >50 ml/min/1.73 m2 (n = 361) were geographically divided into a training set (n = 226) and an independent external validation set (n = 135) for further analysis. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Using transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD) guidelines, a nomogram to predict postoperative eGFR <50 ml/min/1.73 m2 was built based on the coefficients of the least absolute shrinkage and selection operation (LASSO) logistic regression. The discrimination, calibration, and clinical use of the nomogram were investigated. RESULTS AND LIMITATIONS The model that incorporated age, body mass index, preoperative eGFR, and hydroureteronephrosis was developed with an area under the curve of 0.771, which was confirmed to be 0.773 in the external validation set. The calibration curve demonstrated good agreement. Besides, the model was converted into a risk score with a cutoff value of 0.583, and the difference between the low- and high-risk groups both in overall death risk (hazard ratio [HR]: 4.59, p < 0.001) and cancer-specific death risk (HR: 5.19, p < 0.001) was statistically significant. The limitation mainly lies in its retrospective design. CONCLUSIONS A nomogram incorporating immediately available clinical variables can accurately predict renal insufficiency for cisplatin-based adjuvant chemotherapy after minimally invasive RNU and may serve as a tool facilitating patient selection. PATIENT SUMMARY We have developed a model for the prediction of renal function loss after radical nephroureterectomy to facilitate patient selection for perioperative chemotherapy.
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Affiliation(s)
- Zhenjie Wu
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Qi Chen
- Department of Health Statistics, Naval Medical University, Shanghai, China
| | - Hooman Djaladat
- Institute of Urology & Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence - Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Robert G Uzzo
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | | | - Koon H Rha
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Mark L Gonzalgo
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Reza Mehrazin
- Icahn School of Medicine at Mount Sinai, Department of Urology, New York, NY, USA
| | - Elio Mazzone
- OLV Hospital, Aalst, Belgium;ORSI Academy, Melle, Belgium
| | - Jamil Marcus
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA
| | - Alyssa Danno
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA
| | | | - Aeen Asghar
- Department of Urology, Temple University, Philadelphia, PA, USA
| | - Fady Ghali
- Department of Urology, UCSD, San Diego, CA, USA
| | | | - Antoin Douglawi
- Institute of Urology & Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Giovanni Cacciamani
- Institute of Urology & Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Alireza Ghoreifi
- Institute of Urology & Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Giuseppe Simone
- Department of Urology, Regina Elena National Cancer Institute, Rome, Italy
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Matteo Ferro
- Division of Urology - European Institute of Oncology, IRCCS
| | - Riccardo Tellini
- Department of Experimental and Clinical Medicine, University of Florence - Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Andrea Mari
- Department of Experimental and Clinical Medicine, University of Florence - Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Abhishek Srivastava
- Division of Urologic Oncology, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - James Steward
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ali Al-Qathani
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ahmad Al-Mujalhem
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Amit Satish Bhattu
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Firas Abdollah
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA
| | - Daniel D Eun
- Department of Urology, Temple University, Philadelphia, PA, USA
| | | | | | | | - Linhui Wang
- Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, China.
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Farinha R, Puliatti S, Mazzone E, Amato M, Rosiello G, Yadav S, De Groote R, Piazza P, Bravi CA, Koukourikis P, Rha KH, Cacciamani G, Micali S, Wiklund P, Rocco B, Mottrie A. Potential Contenders for the Leadership in Robotic Surgery. J Endourol 2021; 36:317-326. [PMID: 34579555 DOI: 10.1089/end.2021.0321] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Purpose: To summarize the scientific published literature on new robotic surgical platforms with potential use in the urological field, reviewing their evolution from presentation until the present day. Our goal is to describe the current characteristics and possible prospects for these platforms. Materials and Methods: A nonsystematic search of the PubMed, Cochrane library's Central, EMBASE, MEDLINE, and Scopus databases was conducted to identify scientific literature about new robotic platforms other than the Da Vinci® system, reviewing their evolution from inception until December 2020. Only English language publications were included. The following keywords were used: "new robotic platforms," "Revo-I robot," "Versius robot," and "Senhance robot." All relevant English-language original studies were analyzed by one author (R.F.) and summarized after discussion with an independent third party (E.M., S.Y., S.P., and M.A.). Results: Since 1995, Intuitive Surgical, Inc., with the Da Vinci surgical system, is the leading company in the robotic surgical market. However, Revo-I®, Versius®, and Senhance® are the other three platforms that recently appeared on the market with available articles published in peer-reviewed journals. Among these three new surgical systems, the Senhance robot has the most substantial scientific proof of its capacity to perform minimally invasive urological surgery and as such, it might become a contender of the Da Vinci robot. Conclusions: The Da Vinci surgical platform has allowed the diffusion of robotic surgery worldwide and showed the different advantages of this type of technique. However, its use has some drawbacks, especially its price. New robotic platforms characterized by unique features are under development. Of note, they might be less expensive compared with the Da Vinci robotic system. We found that these new platforms are still at the beginning of their technical and scientific validation. However, the Senhance robot is in a more advanced stage, with clinical studies supporting its full implementation.
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Affiliation(s)
- Rui Farinha
- ORSI Academy, Melle, Belgium.,Department of Urology, OLV, Aalst, Belgium.,Urology Department, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal.,Urology Department, Lusíadas Hospital, Lisbon, Portugal
| | - Stefano Puliatti
- ORSI Academy, Melle, Belgium.,Department of Urology, OLV, Aalst, Belgium.,Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Elio Mazzone
- Unit of Urology, Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Urology, Vita-Salute San Raffaele University, Milan, Italy
| | - Marco Amato
- ORSI Academy, Melle, Belgium.,Department of Urology, OLV, Aalst, Belgium.,Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giuseppe Rosiello
- Unit of Urology, Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Urology, Vita-Salute San Raffaele University, Milan, Italy
| | - Siddharth Yadav
- Department of Urology & Renal Transplant, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Ruben De Groote
- ORSI Academy, Melle, Belgium.,Department of Urology, OLV, Aalst, Belgium
| | - Pietro Piazza
- ORSI Academy, Melle, Belgium.,Department of Urology, OLV, Aalst, Belgium.,Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Carlo Andrea Bravi
- ORSI Academy, Melle, Belgium.,Department of Urology, OLV, Aalst, Belgium.,Unit of Urology, Division of Oncology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Urology, Vita-Salute San Raffaele University, Milan, Italy
| | - Periklis Koukourikis
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.,Second Department of Urology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Koon Ho Rha
- Department of Urology and Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Giovanni Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, California, USA
| | - Salvatore Micali
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Peter Wiklund
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Bernardo Rocco
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Alexandre Mottrie
- ORSI Academy, Melle, Belgium.,Department of Urology, OLV, Aalst, Belgium
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Di Mauro M, Tonioni C, Cocci A, Kluth L, Russo G, Rivas JG, Cacciamani G, Cito G, Morelli G, Polloni G, Di Maida F, Giunti D. Penile length, circumference dimensions and somotometry in a large study in young italian men. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00765-5] [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: 10/20/2022] Open
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Veccia A, Carbonara U, Tellini R, Meherazin R, Eun D, Margulis V, Uzzo R, Porter J, Sundaram C, Abdollah F, Mottrie A, Minervini A, Mari A, Rha K, Cacciamani G, Simone G, Ferro M, Wu Z, Djaladat H, Derweesh I, Autorino R. Surgical quality of robotic vs laparoscopic radical nephroureterectomy for upper tract urothelial carcinoma: a multicenter retrospective analysis (ROBUUST collaborative group). EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00823-5] [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: 10/20/2022] Open
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34
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Veccia A, Carbonara U, Tellini R, Meherazin R, Eun D, Margulis V, Uzzo R, Porter J, Sundaram C, Abdollah F, Mottrie A, Minervini A, Mari A, Rha K, Cacciamani G, Simone G, Ferro M, Wu Z, Djaladat H, Derweesh I, Autorino R. Oncological outcomes of patients who achieved surgical quality during minimally invasive radical nephroureterectomy for upper tract urothelial carcinoma: a multicenter retrospective analysis (ROBUUST collaborative group). EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00822-3] [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] Open
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35
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Checcucci E, Amparore D, Volpi G, Piramide F, De Cillis S, Piana A, Alessio P, Verri P, Piscitello S, Carbonaro B, Meziere J, Zamengo D, Tsaturyan A, Cacciamani G, Rivas JG, De Luca S, Manfredi M, Fiori C, Liatsikos E, Porpiglia F. Percutaneous puncture during PCNL: new perspective for the future with virtual imaging guidance. World J Urol 2021; 40:639-650. [PMID: 34468886 DOI: 10.1007/s00345-021-03820-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 03/04/2021] [Accepted: 08/19/2021] [Indexed: 12/21/2022] Open
Abstract
CONTEXT Large and complex renal stones are usually treated with percutaneous nephrolithotomy (PCNL). One of the crucial steps in this procedure is the access to the collecting system with the percutaneous puncture and this maneuver leads to a risk of vascular and neighboring organs' injury. In the last years, the application of virtual image-guided surgery has gained wide diffusion even in this specific field. OBJECTIVES To provide a short overview of the most recent evidence on current applications of virtual imaging guidance for PCNL. EVIDENCE ACQUISITION A non-systematic review of the literature was performed. Medline, PubMed, the Cochrane Database and Embase were screened for studies regarding the use virtual imaging guidance for PCNL. EVIDENCE SYNTHESIS 3D virtual navigation technology for PCNL was first used in urology with the purpose of surgical training and surgical planning; subsequently, the field of surgical navigation with different modalities (from cognitive to augmented reality or mixed reality) had been explored. Finally, anecdotal preliminary experiences explored the potential application of artificial intelligence guidance for percutaneous puncture. CONCLUSION Nowadays, many experiences proved the potential benefit of virtual guidance for surgical simulation and training. Focusing on surgery, this tool revealed to be useful both for surgical planning, allowed to achieve a better surgical performance, and for surgical navigation by using augmented reality and mixed reality systems aimed to assist the surgeon in real time during the intervention.
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Affiliation(s)
- E Checcucci
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, Strada Provinciale 142, km 3,95, 10060, Candiolo, Turin, Italy.
- Uro-Technology and SoMe Working Group of the Young Academic Urologists (YAU) Working Party of the European Association of Urology (EAU), Arnhem, The Netherlands.
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy.
| | - D Amparore
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy
| | - G Volpi
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy
| | - F Piramide
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy
| | - S De Cillis
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy
| | - A Piana
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy
| | - P Alessio
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy
| | - P Verri
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy
| | - S Piscitello
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy
| | - B Carbonaro
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy
| | - J Meziere
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy
| | - D Zamengo
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy
| | - A Tsaturyan
- Department of Urology, University Hospital of Patras, Patras, Greece
| | - G Cacciamani
- USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Juan Gomez Rivas
- Department of Urology, La Paz University Hospital, Madrid, Spain
| | - S De Luca
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy
| | - M Manfredi
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy
| | - C Fiori
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy
| | - E Liatsikos
- Department of Urology, University Hospital of Patras, Patras, Greece
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - F Porpiglia
- Department of Oncology, Division of Urology, University of Turin, Turin, Italy
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Cacciamani G, Sholklapper T, Sotelo R, Desai M, Gill I. A Protocol for the Development of the Intraoperative Complications Assessment and Reporting With Universal Standards Criteria: The ICARUS Project. Int J Surg Protoc 2021; 25:160-164. [PMID: 34430764 DOI: 10.29337/ijsp.155] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 06/28/2021] [Accepted: 07/27/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction Perioperative complications, especially intraoperative adverse events (iAEs), carry significant potential for long-term sequelae in a patient's postoperative course. These events represent a substantial gap in contemporary surgical literature, with only a fraction of publications reporting intraoperative complications as outcomes of interest. To date, there is no universal standard for comprehensively reporting intraoperative complications in surgical practice and literature beyond the systems developed for grading individual events. We aim to establish a set of best-practice criteria for iAE reporting known as the Intraoperative Complication Assessment and Reporting with Universal Standards (ICARUS) Guidelines. Methods and analysis We will generate the ICARUS reporting guidelines using the EQUATOR Network development framework and the SQUIRE Guidelines. The initial step involves an umbrella review and meta-analysis of systemic reviews (SRs) assessing the perioperative adverse events of common surgeries. Measures for assessing, collecting, grading, and reporting the iAEs will be merged into a comprehensive list of criteria. Using a modified Delphi methodology, a team of expert surgeons (≥ 200 inpatient procedures/years) will contribute to and evaluate the proposed reporting guidelines. The panel will evaluate both the clinical usefulness and quality assessment and improvement utility of each criterion using a 5-point Likert. We expect multiple survey rounds until consensus regarding the utility of the guidelines is reached. Dissemination We plan to share then validate the newly developed guidelines within each surgical field. Dissemination will involve publicly shared guidelines, simultaneous journal publications, conference presentations, encouragement for journal endorsement, and application for inclusion in the Equator Network database. The study team plans to continue collecting feedback for future extension of the intraoperative reporting guidelines. Highlights Intraoperative adverse events are underreported and lack homogeneity in surgical literatureWe aim to use a modified Delphi methodology to develop the consensus-based, intraoperative complications assessment and reporting with universal standards (ICARUS) guidelinesWe will disseminate the ICARUS guidelines through journal publications and presentations at national and international meetings; journals and professional organizations will be encouraged to endorse the ICARUS guidelines.
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Affiliation(s)
- Giovanni Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, US
| | - Tamir Sholklapper
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, US
| | - Rene Sotelo
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, US
| | - Mihir Desai
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, US
| | - Inderbir Gill
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, US
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Russo GI, Campisi D, Di Mauro M, Falcone M, Cocci A, Cito G, Verze P, Capogrosso P, Fode M, Cacciamani G, Morgia G. The impact of asexual trait and porn addiction in a young men healthy cohort. Andrologia 2021; 53:e14142. [PMID: 34105178 PMCID: PMC8459256 DOI: 10.1111/and.14142] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 05/25/2021] [Indexed: 01/21/2023] Open
Abstract
In the present study, we aimed to evaluate the association between asexual trait, erectile dysfunction (ED) and porn addiction in a community sample of young men. Between August 2019 and October 2019, a total of 559 young male adults were subjected to an online survey sponsored by social networks with the aim of assessing their sexual habits. The following questionnaires were administered: The International Index of Erectile Function (IIEF-5), Masturbation Erection index (MEI), Pornography Craving Questionnaire (PCQ) and Asexuality Identification Scale (AIS). The overall rate of ED according to IIEF-5 was 26.0% (165/478), the rate of ED according to MEI was 16.9% (81/478) and the rate ED in patients with AIS ≥23 indicating asexual trait was 10.0% (48/478). We found that IIEF-5 was positively associated with MEI (b = 0.32; p < .01) and negatively with AIS (b = -0.36; p < .01) and MEI was negatively associated with AIS (b = -0.36; p < .01). We found that MEI (odds ratio [OR]: 0.86; p < .01) and IIEF-5 (OR: 0.89; p < .01) were inversely associated with asexual trait. The presence of asexual trait can hide a greater risk of finding ED both in intercourse or masturbation. These results should be taken into consideration during the general assessment of the patient with sexual problems.
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Affiliation(s)
- Giorgio Ivan Russo
- Urology section, Department of Surgery, University of Catania, Catania, Italy
| | - Daniele Campisi
- Urology section, Department of Surgery, University of Catania, Catania, Italy
| | - Marina Di Mauro
- Urology section, Department of Surgery, University of Catania, Catania, Italy
| | - Marco Falcone
- Department of Urology, San Giovanni Battista Hospital, Città della Salute e della Scienza and University of Turin, Turin, Italy
| | - Andrea Cocci
- Department of Urology, University of Florence, Florence, Italy
| | - Gianmartin Cito
- Department of Urology, University of Florence, Florence, Italy
| | - Paolo Verze
- Department of Medicine, Surgery, Dentistry "Scuola Medica Salernitana" - Urology Unit, University of Salerno, Salerno, Italy
| | - Paolo Capogrosso
- Department of Urology, ASST Sette Laghi; Circolo and Fondazione Macchi Hospital, Varese, Italy
| | - Mikkel Fode
- Department of Urology, Roskilde, and Department of Clinical Medicine, Zealand University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Giovanni Cacciamani
- University of Southern California Catherine and Joseph Aresty Department of Urology, Los Angeles, CA, USA
| | - Giuseppe Morgia
- Urology section, Department of Surgery, University of Catania, Catania, Italy.,Urology Section, Istituto Oncologico Del Mediterraneo (IOM), Viagrande, Italy
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- Department of Urology, San Giovanni Battista Hospital, Città della Salute e della Scienza and University of Turin, Turin, Italy
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Cacciamani G, Maas M, Yip W, Gill K, Nassiri N, Campi R, Amparore D, Dell'oglio P, Cocci A, Russo GI, Abreu A, Fuchs G, Gill I. Digital urologic education during COVID-19: the rise of the "webin-era". Minerva Urol Nephrol 2021; 73:137-140. [PMID: 34036764 DOI: 10.23736/s2724-6051.21.04326-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Giovanni Cacciamani
- Keck School of Medicine, Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA -
| | - Marissa Maas
- Keck School of Medicine, Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Wesley Yip
- Keck School of Medicine, Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Karanvir Gill
- Keck School of Medicine, Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Nima Nassiri
- Keck School of Medicine, Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Riccardo Campi
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Daniele Amparore
- School of Medicine, Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Paolo Dell'oglio
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Andrea Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Giorgio I Russo
- Section of Urology, Department of Surgery, University of Catania, Catania, Italy
| | - Andre Abreu
- Keck School of Medicine, Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Gerhard Fuchs
- Keck School of Medicine, Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
| | - Inderbir Gill
- Keck School of Medicine, Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, University of Southern California, Los Angeles, CA, USA
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Dell’Oglio P, Andras I, Ortega D, Galfano A, Artibani W, Autorino R, Mazzone E, Crisan N, Bocciardi A, Sanchez-Salas R, Gill I, Wiklund P, Desai M, Mitropoulos D, Mottrie A, Cacciamani G. Impact of the implementation of the EAU Guidelines recommendation on reporting and grading of complications in patients undergoing robot assisted radical cystectomy: A systematic review. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00708-9] [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: 11/26/2022]
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40
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Ghoreifi Nejadian S, Kaneko M, Cacciamani G, Iwata A, Shakir A, Lebastchi A, Park D, Ukimura O, Bahn D, Gill I, Peretsman S, Abreu A. Patients report satisfaction/regret following focal therapy for localized prostate cancer: A prospective multicenter evaluation. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01432-9] [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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Di Mauro M, Tonioni C, Cocci A, Kluth LA, Russo GI, Gomez Rivas J, Cacciamani G, Cito G, Morelli G, Polloni G, di Maida F, Giunti D. Penile length and circumference dimensions: A large study in young Italian men. Andrologia 2021; 53:e14053. [PMID: 33748967 PMCID: PMC8243978 DOI: 10.1111/and.14053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/22/2021] [Accepted: 03/08/2021] [Indexed: 02/03/2023] Open
Abstract
The aim of the present study was to evaluate the size of the penis in flaccidity and in erection of Italian men. A total of 4,685 men living in Italy and who have been visited at the Italian urology operating units were involved in the study between January 2019 and January 2020. Each patient was given details on how to measure their penis (erect length and circumference) in flaccidity and in erection, from the lower base to the distal penile tip. Mean (standard deviation [SD]) flaccid penis length was 9.47 (2.69), mean (SD) flaccid penis circumference was 9.59 (3.08), mean (SD) erect penis length was 16.78 (2.55) and mean (SD) erect penis circumference was 12.03 (3.82). At the linear regression analysis, height was associated with flaccid penis length (β = 0.04; p-value = .01), and erect penis length was (β = 0.05; p-value < .01) and erect penis circumference was (β = 0.06; p-value < .01). Height is proportional to the length of the penis in flaccidity and in erection, and to the circumference in erection. The increase in BMI leads to a reduction in the length of the erect penis, as well as weight gain reduces the length of the flaccid penis.
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Affiliation(s)
- Marina Di Mauro
- Urology Section, Department of Surgery, University of Catania, Catania, Italy
| | | | - Andrea Cocci
- Department of Urology, University of Florence, Florence, Italy
| | - Luis A Kluth
- Department of Urology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Giorgio Ivan Russo
- Urology Section, Department of Surgery, University of Catania, Catania, Italy
| | - Juan Gomez Rivas
- Department of Urology, La Paz University Hospital, Madrid, Spain
| | - Giovanni Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Gianmartin Cito
- Department of Urology, University of Florence, Florence, Italy
| | | | | | | | - Daniel Giunti
- Centro Integrato di Sessuologia Il Ponte, Florence, Italy
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Nassiri N, Maas M, Asanad K, Cacciamani G, Nabhani J. Testicular cancer with neurological symptoms indicates brain metastases. Lancet 2021; 397:e7. [PMID: 33640071 DOI: 10.1016/s0140-6736(21)00211-7] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/19/2020] [Accepted: 12/30/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Nima Nassiri
- Department of Urology, Los Angeles County + University of Southern California Medical Center, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Marissa Maas
- Department of Urology, Los Angeles County + University of Southern California Medical Center, Los Angeles, CA, USA
| | - Kian Asanad
- Department of Urology, Los Angeles County + University of Southern California Medical Center, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Giovanni Cacciamani
- Department of Urology, Los Angeles County + University of Southern California Medical Center, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jamal Nabhani
- Department of Urology, Los Angeles County + University of Southern California Medical Center, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Cocci A, Ralph D, Djinovic R, Hatzichristodoulou G, Morelli G, Salonia A, Capogrosso P, Romano A, Cito G, Di Maida F, Fernández-Pascual E, Romero-Otero J, Egydio P, Falcone M, Preto M, Chiriacò G, Beck J, Albersen M, Minhas S, Cacciamani G, Salamanca JIM, Mondani N, Minervini A, Russo GI. Surgical outcomes after collagenase Clostridium histolyticum failure in patients with Peyronie's disease in a multicenter clinical study. Sci Rep 2021; 11:166. [PMID: 33420247 PMCID: PMC7794401 DOI: 10.1038/s41598-020-80551-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 12/23/2020] [Indexed: 12/14/2022] Open
Abstract
In the present study we aimed to investigate the surgical outcomes of patients with persistent penile curvature (PC) after Collagenase Clostridium histolyticum (CCH) intraplaque injections. Data from 90 patients with persistent PC after CCH in a multicentre study from 6 andrological centres were retrospectively reviewed. Three standardized surgical techniques were performed. Group 1: plaque incision grafting (PIG) with penile prosthesis implant (PPI); Group 2: PIG without PPI; Group 3: Nesbit technique. Hospital stay, operative time, postoperative complications and PC persistency/recurrence (> 20°) were evaluated. Overall satisfaction and functional outcomes were assessed through International Index of Erectile Function-Erectile Function (IIEF-EF), Peyronie's Disease Questionnaire (PDQ), Female Sexual Function Index (FSFI) administered pre and 3 months postoperatively. Of all, 25 (27.8%) patients received grafting procedure + PPI (Group 1), 18 (20.0%) patients belonged to Group 2, and 47 (52.2%) to Group 3. Bovine pericardium graft and collagen fleece have been used in in 22 (51.2%) and 21 (48.8%) patients, respectively. Median penile length after surgery was 13.0 cm (IQR 12.0-15.0). After surgery, Group 1 showed higher increase in penile length after surgery and better improvements in terms of PDQ-PS. In contrast, both IIEF-EF and FSFI scores did not differ among groups. Overall, 86 (95.6%) did not report any complication. 4 (4.4%) patients had PC recurrence; of those, 2 (8.0%), 1 (5.6%) and 1 (2.1%) cases were observed in Group 1, Group 2 and Group 3, respectively. In case of persistent PC after CCH, surgical correction by grafting with or without concomitant PPI or Nesbit technique emerged as a technically feasible, effective and safe procedure, with no significant postoperative complications.
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Affiliation(s)
- Andrea Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - David Ralph
- St. Peter's Andrology Centre and UCLH, London, UK
| | - Rados Djinovic
- Sava Perovic Foundation, Center for Genito-Urinary Reconstructive Surgery, BelMedic General Hospital, Belgrade, Serbia
| | | | - Girolamo Morelli
- Department of Urology, Cisanello Hospital, University of Pisa, Pisa, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Paolo Capogrosso
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Romano
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Gianmartin Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Fabrizio Di Maida
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | | | | | | | - Marco Falcone
- Urology Department, Città della Salute e della Scienza-Molinette Hospital, University of Turin, Turin, Italy
| | - Mirko Preto
- Urology Department, Città della Salute e della Scienza-Molinette Hospital, University of Turin, Turin, Italy
| | | | - Jack Beck
- Department of Urology and Men's Health, St. Antonius Hospital Nieuwegein, Utrecht, The Netherlands
| | | | - Suks Minhas
- Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
| | - Giovanni Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | | | - Nicola Mondani
- Andrology Center, Villa Donatello Private Hospital, Florence, Italy
| | - Andrea Minervini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Giorgio Ivan Russo
- Department of Surgery, Urology Section, University of Catania, Catania, Italy.
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Claps F, Amparore D, Esperto F, Cacciamani G, Fiori C, Minervini A, Liguori G, Trombetta C, Porpiglia F, Serni S, Checcucci E, Campi R. Smart learning for urology residents during the COVID-19 pandemic and beyond: insights from a nationwide survey in Italy. MINERVA UROL NEFROL 2020; 72:647-649. [DOI: 10.23736/s0393-2249.20.03921-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Rocco B, Sighinolfi MC, Sandri M, Altieri V, Amenta M, Annino F, Antonelli A, Baio R, Bertolo R, Bocciardi A, Borghesi M, Bove P, Bozzini G, Brunocilla E, Cacciamani G, Calori A, Cafarelli A, Celia A, Carbone A, Cocci A, Corsaro A, Costa G, Ceruti C, Cindolo L, Crivellaro S, Dalpiaz O, D'Agostino D, Dall'Oglio B, Dente D, Falabella R, Falsaperla M, Ferrari G, Finocchiaro M, Flammia S, Gaboardi F, Galfano A, Gallo F, Gatti L, Greco F, Khorrami S, Leonardo C, Marenghi C, Nucciotti R, Oderda M, Pagliarulo V, Parma P, Pastore AL, Pini G, Porreca A, Pucci L, Schenone M, Schiavina R, Sciorio C, Spirito L, Tafuri A, Terrone C, Umari P, Varca V, Veneziano D, Verze P, Volpe A, Micali S, Berti L, Zaramella S, Zegna L, Bertellini E, Minervini A. The dramatic COVID 19 outbreak in Italy is responsible of a huge drop of urological surgical activity: a multicenter observational study. BJU Int 2020; 127:56-63. [PMID: 32558053 PMCID: PMC7322984 DOI: 10.1111/bju.15149] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective To describe the trend in surgical volume in urology in Italy during the coronavirus disease 2019 (COVID‐19) outbreak, as a result of the abrupt reorganisation of the Italian national health system to augment care provision to symptomatic patients with COVID‐19. Methods A total of 33 urological units with physicians affiliated to the AGILE consortium (Italian Group for Advanced Laparo‐Endoscopic Surgery; www.agilegroup.it) were surveyed. Urologists were asked to report the amount of surgical elective procedures week‐by‐week, from the beginning of the emergency to the following month. Results The 33 hospitals involved in the study account overall for 22 945 beds and are distributed in 13/20 Italian regions. Before the outbreak, the involved urology units performed overall 1213 procedures/week, half of which were oncological. A month later, the number of surgeries had declined by 78%. Lombardy, the first region with positive COVID‐19 cases, experienced a 94% reduction. The decrease in oncological and non‐oncological surgical activity was 35.9% and 89%, respectively. The trend of the decline showed a delay of roughly 2 weeks for the other regions. Conclusion Italy, a country with a high fatality rate from COVID‐19, experienced a sudden decline in surgical activity. This decline was inversely related to the increase in COVID‐19 care, with potential harm particularly in the oncological field. The Italian experience may be helpful for future surgical pre‐planning in other countries not so drastically affected by the disease to date.
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Affiliation(s)
- Bernardo Rocco
- Urology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Marco Sandri
- Data Methods and Systems Statistical Laboratory, University of Brescia, Brescia, Italy
| | | | - Michele Amenta
- Urology Unit, Azienda ULSS n.4 Veneto Orientale, Portogruaro, Italy
| | | | | | - Raffaele Baio
- Urology Unit, AOU San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy
| | | | | | | | | | | | | | - Giovanni Cacciamani
- Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Los Angeles, CA, USA
| | | | | | - Antonio Celia
- Urology Unit, Ospedale San Bassiano, Bassano del Grappa, Italy
| | | | - Andrea Cocci
- Urology Unit, Azienda Ospedaliero Universitaria Careggi Firenze, Italy
| | | | - Giovanni Costa
- Urology Unit, Ospedale San Bassiano, Bassano del Grappa, Italy
| | - Carlo Ceruti
- Urology Unit, AOU Citta della Salute e della Scienza, Torino, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | - Antonio Galfano
- Endourology Sub-Unit, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | - Fabrizio Gallo
- Urology Unit, Ospedale San Paolo di Savona, Savona, Italy
| | | | | | | | | | - Carlo Marenghi
- ASAT Rhodense Ospedale Guido Salvini di Garbagnate, Garbagnate, Italy
| | | | - Marco Oderda
- Urology Unit, Città della Salute e della Scienza Hospital, Torino, Italy
| | | | - Paolo Parma
- Urology Unit, Ospedale San Carlo Poma, Mantova, Italy
| | | | | | - Angelo Porreca
- Urology Unit, Policlinico Abano Terme, Abano, Padova, Italy
| | - Luigi Pucci
- Urology Unit, Azienda Ospedaliera A. Cardarelli, Naples, Italy
| | | | | | | | | | - Alessandro Tafuri
- Urology Unit, Azienda Ospedaliera Universitaria Integrata di Verona - Ospedale Maggiore Borgo Trento, Verona, Italy
| | - Carlo Terrone
- Urology, Ospedale IRRCS Policlinico San Martino Genova, Italy
| | - Paolo Umari
- Urology Unit, Maggiore della Carità Hospital, Novara, Italy
| | - Virginia Varca
- Urology Unit, ASAT Rhodense Ospedale Guido Salvini di Garbagnate, Garbagnate, Italy
| | | | - Paolo Verze
- Urology Unit, AOU San Giovanni di Rio e Ruggi d'Aragona, Salerno, Italy
| | - Alessandro Volpe
- Urology, Urology Unit, Ospedale Maggiore della Carita, Novara, Italy
| | - Salvatore Micali
- Urology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Lorenzo Berti
- University of Modena and Reggio Emilia, Modena, Italy
| | | | | | - Elisabetta Bertellini
- Department of Anesthesiology, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
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46
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Veneziano D, Patruno G, Talso M, Tokas T, Proietti S, Porreca A, Kamphuis G, Biyani S, Emiliani E, Cepeda Delgado M, de Mar Perez LM, Miano R, Ferretti S, Macchione N, Kallidonis P, Montanari E, Tripepi G, Ploumidis A, Cacciamani G, Lima E, Somani B. Exploratory analysis on the usage of Pi-score algorithm over endoscopic stone treatment step 1 protocol. Minerva Urol Nephrol 2020; 73:662-667. [PMID: 32748615 DOI: 10.23736/s2724-6051.20.03747-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The Performance Improvement score (Pi-score) has been proven to be reliable to measure performance improvement during E-BLUS hands-on training sessions. Our study is aimed to adapt and test the score to EST s1 (Endoscopic Stone Treatment step 1) protocol, in consideration of its worldwide adoption for practical training. METHODS The Pi-score algorithm considers time measurement and number of errors from two different repetitions (first and fifth) of the same training task and compares them to the relative task goals, to produce an objective score. Data were obtained from the first edition of 'ART in Flexible Course', during four courses in Barcelona and Milan. Collected data were independently analyzed by the experts for Pi assessment. Their scores were compared for inter-rater reliability. The average scores from all tutors were then compared to the PI-score provided by our algorithm for each participant, in order to verify their statistical correlation. Kappa statistics were used for comparison analysis. RESULTS Sixteen hands-on training expert tutors and 47 3rd-year residents in Urology were involved. Concordance found between the 16 proctors' scores was the following: Task 1=0.30 ("fair"); Task 2=0.18 ("slight"); Task 3=0.10 ("slight"); Task 4=0.20, ("slight"). Concordance between Pi-score results and proctor average scores per-participant was the following: Task 1=0.74 ("substantial"); Task 2=0.71 ("substantial"); Task 3=0.46 ("moderate"); Task 4=0.49 ("moderate"). CONCLUSIONS Our exploratory study demonstrates that Pi-score can be effectively adapted to EST s1. Our algorithm successfully provided an objective score that equals the average performance improvement scores assigned by of a cohort of experts, in relation to a small amount of training attempts.
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Affiliation(s)
- Domenico Veneziano
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal - .,ICVS/3B's Associate Laboratory, Braga, Portugal - .,Department of Urology and Kidney Transplant, Grande Ospedale Metropolitano, Reggio Calabria, Italy -
| | - Giulio Patruno
- Department of Urology, San Giovanni Addolorata Hospital, Rome, Italy
| | - Michele Talso
- Department of Urology, ASST Vimercate, Vimercate, Monza-Brianza, Italy
| | - Theodore Tokas
- Department of Urology and Andrology, General Hospital, Hall in Tirol, Austria
| | - Silvia Proietti
- Department of Urology, San Raffaele-Turro Hospital, Milan, Italy
| | - Angelo Porreca
- Department of Urology, Policlinico Abano Terme, Abano Terme, Padua, Italy
| | - Guido Kamphuis
- Department of Urology, AMC University Hospital, Amsterdam, The Netherlands
| | - Shekhar Biyani
- Department of Urology, St. James's University Hospital Leeds Teaching Hospitals NHS, Leeds, UK
| | | | | | - Lopez M de Mar Perez
- Department of Urology, Jesús Usón Center of Minimally Invasive Surgery, Caceres, Spain
| | - Roberto Miano
- Department of Urology, University of Rome Tor Vergata, Rome, Italy
| | | | | | | | | | - Giovanni Tripepi
- Institute of Clinical Physiology (IFC), National Research Council (CNR), Reggio Calabria, Italy
| | | | - Giovanni Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Estevao Lima
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's Associate Laboratory, Braga, Portugal
| | - Bhaskar Somani
- Department of Urology, University of Southampton, Southampton, UK
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47
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Veneziano D, Patruno G, Talso M, Tokas T, Proietti S, Porreca A, Kamphuis G, Biyani S, Emiliani E, Cepeda Delgado M, Maria De Mar Perez L, Miano R, Ferretti S, Macchione N, Kallidonis P, Montanari E, Tripepi G, Ploumidis A, Cacciamani G, Lima E, Somani BK. The performance improvement-score algorithm applied to endoscopic stone. Treatment step 1 protocol. Minerva Urol Nefrol 2020. [PMID: 32748615 DOI: 10.23736/s0393-2249.20.03747-9] [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] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Pi-score (Performance Improvement score) has been proven to be reliable to measure performance improvement during E-BLUS hands-on training sessions. Our study is aimed to adapt and test the score to EST s1 (Endoscopic Stone Treatment step 1) protocol, in consideration of its worldwide adoption for practical training. METHODS The Pi-score algorithm considers time measurement and number of errors from two different repetitions (first and fifth) of the same training task and compares them to the relative task goals, to produce an objective score. Data were obtained from the first edition of 'ART in Flexible Course', during 4 courses in Barcelona and Milan. Collected data were independently analysed by the experts for Pi assessment. Their scores were compared for inter-rater reliability. The average scores from all tutors were then compared to the PI-score provided by our algorithm for each participant, in order to verify their statistical correlation. Kappa Statistics was used for comparison analysis. RESULTS 16 Hands-on Training expert tutors and 47 3rd year residents in Urology were involved. Concordance found between the 16 proctors' scores was the following: Task1=0.30 ("fair"); Task2=0.18 ("slight"); Task3=0.10 ("slight"); Task4=0.20, ("slight"). Concordance between Pi-score results and proctor average scores per-participant was the following: Task1=0.74 ("substantial"); Task2=0.71 ("substantial"); Task3=0.46 ("moderate"); Task4=0.49 ("moderate"). CONCLUSIONS Our exploratory study demonstrates that Pi-score can be effectively adapted to EST s1. Our algorithm successfully provided an objective score that equals the average performance improvement scores assigned by of a cohort of experts, in relation to a small amount of training attempts.
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Affiliation(s)
- Domenico Veneziano
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal - .,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal - .,Department of Urology and Kidney Transplant, Grande Ospedale Metropolitano, Reggio Calabria, Italy -
| | - Giulio Patruno
- Department of Urology, AO San Giovanni Addolorata, Rome, Italy
| | | | - Theodore Tokas
- Department of Urology and Andrology, General Hospital, Hall in Tirol, Austria
| | - Silvia Proietti
- Department of Urology, San Raffaele-Turro Hospital, Milan, Italy
| | - Angelo Porreca
- Department of Urology, Policlinico Abano Terme, Padova, Italy
| | - Guido Kamphuis
- Department of Urology, AMC University Hospital, Amsterdam, The Netherlands
| | - Shekhar Biyani
- Department of Urology, St. James's University Hospital Leeds Teaching Hospitals NHS, Leeds, UK
| | | | | | | | - Roberto Miano
- Department of Urology, Università Tor Vergata, Rome, Italy
| | | | | | | | | | | | | | - Giovanni Cacciamani
- USC Institute of Urology & Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University, of Southern California, Los Angeles, CA, USA
| | - Estevão Lima
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Bhaskar K Somani
- Department of Urology, University of Southampton, Southampton, UK
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48
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Sebben M, Tafuri A, Porcaro AB, Artibani W, Cacciamani G. Response to: Bando et al. Diagnostic and therapeutic value of pelvic lymph node dissection in the fossa of Marcille in patients with clinically localized high-risk prostate cancer: Histological and molecular analyses. Prostate 2020; 80:795-796. [PMID: 32324906 DOI: 10.1002/pros.23987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 04/09/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Marco Sebben
- Department of Urology, Ospedale Sacro Cuore Don Calabria IRCCS, Negrar, Italy
| | - Alessandro Tafuri
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
- Department of Neurosciences, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Antonio B Porcaro
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Walter Artibani
- Department of Urology, Policlinico Abano Terme, Abano Terme, Italy
| | - Giovanni Cacciamani
- Catherine and Joseph Aresty Department of Urology, USC/Norris Institute of Urology, University of Southern California, Los Angeles, California
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Fujihara A, Iwata T, Oishi M, Shakir A, Tafuri A, Cacciamani G, Ukimura O, Gill I, Bahn D, Abreu A. Primary focal- versus whole-gland cryoablation for intermediate- and high-risk prostate cancer. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33478-9] [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: 12/01/2022] Open
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50
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Veccia A, Steward J, Derweesh I, Margulis V, Uzzo R, Abdollah F, Minervini A, Cacciamani G, Mottrie A, Simone G, Rha K, Eun D, Mehrazin R, Gonzalgo M, Ghali F, Meng X, Srivastava A, Jamil M, Tellini R, Aron M, Mazzone E, Al-Qathani A, Asghar A, Sundaram C, Autorino R. Safety profile of robotic vs. laparoscopic radical nephroureterectomy for upper tract urothelial carcinoma: Data from the Robotic Surgery for Upper Tract Urothelial Cancer Study (ROBUUST) collaborative group. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32769-5] [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: 11/24/2022] Open
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