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Tolbatov I, Umari P, Marrone A. Mechanism of Action of Antitumor Au(I) N-Heterocyclic Carbene Complexes: A Computational Insight on the Targeting of TrxR Selenocysteine. Int J Mol Sci 2024; 25:2625. [PMID: 38473872 DOI: 10.3390/ijms25052625] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
The targeting of human thioredoxin reductase is widely recognized to be crucially involved in the anticancer properties of several metallodrugs, including Au(I) complexes. In this study, the mechanism of reaction between a set of five N-heterocyclic carbene Au(I) complexes and models of the active Sec residue in human thioredoxin reductase was investigated by means of density functional theory approaches. The study was specifically addressed to the kinetics and thermodynamics of the tiled process by aiming at elucidating and explaining the differential inhibitory potency in this set of analogous Au(I) bis-carbene complexes. While the calculated free energy profile showed a substantially similar reactivity, we found that the binding of these Au(I) bis-carbene at the active CysSec dyad in the TrxR enzyme could be subjected to steric and orientational restraints, underlining both the approach of the bis-carbene scaffold and the attack of the selenol group at the metal center. A new and detailed mechanistic insight to the anticancer activity of these Au(I) organometallic complexes was thus provided by consolidating the TrxR targeting paradigm.
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Affiliation(s)
- Iogann Tolbatov
- Department of Physics and Astronomy, University of Padova, Via F. Marzolo 8, 35131 Padova, Italy
| | - Paolo Umari
- Department of Physics and Astronomy, University of Padova, Via F. Marzolo 8, 35131 Padova, Italy
| | - Alessandro Marrone
- Dipartimento di Farmacia, Università "G d'Annunzio" di Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy
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Cremaschini S, Cattelan A, Ferraro D, Filippi D, Marinello F, Meggiolaro A, Pierno M, Sada C, Zaltron A, Umari P, Mistura G. Trifurcated Splitting of Water Droplets on Engineered Lithium Niobate Surfaces. ACS Appl Mater Interfaces 2024; 16:4271-4282. [PMID: 38194671 PMCID: PMC10811617 DOI: 10.1021/acsami.3c16573] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 01/11/2024]
Abstract
Controlled splitting of liquid droplets is a key function in many microfluidic applications. In recent years, various methodologies have been used to accomplish this task. Here, we present an optofluidic technique based on an engineered surface formed by coating a z-cut iron-doped lithium niobate crystal with a lubricant-infused layer, which provides a very slippery surface. Illuminating the crystal with a light spot induces surface charges of opposite signs on the two crystal faces because of the photovoltaic effect. If the light spot is sufficiently intense, millimetric water droplets placed near the illuminated spot split into two charged fragments, one fragment being trapped by the bright spot and the other moving away from it. The latter fragment does not move randomly but rather follows one of three well-defined trajectories separated by 120°, which reflect the anisotropic crystalline structure of Fe:LiNbO3. Numerical simulations explain the behavior of water droplets in the framework of the forces induced by the interplay of pyroelectric, piezoelectric, and photovoltaic effects, which originate simultaneously inside the illuminated crystal. Such a synergetic effect can provide a valuable feature in applications that require splitting and coalescence of droplets, such as chemical microreactors and biological encapsulation and screening.
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Affiliation(s)
- Sebastian Cremaschini
- Dipartimento di Fisica e
Astronomia “G. Galilei”, Università
di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - Alberto Cattelan
- Dipartimento di Fisica e
Astronomia “G. Galilei”, Università
di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - Davide Ferraro
- Dipartimento di Fisica e
Astronomia “G. Galilei”, Università
di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - Daniele Filippi
- Dipartimento di Fisica e
Astronomia “G. Galilei”, Università
di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - Filippo Marinello
- Dipartimento di Fisica e
Astronomia “G. Galilei”, Università
di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - Alessio Meggiolaro
- Dipartimento di Fisica e
Astronomia “G. Galilei”, Università
di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - Matteo Pierno
- Dipartimento di Fisica e
Astronomia “G. Galilei”, Università
di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - Cinzia Sada
- Dipartimento di Fisica e
Astronomia “G. Galilei”, Università
di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - Annamaria Zaltron
- Dipartimento di Fisica e
Astronomia “G. Galilei”, Università
di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - Paolo Umari
- Dipartimento di Fisica e
Astronomia “G. Galilei”, Università
di Padova, Via Marzolo 8, 35131 Padova, Italy
| | - Giampaolo Mistura
- Dipartimento di Fisica e
Astronomia “G. Galilei”, Università
di Padova, Via Marzolo 8, 35131 Padova, Italy
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Courboin E, Mathieu R, Panetta V, Mjaess G, Diamand R, Verhoest G, Roumiguié M, Bajeot AS, Soria F, Lonati C, Simeone C, Simone G, Anceschi U, Umari P, Sridhar A, Kelly J, Mertens LS, Sanchez-Salas R, Colomer A, Cerruto MA, Antonelli A, Krajewski W, Quackels T, Peltier A, Montorsi F, Briganti A, Teoh JYC, Pradere B, Moschini M, Roumeguère T, Albisinni S. Comparing Robotic-Assisted to Open Radical Cystectomy in the Management of Non-Muscle-Invasive Bladder Cancer: A Propensity Score Matched-Pair Analysis. Cancers (Basel) 2023; 15:4732. [PMID: 37835425 PMCID: PMC10571883 DOI: 10.3390/cancers15194732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/22/2023] [Accepted: 09/03/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND For non-muscle-invasive bladder cancer (NMIBC) requiring radical surgery, limited data are available comparing robotic-assisted radical cystectomy with intracorporeal urinary diversion (iRARC) to open radical cystectomy (ORC). The objective of this study was to compare the two surgical techniques. METHODS A multicentric cohort of 593 patients with NMIBC undergoing iRARC or ORC between 2015 and 2020 was prospectively gathered. Perioperative and pathologic outcomes were compared. RESULTS A total of 143 patients operated on via iRARC were matched to 143 ORC patients. Operative time was longer in the iRARC group (p = 0.034). Blood loss was higher in the ORC group (p < 0.001), with a consequent increased post-operative transfusion rate in the ORC group (p = 0.003). Length of stay was longer in the ORC group (p = 0.007). Post-operative complications did not differ significantly (all p > 0.05). DFS at 60 months was 55.9% in ORC and 75.2% in iRARC with a statistically significant difference (p = 0.033) found in the univariate analysis. CONCLUSION We found that iRARC for patients with NMIBC is safe, associated with a lower blood loss, a lower transfusion rate and a shorter hospital stay compared to ORC. Complication rates were similar. No significant differences in survival analyses emerged across the two techniques.
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Affiliation(s)
- Etienne Courboin
- Department of Urology, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium; (G.M.); (T.Q.); (T.R.); (S.A.)
- Department of Urology, CHU Rennes, 35000 Rennes, France; (R.M.); (G.V.)
| | - Romain Mathieu
- Department of Urology, CHU Rennes, 35000 Rennes, France; (R.M.); (G.V.)
| | - Valentina Panetta
- L’altrastatistica S.R.L., Consultancy & Training, Biostatistics Office, 00100 Rome, Italy;
| | - Georges Mjaess
- Department of Urology, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium; (G.M.); (T.Q.); (T.R.); (S.A.)
| | - Romain Diamand
- Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, 1070 Brussels, Belgium; (R.D.); (A.P.)
| | - Gregory Verhoest
- Department of Urology, CHU Rennes, 35000 Rennes, France; (R.M.); (G.V.)
| | - Mathieu Roumiguié
- Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Paul-Sabatier University, 31000 Toulouse, France; (M.R.); (A.S.B.)
| | - Anne Sophie Bajeot
- Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Paul-Sabatier University, 31000 Toulouse, France; (M.R.); (A.S.B.)
| | - Francesco Soria
- Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, 10024 Turin, Italy;
| | - Chiara Lonati
- Department of Urology, Spedali Civili di Brescia, 25123 Brescia, Italy; (C.L.); (C.S.)
| | - Claudio Simeone
- Department of Urology, Spedali Civili di Brescia, 25123 Brescia, Italy; (C.L.); (C.S.)
| | - Giuseppe Simone
- Department of Urology, Regina Elena National Cancer Institute, 00100 Rome, Italy; (G.S.); (U.A.)
| | - Umberto Anceschi
- Department of Urology, Regina Elena National Cancer Institute, 00100 Rome, Italy; (G.S.); (U.A.)
| | - Paolo Umari
- Departement of Urology, Ospedale Maggiore della Caritá di Novara, Universitá del Piemonte Orientale, 28100 Novarra, Italy;
| | - Ashwin Sridhar
- Division of Surgery and Interventional Sciences, University College London, London WC1E 6BT, UK; (A.S.); (J.K.)
| | - John Kelly
- Division of Surgery and Interventional Sciences, University College London, London WC1E 6BT, UK; (A.S.); (J.K.)
| | - Laura S. Mertens
- Department of Urology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands;
| | - Rafael Sanchez-Salas
- Department of Urology, Institut Mutualiste Montsouris, 70123 Paris, France; (R.S.-S.); (A.C.)
| | - Anna Colomer
- Department of Urology, Institut Mutualiste Montsouris, 70123 Paris, France; (R.S.-S.); (A.C.)
| | - Maria Angela Cerruto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, 37100 Verona, Italy; (M.A.C.); (A.A.)
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, 37100 Verona, Italy; (M.A.C.); (A.A.)
| | - Wojciech Krajewski
- Department of Minimally Invasive and Robotic Urology, Wrocław Medical University, 50-556 Wroclaw, Poland;
| | - Thierry Quackels
- Department of Urology, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium; (G.M.); (T.Q.); (T.R.); (S.A.)
| | - Alexandre Peltier
- Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, 1070 Brussels, Belgium; (R.D.); (A.P.)
| | - Francesco Montorsi
- Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (F.M.); (A.B.); (M.M.)
| | - Alberto Briganti
- Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (F.M.); (A.B.); (M.M.)
| | - Jeremy Y. C. Teoh
- S.H. Ho Urology Centre, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China;
| | - Benjamin Pradere
- Department of Urology, University of Vienna, 1010 Vienna, Austria;
- Department of Urology, Hopital La Croix du Sud, 31000 Toulouse, France
| | - Marco Moschini
- Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (F.M.); (A.B.); (M.M.)
| | - Thierry Roumeguère
- Department of Urology, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium; (G.M.); (T.Q.); (T.R.); (S.A.)
- Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, 1070 Brussels, Belgium; (R.D.); (A.P.)
| | - Simone Albisinni
- Department of Urology, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium; (G.M.); (T.Q.); (T.R.); (S.A.)
- Urology Unit, Department of Surgical Sciences, Tor Vergata University Hospital, University of Rome Tor Vergata, 00100 Rome, Italy
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Mjaess G, Diamand R, Aoun F, Assenmacher G, Assenmacher C, Verhoest G, Holz S, Naudin M, Ploussard G, Mari A, Tay A, Issa R, Roumiguié M, Bajeot AS, Umari P, Sridhar A, Kelly J, Hendricksen K, Einerhand S, Mertens LS, Sanchez-Salas R, Gallardo AC, Quackels T, Peltier A, Pradere B, Moschini M, Roumeguère T, Albisinni S. Cost-analysis of robot-assisted radical cystectomy in Europe: A cross-country comparison. Eur J Surg Oncol 2023; 49:1511-1518. [PMID: 35970622 DOI: 10.1016/j.ejso.2022.07.023] [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: 04/30/2022] [Revised: 07/22/2022] [Accepted: 07/31/2022] [Indexed: 12/18/2022]
Abstract
BACKGROUND Robotic-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) is surging worldwide. Aim of the study was to perform a multicentric cost-analysis of RARC by comparing the gross cost of the intervention across hospitals in four different European countries. METHODS Patients who underwent RARC + ICUD were recruited from eleven European centers in four European countries (Belgium, France, Netherlands, and UK) between 2015 and 2020. Costs were divided into six parts: cost for hospital stay, cost for ICU stay, cost for surgical theater occupation, cost for transfusion, cost for robotic instruments, and cost for stapling instruments. These costs were individually assessed for each patient. RESULTS A total of 490 patients were included. Median operative time was 300(270-360) minutes and median hospital length-of-stay was 11(8-15) days. The average total cost of RARC was 14.794€ (95%CI 14.300-15.200€). A significant difference was found for the total cost, as well as the various subcosts abovementioned, between the four included countries. Different sets and types of robotic instruments were used by each center, leading to a difference in cost of robotic instrumentation. Nearly 84% of costs of RARC were due to hospital stay (42%), ICU stay (3%) and operative time (39%), while 16% of costs were due to robotic (8%) and stapling (8%) instruments. CONCLUSION Costs and subcosts of RARC + ICUD vary significantly across European countries and are mainly dependent of hospital length-of-stay and operative time rather than robotic instrumentation. Decreasing length-of-stay and reducing operative time could help to decrease the cost of RARC and make it more widely accessible.
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Affiliation(s)
- Georges Mjaess
- Department of Urology, Hôpital Erasme, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium.
| | - Romain Diamand
- Department of Urology, Institut Jules Bordet, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Fouad Aoun
- Department of Urology, Hotel Dieu de France, Beirut, Lebanon
| | | | | | | | - Serge Holz
- Department of Urology, CHU Ambroise Paré, Mons, Belgium
| | - Michel Naudin
- Department of Urology, CHU Ambroise Paré, Mons, Belgium
| | - Guillaume Ploussard
- Department of Urology, La Croix du Sud Hospital, Toulouse, France; Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France
| | - Andrea Mari
- Department of Experimental and Clinical Medicine, Unit of Oncologic Minimally-Invasive Urology and Andrology, University of Florence, Careggi University Hospital, Florence, Italy
| | - Andrea Tay
- Department of Urology, Saint Georges Hospital, London, UK
| | - Rami Issa
- Department of Urology, Saint Georges Hospital, London, UK
| | - Mathieu Roumiguié
- Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Paul-Sabatier University, Toulouse Cedex, France
| | - Anne Sophie Bajeot
- Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Paul-Sabatier University, Toulouse Cedex, France
| | - Paolo Umari
- Division of Surgery and Interventional Sciences, University College London, London, UK
| | - Ashwin Sridhar
- Division of Surgery and Interventional Sciences, University College London, London, UK
| | - John Kelly
- Division of Surgery and Interventional Sciences, University College London, London, UK
| | - Kees Hendricksen
- Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Sarah Einerhand
- Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Laura S Mertens
- Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | - Anna Colomer Gallardo
- Department of Urology, Institut Mutualiste Montsouris, Paris, France; Department of Urology, Hospital Universitari Germans Trias i Pujol, Badolona, Spain
| | - Thierry Quackels
- Department of Urology, Hôpital Erasme, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium; Department of Urology, Institut Jules Bordet, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Alexandre Peltier
- Department of Urology, Hôpital Erasme, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium; Department of Urology, Institut Jules Bordet, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Department of Urology, La Croix du Sud Hospital, Quint Fonsegrives, France
| | - Marco Moschini
- Unit of Urology/Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Thierry Roumeguère
- Department of Urology, Hôpital Erasme, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium; Department of Urology, Institut Jules Bordet, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Simone Albisinni
- Department of Urology, Hôpital Erasme, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium; Department of Urology, Institut Jules Bordet, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium; Urology Unit, Department of Surgical Sciences, Tor Vergata University Hospital, University of Rome Tor Vergata, Rome, Italy
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5
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Van der Jeugt J, Umari P, Mottaran A, Ribeiro L, Lambert E, Vollemaere J, Develtere D, Veys R, Goossens M, Scarcella S, Pauwaert K, Van Praet C, Pauwels E, De Groote R, Dhondt F, Naeyer G, Mottrie A, Schatteman P. Holmium Laser Enucleation of the Prostate versus Robotic Assisted Simple Prostatectomy for lower urinary tract symptoms in patients with extremely large prostates ≧200 ml: A comparative analysis. J Endourol 2023. [PMID: 37335047 DOI: 10.1089/end.2022.0851] [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: 06/21/2023] Open
Abstract
Introduction and objectives Robot-Assisted Simple Prostatectomy (RASP) and Holmium Laser Enucleation of the prostate (HoLEP) are both well-established, minimally-invasive surgical treatment options for lower urinary tract symptoms caused by benign prostatic enlargement. We have reported the first comparative analysis of both techniques in patients with prostates of 200ml. Materials & methods Between 2009 and 2020 a total of 53 patients with a prostate volume of 200ml were surgically treated at OLV Hospital Aalst (Belgium): 31 underwent RASP and 22 underwent HoLEP. Preoperative and postoperative assessments included uroflowmetry with maximum urinary flow rate (Qmax) and post-void residual volume (PVR), as well as the International Prostate Symptom Score (IPSS) and quality of life (IPSS-QoL). The complication rates were evaluated according to the Clavien-Dindo Classification. Results Patients treated with RASP had significantly larger prostate volumes compared to HoLEP (median 226 vs. 204.5 ml, p=0.004). After a median follow-up of 14 months, both groups showed a significant improvement in the maximum flow rate (+10.60 vs. +10.70 ml/s, p=0.724) and a reduction of the IPSS score (-12.50 vs. -9, p=0.246) as well as improvement of the QoL (-3 vs. -3, p=0.880). Median operative time was similar in both groups (150 vs. 132.5 min, p=0.665). The amount of resected tissue was lower in the RASP group (134.5 vs. 180 g, p=0.029) and there was no significant difference in postoperative PSA (1.2 vs. 0.8 ng/ml, p=0,112). Despite a similar median catheterization time (3 vs. 2 days, p=0.748), the median hospitalization time was shorter in the HoLEP group (4 vs. 3 days, p=0.052). Complication rates were similar in both groups (32% vs. 36%, p=0.987). Conclusion Our results suggest similar outcomes for RASP and HoLEP in patients with very large prostates 200ml. These findings will require external validation at other high-volume centers.
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Affiliation(s)
| | - Paolo Umari
- St. George's University Hospital, Department of Urology, London, United Kingdom of Great Britain and Northern Ireland
- OLV Ziekenhuis Campus Aalst, 74840, urology, Aalst, Belgium;
| | - Angelo Mottaran
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola-Malpighi, 18508, Department of Urology, Bologna, Emilia-Romagna, Italy
- OLV Ziekenhuis Campus Aalst, 74840, urology, Aalst, Belgium;
| | - Luis Ribeiro
- St. George's University Hospital, urology, London, United Kingdom of Great Britain and Northern Ireland;
| | - Edward Lambert
- OLV Ziekenhuis Campus Aalst, 74840, urology, Aalst, Belgium;
| | | | - Dries Develtere
- OLV Ziekenhuis Campus Aalst, 74840, urology, Aalst, Belgium;
| | - Ralf Veys
- OLV Ziekenhuis Campus Aalst, 74840, urology, Aalst, Belgium;
| | - Marijn Goossens
- OLV Ziekenhuis Campus Aalst, 74840, urology, Aalst, Belgium;
| | - Simone Scarcella
- Polytechnic University of Marche Region, Department of Urology, Ancona, Italy
- OLV Ziekenhuis Campus Aalst, 74840, urology, Aalst, Belgium;
| | - Kim Pauwaert
- OLV Ziekenhuis Campus Aalst, 74840, urology, Aalst, Belgium;
| | - Charles Van Praet
- University Hospital Ghent, 60200, urology, Gent, Oost-Vlaanderen, Belgium;
| | | | - Ruben De Groote
- OLV Ziekenhuis Campus Aalst, 74840, urology, Aalst, Belgium;
| | | | - Geert Naeyer
- OLV Ziekenhuis Campus Aalst, 74840, urology, Aalst, Belgium;
| | - Alex Mottrie
- OLV Ziekenhuis Campus Aalst, 74840, urology, Aalst, Belgium;
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6
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Dell'Oglio P, Tappero S, Panunzio A, Antonelli A, Salvador D, Xylinas E, Alvarez-Maestro M, Hurle R, Salas RS, Colomer A, Simone G, Hendricksen K, Peroni A, Lonati C, Olivero A, Rouprêt M, Roumiguié M, Soria F, Umari P, D'Andrea D, Terrone C, Galfano A, Moschini M, Trapani ED. Age represents the main driver of surgical decision making in patients candidate to radical cystectomy. J Surg Oncol 2023. [PMID: 37126407 DOI: 10.1002/jso.27255] [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: 12/20/2022] [Revised: 02/10/2023] [Accepted: 03/13/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND AND OBJECTIVES Age might influence the choice of surgical approach, type of urinary diversion (UD) and lymph node dissection (LND) in patients candidate to radical cystectomy (RC) for urothelial bladder cancer (UBC). Similarly, age may enhance surgical morbidity and worsen perioperative outcomes. We tested the impact of age (octogenarian vs. younger patients) on surgical decision making and peri- and postoperative outcomes of RC. METHODS Non-metastatic muscle-invasive UBC patients treated with RC at 18 high-volume European institutions between 2006 and 2021 were identified and stratified according to age (≥80 vs. <80 years). Intraoperative Complications Assessment and Reporting with Universal Standards and European Association of Urology guidelines recommendations were accomplished in collection and reporting of, respectively, intraoperative and postoperative complications. Multivariable logistic regression models (MVA) tested the impact of age on outcomes of interest. Sensitivity analyses after 1:3 propensity score matching were performed. RESULTS Of 1955 overall patients, 251 (13%) were ≥80-year-old. Minimally invasive RC was performed in 18% and 40% of octogenarian and younger patients, respectively (p < 0.001). UD without bowel manipulation (ureterocutaneostomy, UCS) was performed in 31% and 7% of octogenarian and younger patients (p < 0.001). LND was delivered to 81% and 93% of octogenarian and younger patients (p < 0.001). At MVA, age ≥80 years independently predicted open approach (odds ratio [OR]: 1.55), UCS (OR: 3.70), and omission of LND (OR: 0.41; all p ≤ 0.02). Compared to their younger counterparts, octogenarian patients experienced higher rates of intraoperative (8% vs. 4%, p = 0.04) but not of postoperative complications (64% vs. 61%, p = 0.07). At MVA, age ≥80 years was not an independent predictor of length of stay, intraoperative or postoperative transfusions and complications, and readmissions (all p values >0.1). These results were replicated in sensitivity analyses. CONCLUSIONS Age ≥80 years does not independently portend worse surgical outcomes for RC. However, octogenarians are unreasonably more likely to receive open approach and UCS diversion, and less likely to undergo LND.
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Affiliation(s)
- Paolo Dell'Oglio
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Department of Urology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Radiology, Interventional Molecular Imaging Laboratory, Leiden University Medical Center, Leiden, The Netherlands
| | - Stefano Tappero
- Department of Urology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada
| | - Andrea Panunzio
- Department of Urology, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
| | - Alessandro Antonelli
- Department of Urology, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
| | - Daniel Salvador
- Department of Urology, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Evanguelos Xylinas
- Department of Urology, Medical University of Vienna, Vienna, Austria
- Department of Urology Cochin Hospital, APHP, Paris Descartes University, Paris, France
| | | | - Rodolfo Hurle
- Department of Urology, Istituto Clinico Humanitas Istituto di Ricovero e Cura a Carattere Scientifico-Clinical and Research Hospital, Milan, Italy
| | | | - Anna Colomer
- Department of Urology, Institut Mutualiste Montsouris, Paris, France
| | - Giuseppe Simone
- Department of Urology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Kees Hendricksen
- Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Angelo Peroni
- Department of Urology, ASST Spedali Civili, Brescia, Italy
| | - Chiara Lonati
- Department of Urology, ASST Spedali Civili, Brescia, Italy
| | - Alberto Olivero
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Morgan Rouprêt
- Department of Urology, Pierre and Marie Curie Medical School, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, University Paris Sorbonne, Paris, France
| | - Mathieu Roumiguié
- Department of Urology, Institut Universitaire du Cancer, Oncopole, Toulouse, France
| | - Francesco Soria
- Department of Surgical Sciences, Division of Urology, Torino School of Medicine, AOU Città della Salute e della Scienza di Torino, Torino, Italy
| | - Paolo Umari
- Division of Surgery and Interventional Sciences, University College London, London, UK
| | - David D'Andrea
- Department of Urology, Medical University of Vienna, Vienna, Austria
| | - Carlo Terrone
- Department of Urology, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Antonio Galfano
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marco Moschini
- University Vita-Salute San Raffaele, Milan, Italy
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Ettore Di Trapani
- Division of Urology, IEO-European Institute of Oncology, IRCCS, Milan, Italy
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7
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Tappero S, Dell'Oglio P, Cerruto MA, Sanchez Salas R, Buisan Rueda O, Simone G, Hendricksen K, Soria F, Umari P, Antonelli A, Briganti A, Montorsi F, de Cobelli O, Terrone C, Galfano A, Moschini M, Di Trapani E. Ileal Conduit Versus Orthotopic Neobladder Urinary Diversion in Robot-assisted Radical Cystectomy: Results from a Multi-institutional Series. EUR UROL SUPPL 2023; 50:47-56. [PMID: 37101775 PMCID: PMC10123439 DOI: 10.1016/j.euros.2023.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2023] [Indexed: 02/22/2023] Open
Abstract
Background Head-to-head comparisons between ileal conduit (IC) and orthotopic neobladder (ONB) in terms of peri- and postoperative outcomes and complications, in the specific setting of robot-assisted radical cystectomy (RARC), are not available. Objective To address the impact of the type of urinary diversion (UD, IC vs ONB) on RARC morbidity, as well as operative time (OT), length of stay (LOS), and readmissions. Design setting and participants Urothelial bladder cancer patients treated with RARC at nine high-volume European institutions between 2008 and 2020 were identified. Intervention RARC with either IC or ONB. Outcome measurements and statistical analysis Intra- and postoperative complications were collected and reported according to the Intraoperative Complications Assessment and Reporting with Universal Standards recommendations and European Association of Urology guidelines, respectively. Multivariable logistic regression models tested the impact of UD on outcomes, after adjustment for clustering at single hospital level. Results and limitations Overall, 555 nonmetastatic RARC patients were identified. In 280 (51%) and 275 (49%) patients, an IC and an ONB were performed, respectively. Eighteen intraoperative complications were recorded. The rates of intraoperative complications were 4% in IC patients and 3% in ONB patients (p = 0.4). The median LOS and readmission rates were 10 versus 12 d (p < 0.001) and 20% versus 21% (p = 0.8) in IC versus ONB patients, respectively. At a multivariable logistic regression analyses, the type of UD (IC vs ONB) reached the independent predictor status for prolonged OT (odds ratio [OR]: 0.61, p = 0.03) and prolonged LOS (OR: 0.34, p < 0.001), but not for readmission (OR: 0.92, p = 0.7). Overall, 513 postoperative complications were experienced by 324 patients (58%). At least one postoperative complication was experienced by 160 (57%) IC patients versus 164 (60%) ONB patients (p = 0.6). The type of UD reached the status of an independent predictor of UD-related complications (OR: 0.64, p = 0.03). Conclusions Compared with RARC with ONB, RARC with IC is less prone to UD-related postoperative complications, prolonged OT, and prolonged LOS. Patient summary To date, the impact of the type of urinary diversion, namely, ileal conduit versus orthotopic neobladder, on peri- and postoperative outcomes of robot-assisted radical cystectomy is unknown. Based on a rigorous data accrual, which relied on established complication reporting systems (Intraoperative Complications Assessment and Reporting with Universal Standards and European Association of Urology recommended systems), we reported intra- and postoperative complications according to urinary diversion type. Moreover, we found that ileal conduit was associated with lower operative time and length of stay, and yielded a protective effect in terms of urinary diversion-related complications.
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Affiliation(s)
- Stefano Tappero
- Department of Urology, IRCCS Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada
- Corresponding author. Department of Urology, IRCCS Policlinico San Martino, Largo R. Benzi 10, 16132 Genova, Italy; Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy; Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada. Tel. +39 3287132369, +39 0105553935.
| | - Paolo Dell'Oglio
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Department of Urology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Maria Angela Cerruto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | | | - Giuseppe Simone
- Department of Urology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Kees Hendricksen
- Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Francesco Soria
- Division of Urology, Department of Surgical Sciences, AOU Città della Salute e della Scienza di Torino, Torino School of Medicine, Torino, Italy
| | - Paolo Umari
- Division of Surgery and Interventional Sciences, University College London, London, UK
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | | | - Ottavio de Cobelli
- Department of Urology, European Institute of Oncology IRCCS, Milan, Italy
| | - Carlo Terrone
- Department of Urology, IRCCS Policlinico San Martino, Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Antonio Galfano
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Ettore Di Trapani
- Department of Urology, European Institute of Oncology IRCCS, Milan, Italy
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8
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Yang Y, Volpato GA, Rossin E, Peruffo N, Tumbarello F, Nicoletti C, Bonetto R, Paoloni L, Umari P, Colusso E, Dell'Amico L, Berardi S, Collini E, Caramori S, Agnoli S, Sartorel A. Photoelectrochemical C-H Activation Through a Quinacridone Dye Enabling Proton-Coupled Electron Transfer. ChemSusChem 2023; 16:e202201980. [PMID: 36507568 DOI: 10.1002/cssc.202201980] [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] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/30/2022] [Indexed: 06/17/2023]
Abstract
Dye-sensitized photoanodes for C-H activation in organic substrates are assembled by vacuum sublimation of a commercially available quinacridone (QNC) dye in the form of nanosized rods onto fluorine-doped tin oxide (FTO), TiO2 , and SnO2 slides. The photoanodes display extended absorption in the visible range (450-600 nm) and ultrafast photoinduced electron injection (<1 ps, as revealed by transient absorption spectroscopy) of the QNC dye into the semiconductor. The proton-coupled electron-transfer reactivity of QNC is exploited for generating a nitrogen-based radical as its oxidized form, which is competent in C-H bond activation. The key reactivity parameter is the bond-dissociation free energy (BDFE) associated with the N⋅/N-H couple in QNC of 80.5±2.3 kcal mol-1 , which enables hydrogen atom abstraction from allylic or benzylic C-H moieties. A photoelectrochemical response is indeed observed for organic substrates characterized by C-H bonds with BDFE below the 80.5 kcal mol-1 threshold, such as γ-terpinene, xanthene, or dihydroanthracene. This work provides a rational, mechanistically oriented route to the design of dye-sensitized photoelectrodes for selective organic transformations.
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Affiliation(s)
- Yunshuo Yang
- Department of Chemical Sciences, University of Padova, via Marzolo 1, 35131, Padova, Italy
| | - Giulia Alice Volpato
- Department of Chemical Sciences, University of Padova, via Marzolo 1, 35131, Padova, Italy
| | - Elena Rossin
- Department of Chemical Sciences, University of Padova, via Marzolo 1, 35131, Padova, Italy
| | - Nicola Peruffo
- Department of Chemical Sciences, University of Padova, via Marzolo 1, 35131, Padova, Italy
| | - Francesco Tumbarello
- Department of Chemical Sciences, University of Padova, via Marzolo 1, 35131, Padova, Italy
| | - Catia Nicoletti
- Department of Chemical Sciences, University of Padova, via Marzolo 1, 35131, Padova, Italy
| | - Ruggero Bonetto
- Department of Chemical Sciences, University of Padova, via Marzolo 1, 35131, Padova, Italy
| | - Lorenzo Paoloni
- Department of Physics and Astronomy, University of Padova, via F. Marzolo 8, 35131, Padova, Italy
| | - Paolo Umari
- Department of Physics and Astronomy, University of Padova, via F. Marzolo 8, 35131, Padova, Italy
| | - Elena Colusso
- Department of Industrial Engineering and INSTM, University of Padova, F. Marzolo 9, 35131, Padova, Italy
| | - Luca Dell'Amico
- Department of Chemical Sciences, University of Padova, via Marzolo 1, 35131, Padova, Italy
| | - Serena Berardi
- Department of Chemical and Pharmaceutical Sciences, Centro Interuniversitario per la Conversione Chimica dell'Energia Solare (SolarChem), Sez. di Ferrara, University of Ferrara, Via L. Borsari 46, 44121, Ferrara, Italy
| | - Elisabetta Collini
- Department of Chemical Sciences, University of Padova, via Marzolo 1, 35131, Padova, Italy
| | - Stefano Caramori
- Department of Chemical and Pharmaceutical Sciences, Centro Interuniversitario per la Conversione Chimica dell'Energia Solare (SolarChem), Sez. di Ferrara, University of Ferrara, Via L. Borsari 46, 44121, Ferrara, Italy
| | - Stefano Agnoli
- Department of Chemical Sciences, University of Padova, via Marzolo 1, 35131, Padova, Italy
| | - Andrea Sartorel
- Department of Chemical Sciences, University of Padova, via Marzolo 1, 35131, Padova, Italy
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9
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Sarkis J, Diamand R, Aoun F, Assenmacher G, Assenmacher C, Verhoest G, Holz S, Naudin M, Ploussard G, Mari A, Minervini A, Tay A, Issa R, Roumiguié M, Bajeot AS, Simone G, Anceschi U, Umari P, Sridhar A, Kelly J, Hendricksen K, Einerhand S, Mertens LS, Sanchez-Salas R, Colomer A, Quackels T, Peltier A, Montorsi F, Briganti A, Pradere B, Moschini M, Roumeguère T, Albisinni S. Do perioperative blood transfusions impact oncological outcomes of robot-assisted radical cystectomy with intracorporeal urinary diversion? Results from a large multi-institutional registry. Minerva Urol Nephrol 2023; 75:50-58. [PMID: 36800680 DOI: 10.23736/s2724-6051.22.05109-6] [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: 02/21/2023]
Abstract
BACKGROUND Blood transfusions (BT) have been associated with adverse oncologic outcomes in multiple malignancies including open radical cystectomy (ORC) for urothelial carcinoma of the bladder (UCB). Robot-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) delivers similar oncologic outcomes compared to ORC, yet with lower blood loss and reduced transfusions. However, the impact of BT after robotic cystectomy is still unknown. METHODS This is a multicenter study including patients treated for UCB with RARC and ICUD in 15 academic institutions, between January 2015 and January 2022. BT were administered during surgery (intraoperative blood transfusions, iBT) or during the first 30 days after surgery (post-operative blood transfusions, pBT). The association of iBT and pBT with recurrence-free survival (RFS), cancer-specific survival (CSS) and overall survival (OS) were evaluated by univariate and multivariate regression analysis. RESULTS A total of 635 patients were included in the study. Overall, 35/635 patients (5.51%) received iBT while 70/635 (11.0%) received pBT. After a mean follow-up of 23±18 months, 116 patients (18.3%) had died, including 96 (15.1%) from bladder cancer. Recurrence occurred in 146 patients (23%). iBT were associated with decreased RFS, CSS and OS (P<0.001) on univariate Cox analysis. After adjusting for clinicopathologic covariates, iBT were associated only with the risk of recurrence (HR: 1.7; 95% CI, 1.0-2.8, P=0.04). pBT were not significantly associated to RFS, CSS or OS on univariate and multivariate Cox regression models (P>0.05). CONCLUSIONS In the present study, patients treated by RARC with ICUD for UCB have a higher risk of recurrence after iBT, yet no significant association with CSS and OS was found. pBT are not associated with worse oncological prognosis.
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Affiliation(s)
- Julien Sarkis
- Department of Urology, Erasme Hospital, University Clinics of Brussels, Université Libre de Bruxelles, Brussels, Belgium -
| | - Romain Diamand
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Fouad Aoun
- Department of Urology, Hotel Dieu de France, Beirut, Lebanon
| | | | | | | | - Serge Holz
- Department of Urology, CHU Ambroise Paré, Mons, Belgium
| | - Michel Naudin
- Department of Urology, CHU Ambroise Paré, Mons, Belgium
| | - Guillaume Ploussard
- Department of Urology, La Croix du Sud Hospital, Quint-Fonsegrives, France.,Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France
| | - Andrea Mari
- Department of Experimental and Clinical Medicine, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi University Hospital, University of Florence, Florence, Italy
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi University Hospital, University of Florence, Florence, Italy
| | - Andrea Tay
- Department of Urology, Saint Georges Hospital, London, UK
| | - Rami Issa
- Department of Urology, Saint Georges Hospital, London, UK
| | - Mathieu Roumiguié
- Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Paul-Sabatier University, Toulouse Cedex, France
| | - Anne S Bajeot
- Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Paul-Sabatier University, Toulouse Cedex, France
| | - Giuseppe Simone
- Department of Urology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Umberto Anceschi
- Department of Urology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Umari
- Division of Surgery and Interventional Sciences, University College of London, London, UK
| | - Ashwin Sridhar
- Division of Surgery and Interventional Sciences, University College of London, London, UK
| | - John Kelly
- Division of Surgery and Interventional Sciences, University College of London, London, UK
| | - Kees Hendricksen
- Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Sarah Einerhand
- Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Laura S Mertens
- Department of Urology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | - Anna Colomer
- Department of Urology, Montsouris Mutualiste Institute, Paris, France
| | - Thierry Quackels
- Department of Urology, Erasme Hospital, University Clinics of Brussels, Université Libre de Bruxelles, Brussels, Belgium
| | - Alexandre Peltier
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Francesco Montorsi
- Division of Oncology, Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Alberto Briganti
- Division of Oncology, Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology UROSUD, Croix Du Sud Hospital, Quint-Fonsegrives, France
| | - Marco Moschini
- Division of Oncology, Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Thierry Roumeguère
- Department of Urology, Erasme Hospital, University Clinics of Brussels, Université Libre de Bruxelles, Brussels, Belgium.,Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Simone Albisinni
- Department of Urology, Erasme Hospital, University Clinics of Brussels, Université Libre de Bruxelles, Brussels, Belgium.,Unit of Urology, Department of Surgical Sciences, Tor Vergata University Hospital, University of Rome Tor Vergata, Rome, Italy
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10
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Cacciamani GE, Sholklapper T, Dell'Oglio P, Rocco B, Annino F, Antonelli A, Amenta M, Borghesi M, Bove P, Bozzini G, Cafarelli A, Celia A, Leonardo C, Ceruti C, Cindolo L, Crivellaro S, Dalpiaz O, Falabella R, Falsaperla M, Galfano A, Gallo F, Greco F, Minervini A, Parma P, Chiara Sighinolfi M, Pastore AL, Pini G, Porreca A, Pucci L, Sciorio C, Schiavina R, Umari P, Varca V, Veneziano D, Verze P, Volpe A, Zaramella S, Lebastchi A, Abreu A, Mitropoulos D, Shekhar Biyani C, Sotelo R, Desai M, Artibani W, Gill I. The Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration Project: Development of Criteria for Reporting Adverse Events During Surgical Procedures and Evaluating Their Impact on the Postoperative Course. Eur Urol Focus 2022; 8:1847-1858. [PMID: 35177353 DOI: 10.1016/j.euf.2022.01.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 11/17/2021] [Revised: 12/22/2021] [Accepted: 01/28/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Intraoperative adverse events (iAEs) are surgical and anesthesiologic complications. Despite the availability of grading criteria, iAEs are infrequently reported in the surgical literature and in cases for which iAEs are reported, these events are described with significant heterogeneity. OBJECTIVE To develop Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration criteria to standardize the assessment, reporting, and grading of iAEs. The ultimate aim is to improve our understanding of the nature and frequency of iAEs and our ability to counsel patients regarding surgical procedures. DESIGN, SETTING, AND PARTICIPANTS The present study involved the following steps: (1) collecting criteria for assessing, reporting, and grading of iAEs via a comprehensive umbrella review; (2) collecting additional criteria via a survey of a panel of experienced surgeons (first round of a modified Delphi survey); (3) creating a comprehensive list of reporting criteria; (4) combining criteria acquired in the first two steps; and (5) establishing a consensus on clinical and quality assessment utility as determined in the second round of the Delphi survey. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Panel inter-rater agreement and consistency were assessed as the overall percentage agreement and Cronbach's α. RESULTS AND LIMITATIONS The umbrella review led to nine common criteria for assessing, grading, and reporting iAEs, and review of iAE grading systems led to two additional criteria. In the first Delphi round, 35 surgeons responded and two criteria were added. In the second Delphi round, 13 common criteria met the threshold for final guideline inclusion. All 13 criteria achieved the consensus minimum of 70%, with agreement on the usefulness of the criteria for clinical and quality improvement ranging from 74% to 100%. The mean inter-rater agreement was 89.0% for clinical improvement and 88.6% for quality improvement. CONCLUSIONS The ICARUS Global Collaboration criteria might aid in identifying important criteria when reporting iAEs, which will support all those involved in patient care and scientific publishing. PATIENT SUMMARY We consulted a panel of experienced surgeons to develop a set of guidelines for academic surgeons to follow when publishing surgical studies. The surgeon panel proposed a list of 13 criteria that may improve global understanding of complications during specific procedures and thus improve the ability to counsel patients on surgical risk.
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Affiliation(s)
- Giovanni E Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA.
| | - Tamir Sholklapper
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Paolo Dell'Oglio
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Bernardo Rocco
- Urological Unit, Department of Health Sciences, ASST Santi Paolo e Carlo, University of Milan, Milan, Italy
| | | | | | - Michele Amenta
- Department of Urology, Azienda ULSS n.4 Veneto Orientale, Portogruaro, Italy
| | | | | | | | | | - Antonio Celia
- Urology Unit, Ospedale San Bassiano, Bassano del Grappa, Italy
| | | | - Carlo Ceruti
- Urology Unit, AOU Citta della Salute e della Scienza, Turin, Italy
| | | | - Simone Crivellaro
- Department of Urology, University of Illinois at Chicago, Chicago, IL, USA
| | | | | | | | - Antonio Galfano
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | | | - Andrea Minervini
- Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Experimental and Clinical Medicine, Careggi Hospital, University of Florence, Florence, Italy
| | - Paolo Parma
- Urology Unit, Ospedale San Carlo Poma, Mantova, Italy
| | | | | | | | - Angelo Porreca
- Department of Oncological Urology, Veneto Institute of Oncology IRCCS, Padua, Italy
| | - Luigi Pucci
- Urology Unit, Azienda Ospedaliera A. Cardarelli, Naples, Italy
| | | | | | - Paolo Umari
- Urology Unit, Ospedale Maggiore della Carita, 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
| | | | | | - Amir Lebastchi
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Andre Abreu
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Dionysios Mitropoulos
- Department of Urology, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Chandra Shekhar Biyani
- Department of Urology, St. James' Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Rene Sotelo
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | - Mihir Desai
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
| | | | - Inderbir Gill
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, University of Southern California, Los Angeles, CA, USA
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11
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Abstract
![]()
We present a G0W0 approach that is based
on the evaluation of the linear response of the actions of the G0 and W0 operators.
In this way we avoid sums over empty one-particle orbitals and do
not have to explicitly develop the screened Coulomb interaction W0 on a dedicated basis. For a given orbital,
the self-energy is found by summing terms relative to a set of points
in the real-space simulation cell. This permits us to easily control
the ratio of the accuracy to the computational cost. A trivial parallelization
strategy allows strong linear scaling up to tens of thousands of computing
cores.
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Affiliation(s)
- Paolo Umari
- Dipartimento di Fisica e Astronomia, Università di Padova, Padova I-35131, Italy.,CNR-IOM Democritos, Istituto Officina dei Materiali, Consiglio Nazionale delle Ricerchei, Trieste I-34149, Italy
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12
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Cimadamore A, Lonati C, Di Trapani E, De Cobelli O, Rink M, Zamboni S, Simeone C, Soria F, Briganti A, Montorsi F, Afferi L, Mattei A, Carando R, Ornaghi PI, Tafuri A, Antonelli A, Karnes RJ, Colomer A, Sanchez-Salas R, Contieri R, Hurle R, Poyet C, Simone G, D'Andrea D, Shariat SF, Galfano A, Umari P, Francavilla S, Roumiguie M, Terrone C, Hendricksen K, Krajewski W, Buisan O, Laukhtina E, Xylinas E, Alvarez-Maestro M, Rouprêt M, Montironi R, Moschini M. Variant histologies in bladder cancer: Does the centre have an impact in detection accuracy? Urol Oncol 2022; 40:273.e11-273.e20. [DOI: 10.1016/j.urolonc.2022.01.008] [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] [Received: 10/21/2021] [Revised: 12/23/2021] [Accepted: 01/15/2022] [Indexed: 10/19/2022]
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13
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Nelson AW, Arianayagam R, Umari P, Campbell E, Tetlow N, Duncan J, Baker H, Parker J, Lucetta C, Perkins R, Tan M, Kasivisvanathan V, Kelly JD, Sridhar A. Components of a safe cystectomy service during coronavirus disease 2019 in a high-volume centre. Journal of Clinical Urology 2022. [DOI: 10.1177/2051415820970370] [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: 11/16/2022]
Abstract
Objective: Delivery of a safe cystectomy service is a multidisciplinary exercise. In this article, we detail the measures implemented at our institution to deliver a cystectomy service for bladder cancer patients during coronavirus disease 2019 (COVID-19). Methods: A ‘one-stop’ enhanced recovery clinic had been established at our hospital, consisting of an anaesthetist, an exercise testing service, urinary diversion nurses, clinical nurse specialists and surgeons. During COVID-19, we modified these processes in order to continue to provide urgent cystectomy safely for bladder cancer. We collected patients’ outcomes prospectively measuring demographic characteristics, oncological and perioperative outcomes, the presence of COVID-19 symptoms and confirmed COVID-19 test results. Results: From March to May 2020, 25 patients underwent radical cystectomy for bladder cancer. Twenty-four procedures were performed with robotic assistance and one open as part of a research trial. We instituted modifications at various multidisciplinary steps, including patient selection, preoperative optimisation, enhanced recovery protocols, patient counselling and perioperative protocols. Thirty-day mortality was 0%. The 30-day rate of Clavien ⩾3 complications was 8%. Postoperatively, none of the patients developed COVID-19 based on World Health Organization criteria and testing. Conclusion: We safely delivered a complex cystectomy service during the peak of the COVID-19 pandemic without any COVID-19-related morbidity or mortality. Level of evidence: Level 2b.
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Affiliation(s)
- Adam W Nelson
- Department of Urology, University College London Hospitals, UK
| | | | - Paolo Umari
- Department of Urology, University College London Hospitals, UK
| | - Emily Campbell
- Department of Urology, University College London Hospitals, UK
| | - Nicholas Tetlow
- Division of Surgery and Interventional Science, University College London, UK
- Department of Anaesthesia and Perioperative Medicine, University College London Hospitals, UK
| | | | - Hilary Baker
- Department of Urology, University College London Hospitals, UK
| | - Jo Parker
- Department of Urology, University College London Hospitals, UK
| | | | - Rachel Perkins
- Department of Urology, University College London Hospitals, UK
| | - Melanie Tan
- Department of Anaesthesia and Perioperative Medicine, University College London Hospitals, UK
| | - Veeru Kasivisvanathan
- Department of Urology, University College London Hospitals, UK
- Division of Surgery and Interventional Science, University College London, UK
| | - John D Kelly
- Department of Urology, University College London Hospitals, UK
- Division of Surgery and Interventional Science, University College London, UK
| | - Ashwin Sridhar
- Department of Urology, University College London Hospitals, UK
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14
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Albisinni S, Diamand R, Mjaess G, Aoun F, Assenmacher G, Assenmacher C, Verhoest G, Holz S, Naudin M, Ploussard G, Mari A, Minervini A, Tay A, Issa R, Roumiguie M, Bajeot AS, Simone G, Anceschi U, Umari P, Sridhar A, Kelly J, Hendricksen K, Einerhand S, Sandel N, Sanchez-Salas R, Colore A, Quackels T, Peltier A, Montorsi F, Briganti A, Teoh JYC, Pradere B, Moschini M, Roumeguere T. Defining the morbidity of Robotic-Assisted Radical Cystectomy with Intracorporeal Urinary Diversion: adoption of the Comprehensive Complication Index. J Endourol 2022; 36:785-792. [PMID: 35109696 DOI: 10.1089/end.2021.0843] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND & OBJECTIVE The Clavien-Dindo Classification (CDC) only reports the post-operative complication of highest grade. It is thus of limited value for radical cystectomy after which patients usually experience multiple complications. The CCI is a novel scoring system which incorporates all post-operative events in one single value. To adopt the Comprehensive Complication Index (CCI) for the evaluation of complications in patients undergoing Robot-Assisted Radical Cystectomy (RARC) with Intra-Corporeal Urinary Diversion (ICUD) and explore its advantages in the analysis of the morbidity of RARC with ICUD. PATIENTS AND METHODS Multicentric cohort of 959 patients undergoing RARC+ICUD between 2015-2020, whose complications are encoded in local prospective registries. Post-operative complications at 30 days were assessed using both the CDC and CCI. The CCI was calculated using an online tool (assessurgery.com). Risk factors for overall, major complications (CDC≥III) and CCI were evaluated using uni- and multivariable logistic and linear regressions. To analyse the potential advantage of using the CCI in clinical trials, a sample size calculation of a hypothetic clinical trial was performed using as endpoint reduction of morbidity with either the CDC or CCI. RESULTS Overall, 885 post-operative complications were reported in 507 patients (53%). The CCI improved the definition of post-operative morbidity in 22.6% of patients. Male sex and neobladder were associated to major complications and to a significant increase in CCI on adjusted regressions. In a hypothetical clinical trial, 80 patients would be needed to demonstrate a ten point reduction in CCI, compared to 186 needed to demonstrate an absolute risk reduction of 20% in overall morbidity using the CDC. CONCLUSION CCI improves the evaluation of post-operative morbidity by considering the cumulative aspect of complications compared to the CDC. Implementing the CCI for radical cystectomy would help reducing sample sizes in clinical trials.
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Affiliation(s)
- Simone Albisinni
- Hopital Erasme, 70496, Route de Lennik 808, Bruxelles, Belgium, 1070;
| | - Romain Diamand
- Institut Jules Bordet, 60210, Bruxelles, Bruxelles, Belgium;
| | | | | | | | | | | | - Serge Holz
- Ambroise Pare Ziekenhuis, 82241, Mons, Wallonie, Belgium;
| | - Michel Naudin
- Ambroise Pare Ziekenhuis, 82241, Mons, Wallonie, Belgium;
| | - Guillaume Ploussard
- Clinique Capio La Croix du Sud, 538719, Quint-Fonsegrives, Occitanie, France;
| | - 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.;
| | - 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;
| | - Andrea Tay
- St George's Healthcare NHS Trust, 4968, London, London, United Kingdom of Great Britain and Northern Ireland;
| | - Rami Issa
- St George's Healthcare NHS Trust, 4968, London, London, United Kingdom of Great Britain and Northern Ireland;
| | | | | | - Giuseppe Simone
- Regina Elena, urology, via elio chianesi 53, Roma, Italy, 00144.,Italy;
| | | | - Paolo Umari
- University of Eastern Piedmont Amedeo Avogadro Department of Translational Medicine, 370891, Department of Urology, Via Solaroli 17, 28100, Novara, Italy, Novara, Italy, 28100.,United States;
| | - Ashwin Sridhar
- UCLH, 8964, London, London, United Kingdom of Great Britain and Northern Ireland;
| | - John Kelly
- UCLH, 8964, London, London, United Kingdom of Great Britain and Northern Ireland;
| | - Kees Hendricksen
- Netherlands Cancer Institute, 1228, Amsterdam, Noord-Holland, Netherlands;
| | - Sarah Einerhand
- Netherlands Cancer Institute, 1228, Amsterdam, Noord-Holland, Netherlands;
| | - Noah Sandel
- Netherlands Cancer Institute, 1228, Amsterdam, Noord-Holland, Netherlands;
| | - Rafael Sanchez-Salas
- Institute Mutualiste Monsouris, Urology, 142, Bd. Jourdan, Paris, Not Applicable, France, 75014;
| | - Anne Colore
- Institut Mutualiste Montsouris, 26953, Paris, Île-de-France, France;
| | | | | | | | | | - Jeremy Y C Teoh
- Prince of Wales Hospital, Surgery, 30-32 Ngan Shing Street, Shatin, New Territories., Hong Kong, Hong Kong;
| | - Benjamin Pradere
- Medical University of Vienna, 27271, Department of urology, Wien, Wien, Austria;
| | - Marco Moschini
- Luzerner Kantonsspital, 30748, Luzern, Switzerland.,Vita-Salute University, urology, Milan, Italy;
| | - Thierry Roumeguere
- Hôpital Erasme, 70496, Urology, route de Lennik 808, Bruxelles, Belgium, 1070.,United States;
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15
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Umari P, Aditya Narain T, Eden D, Eden C, Sooriakumaran P. Learning curve for Retzius-Sparing Robot-Assisted Radical Prostatectomy (RS-RARP): Experience of two high volume UK surgeons. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01218-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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Scarcella S, Mottaran A, Bravi C, Van Der Jeugt J, Piazza P, Sarchi L, Paciotti M, Puliatti S, Umari P, Giuloni C, Milanese G, Dell'Atti L, Castellani D, Galosi A, De Groote R, Schatteman P, Mottrie A. Peri-operative outcomes of open versus robot-assisted simple prostatectomy: Results from two high-volume centres. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00961-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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17
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Umari P, Aditya Narain T, Dominic E, Cahill D, Eden C, Sooriakumaran P. Retzius-sparing robot assisted radical prostatectomy has similar 1-year functional and oncological outcomes as standard robot-assisted radical prostatectomy: Results from a high volume UK centre. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01216-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Scarcella S, Castellani D, Piazza P, Giulioni C, Sarchi L, Amato M, Bravi CA, Lores MP, Farinha R, Knipper S, Palagonia E, Skrobot SA, Develtere D, Berquin C, Sinatti C, Van Puyvelde H, De Groote R, Umari P, De Naeyer G, Dell'Atti L, Milanese G, Puliatti S, Teoh JYC, B Galosi A, Mottrie A. Concomitant robot-assisted laparoscopic surgeries for upper and lower urinary tract malignancies: a comprehensive literature review. J Robot Surg 2021; 16:991-1005. [PMID: 34748165 DOI: 10.1007/s11701-021-01317-1] [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: 08/25/2021] [Accepted: 10/03/2021] [Indexed: 12/24/2022]
Abstract
Worldwide, we have witnessed an expansion of robot-assisted laparoscopic surgery (RALS) and thanks to the global adoption of high-resolution diagnostic imaging technologies, an increased incidence of newly diagnosed prostatic, renal and bladder cancers has been recorded with concurrent second primary urological cancer diagnoses increasing by 1.5%. Diverse authors have reported their findings concerning synchronous multi-visceral malignances robotic treatment within the scientific literature. The aim of this study is to comprehensively review all reported articles describing concurrent upper and lower RALS using a singular robotic port scheme within the same intervention for renal malignances and concomitant prostatic or bladder cancers. To the best of our knowledge and vigorous literature search, this is the first study that comprehensively evaluates and reports all combined upper and lower urinary tract surgeries published so far. In carefully selected patients, thanks to multidisciplinary preoperative assessment and surgical planning a combined robotic approach can reduce the morbidity, complications, hospital admissions and the overall length of hospitalization.
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Affiliation(s)
- Simone Scarcella
- Department of Urology, Polytechnic University of Marche Region, Umberto I Hospital "Ospedali Riuniti", 71 Conca Street, 60126, Ancona, Italy.
| | - Daniele Castellani
- Department of Urology, Polytechnic University of Marche Region, Umberto I Hospital "Ospedali Riuniti", 71 Conca Street, 60126, Ancona, Italy
| | - Pietro Piazza
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Carlo Giulioni
- Department of Urology, Polytechnic University of Marche Region, Umberto I Hospital "Ospedali Riuniti", 71 Conca Street, 60126, Ancona, Italy
| | - Luca Sarchi
- Urology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Amato
- Urology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Carlo Andrea Bravi
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium.,ORSI Academy, Melle, Belgium.,Division of Oncology/Unit of Urology; URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Maria Peraire Lores
- Department of Urology, Son Espases University Hospital, Palma de Mallorca, Spain
| | | | - Sophie Knipper
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Erika Palagonia
- Department of Urology, Polytechnic University of Marche Region, Umberto I Hospital "Ospedali Riuniti", 71 Conca Street, 60126, Ancona, Italy
| | | | - Dries Develtere
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
| | - Camille Berquin
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
| | - Céline Sinatti
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
| | | | - Ruben De Groote
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
| | - Paolo Umari
- Division of Surgery and Interventional Sciences, University College London, London, UK
| | - Geert De Naeyer
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
| | - Lucio Dell'Atti
- Department of Urology, Polytechnic University of Marche Region, Umberto I Hospital "Ospedali Riuniti", 71 Conca Street, 60126, Ancona, Italy
| | - Giulio Milanese
- Department of Urology, Polytechnic University of Marche Region, Umberto I Hospital "Ospedali Riuniti", 71 Conca Street, 60126, Ancona, Italy
| | - Stefano Puliatti
- Urology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Jeremy Yuen-Chun Teoh
- S.H.Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Andrea B Galosi
- Department of Urology, Polytechnic University of Marche Region, Umberto I Hospital "Ospedali Riuniti", 71 Conca Street, 60126, Ancona, Italy
| | - Alexandre Mottrie
- Department of Urology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium.,ORSI Academy, Melle, Belgium
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19
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Volpato GA, Colusso E, Paoloni L, Forchetta M, Sgarbossa F, Cristino V, Lunardon M, Berardi S, Caramori S, Agnoli S, Sabuzi F, Umari P, Martucci A, Galloni P, Sartorel A. Artificial photosynthesis: photoanodes based on polyquinoid dyes onto mesoporous tin oxide surface. Photochem Photobiol Sci 2021; 20:1243-1255. [PMID: 34570354 DOI: 10.1007/s43630-021-00097-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/30/2021] [Indexed: 12/27/2022]
Abstract
Dye-sensitized photoelectrochemical cells represent an appealing solution for artificial photosynthesis, aimed at the conversion of solar light into fuels or commodity chemicals. Extensive efforts have been directed towards the development of photoelectrodes combining semiconductor materials and organic dyes; the use of molecular components allows to tune the absorption and redox properties of the material. Recently, we have reported the use of a class of pentacyclic quinoid organic dyes (KuQuinone) chemisorbed onto semiconducting tin oxide as photoanodes for water oxidation. In this work, we investigate the effect of the SnO2 semiconductor thickness and morphology and of the dye-anchoring group on the photoelectrochemical performance of the electrodes. The optimized materials are mesoporous SnO2 layers with 2.5 μm film thickness combined with a KuQuinone dye with a 3-carboxylpropyl-anchoring chain: these electrodes achieve light-harvesting efficiency of 93% at the maximum absorption wavelength of 533 nm, and photocurrent density J up to 350 μA/cm2 in the photoelectrochemical oxidation of ascorbate, although with a limited incident photon-to-current efficiency of 0.075%. Calculations based on the density functional theory (DFT) support the role of the reduced species of the KuQuinone dye via a proton-coupled electron transfer as the competent species involved in the electron transfer to the tin oxide semiconductor. Finally, a preliminary investigation of the photoelectrodes towards benzyl alcohol oxidation is presented, achieving photocurrent density up to 90 μA/cm2 in acetonitrile in the presence of N-hydroxysuccinimide and pyridine as redox mediator and base, respectively. These results support the possibility of using molecular-based materials in synthetic photoelectrochemistry.
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Affiliation(s)
- Giulia Alice Volpato
- Department of Chemical Sciences, University of Padova, Via F. Marzolo 1, 35131, Padua, Italy
| | - Elena Colusso
- Department of Industrial Engineering and INSTM, University of Padova, F. Marzolo 9, 35131, Padua, Italy
| | - Lorenzo Paoloni
- Department of Physics and Astronomy, University of Padova, Via F. Marzolo 8, 35131, Padua, Italy
| | - Mattia Forchetta
- Department of Chemical Science and Technologies, University of Rome "Tor Vergata", Via della Ricerca Scientifica, snc, 00133, Rome, Italy
| | - Francesco Sgarbossa
- Department of Physics and Astronomy, University of Padova, Via F. Marzolo 8, 35131, Padua, Italy
| | - Vito Cristino
- Department of Chemical and Pharmaceutical Sciences, Centro Interuniversitario per la Conversione Chimica dell'Energia Solare (SolarChem), Sez. di Ferrara, University of Ferrara, Via L. Borsari 46, 44121, Ferrara, Italy
| | - Marco Lunardon
- Department of Chemical Sciences, University of Padova, Via F. Marzolo 1, 35131, Padua, Italy
| | - Serena Berardi
- Department of Chemical and Pharmaceutical Sciences, Centro Interuniversitario per la Conversione Chimica dell'Energia Solare (SolarChem), Sez. di Ferrara, University of Ferrara, Via L. Borsari 46, 44121, Ferrara, Italy
| | - Stefano Caramori
- Department of Chemical and Pharmaceutical Sciences, Centro Interuniversitario per la Conversione Chimica dell'Energia Solare (SolarChem), Sez. di Ferrara, University of Ferrara, Via L. Borsari 46, 44121, Ferrara, Italy
| | - Stefano Agnoli
- Department of Chemical Sciences, University of Padova, Via F. Marzolo 1, 35131, Padua, Italy
| | - Federica Sabuzi
- Department of Chemical Science and Technologies, University of Rome "Tor Vergata", Via della Ricerca Scientifica, snc, 00133, Rome, Italy
| | - Paolo Umari
- Department of Physics and Astronomy, University of Padova, Via F. Marzolo 8, 35131, Padua, Italy.
| | - Alessandro Martucci
- Department of Industrial Engineering and INSTM, University of Padova, F. Marzolo 9, 35131, Padua, Italy.
| | - Pierluca Galloni
- Department of Chemical Science and Technologies, University of Rome "Tor Vergata", Via della Ricerca Scientifica, snc, 00133, Rome, Italy.
| | - Andrea Sartorel
- Department of Chemical Sciences, University of Padova, Via F. Marzolo 1, 35131, Padua, Italy.
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20
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Albisinni S, Diamand R, Mjaess G, Assenmacher G, Assenmacher C, Loos S, Verhoest G, Holz S, Naudin M, Ploussard G, Mari A, Di Maida F, Minervini A, Aoun F, Tay A, Issa R, Roumiguié M, Bajeot AS, Simone G, Anceschi U, Umari P, Sridhar A, Kelly J, Hendricksen K, Einerhand S, Sanchez-Salas R, Colomer A, Quackels T, Peltier A, Montorsi F, Briganti A, Pradere B, Moschini M, Roumeguère T. Continuing acetylsalicylic acid during Robotic-Assisted Radical Cystectomy with intracorporeal urinary diversion does not increase hemorrhagic complications: results from a large multicentric cohort. Urol Oncol 2021; 40:163.e11-163.e17. [PMID: 34580028 DOI: 10.1016/j.urolonc.2021.08.023] [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] [Received: 07/01/2021] [Revised: 07/26/2021] [Accepted: 08/23/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate whether continuing the antiplatelet drug acetylsalicylic acid≤100mg (ASA) during Robotic-assisted radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) increases the risk of peri-and postoperative hemorrhagic complications and overall morbidity. Indeed, guidelines recommend interrupting antiplatelet therapy before radical cystectomy; however, RARC with ICUD is associated to reduced estimated blood loss and blood transfusions compared to its open counterpart. METHODS Data from a multicentric European database were analyzed. All participating centers maintained a prospective database of patients undergoing RARC with ICUD. We identified patients receiving antiplatelet therapy by acetylsalicylic acid ≤100mg. Patients were divided into three groups: those not taking acetylsalicylic acid (no-ASA), those where ASA was continued perioperatively (c-ASA) and those where ASA was interrupted perioperatively (i-ASA). Estimated blood loss and peri-and post-operative transfusions were recorded. Hemorrhagic complications, ischemic, thrombotic and cardiac morbidity was recorded and classified using the Clavien-Dindo score by a senior urologist. RESULTS 640 patients were analyzed. Patients on acetylsalicylic acid were significantly older and had more comorbidities. No significant difference was found for estimated blood loss between no-ASA, c-ASA and i-ASA (280 vs. 300 vs. 200ml respectively; P = 0.09). Similarly, no significant difference was found for intraoperative (5% vs. 9% vs. 11%; P = 0.07) and postoperative transfusion rate (11% vs. 13% vs. 18%; P = 0.17). Higher ischemic complications were noted in the i-ASA group compared to no-ASA and c-ASA (4% vs. 0.6% vs. 1.4%; P = 0.03). On uni and multivariate logistic regression, continuing acetylsalicylic acid was not significantly associated to either major complications or post-operative transfusions. CONCLUSIONS Peri-operative acetylsalicylic acid continuation in RARC with ICUD does not increase hemorrhagic complications. Interrupting acetylsalicylic acid peri-operatively may expose patients to a higher risk of ischemic events.
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Affiliation(s)
- Simone Albisinni
- Department of Urology, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
| | - Romain Diamand
- Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Georges Mjaess
- Department of Urology, Hotel Dieu de France, Beirut, Lebanon
| | | | | | - Shirley Loos
- Department of Urology, Cliniques de l'Europe-Saint Elisabeth, Brussels, Belgium
| | | | - Serge Holz
- Department of Urology, CHU Ambroise Paré, Mons, Belgium
| | - Michel Naudin
- Department of Urology, CHU Ambroise Paré, Mons, Belgium
| | - Guillaume Ploussard
- Department of Urology, La Croix du Sud Hospital, Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France
| | - Andrea Mari
- Department of Experimental and Clinical Medicine, Unit of Oncologic Minimally-Invasive Urology and Andrology, University of Florence, Careggi University Hospital, Florence, Italy
| | - Fabrizio Di Maida
- Department of Experimental and Clinical Medicine, Unit of Oncologic Minimally-Invasive Urology and Andrology, University of Florence, Careggi University Hospital, Florence, Italy
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, Unit of Oncologic Minimally-Invasive Urology and Andrology, University of Florence, Careggi University Hospital, Florence, Italy
| | - Fouad Aoun
- Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium; Department of Urology, Hotel Dieu de France, Beirut, Lebanon
| | - Andrea Tay
- Department of Urology, Saint Georges Hospital, London, UK
| | - Rami Issa
- Department of Urology, Saint Georges Hospital, London, UK
| | - Mathieu Roumiguié
- Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Paul-Sabatier University, Toulouse Cedex, France
| | - Anne Sophie Bajeot
- Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Paul-Sabatier University, Toulouse Cedex, France
| | - Giuseppe Simone
- Department of Urology, Regina Elena National Cancer Institute, Rome, Italy
| | - Umberto Anceschi
- Department of Urology, Regina Elena National Cancer Institute, Rome, Italy
| | - Paolo Umari
- Division of Surgery and Interventional Sciences, University College London, London, UK
| | - Ashwin Sridhar
- Division of Surgery and Interventional Sciences, University College London, London, UK
| | - John Kelly
- Division of Surgery and Interventional Sciences, University College London, London, UK
| | - Kees Hendricksen
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Sarah Einerhand
- Department of Urology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Anna Colomer
- Department of Urology, Institut Mutualiste Montsouris, Paris, France
| | - Thierry Quackels
- Department of Urology, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Alexandre Peltier
- Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Francesco Montorsi
- Unit of Urology/Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Alberto Briganti
- Unit of Urology/Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Marco Moschini
- Unit of Urology/Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Thierry Roumeguère
- Department of Urology, University Clinics of Brussels, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; Department of Urology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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21
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Elliott JD, Mosconi E, De Angelis F, Ambrosetti A, Umari P. Real Space-Real Time Evolution of Excitonic States Based on the Bethe-Salpeter Equation Method. J Phys Chem Lett 2021; 12:7261-7269. [PMID: 34314589 DOI: 10.1021/acs.jpclett.1c01742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
We introduce a method for constructing localized excitations and simulating the real time dynamics of excitons at the Many-Body Perturbation Theory Bethe-Salpeter Equation level. We track, on the femto-seconds scale, electron injection from a photoexcited dye into a semiconducting slab. From the time-dependent many-body wave function we compute the spatial evolution of the electron and of the hole; full electron injection is attained within 5 fs. Time-resolved analysis of the electron density and electron-hole interaction energy hints at a two-step charge transfer mechanism through an intermediary partially injected state. We adopt the Von-Neumann entropy for analyzing how the electron and hole entangle. We find that the excitation of the dye-semiconductor model may be represented by a four-level system and register a decrease in entanglement upon electron injection. At full injection, the electron and the hole exhibit only a small degree of entanglement indicative of pure electron and hole states.
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Affiliation(s)
- Joshua D Elliott
- School of Chemical Engineering and Analytical Science, University of Manchester, Manchester, United Kingdom
| | - Edoardo Mosconi
- Istituto CNR di Scienze e Technologie Molecolare, via Elce di Sotto, 8, I-06123, Perugia, Italy
| | - Filippo De Angelis
- Istituto CNR di Scienze e Technologie Molecolare, via Elce di Sotto, 8, I-06123, Perugia, Italy
- CompuNet, Istituto Italiano di Technologie, via Morego 30, 16163, Genova, Italy
| | - Alberto Ambrosetti
- Dipartimento di Fisica e Astronomia, University of Padova, Padova, Italy
| | - Paolo Umari
- Dipartimento di Fisica e Astronomia, University of Padova, Padova, Italy
- CNR-IOM DEMOCRITOS, Consiglio Nazionale delle Ricerche-Istituto Officina dei Materiali, c/o SISSA, Via Bonomea 265, 34136, Trieste, Italy
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Rizzo M, Umari P, Bucci S, Trombetta C. Re: "Immediate Shockwave Lithotripsy vs Delayed Shockwave Lithotripsy After Urgent Ureteral Stenting in Patients with Ureteral or Pyeloureteral Urolithiasis: A Matched-Pair Analysis" by Cornelius et al. J Endourol 2021; 35:1275. [PMID: 33980029 DOI: 10.1089/end.2021.0116] [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: 10/21/2022] Open
Affiliation(s)
- Michele Rizzo
- Department of Urology, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Paolo Umari
- Urologic Clinic, Ospedale Maggiore della Carità, University of Eastern Piedmont, Novara, Italy
| | - Stefano Bucci
- Department of Urology, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Carlo Trombetta
- Department of Urology, Cattinara Hospital, University of Trieste, Trieste, Italy
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Perri D, Palumbo C, Billia M, Umari P, Zacchero M, D'Agate D, Bondonno G, Volpe A. Assessment of predictors of renal cell carcinoma progression after nephrectomy at short and intermediate term follow-up and implication on surveillance protocols. Minerva Urol Nephrol 2021; 74:599-606. [PMID: 34114786 DOI: 10.23736/s2724-6051.21.04322-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Prediction of risk of RCC progression after surgery is important for follow-up planning. We identified predictors of progression-free survival (PFS) and cancer-specific survival (CSS) in a large single institutional cohort and investigated patterns and sites of progression according to stage and grade. METHODS Node-negative non-metastatic clear-cell RCC (ccRCC) patients treated with radical or partial nephrectomy from 2000 to 2020 were included. Sites of progression were defined as thoracic, abdominal and others (bone/brain). Kaplan Meier curves and multivariable Cox regression (MCR) models tested for PFS and CSS. RESULTS Of 384 clear cell RCC N0M0 patients, 301 (78.4%) vs. 83 (21.6%) were pT1-2 vs. pT3-4, respectively; 253 (65.9%) vs. 130 (33.9%) were G1-G2 vs. G3-G4. Thoracic progressions occurred in 2.7% pT1-T2 vs. 21.7% pT3-T4 and 2.8% G1-G2 vs. 14.6% G3-G4 tumors. Abdominal progressions occurred in 4.0% pT1-T2 vs. 13.3% pT3-T4 and 4.3% G1-G2 vs. 9.2% G3-G4. Other progressions occurred in 0.3% pT1-T2 vs. 9.6% pT3-T4 and 0.8% G1-G2 vs. 5.4% G3-G4 (5.4%). Five-year PFS and CSS were 81.7 and 90.6%, respectively. At MCR models, pT3-4 (HR 9.1, p<0.001), G3-G4 (HR 2.7, p=0.003) and PSMs (HR 6.1, p<0.001) independently predicted PFS. Similarly, pT3-4 (HR 10.1, p<0.001), G3-G4 (HR 4.1, p=0.02), and PSMs (HR 5.2, p=0.04) independently predicted CSS. CONCLUSIONS In ccRCC N0M0 patients, G3-G4, pT3-4, PSMs were independent predictors of progression after surgery. Lower stage and grade ccRCCs progress predominantly in the abdominal sites and may be followed with less frequent extra-abdominal imaging compared to more advanced/aggressive tumors.
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Affiliation(s)
- Davide Perri
- Division of Urology, Department of Translational Medicine, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Carlotta Palumbo
- Division of Urology, Department of Translational Medicine, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Michele Billia
- Division of Urology, Department of Translational Medicine, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Paolo Umari
- Division of Urology, Department of Translational Medicine, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Monica Zacchero
- Division of Urology, Department of Translational Medicine, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Daniele D'Agate
- Division of Urology, Department of Translational Medicine, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Gianmarco Bondonno
- Division of Urology, Department of Translational Medicine, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Alessandro Volpe
- Division of Urology, Department of Translational Medicine, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy -
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Umari P, Aditya Narain T, Eden C, Cahill D, Eden D, Sooriakumaran P. Retzius-sparing robot assisted radical prostatectomy has similar 1-year functional and oncological outcomes as standard robot-assisted radical prostatectomy: Results from a high volume UK centre. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01474-3] [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]
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Umari P, Aditya Narain T, Sooriakumaran P. Retzius-sparing robot assisted radical prostatectomy (rs-rarp) made easy: A step-by-step guide. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01602-x] [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]
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Lonati C, Afferi L, Baumeister P, Minervini A, Mari A, Krajewski W, Borghesi M, Rink M, Montorsi F, Briganti A, Hurle R, Contieri R, Umari P, Klatte T, Teoh JC, Soria F, Simeone C, Zamboni S, Roumiguié M, Rouprêt M, Masson-Lecomte A, Einerhand S, Mattei A, Moschini M. Survival outcomes of urothelial carcinoma with squamous differentiation versus pure squamous cell carcinoma. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01111-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Minervini A, Di Maida F, Mari A, Porreca A, Rocco B, Celia A, Bove P, Umari P, Volpe A, Galfano A, Pastore AL, Annino F, Parma P, Greco F, Nucciotti R, Schiavina R, Esposito F, Romagnoli D, Leonardo C, Falabella R, Gallo F, Amenta M, Sciorio C, Verze P, Tafuri A, Pucci L, Varca V, Zaramella S, Pagliarulo V, Bozzini G, Ceruti C, Falsaperla M, Cafarelli A, Antonelli A. Perioperative outcomes of patients undergoing urological elective surgery during the COVID-19 pandemic: a national overview across 28 Italian institutions. Cent European J Urol 2021; 74:259-268. [PMID: 34336248 PMCID: PMC8318031 DOI: 10.5173/ceju.2021.0374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 03/02/2021] [Accepted: 04/08/2021] [Indexed: 12/11/2022] Open
Abstract
Introduction The aim of this study was to assess the safety of elective urological surgery performed during the pandemic by estimating the prevalence of COVID-19-like symptoms in the postoperative period and its correlation with perioperative and clinical factors. Material and methods In this multicenter, observational study we recorded clinical, surgical and postoperative data of consecutive patients undergoing elective urological surgery in 28 different institutions across Italy during initial stage of the COVID-19 pandemic (between February 24 and March 30, 2020, inclusive). Results A total of 1943 patients were enrolled. In 12%, 7.1%, 21.3%, 56.7% and 2.6% of cases an open, laparoscopic, robotic, endoscopic or percutaneous surgical approach was performed, respectively. Overall, 166 (8.5%) postoperative complications were registered, 77 (3.9%) surgical and 89 (4.6%) medical. Twenty-eight (1.4%) patients were readmitted to hospital after discharge and 13 (0.7%) died. In the 30 days following discharge, fever and respiratory symptoms were recorded in 101 (5.2%) and 60 (3.1%) patients. At multivariable analysis, not performing nasopharyngeal swab at hospital admission (HR 2.3; CI 95% 1.01–5.19; p = 0.04) was independently associated with risk of developing postoperative medical complications. Number of patients in the facility was confirmed as an independent predictor of experiencing postoperative respiratory symptoms (p = 0.047, HR:1.12; CI95% 1.00–1.05), while COVID-19-free type of hospitalization facility was a strong independent protective factor (p = 0.02, HR:0.23, CI95% 0.07–0.79). Conclusions Performing elective surgery during the COVID-19 pandemic does not seem to affect perioperative outcomes as long as proper preventive measures are adopted, including nasopharyngeal swab before hospital admission and hospitalization in dedicated COVID-19-free facilities.
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Affiliation(s)
- Andrea Minervini
- Department of Experimental and Clinical Medicine, University of Florence - Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi Hospital, Florence, Italy
| | - Fabrizio Di Maida
- 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
| | - Angelo Porreca
- Department of Oncological Urology - Veneto Institute of Oncology (IOV) IRCCS, Padua, Italy
| | - Bernardo Rocco
- Department of Urology, ASST Santi Paolo e Carlo Dipartimento di Scienze della Salute - Università degli Studi di Milano, Milano, Italy
| | - Antonio Celia
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Italy
| | - Pierluigi Bove
- Department of Urology, San Carlo di Nancy Hospital, Rome, Italy
| | - Paolo Umari
- Division of Urology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Alessandro Volpe
- Division of Urology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | | | - Antonio Luigi Pastore
- Department of Medical-Surgical Sciences and Biotechnologies, 'Sapienza' University of Rome, Urology Unit ICOT, Latina, Italy
| | | | - Paolo Parma
- Urology Department, Ospedale Poma, Mantova, Italy
| | | | | | | | - Fabio Esposito
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Italy
| | - Daniele Romagnoli
- Department of Oncological Urology - Veneto Institute of Oncology (IOV) IRCCS, Padua, Italy
| | | | - Roberto Falabella
- Department of Urology, Azienda Ospedaliera Regionale di Potenza, Potenza, Italy
| | - Fabrizio Gallo
- Department of Urology, San Paolo Hospital, Savona, Italy
| | | | | | - Paolo Verze
- Department of Urology, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Alessandro Tafuri
- Department of Urology, Azienda Ospedaliera Universitaria Integrata of Verona, University of Verona, Italy
| | - Luigi Pucci
- Department of Urology, AORN A. Cardarelli, Naples, Italy
| | - Virginia Varca
- Hospital G. Salvini, ASST Rhodense Garbagnate Milanese, Milan, Italy
| | | | | | - Giorgio Bozzini
- Urology Department, ASST Valle Olona, Busto Arsizio, Varese, Italy
| | - Carlo Ceruti
- SCDU Urologia, Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | - Alessandro Antonelli
- Department of Urology, Azienda Ospedaliera Universitaria Integrata of Verona, University of Verona, Italy
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Umari P, Rizzo M, Billia M, Stacul F, Bertolotto M, Cova MA, Bondonno G, Perri D, Liguori G, Volpe A, Trombetta C. Oncological outcomes of active surveillance and percutaneous cryoablation of small renal masses are similar at intermediate term follow-up. Minerva Urol Nephrol 2021; 74:321-328. [PMID: 33781019 DOI: 10.23736/s2724-6051.21.04217-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Active surveillance (AS) and minimally invasive ablative therapies such as percutaneous cryoablation (PCA) are emerging as alternative treatment modalities in the management of small renal masses (SRMs). METHODS Fifty-nine patients underwent PCA since 2011 and 75 underwent AS since 2010 at two different institutions. Only patients with follow-up ≥ 6 months were included. All patients were followed with a standardized protocol. Treatment failure was defined by dimensional progression for AS and renal recurrence for PCA, in addition to stage and/or metastatic progression for both groups. RESULTS Treatment failure was observed in 14 cases (18,7%) during AS (mainly due to dimensional progression) and 12 patients (16%) underwent delayed intervention with a mean follow-up of 36,83 months. Seven patients (11,9%) in the PCA group experienced treatment failure with a mean follow-up of 33,39 months and 3 of them underwent re-ablation successfully. Cancer-specific-survival at 2 and 5 years was 100% and 95,8% in AS-group vs. 98,2% and 98,2% in PCA-group (p=0,831). One patient in both groups died from metastatic disease. Overall-survival at 2 and 5 years was 91,7% and 82,4% in the AS-group vs. 96,5% and 96,5% in the PCA-group (p=0,113). Failure-free survival at 2 and 5 years was 90,9% and 70,1% in the AS-group vs. 93,1% and 70,9% in the PCA-group (p=0,645). CONCLUSIONS AS and PCA provide similar survival outcomes and are safe and valid treatment options for elderly and comorbid patients with SRMs.
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Affiliation(s)
- Paolo Umari
- Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy -
| | - Michele Rizzo
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Michele Billia
- Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Fulvio Stacul
- Radiology Department, Maggiore Hospital, Trieste, Italy
| | - Michele Bertolotto
- Radiology Department, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Maria Assunta Cova
- Radiology Department, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Gianmarco Bondonno
- Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Davide Perri
- Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Giovanni Liguori
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Alessandro Volpe
- Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Carlo Trombetta
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
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Rizzo M, Piasentin A, Rebez G, Giannarini G, Umari P, Sachs C, Celia A, Pavan N, Balestrieri L, Artuso G, Bertolotto M, Trombetta C, Liguori G. Percutaneous cryoablation for high-complexity renal masses: complications, functional and oncological outcomes. Minerva Urol Nephrol 2021; 73:518-524. [PMID: 33769011 DOI: 10.23736/s2724-6051.21.04015-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND During the past two decades cryoablation (CA) has become a therapeutic option for the management of localized cT1 renal masses in comorbid patients. We analyzed the mid-term functional and oncological outcomes of CA in the treatment of cT1 renal masses which were classified as high-complexity masses according to the PADUA system. METHODS A total of 299 patients underwent percutaneous CA between November 2007 and December 2018 in 4 institutions for cT1N0M0 renal masses. All patients with high-complexity (PADUA≥10) renal tumors were included. Technical failure of CA was considered an exclusion criterion. RESULTS Inclusion criteria were met by 45 patients. Median Charlson Comorbidity Index (CCI) was 6.0 (IQR: 5.0-7.0), median age was 74 years (IQR: 64.5-79.5). Seven Clavien 1 and 1 Clavien 2 procedure-related complications were reported. Median eGFR at baseline was 64.3mL/min (IQR: 52.0-82.3) while at the 1-year follow-up was 61.4 mL/min (IQR: 44.0-74.5). The median follow-up was 32 months (IQR: 13.25-47.5). Local recurrences were detected in 6 patients; 3 of them underwent re-cryoablation while the others started active surveillance. Median time to recurrence was 17.5 months (IQR: 7.8-27.3). Cancer-specific survival and metastasis-free survival were 100%, while overall survival was 86.7%. CONCLUSIONS CA proved to be a valuable therapeutic option for the management of patients with cT1 high-complexity PADUA≥10 renal tumors as it provides a low rate of procedural morbidity and good preservation of renal function. However, these results are counterbalanced by a recurrence rate that appears to be higher than those reported on surgically treated patients.
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Affiliation(s)
- Michele Rizzo
- Department of Urology, Surgery and Health Science, University of Trieste, Trieste, Italy -
| | - Andrea Piasentin
- Department of Urology, Surgery and Health Science, University of Trieste, Trieste, Italy
| | - Giacomo Rebez
- Department of Urology, Surgery and Health Science, University of Trieste, Trieste, Italy
| | - Gianluca Giannarini
- Department of Urology, Santa Maria della Misericordia Hospital, Udine, Italy
| | - Paolo Umari
- Department of Surgery, Clinic of Urology, University of Eastern Piedmont, Novara, Italy
| | - Camilla Sachs
- Department of Radiology, University of Trieste, Trieste, Italy
| | - Antonio Celia
- ULSS 7 Pedemontana, Bassano del Grappa, Vicenza, Italy
| | - Nicola Pavan
- Department of Urology, Surgery and Health Science, University of Trieste, Trieste, Italy
| | | | - Giorgio Artuso
- Department of Urology, ULSS 3 Serenissima, Dolo, Venezia, Italy
| | | | - Carlo Trombetta
- Department of Urology, Surgery and Health Science, University of Trieste, Trieste, Italy
| | - Giovanni Liguori
- Department of Urology, Surgery and Health Science, University of Trieste, Trieste, Italy
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Rizzo M, Ongaro L, Claps F, Ghassempour D, Verzotti E, Migliozzi F, Boltri M, Pavan N, Garaffa G, Bucci S, Umari P, Trombetta C, Liguori G. Analysis of clinical utility of abdominopelvic computed tomography in the follow-up of Stage I seminoma: a single center evaluation. Minerva Urol Nephrol 2021; 73:84-89. [PMID: 31833335 DOI: 10.23736/s2724-6051.19.03562-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Indexed: 11/08/2022]
Abstract
BACKGROUND Abdominopelvic computed tomography (CT) is widely used in the follow-up of seminoma patients after radical orchidectomy. The aim of this study was to evaluate the clinical utility of abdominopelvic computed tomography in the follow-up of patients with Stage I seminoma. METHODS The pathological reports of all patients that have undergone radical orchidectomy in our tertiary referral center between January 2002 and January 2018 have been retrospectively reviewed. All patients with Stage I seminoma and negative serum tumor markers after radical orchidectomy were included. Patients with follow-up shorter than 12 months were excluded. Surveillance records of every patient were reviewed with regard to abdominopelvic imaging. RESULTS Of the 133 patients who have undergone radical orchidectomy in our center, 55 had Stage I pure seminoma with normal levels of serum tumor markers after surgery. Two patients were excluded as the follow-up was inadequate. Mean follow-up was 63.2 months (IQR: 30-73). The results of 211 abdominopelvic CTs performed as part of the follow-up were reviewed. Two (3,7%) patients developed recurrence; one consisted of a scrotal lump and was diagnosed with ultrasonography (US) while the second appeared as paraaortic nodal metastasis and was diagnosed with abdominopelvic CT. The recurrence was successfully treated in both patients. A single abdominopelvic CT was useful for the detection of recurrent disease in our entire study population. No cancer specific death has been reported in the study population. CONCLUSIONS Follow-up schedules for Stage I seminoma expose patients to potential risks of radiation-induced tumors, emotional distress and represent a significant burden for the healthcare system. The current series suggests that a better risk adapted patient-tailored follow-up program is needed in order to avoid unnecessary investigations.
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Affiliation(s)
- Michele Rizzo
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy -
| | - Luca Ongaro
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Francesco Claps
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Dario Ghassempour
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Enrica Verzotti
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Francesca Migliozzi
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Matteo Boltri
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Nicola Pavan
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Giulio Garaffa
- The Institute of Urology, University College London Hospitals, London, UK
| | - Stefano Bucci
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Paolo Umari
- Department of Surgery, Clinic of Urology, University of Eastern Piedmont, Novara, Italy
| | - Carlo Trombetta
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Giovanni Liguori
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
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Beulens A, Brinkman W, Umari P, Koldewijn E, Hendrikx A, Van Basten JP, Van Merrienboer J, Van Der Poel H, Bangma C, Wagner C. Identifying the relationship between postoperative urinary continence and residual urethra stump measurements in robot assisted radical prostatectomy patients. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35867-5] [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: 10/23/2022] Open
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Beulens A, Vaartjes L, Tilli S, Brinkman W, Umari P, Puliatti S, Koldewijn E, Hendrikx A, Van Basten JP, Van Merriënboer J, Van Der Poel H, Bangma C, Wagner C. Structured robot assisted surgery training curriculum for residents in Urology and impact on future surgical activity. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35866-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Umari P, Bondonno G, Di Martino J, Perri D, La Rocca A, D'agate D, Billia M, Volpe A. Complex robot-assisted vescico-vaginal fistula repair: A step by step approach. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35891-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Beulens A, Hashish Y, Brinkman W, Umari P, Puliatti S, Koldewijn E, Hendrikx A, Van Basten JP, Van Merrienboer J, Van Der Poel H, Bangma C, Wagner C. Training novice robot surgeons: Proctoring provides same results as simulator-generated guidance. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35868-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Beulens AJW, Brinkman WM, Umari P, Koldewijn EL, Hendrikx AJM, van Basten JP, van Merriënboer JJG, van der Poel HG, Bangma C, Wagner C. Identifying the relationship between postoperative urinary continence and residual urethra stump measurements in robot assisted radical prostatectomy patients. Int J Med Robot 2020; 17:e2196. [PMID: 33113236 DOI: 10.1002/rcs.2196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate the feasibility of urethral stump length and width measurements in recorded videos of robot assisted radical prostatectomy procedures using the Kinovea software and to assess if these measurements could be used as predictors of postoperative urinary continence. METHODS Fifty-three patients were selected from an institutional database of 1400 cases and included in the study. All videos were analysed using the computer software 'Kinovea'. All measurements were performed using the inserted bladder catheter as a reference point. RESULTS The reference point (bladder catheter) was available in 33 out of 53 patients. The median surgical urethral length (SUL) was significantly higher in the continent group (1050 vs. 1294 mm, p = 0.018). The urethral width measurements did not show a difference between the groups. In order to validate the Kinovea software as an accurate tool for the measurement of the urethral stump length and width results were correlated with the magnetic resonance imaging measurements of the urethra. CONCLUSIONS The results of this study showed a significantly longer median SUL incontinent patients.
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Affiliation(s)
- Alexander J W Beulens
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.,Department of Urology, Catharina Hospital, Eindhoven, The Netherlands.,Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Willem M Brinkman
- Department of Oncological Urology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Paolo Umari
- University of Eastern Piedmont, Novara, Italy
| | - Evert L Koldewijn
- Department of Urology, Catharina Hospital, Eindhoven, The Netherlands
| | - Ad J M Hendrikx
- Department of Urology, Catharina Hospital, Eindhoven, The Netherlands.,Urologist, Not Practicing
| | - Jean Paul van Basten
- Prosper Prostate Cancer Center, Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | | | - Henk G van der Poel
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Chris Bangma
- Department of Urology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Cordula Wagner
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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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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Perri D, Palumbo C, Zacchero M, Bondonno G, La Rocca A, Di Martino J, Portè F, Umari P, Volpe A. Assessment of patterns of progression of clear cell renal cell carcinoma after nephrectomy in a large single institutional series. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35504-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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38
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La Rocca A, Bondonno G, Ceratti G, Zacchero M, Poletti F, Cavalli S, Billia M, Umari P, Volpe A. Robot-assisted surgical management of ureteral strictures: technical aspects and preliminary outcomes in a single centre series. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35418-5] [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: 10/23/2022] Open
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39
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Heinze A, Umari P, Basulto-Martínez M, Suárez-Ibarrola R, Liatsikos E, Rassweiler J, Guven S, Gözen AS. Impact of COVID-19 on Clinical and Academic Urological Practice: A Survey from European Association of Urology Section of Uro-technology. EUR UROL SUPPL 2020; 21:22-28. [PMID: 33123688 PMCID: PMC7430276 DOI: 10.1016/j.euros.2020.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 08/06/2020] [Indexed: 01/22/2023] Open
Abstract
Background The unexpected coronavirus disease 2019 (COVID-19) pandemic has spread worldwide rapidly, developing into a global health crisis. At the same time, it has seriously impacted the daily activities in all the fields of urology. Objective To better understand the impact of the COVID-19 pandemic on clinical, academic, and scientific activities as well as on the quality of life of urologists from the main centers in Europe. Design setting and participants We conducted a survey using a 37-item questionnaire. The survey included three main sections: clinical practice, academic/scientific activities, and personal/social quality of life. Outcome measurements and statistical analysis A descriptive analysis was performed using the collected data. Results and limitations A total of 107 representatives affiliated to different centers from 22 countries completed the survey. Clinical activities were affected in 54.2% of the centers, and 85.0% of the elective surgeries were cancelled. Of the urological departments, 64.5% were still performing minimally invasive surgery for malignant disease. In 33.6% of the hospitals, dedicated and specially equipped operating theaters for COVID-19-positive patients were not available. According to 72.9% of participants, COVID-19 had a substantial negative impact on academic activities, and 82.3% of the respondents agreed that their quality of life has been affected negatively by the pandemic. Finally, 92.5% of the participants believe that the pandemic will have a moderate to severe impact on the health system of their countries. Conclusions Data collected in this survey provide insight into changes brought about in clinical and academic settings amid COVID-19. Along with shortages such as bed occupancy and personal protective equipment, it highlights negative impacts on academic and scientific activities, including the personal and social life of urologists. Patient summary It is essential to understand the impact of the coronavirus disease 2019 (COVID-19) pandemic on clinical, academic, and scientific urological activities, as well as on related personal and social issues.
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Affiliation(s)
- Alexander Heinze
- American British Cowdray Medical Center, Mexico City, Mexico.,Department of Urology, Marienkrankenhaus, Hamburg, Germany
| | - Paolo Umari
- University of Eastern Piedmont, Department of Translational Medicine, Novara, Italy
| | - Mario Basulto-Martínez
- Department of Urology, Hospital Regional de Alta Especialidad de la Península de Yucatan, Merida, Mexico.,Department of Urology, IRCCS Ospedale San Raffaele-Turro, Milan, Italy
| | - Rodrigo Suárez-Ibarrola
- Department of Urology, Faculty of Medicine, University of Freiburg Medical Centre, Freiburg, Germany
| | | | - Jens Rassweiler
- SLK Kliniken Urology Department, Teaching Hospital of Heidelberg University, Heilbronn, Germany
| | - Selcuk Guven
- Urology Department, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Ali S Gözen
- SLK Kliniken Urology Department, Teaching Hospital of Heidelberg University, Heilbronn, Germany
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40
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Beulens AJW, Vaartjes L, Tilli S, Brinkman WM, Umari P, Puliatti S, Koldewijn EL, Hendrikx AJM, van Basten JP, van Merriënboer JJG, Van der Poel HG, Bangma CH, Wagner C. Structured robot-assisted surgery training curriculum for residents in Urology and impact on future surgical activity. J Robot Surg 2020; 15:497-510. [PMID: 32772237 DOI: 10.1007/s11701-020-01134-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 07/04/2020] [Accepted: 08/03/2020] [Indexed: 11/25/2022]
Abstract
To gain insight into the availability of training for robot assisted surgery (RAS) and the possibility to perform RAS during Dutch residency curriculum and to analyze the effects on surgical skills by the introduction of an advanced course in RAS for residents. A combination of a validated snap shot survey and a prospective cohort study. Structured advanced RAS training including virtual reality (VR) simulation, dry and wet lab facility at ORSI academy (Belgium). A snap-shot survey has been sent to all the residents and specialists in Urology graduated during the years 2017-2020 in Netherlands. Among residents, only last year residents (5th and 6th year) have been considered for the RAS training. Although most of the residents (88.2%) and young urologists (95%) were asked to follow a basic training or meet basic requirements before starting RAS, the requirements set by the educators were different from center to center. Some of them were required to attend only an online course on RAS, whereas others were asked to achieve threshold scores at VR simulator and participate in a standardized course at a training institute. The attendance to a structured advanced course in RAS showed a significant increase in surgical skills. Our study shows residents in urology are allowed to perform RAS during their residency though the criteria for starting RAS differ significantly amongst the teaching hospitals. To guarantee a basic level of skills and knowledge a structured, (multi-step) training and certification program for RAS should be implemented.
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Affiliation(s)
- A J W Beulens
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
- Department of Urology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
| | - L Vaartjes
- Department of Urology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands
| | - S Tilli
- Department of Urology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands
| | - W M Brinkman
- Department of Oncological Urology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - P Umari
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - S Puliatti
- Urology Department, University of Modena and Reggio Emilia, Modena, Italy
- Orsi Academy, Melle, Belgium
- Department of Urology, Onze Lieve Vrouw Hospital, Aalst, Belgium
| | - E L Koldewijn
- Department of Urology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands
| | - A J M Hendrikx
- Department of Urology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands
| | - J P van Basten
- Department of Urology, Prosper Prostate Cancer Center, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - J J G van Merriënboer
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - H G Van der Poel
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - C H Bangma
- Department of Urology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - C Wagner
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
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41
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Beulens AJW, Hashish YAF, Brinkman WM, Umari P, Puliatti S, Koldewijn EL, Hendrikx AJM, van Basten JP, van Merriënboer JJG, Van der Poel HG, Bangma CH, Wagner C. Training novice robot surgeons: Proctoring provides same results as simulator-generated guidance. J Robot Surg 2020; 15:397-428. [PMID: 32651769 DOI: 10.1007/s11701-020-01118-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 06/15/2020] [Accepted: 06/29/2020] [Indexed: 11/29/2022]
Abstract
To understand the influence of proctored guidance versus simulator generated guidance (SGG) on the acquisition dexterity skills in novice surgeons learning RAS (robot assisted surgery). Prospective non-blinded 3-arm randomised controlled trial (RTC). Exclusion criteria: previous experience in RAS or robotic surgery simulation. The participants were assigned to three different intervention groups and received a different form of guidance: (1) proctored guidance, (2) simulator generated guidance, (3) no guidance, during training on virtual reality (VR) simulator. All participants were asked to complete multiple questionnaires. The training was the same in all groups with the exception of the intervention part. Catharina Hospital Eindhoven, The Netherlands. A total of 70 Dutch medical students, PhD-students, and surgical residents were included in the study. The participants were randomly assigned to one of the three groups. Overall, all the participants showed a significant improvement in their dexterity skills after the training. There was no significant difference in the improvement of surgical skills between the three different intervention groups. The proctored guidance group reported a higher participant satisfaction compared to the simulator-generated guidance group, which could indicate a higher motivation to continue the training. This study showed that novice surgeons. Significantly increase their dexterity skills in RAS after a short time of practicing on simulator. The lack of difference in results between the intervention groups could indicate there is a limited impact of "human proctoring" on dexterity skills during surgical simulation training. Since there is no difference between the intervention groups the exposure alone of novice surgeons to the robotic surgery simulator could possibly be sufficient to achieve a significant improvement of dexterity skills during the initial steps of RAS learning.
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Affiliation(s)
- A J W Beulens
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands. .,Department of Urology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
| | - Y A F Hashish
- Department of Urology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands
| | - W M Brinkman
- Department of Oncological Urology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - P Umari
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - S Puliatti
- Urology Department, University of Modena & Reggio Emilia, Modena, Italy.,Orsi Academy, Melle, Belgium.,Department of Urology, Onze Lieve Vrouw Hospital, Aalst, Belgium
| | - E L Koldewijn
- Department of Urology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands
| | - A J M Hendrikx
- Department of Urology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - J P van Basten
- Department of Urology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - J J G van Merriënboer
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - H G Van der Poel
- Department of Urology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - C H Bangma
- Department of Urology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - C Wagner
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.,Amsterdam Public Health Research Institute, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
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42
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Porreca A, Colicchia M, D'Agostino D, Amenta M, Corsaro A, Zaramella S, Zegna L, Gallo F, Schenone M, Bozzini G, Calori A, Pastore AL, Al Salhi Y, Sciorio C, Spirito L, Varca V, Marenghi C, Greco F, Altieri VM, Verze P, Barba C, Antonelli A, Cerruto MA, Falabella R, Di Bello S, Leonardo C, Tufano A, Volpe A, Umari P, Parma P, Nidini M, Pini G, Borghesi M, Terrone C, Cacciamani GE, Sighinolfi MC, Busetto GM, Wennberg AM, Finocchiaro M, Falsaperla M, Oderda M, Ceruti C, Rocco B, Schiavina R, Bianchi L, Mari A, Di Maida F, Dalpiaz O, Celia A, Pirozzi M, Bove P, Iacovelli V, Cafarelli A, Cindolo L, Ferrari G, Gatti L, Pirola G, Annino F, Pucci L, Romagnoli D, Artibani W, Minervini A. Urology in the Time of Coronavirus: Reduced Access to Urgent and Emergent Urological Care during the Coronavirus Disease 2019 Outbreak in Italy. Urol Int 2020. [PMID: 32434207 DOI: 10.1159/000508512.] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic has put a substantial burden on the Italian healthcare system, resulting in the restructuring of hospitals to care for COVID-19 patients. However, this has likely impacted access to care for patients experiencing other conditions. We aimed to quantify the impact of COVID-19 on access to care for patients with urgent/emergent urological conditions throughout Italy. MATERIALS AND METHODS A questionnaire was sent to 33 urological units in the AGILE consortium, asking clinicians to report on the number of urgent/emergent urological patients seen and/or undergoing surgery over a 3-week period during the peak of the COVID-19 outbreak and a reference week prior to the outbreak. ANOVA and linear regression models were used to quantify these changes. RESULTS Data from 27 urological centres in Italy showed a decrease from 956 patients/week seen just prior to the outbreak to 291 patients/week seen by the end of the study period. There was a difference in the number of patients with urgent/emergent urological disease seen within/during the different weeks (all p values < 0.05). A significant decrease in the number of patients presenting with haematuria, urinary retention, urinary tract infection, scrotal pain, renal colic, or trauma and urgent/emergent cases that required surgery was reported (all p values < 0.05). CONCLUSION In Italy, during the COVID-19 outbreak there has been a decrease in patients seeking help for urgent/emergent urological conditions. Restructuring of hospitals and clinics is mandatory to cope with the COVID-19 pandemic; however, the healthcare system should continue to provide adequate levels of care also to patients with other conditions.
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Affiliation(s)
- Angelo Porreca
- Department of Urology, Policlinico Abano Terme, Abano Terme, Italy
| | | | | | - Michele Amenta
- Department of Urology, Ospedale Civile di Portogruaro, Portogruaro, Italy
| | - Alfio Corsaro
- Department of Urology, Ospedale Civile di Portogruaro, Portogruaro, Italy
| | | | - Luisa Zegna
- Department of Urology, Biella Hospital, Ponderano, Italy
| | - Fabrizio Gallo
- Department of Surgery, Division of Urology, San Paolo Hospital, Savona, Italy
| | - Maurizio Schenone
- Department of Surgery, Division of Urology, San Paolo Hospital, Savona, Italy
| | - Giorgio Bozzini
- Department of Urology, ASST Valle Olona, Busto Arsizio, Italy
| | - Alberto Calori
- Department of Urology, ASST Valle Olona, Busto Arsizio, Italy
| | - Antonio L Pastore
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Urology Unit, ICOT Hospital Latina, Rome, Italy
| | - Yazan Al Salhi
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Urology Unit, ICOT Hospital Latina, Rome, Italy
| | | | | | - Virginia Varca
- Hospital G. Salvini, ASST Rhodense Garbagnate Milanese, Milan, Italy
| | - Carlo Marenghi
- Hospital G. Salvini, ASST Rhodense Garbagnate Milanese, Milan, Italy
| | | | | | - Paolo Verze
- Department of Urology, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Ciro Barba
- Department of Urology, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Alessandro Antonelli
- Department of Urology, Azienda Ospedaliera Universitaria Integrata of Verona, University of Verona, Verona, Italy
| | - Maria A Cerruto
- Department of Urology, Azienda Ospedaliera Universitaria Integrata of Verona, University of Verona, Verona, Italy
| | - Roberto Falabella
- Department of Urology, Azienda Ospedaliera Regionale di Potenza, Potenza, Italy
| | - Silvana Di Bello
- UO Pronto Soccorso, Accettazione, Medicina Urgenza, Azienda Ospedaliera Regionale di Potenza, Potenza, Italy
| | | | - Antonio Tufano
- Department of Urology, La Sapienza University of Rome, Rome, Italy
| | - Alessandro Volpe
- Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Paolo Umari
- Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Paolo Parma
- Urology Department, ASST Mantova, Mantova, Italy
| | | | | | - Marco Borghesi
- Department of Urology, S. Martino Hospital, Department of Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
| | - Carlo Terrone
- Department of Urology, S. Martino Hospital, Department of Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
| | - Giovanni E Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Maria C Sighinolfi
- Urology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Gian Maria Busetto
- Department of Urology, Sapienza Rome University Policlinico Umberto I, Rome, Italy
| | - Alexandra M Wennberg
- Department of Neurosciences (Padova Neuroscience Centre), Università degli Studi di Padova, Padova, Italy
| | | | | | - Marco Oderda
- Università di Torino, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Carlo Ceruti
- Università di Torino, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Bernardo Rocco
- Urology Department, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Lorenzo Bianchi
- Department of Urology, University of Bologna, Bologna, Italy
| | - Andrea Mari
- Department of Urology, University of Florence, Florence, Italy
| | | | - Orietta Dalpiaz
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Antonio Celia
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Italy
| | - Marco Pirozzi
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Italy
| | - Pierluigi Bove
- Urology Unit, San Carlo Di Nancy Hospital, GVM Care and Research, Rome, Italy
| | - Valerio Iacovelli
- Urology Unit, San Carlo Di Nancy Hospital, GVM Care and Research, Rome, Italy
| | | | - Luca Cindolo
- Department of Urology, Villa Stuart Casa di Cura, Rome, Italy
| | | | - Lorenzo Gatti
- Department of Urology, Hesperia Hospital, Modena, Italy
| | - Giacomo Pirola
- Department of Urology, San Donato Hospital, USL Toscana Sudest, Arezzo, Italy
| | - Filippo Annino
- Department of Urology, San Donato Hospital, USL Toscana Sudest, Arezzo, Italy
| | - Luigi Pucci
- Department of Urology, AORN A. Cardarelli, Naples, Italy
| | | | - Walter Artibani
- Department of Urology, Policlinico Abano Terme, Abano Terme, Italy
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Porreca A, Colicchia M, D'Agostino D, Amenta M, Corsaro A, Zaramella S, Zegna L, Gallo F, Schenone M, Bozzini G, Calori A, Pastore AL, Al Salhi Y, Sciorio C, Spirito L, Varca V, Marenghi C, Greco F, Altieri VM, Verze P, Barba C, Antonelli A, Cerruto MA, Falabella R, Di Bello S, Leonardo C, Tufano A, Volpe A, Umari P, Parma P, Nidini M, Pini G, Borghesi M, Terrone C, Cacciamani GE, Sighinolfi MC, Busetto GM, Wennberg AM, Finocchiaro M, Falsaperla M, Oderda M, Ceruti C, Rocco B, Schiavina R, Bianchi L, Mari A, Di Maida F, Dalpiaz O, Celia A, Pirozzi M, Bove P, Iacovelli V, Cafarelli A, Cindolo L, Ferrari G, Gatti L, Pirola G, Annino F, Pucci L, Romagnoli D, Artibani W, Minervini A. Urology in the Time of Coronavirus: Reduced Access to Urgent and Emergent Urological Care during the Coronavirus Disease 2019 Outbreak in Italy. Urol Int 2020; 104:631-636. [PMID: 32434207 PMCID: PMC7360500 DOI: 10.1159/000508512] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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: 04/27/2020] [Accepted: 05/07/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic has put a substantial burden on the Italian healthcare system, resulting in the restructuring of hospitals to care for COVID-19 patients. However, this has likely impacted access to care for patients experiencing other conditions. We aimed to quantify the impact of COVID-19 on access to care for patients with urgent/emergent urological conditions throughout Italy. MATERIALS AND METHODS A questionnaire was sent to 33 urological units in the AGILE consortium, asking clinicians to report on the number of urgent/emergent urological patients seen and/or undergoing surgery over a 3-week period during the peak of the COVID-19 outbreak and a reference week prior to the outbreak. ANOVA and linear regression models were used to quantify these changes. RESULTS Data from 27 urological centres in Italy showed a decrease from 956 patients/week seen just prior to the outbreak to 291 patients/week seen by the end of the study period. There was a difference in the number of patients with urgent/emergent urological disease seen within/during the different weeks (all p values < 0.05). A significant decrease in the number of patients presenting with haematuria, urinary retention, urinary tract infection, scrotal pain, renal colic, or trauma and urgent/emergent cases that required surgery was reported (all p values < 0.05). CONCLUSION In Italy, during the COVID-19 outbreak there has been a decrease in patients seeking help for urgent/emergent urological conditions. Restructuring of hospitals and clinics is mandatory to cope with the COVID-19 pandemic; however, the healthcare system should continue to provide adequate levels of care also to patients with other conditions.
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Affiliation(s)
- Angelo Porreca
- Department of Urology, Policlinico Abano Terme, Abano Terme, Italy
| | | | | | - Michele Amenta
- Department of Urology, Ospedale Civile di Portogruaro, Portogruaro, Italy
| | - Alfio Corsaro
- Department of Urology, Ospedale Civile di Portogruaro, Portogruaro, Italy
| | | | - Luisa Zegna
- Department of Urology, Biella Hospital, Ponderano, Italy
| | - Fabrizio Gallo
- Department of Surgery, Division of Urology, San Paolo Hospital, Savona, Italy
| | - Maurizio Schenone
- Department of Surgery, Division of Urology, San Paolo Hospital, Savona, Italy
| | - Giorgio Bozzini
- Department of Urology, ASST Valle Olona, Busto Arsizio, Italy
| | - Alberto Calori
- Department of Urology, ASST Valle Olona, Busto Arsizio, Italy
| | - Antonio L Pastore
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Urology Unit, ICOT Hospital Latina, Rome, Italy
| | - Yazan Al Salhi
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Urology Unit, ICOT Hospital Latina, Rome, Italy
| | | | | | - Virginia Varca
- Hospital G. Salvini, ASST Rhodense Garbagnate Milanese, Milan, Italy
| | - Carlo Marenghi
- Hospital G. Salvini, ASST Rhodense Garbagnate Milanese, Milan, Italy
| | | | | | - Paolo Verze
- Department of Urology, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Ciro Barba
- Department of Urology, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Alessandro Antonelli
- Department of Urology, Azienda Ospedaliera Universitaria Integrata of Verona, University of Verona, Verona, Italy
| | - Maria A Cerruto
- Department of Urology, Azienda Ospedaliera Universitaria Integrata of Verona, University of Verona, Verona, Italy
| | - Roberto Falabella
- Department of Urology, Azienda Ospedaliera Regionale di Potenza, Potenza, Italy
| | - Silvana Di Bello
- UO Pronto Soccorso, Accettazione, Medicina Urgenza, Azienda Ospedaliera Regionale di Potenza, Potenza, Italy
| | | | - Antonio Tufano
- Department of Urology, La Sapienza University of Rome, Rome, Italy
| | - Alessandro Volpe
- Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Paolo Umari
- Division of Urology, Department of Translational Medicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy
| | - Paolo Parma
- Urology Department, ASST Mantova, Mantova, Italy
| | | | | | - Marco Borghesi
- Department of Urology, S. Martino Hospital, Department of Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
| | - Carlo Terrone
- Department of Urology, S. Martino Hospital, Department of Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
| | - Giovanni E Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Maria C Sighinolfi
- Urology Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Gian Maria Busetto
- Department of Urology, Sapienza Rome University Policlinico Umberto I, Rome, Italy
| | - Alexandra M Wennberg
- Department of Neurosciences (Padova Neuroscience Centre), Università degli Studi di Padova, Padova, Italy
| | | | | | - Marco Oderda
- Università di Torino, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Carlo Ceruti
- Università di Torino, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Bernardo Rocco
- Urology Department, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Lorenzo Bianchi
- Department of Urology, University of Bologna, Bologna, Italy
| | - Andrea Mari
- Department of Urology, University of Florence, Florence, Italy
| | | | - Orietta Dalpiaz
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Antonio Celia
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Italy
| | - Marco Pirozzi
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Italy
| | - Pierluigi Bove
- Urology Unit, San Carlo Di Nancy Hospital, GVM Care and Research, Rome, Italy
| | - Valerio Iacovelli
- Urology Unit, San Carlo Di Nancy Hospital, GVM Care and Research, Rome, Italy
| | | | - Luca Cindolo
- Department of Urology, Villa Stuart Casa di Cura, Rome, Italy
| | | | - Lorenzo Gatti
- Department of Urology, Hesperia Hospital, Modena, Italy
| | - Giacomo Pirola
- Department of Urology, San Donato Hospital, USL Toscana Sudest, Arezzo, Italy
| | - Filippo Annino
- Department of Urology, San Donato Hospital, USL Toscana Sudest, Arezzo, Italy
| | - Luigi Pucci
- Department of Urology, AORN A. Cardarelli, Naples, Italy
| | | | - Walter Artibani
- Department of Urology, Policlinico Abano Terme, Abano Terme, Italy
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Rizzo M, Cabas P, Pavan N, Umari P, Verzotti E, Boltri M, Stacul F, Bertolotto M, Liguori G, Trombetta C. Needle tract seeding after percutaneous cryoablation of small renal masses; a case series and literature review. Scand J Urol 2020; 54:122-127. [PMID: 32153242 DOI: 10.1080/21681805.2020.1736149] [Citation(s) in RCA: 4] [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] [Indexed: 12/12/2022]
Abstract
Neoplastic cell seeding due to needle tumor manipulation during renal mass biopsy (RMB) or thermal ablative treatment is a rare but potentially serious event that can turn an organ-confined and curable tumor in a nonorgan-confined and non-curable disease. Despite the widespread use of percutaneous thermal ablative treatment for small renal masses (SRMs), this complication has been described in few case reports and small case series and has never been reported after ablative treatment alone. We report a series of two patients that underwent cryoablation for SRMs and developed recurrence along the needle tract. Available knowledge on the controversial topic of tumor seeding following needle manipulation are poor. So far, reporting cases of tumor cell seeding due to needle manipulation is useful to permit a better understanding of this complication.
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Affiliation(s)
- Michele Rizzo
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Paolo Cabas
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Nicola Pavan
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Paolo Umari
- Division of Urology, Maggiore della Carita' Hospital, University of Eastern Piedmont, Novara, Italy
| | - Enrica Verzotti
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Matteo Boltri
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Fulvio Stacul
- Department of Radiology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Michele Bertolotto
- Department of Radiology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Giovanni Liguori
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Carlo Trombetta
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
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Claps F, Pavan N, Umari P, Rizzo M, Barbone F, Giangreco M, Liguori G, Mir CM, Bussani R, Trombetta C. Incidence, predictive factors and survival outcomes of incidental prostate cancer in patients who underwent radical cystectomy for bladder cancer. Minerva Urol Nephrol 2020. [PMID: 32026664 DOI: 10.23736/s0393-2249.20.03646-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to analyze the incidence, preoperative findings, pathological features and prognosis in patients with incidental prostate cancer (iPCa) detected at radical cystectomy (RC) for bladder cancer (BCa). METHODS We retrospectively reviewed data of patients who underwent RC for BCa at our Institution between January 2005 and March 2018. Data regarding patient's history, preoperative digital rectal examination (DRE), total serum PSA level were collected from the chart review. Univariable and multivariable Cox regression models addressed the association of iPCa with recurrence-free survival (RFS) and overall survival (OS). RESULTS We obtained a final study cohort of 177 patients. Median age was 69 years (IQR 42-89) and 80(45.2%) patients had iPCa. Patients with iPCa had higher age, preoperative PSA levels and a significant rate of suspicious DRE (all P<0.05). Four patients had BCR during a median follow-up of 28 months (IQR 6-159) and none died for prostate cancer. In multivariable analyses adjusted for age, bladder cancer BCa pT and pN stage and LVI the ten-years RFS and OS rates were not impacted by iPCa regardless of whether it is a clinically significant cancer or not (HR=1.25, 95% CI: 0.65-2.38, P=0.51 vs. HR=1.37, 95% CI: 0.71-2.64, P=0.35) (HR=1.04, 95% CI: 0.53-1.86, P=0.89 vs. HR=1.20, 95% CI: 0.22-6.72, P=0.83). CONCLUSIONS iPCa is quite common in our study group and most of cases are organ-confined and well differentiated. Regardless of clinical relevance, iPCa does not have an impact on survival outcomes as BCa is driving the prognosis of these patients.
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Affiliation(s)
- Francesco Claps
- Urology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Nicola Pavan
- Urology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy -
| | - Paolo Umari
- Department of Urology, A. Avogadro University of Eastern Piedmont, Novara, Italy
| | - Michele Rizzo
- Urology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Fabio Barbone
- IRCCS Burlo Garofalo Children's Hospital, University of Trieste, Trieste, Italy
| | - Manuela Giangreco
- Institute of Hygiene and Clinical Epidemiology, University of Udine, Udine, Italy
| | - Giovanni Liguori
- Urology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Carmen M Mir
- Department of Urology, Valencian Oncology Institute and Foundation (IVO), Valencia, Spain
| | - Rossana Bussani
- Institute of Pathological Anatomy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Carlo Trombetta
- Urology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
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Claps F, Pavan N, Umari P, Rizzo M, Barbone F, Giangreco M, Liguori G, Mir CM, Bussani R, Trombetta C. Incidence, predictive factors and survival outcomes of incidental prostate cancer in patients who underwent radical cystectomy for bladder cancer. Minerva Urol Nephrol 2020; 73:349-356. [PMID: 32026664 DOI: 10.23736/s2724-6051.20.03646-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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 aim of this study was to analyze the incidence, preoperative findings, pathological features and prognosis in patients with incidental prostate cancer (iPCa) detected at radical cystectomy (RC) for bladder cancer (BCa). METHODS We retrospectively reviewed data of patients who underwent RC for BCa at our Institution between January 2005 and March 2018. Data regarding patient's history, preoperative digital rectal examination (DRE), total serum PSA level were collected from the chart review. Univariable and multivariable Cox regression models addressed the association of iPCa with recurrence-free survival (RFS) and overall survival (OS). RESULTS We obtained a final study cohort of 177 patients. Median age was 69 years (IQR 42-89) and 80(45.2%) patients had iPCa. Patients with iPCa had higher age, preoperative PSA levels and a significant rate of suspicious DRE (all P<0.05). Four patients had BCR during a median follow-up of 28 months (IQR 6-159) and none died for prostate cancer. In multivariable analyses adjusted for age, bladder cancer BCa pT and pN stage and LVI the ten-years RFS and OS rates were not impacted by iPCa regardless of whether it is a clinically significant cancer or not (HR=1.25, 95% CI: 0.65-2.38, P=0.51 vs. HR=1.37, 95% CI: 0.71-2.64, P=0.35) (HR=1.04, 95% CI: 0.53-1.86, P=0.89 vs. HR=1.20, 95% CI: 0.22-6.72, P=0.83). CONCLUSIONS iPCa is quite common in our study group and most of cases are organ-confined and well differentiated. Regardless of clinical relevance, iPCa does not have an impact on survival outcomes as BCa is driving the prognosis of these patients.
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Affiliation(s)
- Francesco Claps
- Urology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Nicola Pavan
- Urology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy -
| | - Paolo Umari
- Department of Urology, A. Avogadro University of Eastern Piedmont, Novara, Italy
| | - Michele Rizzo
- Urology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Fabio Barbone
- IRCCS Burlo Garofalo Children's Hospital, University of Trieste, Trieste, Italy
| | - Manuela Giangreco
- Institute of Hygiene and Clinical Epidemiology, University of Udine, Udine, Italy
| | - Giovanni Liguori
- Urology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Carmen M Mir
- Department of Urology, Valencian Oncology Institute and Foundation (IVO), Valencia, Spain
| | - Rossana Bussani
- Institute of Pathological Anatomy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Carlo Trombetta
- Urology Clinic, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
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Proppe AH, Walters GW, Alsalloum AY, Zhumekenov AA, Mosconi E, Kelley SO, De Angelis F, Adamska L, Umari P, Bakr OM, Sargent EH. Transition Dipole Moments of n = 1, 2, and 3 Perovskite Quantum Wells from the Optical Stark Effect and Many-Body Perturbation Theory. J Phys Chem Lett 2020; 11:716-723. [PMID: 31933373 DOI: 10.1021/acs.jpclett.9b03349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Metal halide perovskite quantum wells (PQWs) are quantum and dielectrically confined materials exhibiting strongly bound excitons. The exciton transition dipole moment dictates absorption strength and influences interwell coupling in dipole-mediated energy transfer, a process that influences the performance of PQW optoelectronic devices. Here we use transient reflectance spectroscopy with circularly polarized laser pulses to investigate the optical Stark effect in dimensionally pure single crystals of n = 1, 2, and 3 Ruddlesden-Popper PQWs. From these measurements, we extract in-plane transition dipole moments of 11.1 (±0.4), 9.6 (±0.6) and 13.0 (±0.8) D for n = 1, 2 and 3, respectively. We corroborate our experimental results with density functional and many-body perturbation theory calculations, finding that the nature of band edge orbitals and exciton wave function delocalization depends on the PQW "odd-even" symmetry. This accounts for the nonmonotonic relationship between transition dipole moment and PQW dimensionality in the n = 1-3 range.
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Affiliation(s)
- Andrew H Proppe
- Department of Chemistry , University of Toronto , 80 St. George Street , Toronto , Ontario , Canada M5S 3G4
- The Edward S. Rogers Department of Electrical and Computer Engineering , University of Toronto , 10 King's College Road , Toronto , Ontario , Canada M5S 3G4
| | - Grant W Walters
- The Edward S. Rogers Department of Electrical and Computer Engineering , University of Toronto , 10 King's College Road , Toronto , Ontario , Canada M5S 3G4
| | - Abdullah Y Alsalloum
- Division of Physical Science and Engineering , King Abdullah University of Science and Technology , Thuwal 23955-6900 , Kingdom of Saudi Arabia
| | - Ayan A Zhumekenov
- Division of Physical Science and Engineering , King Abdullah University of Science and Technology , Thuwal 23955-6900 , Kingdom of Saudi Arabia
| | - Edoardo Mosconi
- Computational Laboratory for Hybrid/Organic Photovoltaics (CLHYO) , Istituto CNR di Scienze e Tecnologie Chimiche "Giulio Natta" (CNR-SCITEC) , Via Elce di Sotto 8 , 06123 Perugia , Italy
| | - Shana O Kelley
- Department of Chemistry , University of Toronto , 80 St. George Street , Toronto , Ontario , Canada M5S 3G4
- Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy , University of Toronto , Toronto , Ontario , Canada M5S 3M2
| | - Filippo De Angelis
- Computational Laboratory for Hybrid/Organic Photovoltaics (CLHYO) , Istituto CNR di Scienze e Tecnologie Chimiche "Giulio Natta" (CNR-SCITEC) , Via Elce di Sotto 8 , 06123 Perugia , Italy
- Department of Chemistry, Biology and Biotechnology , University of Perugia , Via Elce di Sotto 8 , 06123 Perugia , Italy
| | - Lyudmyla Adamska
- Dipartimento di Fisica e Astronomia , Università di Padova , via Marzolo 8 , I-35131 Padova , Italy
| | - Paolo Umari
- Dipartimento di Fisica e Astronomia , Università di Padova , via Marzolo 8 , I-35131 Padova , Italy
- CNR-IOM DEMOCRITOS, Istituto Officina dei Materiali , Consiglio Nazionale delle Ricerche , I-34149 Trieste , Italy
| | - Osman M Bakr
- Division of Physical Science and Engineering , King Abdullah University of Science and Technology , Thuwal 23955-6900 , Kingdom of Saudi Arabia
| | - Edward H Sargent
- The Edward S. Rogers Department of Electrical and Computer Engineering , University of Toronto , 10 King's College Road , Toronto , Ontario , Canada M5S 3G4
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Rizzo M, Verzotti E, Di Cosmo G, Cai T, Pavan N, Bonkat G, Umari P, Cocci A, Trombetta C, Liguori G. Perioperative Antimicrobial Prophylaxis for Preventing Infectious Complications After Transurethral Resection of the Bladder: To Use or Not to Use? J Endourol 2020; 34:198-202. [PMID: 31760786 DOI: 10.1089/end.2019.0523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Michele Rizzo
- Department of Urology, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Enrica Verzotti
- Department of Urology, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Giacomo Di Cosmo
- Department of Urology, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Tommaso Cai
- Department of Urology, Santa Chiara Hospital, Trento, Italy
| | - Nicola Pavan
- Department of Urology, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Gernot Bonkat
- Alta Uro AG, Merian Iselin Klinik, Center of Biomechanics and Calorimetry (COB), University Basel, Basel, Switzerland
| | - Paolo Umari
- Division of Urology, Maggiore della Carita' Hospital, University of Eastern Piedmont, Novara, Italy
| | - Andrea Cocci
- Department of Urology, University of Florence, Florence, Italy
| | - Carlo Trombetta
- Department of Urology, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Giovanni Liguori
- Department of Urology, Cattinara Hospital, University of Trieste, Trieste, Italy
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Rizzo M, Ongaro L, Claps F, Ghassempour D, Verzotti E, Migliozzi F, Boltri M, Pavan N, Garaffa G, Bucci S, Umari P, Trombetta C, Liguori G. Analysis of clinical utility of abdominopelvic computed tomography in the follow-up of Stage I seminoma: a single center evaluation. Minerva Urol Nephrol 2019. [PMID: 31833335 DOI: 10.23736/s0393-2249.19.03562-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Abdominopelvic computed tomography (CT) is widely used in the follow-up of seminoma patients after radical orchidectomy. The aim of this study was to evaluate the clinical utility of abdominopelvic computed tomography in the follow-up of patients with Stage I seminoma. METHODS The pathological reports of all patients that have undergone radical orchidectomy in our tertiary referral center between January 2002 and January 2018 have been retrospectively reviewed. All patients with Stage I seminoma and negative serum tumor markers after radical orchidectomy were included. Patients with follow-up shorter than 12 months were excluded. Surveillance records of every patient were reviewed with regard to abdominopelvic imaging. RESULTS Of the 133 patients who have undergone radical orchidectomy in our center, 55 had Stage I pure seminoma with normal levels of serum tumor markers after surgery. Two patients were excluded as the follow-up was inadequate. Mean follow-up was 63.2 months (IQR: 30-73). The results of 211 abdominopelvic CTs performed as part of the follow-up were reviewed. Two (3,7%) patients developed recurrence; one consisted of a scrotal lump and was diagnosed with ultrasonography (US) while the second appeared as paraaortic nodal metastasis and was diagnosed with abdominopelvic CT. The recurrence was successfully treated in both patients. A single abdominopelvic CT was useful for the detection of recurrent disease in our entire study population. No cancer specific death has been reported in the study population. CONCLUSIONS Follow-up schedules for Stage I seminoma expose patients to potential risks of radiation-induced tumors, emotional distress and represent a significant burden for the healthcare system. The current series suggests that a better risk adapted patient-tailored follow-up program is needed in order to avoid unnecessary investigations.
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Affiliation(s)
- Michele Rizzo
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy -
| | - Luca Ongaro
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Francesco Claps
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Dario Ghassempour
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Enrica Verzotti
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Francesca Migliozzi
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Matteo Boltri
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Nicola Pavan
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Giulio Garaffa
- The Institute of Urology, University College London Hospitals, London, UK
| | - Stefano Bucci
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Paolo Umari
- Department of Surgery, Clinic of Urology, University of Eastern Piedmont, Novara, Italy
| | - Carlo Trombetta
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
| | - Giovanni Liguori
- Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy
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Caputo M, Cefarin N, Radivo A, Demitri N, Gigli L, Plaisier JR, Panighel M, Di Santo G, Moretti S, Giglia A, Polentarutti M, De Angelis F, Mosconi E, Umari P, Tormen M, Goldoni A. Electronic structure of MAPbI 3 and MAPbCl 3: importance of band alignment. Sci Rep 2019; 9:15159. [PMID: 31641160 PMCID: PMC6805902 DOI: 10.1038/s41598-019-50108-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 08/28/2019] [Indexed: 12/02/2022] Open
Abstract
Since their first appearance, organic-inorganic perovskite absorbers have been capturing the attention of the scientific community. While high efficiency devices highlight the importance of band level alignment, very little is known on the origin of the strong n-doping character observed in the perovskite. Here, by means of a highly accurate photoemission study, we shed light on the energy alignment in perovskite-based devices. Our results suggest that the interaction with the substrate may be the driver for the observed doping in the perovskite samples.
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Affiliation(s)
- Marco Caputo
- Elettra - Sincrotrone Trieste, s.s. 14 Km 163.5 in Area Science Park, Basovizza (Trieste) 34149, Trieste, Italy.
| | - Nicola Cefarin
- IOM-CNR Lab. TASC, s.s. 14 Km 163.5 in Area Science Park, Basovizza (Trieste) 34149, Trieste, Italy
- Dipartimento di Fisica - Università di Trieste, via Valerio Trieste, Trieste, Italy
| | - Andrea Radivo
- Elettra - Sincrotrone Trieste, s.s. 14 Km 163.5 in Area Science Park, Basovizza (Trieste) 34149, Trieste, Italy
- IOM-CNR Lab. TASC, s.s. 14 Km 163.5 in Area Science Park, Basovizza (Trieste) 34149, Trieste, Italy
| | - Nicola Demitri
- Elettra - Sincrotrone Trieste, s.s. 14 Km 163.5 in Area Science Park, Basovizza (Trieste) 34149, Trieste, Italy
| | - Lara Gigli
- Elettra - Sincrotrone Trieste, s.s. 14 Km 163.5 in Area Science Park, Basovizza (Trieste) 34149, Trieste, Italy
| | - Jasper R Plaisier
- Elettra - Sincrotrone Trieste, s.s. 14 Km 163.5 in Area Science Park, Basovizza (Trieste) 34149, Trieste, Italy
| | - Mirco Panighel
- Elettra - Sincrotrone Trieste, s.s. 14 Km 163.5 in Area Science Park, Basovizza (Trieste) 34149, Trieste, Italy
- Dipartimento di Fisica - Università di Trieste, via Valerio Trieste, Trieste, Italy
| | - Giovanni Di Santo
- Elettra - Sincrotrone Trieste, s.s. 14 Km 163.5 in Area Science Park, Basovizza (Trieste) 34149, Trieste, Italy
| | - Sacha Moretti
- CNR - Institute of Atmospheric pollution Research - Sezione di Rende - c/o Polifunzionale - UNICAL 87036 Rende (CS), Rende, Italy
| | - Angelo Giglia
- IOM-CNR Lab. TASC, s.s. 14 Km 163.5 in Area Science Park, Basovizza (Trieste) 34149, Trieste, Italy
| | - Maurizio Polentarutti
- Elettra - Sincrotrone Trieste, s.s. 14 Km 163.5 in Area Science Park, Basovizza (Trieste) 34149, Trieste, Italy
| | - Filippo De Angelis
- Computational Laboratory for Hybrid/Organic Photovoltaics (CLHYO), CNR-ISTM, Via Elce di Sotto 8, I-06123, Perugia, Italy
- CompuNet, Istituto Italiano di Tecnologia, Via Morego 30, 16163, Genova, Italy
| | - Edoardo Mosconi
- Computational Laboratory for Hybrid/Organic Photovoltaics (CLHYO), CNR-ISTM, Via Elce di Sotto 8, I-06123, Perugia, Italy
- CompuNet, Istituto Italiano di Tecnologia, Via Morego 30, 16163, Genova, Italy
| | - Paolo Umari
- IOM-CNR Lab. TASC, s.s. 14 Km 163.5 in Area Science Park, Basovizza (Trieste) 34149, Trieste, Italy
- Dipartimento di Fisica e Astronomia - Università di Padova, via Marzolo, 35131, Padova, Italy
| | - Massimo Tormen
- IOM-CNR Lab. TASC, s.s. 14 Km 163.5 in Area Science Park, Basovizza (Trieste) 34149, Trieste, Italy
| | - Andrea Goldoni
- Elettra - Sincrotrone Trieste, s.s. 14 Km 163.5 in Area Science Park, Basovizza (Trieste) 34149, Trieste, Italy.
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