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Baruah U, Barmon D, Begum D, Aparajita. Utilizing Condoms in Laparoscopic Gynecologic Cancer Surgeries: A Profitable Safeguard? Indian J Surg Oncol 2023; 14:723-726. [PMID: 37900647 PMCID: PMC10611629 DOI: 10.1007/s13193-023-01758-0] [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: 07/15/2022] [Accepted: 04/25/2023] [Indexed: 10/31/2023] Open
Abstract
Minimally invasive approach is a well-established strategy in the initial exploration or definitive management of the eligible gynecological cancers. It provides the benefits of improved surgical recovery to the patients. However, the last step of the specimen extraction through the smallest incision possible is always challenging for most of the surgeons. The in-bag retrieval of specimen needs utmost attention in most of the malignancies for the preservation of tumor integrity to avoid tumor seedling and upstaging of the disease. The various kinds of commercially available bags are already being utilized for the retrieval of specimens. However, the venture into innovative methods of development of novel and economical specimen retrieval system is desirable owing to the high cost of the commercial endobags. Here, we have described a very simple, safe, and cost-effective technique of specimen retrieval using the ETO sterilized condoms for smaller specimens' extraction in gynecological cancer surgeries.
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Affiliation(s)
- Upasana Baruah
- Department of Gynecological Oncology, Dr. B. Borooah Cancer Institute, Guwahati, India
| | - Debabrata Barmon
- Department of Gynecological Oncology, Dr. B. Borooah Cancer Institute, Guwahati, India
| | - Dimpy Begum
- Department of Gynecological Oncology, Dr. B. Borooah Cancer Institute, Guwahati, India
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Raizenne BL, Zheng X, Oumedjbeur K, Mao J, Zorn KC, Elterman D, Bhojani N, McClure T, Te A, Kaplan S, Sedrakyan A, Chughtai B. Prostatic artery embolization compared to transurethral resection of the prostate and prostatic urethral lift: a real-world population-based study. World J Urol 2023; 41:179-188. [PMID: 36463348 DOI: 10.1007/s00345-022-04218-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/04/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND There are growing interests for minimally invasive surgical techniques (MISTs) for the treatment of benign prostatic hyperplasia (BPH)-associated lower urinary tract symptoms (LUTS). Prostatic artery embolization (PAE) uses selective angioembolization of prostatic arteries, thereby reducing size to improve LUTS/BPH. However, real-world data comparing surgical outcomes between MISTs and tissue resective techniques are lacking. We assessed the differences in surgical outcomes between PAE, transurethral resection of the prostate (TURP), and prostatic urethral lift (PUL) in a real-world population for LUTS/BPH. METHODS We present an observational population-based study of 12,902 men with BPH in New York State who received PAE, TURP, and PUL in outpatient and ambulatory surgery settings from 2014 to 2018. For short-term outcomes, we report 30-day and 90-day risks of readmission to inpatient and emergency room (ER) with/without complications and compared them across groups using χ2 tests and mixed-effect logistic regressions. For long-term outcomes, we report surgical retreatment and stricture rates using Kaplan-Meier failure curves and compared them using Log rank tests and Cox regression models. RESULTS Of 12 902 men, 335 had PAE, 11,205 had TURP, and 1362 had PUL. PAE patients had the highest 30-day (19.9%) and 90-day (35.6%) risks of readmission to inpatient or ER (p < 0.01). Non-specific abdominal pain was the main diagnosis associated with 30-day and 90-day readmissions to inpatient or ER after PAE (14.3% and 26.8%, respectively). After 2 years of follow-up, PAE patients had the highest retreatment rate of 28.5% (95%CI 23.7-34.2%) compared to TURP (3.4% (95%CI 3.1-3.8%)) and PUL (8.5% (95%CI 5.6-12.9%)) (p < 0.001). CONCLUSION In a real-world population, PAE was associated with the most frequent 30-day and 90-day readmission to inpatient or ER and the highest retreatment rate among all surgical techniques even when controlled for individual patient comorbidities and surgical volume.
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Affiliation(s)
- Brendan L Raizenne
- Division of Urology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Xinyan Zheng
- Department of Population Health Sciences, Weill Cornell Medical College/New York Presbyterian, New York, NY, USA
| | | | - Jialin Mao
- Department of Population Health Sciences, Weill Cornell Medical College/New York Presbyterian, New York, NY, USA
| | - Kevin C Zorn
- Division of Urology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Dean Elterman
- Division of Urology, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Naeem Bhojani
- Division of Urology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Timothy McClure
- Department of Urology, Weill Cornell Medical College/New York Presbyterian, 425 East 61St St., 12th Floor, New York, NY, 10065, USA
| | - Alexis Te
- Department of Urology, Weill Cornell Medical College/New York Presbyterian, 425 East 61St St., 12th Floor, New York, NY, 10065, USA
| | - Steven Kaplan
- Department of Urology, Mount Sinai Hospital, New York, NY, USA
| | - Art Sedrakyan
- Department of Population Health Sciences, Weill Cornell Medical College/New York Presbyterian, New York, NY, USA
| | - Bilal Chughtai
- Department of Population Health Sciences, Weill Cornell Medical College/New York Presbyterian, New York, NY, USA. .,Department of Urology, Weill Cornell Medical College/New York Presbyterian, 425 East 61St St., 12th Floor, New York, NY, 10065, USA.
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Raizenne BL, Zheng X, Mao J, Zorn KC, Cho A, Elterman D, Bhojani N, Sedrakyan A, Chughtai B. Real-world data comparing minimally invasive surgeries for benign prostatic hyperplasia. World J Urol 2022. [PMID: 35107632 DOI: 10.1007/s00345-021-03926-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/30/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES To assess the differences in surgical outcomes between the prostatic urethral lift (PUL) and previous thermal energy procedures for the treatment of benign prostatic hyperplasia (BPH). METHODS We present an observational population-based study of 2694 men with BPH in New York State and California who received PUL, transurethral needle ablation (TUNA), or transurethral microwave therapy (TUMT) in outpatient and ambulatory surgery settings from 2005 to 2018. For these surgical procedures, short-term outcomes were reported and compared using a Chi-square test and mixed-effect logistic regressions. Long-term outcomes were described using Kaplan-Meier failure curves and compared using a Log-rank test and Cox regressions. RESULTS A significant portion of PUL patients had a comorbidity count ≥ 2 (n = 838, 37.0%). PUL exhibited the lowest 30 day and 90-day inpatient or ER readmission rates among all surgical techniques except for 90-day ER readmission (p < 0.05). No differences were observed for 1- and 3-year risks of reoperation between PUL [5.5% (95% CI 4.4-6.8%) and 14.9% (95% CI 10.9-20.1%)], TUNA [7.4% (95% CI 5.0-10.9%) and 11.3% (95% CI 8.3-15.4%)] and TUMT [8.5% (95% CI 4.7-15.2%) and 15.3% (95% CI 9.5-24.0%)]. 1- and 3-year risks of stricture development for PUL were 0.2% (95% CI 0.0-0.7%) and 0.2% (95% CI 0.0-0.07%), respectively. CONCLUSION In a patient population with chronic conditions, patients treated with PUL exhibited similar 30- and 90-day inpatient or ER readmission rates when compared to previous reports. However, 1- and 3-year reoperation risks for PUL closely resembled previous thermal energy surgical procedures.
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Perikal PJ, Srikantha U, Joshi KC, J AJ, Khanapure K, Varma RG, Hegde SA. Minimally Invasive Augmented Fixation for Anatomical Reduction of Grade 2 and Grade 3 Listhesis in Patients with Osteoporosis. Asian Spine J 2018; 12:887-892. [PMID: 30213172 PMCID: PMC6147869 DOI: 10.31616/asj.2018.12.5.887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/05/2018] [Indexed: 11/25/2022] Open
Abstract
Study Design A retrospective study. Purpose To study the efficacy of augmented fixation for anatomical reduction of grade 2 and grade 3 listhesis in patients with osteoporosis. Overview of Literature Spondylolisthesis in osteoporotic patients requiring spinal fixation are associated with complications such as loss of surgical construct stability, screw pulling out, and screw loosening. Augmented fixation is a novel strategy to achieve necessary construct integrity. Methods Thirteen consecutive patients with grade 2 or grade 3 listhesis, with proven osteoporosis on dual energy X-ray absorptiometry (DEXA) scan, and who underwent augmented fixation for reduction of listhesis were retrospectively analyzed. In all patients, surgical access was achieved with a fixed 22 mm tubular retractor. A modified technique of bilateral, sequential, transforaminal decompression and discectomy, followed by reduction of listhesis using unilaterally placed augmented screws was employed in all the cases. Patients were followed up with plain X-rays at regular intervals to assess for implant stability and fusion status. All patients were started on medical treatment for osteoporosis. Results The mean age of the patients was 52.46 years, with 12 females and one male. The median T-score on DEXA scan was −3.0. Of the 13 patients, listhesis was at L4–L5 in five and at L5–S1 in eight. Nine patients had grade 2 listhesis, while four patients had grade 3 listhesis. Complete reduction was achieved in 10 patients. The median duration of follow-up was 18 months. Postoperative outcomes were satisfactory in all cases. Conclusions Augmented fixation is a useful technique for achieving anatomical reduction of listhesis in patients with osteoporosis.
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Affiliation(s)
- Parichay J Perikal
- Department of Neurosurgery, M S Ramaiah Institute of Neurosciences, M S Ramaiah Medical College, Bangalore, India
| | - Umesh Srikantha
- Department of Neurosurgery, Aster CMI Hospital, Bangalore, India
| | - Krishna C Joshi
- Department of Neurosurgery, M S Ramaiah Institute of Neurosciences, M S Ramaiah Medical College, Bangalore, India
| | - Aniruddha Jagannath J
- Department of Neurosurgery, M S Ramaiah Institute of Neurosciences, M S Ramaiah Medical College, Bangalore, India
| | - Kiran Khanapure
- Department of Neurosurgery, M S Ramaiah Institute of Neurosciences, M S Ramaiah Medical College, Bangalore, India
| | - Ravi Gopal Varma
- Department of Neurosurgery, Aster CMI Hospital, Bangalore, India
| | - Sathyaranjandas Alanga Hegde
- Department of Neurosurgery, M S Ramaiah Institute of Neurosciences, M S Ramaiah Medical College, Bangalore, India
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