Abstract:
BACKGROUND AND PURPOSE:As life expectancy continues to increase, we will be faced with the need to counsel older patients on the risks and benefits of undergoing surgery. It is clear that laparoscopic renal surgery has significant benefits over open renal surgery. However, contemporary data on whether these benefits carry over to the elderly is less robust. The objective of this study is to compare the perioperative outcomes of laparoscopic nephrectomy in patients age 70 and over to those under age 70. Outcomes from the study can be used to assist in preoperative counseling for older patients. PATIENTS AND METHODS:Between February 2000 and December 2005, 405 consecutive patients underwent laparoscopic nephrectomy for benign or malignant conditions. To decrease selection bias, kidney donors, bilateral nephrectomies, partial nephrectomies, as well as patients under the age of 17 were excluded. Laparoscopic nephrectomies included simple nephrectomies, radical nephrectomies, and nephroureterectomies. A total of 158 patients were included in the analysis. Patient demographics and perioperative data were recorded prospectively. The preoperative American Society of Anesthesiologists (ASA) score was used to reflect patient co-morbidity. Subset analysis between pure laparoscopic nephrectomy (LN) and hand-assisted laparoscopic nephrectomy (HALN) was also performed. RESULTS:Average hospital stay for patients 70 years and older was 3.6 days versus 2.6 days for their younger counterparts (p = 0.02). All other demographic and perioperative parameters were comparable between groups, including incidence of intraoperative or postoperative complications, blood transfusions, and conversions to open surgery. In a subset analysis of patients undergoing HALN, despite having similar co-morbid conditions (ASA score 2.57 vs. 2.56, p = 0.9), the elderly group had a significantly increased length of stay compared to patients younger than 70 years (3.0 vs. 4.2 days, p < 0.05). However, in the group undergoing LN, there was no statistically significant difference in hospital stay (3.1 vs. 2.4 days, p = 0.22), despite the older group having higher co-morbid conditions (ASA score 2.55 vs. 2.10, p < 0.01). CONCLUSION:Other than an increased hospital stay by one day, patients 70 years and older undergoing laparoscopic nephrectomy can expect comparable perioperative outcomes to those achieved in younger patients. Such differences in the length of hospital stay may be mitigated by pure laparoscopic nephrectomy as opposed to hand-assisted laparoscopic nephrectomy in patients 70 years or older. These data may be useful in preoperative decision-making and counseling in this growing subset of patients.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Lai FC,Kau EL,Ng CS,Fuchs GJdoi
10.1089/end.2007.9885subject
Has Abstractpub_date
2007-11-01 00:00:00pages
1309-13issue
11eissn
0892-7790issn
1557-900Xjournal_volume
21pub_type
杂志文章abstract::Extravesical robotic-assisted laparoscopic ureteral reimplantation in children is a challenging procedure. Our top-down suturing technique facilitates this reconstructive surgery. After mobilization of the ureter without the use of ureteral stent placement, the detrusor muscle is divided. Once adequate muscle flaps ar...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0815
更新日期:2015-08-01 00:00:00
abstract:: Purpose: Several case series have demonstrated the safety and feasibility of outpatient robot-assisted radical prostatectomy (RARP) in well-selected patients; however, the patient perspective of this practice has not been well explored. In this study, we explored patients'...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0796
更新日期:2020-04-01 00:00:00
abstract:INTRODUCTION/PURPOSE:Medical simulation offers the advantage of improving resident skill and comfort without impacting patient care. Five years ago, we identified trends in the use of robotic and laparoscopic simulation in 2008 and 2009 at American urology residency training programs. We seek to identify the changes in...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2015.0561
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Biodegradable urethral stents have been used clinically for some years mainly in order to prevent postoperative urinary retention after minimally invasive thermotreatment of benign prostatic hyperplasia. We previously reported a 15-month-follow-up pilot study of a bioabsorbable self-expandable, s...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/08927790260472926
更新日期:2002-12-01 00:00:00
abstract:PURPOSE:To compare blind access and totally tubeless percutaneous antegrade removal and pneumatic transurethral ureterolithotripsy for the management of impacted upper-ureteral calculi >1 cm. PATIENTS AND METHODS:Seventy patients (41 male, 29 female) with impacted upper-ureteral calculi >1 cm were selected in randomiz...
journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2006.20.616
更新日期:2006-09-01 00:00:00
abstract:: Purpose: To conduct a randomized, controlled, multicenter study that could compare the efficacy and stent-related symptom scores between 5F and 6F ureteral stents after ureteroscopic lithotripsy (URS). Materials and Methods: Fr...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0482
更新日期:2020-03-01 00:00:00
abstract:PURPOSE:Microdialysis is an innovative technique used to monitor the chemistry of the interstitial fluid in living tissue. We documented changes in concentration of interstitial fluid metabolites before, during, and after induced renal ischemia. MATERIALS AND METHODS:Under general anesthesia, a microdialysis probe was...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2007.0256
更新日期:2008-03-01 00:00:00
abstract::Distal ureteral stones are usually treated today by extracorporeal shock wave lithotripsy or extraction by retrograde ureteroscopy with or without previous fragmentation. We performed a cost-efficacy study of three methods to treat them: extracorporeal lithotripsy using either a spark gap lithotripter, the unmodified ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1993.7.289
更新日期:1993-08-01 00:00:00
abstract:: Background: Nonmuscle-invasive bladder cancer is diagnosed, treated, and monitored using cystoscopy. Artificial intelligence (AI) is increasingly used to augment tumor detection, but its performance is hindered by the limited availability of cystoscopic images required to ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0919
更新日期:2020-12-04 00:00:00
abstract:OBJECTIVE:To determine the preoperative and perioperative predictive factors of morbidity/mortality in patients undergoing percutaneous nephrolithotomy (PCNL), using the Clavien's classification. MATERIALS AND METHODS:We performed a retrospective chart review of patients who underwent PCNL between January 2005 and Jan...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0781
更新日期:2014-09-01 00:00:00
abstract:PURPOSE:To assess the clinical efficacy and safety of photoselective laser vaporization of the prostate (PVP) in the treatment of patients with acute urinary retention (AUR) secondary to benign prostatic hyperplasia (BPH). PATIENTS AND METHODS:Forty-two patients (mean age 72 +/- 5 years, range 65-89) with AUR because ...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.2007.0045
更新日期:2008-03-01 00:00:00
abstract:: Introduction: How to quantify the impact of metabolic syndrome (MetS) on percutaneous nephrolithotomy (PCNL) is unclear. We aimed to evaluate the quantified effect of the number of MetS components on the outcome of PCNL. Materials and Methods: ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0404
更新日期:2019-11-01 00:00:00
abstract::Raman spectroscopic and microscopic techniques have been used for nondestructive characterization of tissues and to differentiate benign and malignant tissues. The discovery of the principles of spectroscopy is credited to Sir C.V. Raman of India, who in 1930 brought the Nobel Prize in Physics to the East side of Suez...
journal_title:Journal of endourology
pub_type: 传,历史文章,杂志文章
doi:10.1089/end.2006.9998
更新日期:2007-01-01 00:00:00
abstract::After an extensive favorable experience with the Lapides-Ball open retropubic bladder neck suspension, we chose to perform this operation laparoscopically. We describe video-assisted extraperitoneal laparoscopic bladder neck suspension (VELBNS), in which we employ a single laparoscopic cannula and a laparoscopic bladd...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1995.9.259
更新日期:1995-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Laparoscopic radical prostatectomy (LRP) is an established treatment for patients with prostate cancer in selected centers with appropriate expertise. We studied our single-center experience of developing a LRP service and subsequent training of two additional surgeons by the initial surgeon. We ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2011.0635
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Comprehensive metabolic evaluation has become an important aspect of the management of recurrent nephrolithiasis, yet the role of stone analysis is often neglected or perhaps underestimated. The purpose of this study was to determine the role of stone analysis in medical decision making in patien...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277901750134548
更新日期:2001-03-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVE:Despite guidelines, routine 24-hour urine testing is completed in <10% of high-risk, recurrent stone formers. Using surrogates for metabolic testing, such as key patient characteristics, could obviate the cost and burden of this test while providing information needed for proper stone prevent...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2017.0352
更新日期:2017-12-01 00:00:00
abstract::Severe urethral stricture disease as an isolated entity can be a management dilemma. In the patient described here, this problem was associated with prior external-beam radiation and cryosurgical ablation of the prostate, and a functional artificial urethral sphincter (AUS) had been placed. An attempt to relieve parti...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1999.13.585
更新日期:1999-10-01 00:00:00
abstract:PURPOSE:To evaluate the physical properties of urethral catheters that are predictive of ease of placement and risk of urethral trauma: Stiffness, buckling, and friction forces. MATERIALS AND METHODS:Eleven Bard Lubri-Sil and 10 Kendall Dover 16F Foley catheters were tested using a linear motion stage driven by a step...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2008.0503
更新日期:2009-01-01 00:00:00
abstract:PURPOSE:To assess the effectiveness of periurethral microballoon implantation for management of female urinary incontinence. PATIENTS AND METHODS:A total of 45 women with urinary incontinence (age range 47-88 years) were treated between May 2000 and June 2001. Microballoons were placed in the proximal periurethral tis...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2004.18.901
更新日期:2004-11-01 00:00:00
abstract:PURPOSE:To conduct a study to assess the association between calculus location and size and the incidence of both microhematuria and symptoms of urolithiasis in a urology office environment. PATIENTS AND METHODS:After Institutional Review Board approval, a prospective study was conducted with data from 100 consecutive...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2011.0265
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Laparoscopic partial nephrectomy is a demanding procedure. To popularize the procedure, simplifying the technique is of great concern for most laparoscopic urologists. Our objective was to evaluate the results of laparoscopic partial nephrectomy (LPN) when eliminating bolster in repair of the tum...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.2008.0589
更新日期:2009-06-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVES:There is a need to improve prescreening determination of prostate cancer to better select patients who need biopsy. Such a strategy properly implemented, will decrease the number of negative biopsies for prostate cancer and in turn better balance the risks and morbidity for patients recommen...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0383
更新日期:2014-03-01 00:00:00
abstract::The greatest difficulty in performing a laparoscopic pyeloplasty is the suturing of the ureteropelvic junction. The purpose of this study was to evaluate the use of nonperforating titanium vascular closure staple (VCS) clips to perform in laparoscopic ureteroureterostomy in the porcine model. Six female minipigs under...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1998.12.265
更新日期:1998-06-01 00:00:00
abstract::Although most caliceal diverticula are asymptomatic, they can be associated with pain, and concomitant calculi are common. When treatment is indicated, a variety of surgical options are available, although the management is often a challenge even to the most experienced surgeon. We review the indications, surgical opt...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2004.18.805
更新日期:2004-11-01 00:00:00
abstract:INTRODUCTION:To assess the clinical features, outcomes, complications, and cost-effectiveness of shockwave lithotripsy (SWL), flexible ureterorenoscopy (FURS), and percutaneous nephrolithotomy (PCNL) in the treatment of lower pole (LP) stones (10-20 mm) in a large tertiary referral center. PATIENTS AND METHODS:Consecu...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2016.0825
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The management of urolithiasis in patients with a solitary kidney is challenging for endourologists. This study was aimed at evaluating the safety and efficacy of retrograde intrarenal surgery (RIRS) in the treatment of such patients with renal stones. PATIENTS AND METHODS:Between January 2010 a...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0295
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Calculi from patients with musculoskeletal (MS) anomalies who are largely immobile and prone to urinary infections have been traditionally composed primarily of struvite and carbonate apatite. Because of substantial improvements in the care of these patients in recent decades, stone etiology may ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2010.0698
更新日期:2011-09-01 00:00:00
abstract::We describe what appears to be the first case of a port-site hernia at the site of insertion of a 10-mm non-bladed trocar, which was discovered 4 days after laparoscopic live-donor nephrectomy. We now close all 10-mm port sites in adults and all 5-mm port sites in children; this can be done easily using the Carter-Tho...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277903769013649
更新日期:2003-09-01 00:00:00
abstract::Endopyelotomy is currently advocated for management of the obstructed ureteropelvic junction (UPJ). Healing of the stented UPJ occurs by secondary intention. Regardless of the method employed, success rates approach 85%. In order to increase the rate of success, we have devised a method of performing endopyelotomy in ...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.1996.10.147
更新日期:1996-04-01 00:00:00