Abstract:
OBJECTIVE:Accurate tumor staging in renal cancer is critical for prognostic projections, follow-up schedules, clinical trials and potential systemic therapies. We studied patients undergoing laparoscopic radical nephrectomy (LRN) to determine the extent of upstaging on histopathology evaluation and correlated the clinical and pathology staging to determine the factors responsible for upstaging. PATIENTS AND METHODS:A retrospective review of patients undergoing LRN for renal cell cancer was performed. Clinical staging was determined by CT/MRI scan and/or related preoperative work up (using AJCC TNM staging criteria). Histopathology reports were studied in to determine the p-stage. Lymph node (LN) status was evaluated with attention to number and positivity of LNs in the specimen. Pathologic features that dictated upstaging were analyzed. The factors responsible for pathologic upstaging were analyzed. Statistical analysis was performed using JMP 5.0.12 software; comparisons were done using chi square or Fisher exact test. RESULTS:One hundred twenty three patients qualified for the study; mean age was 62.14+/-13.6 years, M:F ratio was 60:63 and mean tumor size of 5.3+/-2.0 cm. Clinical versus pathologic T stage distribution was T1a=41:37, T1b=43:31, T2=25:12, T3a=11:31, T3b=3:10 and T4=0:2. A total 38/123 (31%) patients were upstaged following histopathology examination. Upstaging was due to change in tumor size in 12, renal sinus fat involvement in 8, renal or adrenal vein involvement in 14, focal perirenal fat involvement in 6, and focal renal capsule penetration in 4 patients. Fifty two patients had LNs in the specimen with 19 (16%) patients had 2 or more lymph nodes and 5 had positive LNs. Mean tumor size was 5.3+/-2 cms at clinical, and 5.0+/-2.6 cms at pathology staging (P=NS). 5 patients had LN metastasis detected with tumor size of 5.5, 5.6, 6.8, and 7.2 cms in diameter, and one patient with LN metastasis was T1a stage (3.2 cm). Renal vein/inferior venal cava/adrenal vein was involved in 14 patients, adrenal was involved in 21 patients and renal sinus was involved in 19/123 patients. CONCLUSIONS:Pathologic upstaging of malignant renal neoplasms occurred in about 31% of patients following LRN. Down staging was less common and mean tumor size does not significantly change.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Goel MC,Mohammadi Y,Sethi AS,Brown JA,Sundaram CPdoi
10.1089/end.2008.0399subject
Has Abstractpub_date
2008-10-01 00:00:00pages
2257-61issue
10eissn
0892-7790issn
1557-900Xjournal_volume
22pub_type
杂志文章abstract:BACKGROUND AND PURPOSE:The best management of upper ureteral calculi is undefined. We performed a prospective randomized comparison between semirigid ureteroscopy (URS) and shockwave lithotripsy (SWL) for upper ureteral stones <2 cm to evaluate safety and efficacy of both procedures. PATIENTS AND METHODS:Patients with...
journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2012.0493
更新日期:2015-01-01 00:00:00
abstract:PURPOSE:We describe and evaluate a new transperineal laparoscopic approach for male patients, designed to facilitate laparoscopic prostatectomy and cystectomy. PATIENTS AND METHODS:We operated on 12 patients. We did three laparoscopic prostatectomies and nine laparoscopic cystectomies. On five, an ileal conduit was ma...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2010.0247
更新日期:2011-04-01 00:00:00
abstract:PURPOSE:Burst wave lithotripsy (BWL) is a transcutaneous technique with potential to safely and effectively fragment renal stones. Preclinical investigations of BWL require the assessment of potential renal injury. This study evaluates the capabilities of real-time ultrasound and MRI to detect and evaluate BWL injury t...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2017.0202
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVES:We evaluated the feasibility and effectiveness of percutaneous urinary diversion in patients with obstructive uropathy. PATIENTS AND METHODS:A total of 206 percutaneous nephrostomies (PCNs) (right-sided in 54, left in 56, and bilateral in 48) were performed in 102 male and 57 female patients 18 to 94 years ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2000.14.401
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Adrenalectomy is indicated for patients with large adrenal lesions or functional tumors. Cryoablation is currently used as a surgical alternative for the treatment of prostate, lung, brain, pharynx, and liver tumors. The purpose of this study was to determine if cryosurgery could be delivered ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1999.13.299
更新日期:1999-05-01 00:00:00
abstract:: Purpose: To report on the safety, technical results, and oncologic outcomes of computed tomography guided percutaneous microwave ablation of stage cT1b renal cell carcinoma. Materials and Methods: This single-center retrospecti...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0382
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Routine imaging following ureteroscopy for treatment of renal/ureteral calculi continues to be a topic of debate. However, with the increasing focus on healthcare costs and quality, judicious use of diagnostic imaging to optimize outcomes while minimizing resource utilization is a priority. We so...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2015.0088
更新日期:2015-10-01 00:00:00
abstract:: Objective: To determine if radiologically diagnosed nonalcoholic fatty liver disease (NAFLD) is an independent risk factor for nephrolithiasis using data from National Health and Nutrition Examination Survey III (NHANES III). Patients and Methods: ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0486
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Patients with spinal neuropathy are at an increased risk for urolithiasis. Data on percutaneous nephrolithotomy (PCNL) in this population are limited. Our objective is to review our experience in managing stones with PCNL in patients with spinal neuropathy. PATIENTS AND METHODS:Twenty-one patien...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2012.0344
更新日期:2012-12-01 00:00:00
abstract:PURPOSE:This study aims to provide an overview of type and frequency of musculoskeletal complaints among urologists. In addition, the urologists' knowledge about ergonomic conditions during minimally invasive urology was assessed, and they were asked how they would prefer to gain knowledge about this topic. MATERIALS ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0654
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Patients who are undergoing laparoscopic ablative therapy (LAT) are often older with more comorbidities in comparison with patients who are undergoing laparoscopic partial nephrectomy (LPN). A matched control study was performed to compare the surgical and functional outcomes of LPN and LAT. PAT...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2011.0087
更新日期:2011-12-01 00:00:00
abstract:INTRODUCTION:The learning curve for robotic surgery is not completely defined, and ideal training components have not yet been identified. We attempted to determine whether skill development would be accelerated with formal, organized instruction in robotic surgical techniques versus informal practice alone. MATERIALS...
journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2009.0511
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Increased body mass index (BMI) has been shown to have inferior perioperative outcomes in patients undergoing laparoscopic partial nephrectomy (LPN). The aim of this study was to determine the differences in perioperative outcomes for patients undergoing LPN in normal, overweight, and obese perso...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0725
更新日期:2015-09-01 00:00:00
abstract:: Purpose: To examine the dusting performance of a novel solid state Thulium laser device compared to a standard holmium:yttrium-aluminum-garnet (Ho:YAG) device. Methods: This study compares a Dornier Medilas H Solvo 35 with an e...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0525
更新日期:2020-09-09 00:00:00
abstract:PURPOSE:To review the success rate and complications of radiologically guided percutaneous nephrostomies (PCNs) performed by urologists and compare the complication rates with the standards recommended by the Society of Interventional Radiology (SIR) and the American College of Radiology (ACR). PATIENTS AND METHODS:Fr...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.0281
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Although the evidence is sparse, most urologists advise the insertion of a safety guide wire (SGW) alongside the ureteroscope whenever performing ureteroscopy (URS). The aim of the study was to compare the results of ureteroscopic treatment for ureteral stones at the Oslo University Hospital (OUH...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0248
更新日期:2013-10-01 00:00:00
abstract:PURPOSE:To determine factors affecting patients' discomfort during the period self-retaining ureteral stents are in place. PATIENTS AND METHODS:Between April 2001 and May 2003, 58 male and 42 female patients underwent temporary double-pigtail stenting. The indications were endopyelotomy in 39 patients, ureteroscopy in...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.20.33
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Few studies have addressed the effect of skin-to-stone distance (SSD) on the success of extracorporeal shockwave lithotripsy (SWL). Nevertheless, the effect of the two components of SSD, that is, the fat SSD (FSSD) and nonfat SSD (NFSSD) components, was not previously investigated. METHODS:In this prospecti...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.2009.0685
更新日期:2010-11-01 00:00:00
abstract:: Introduction and Objectives: After transurethral prostatectomy, erectile dysfunction and ejaculatory dysfunction are significant concerns for patients. We compared ejaculatory hood-sparing technique in patients who underwent photoselective vaporization of the prostate usin...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0558
更新日期:2020-03-01 00:00:00
abstract::We describe our experience using an iodinated contrast solution to hydrodissect adjacent structures before percutaneous renal cryoablation. Hydrodissection was performed before cryoablation with placement of a 20-gauge, 15-cm introducer needle into the retroperitoneum under CT or ultrasonographic guidance followed by ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2011.0516
更新日期:2012-05-01 00:00:00
abstract::Urinary incontinence may be the result of various forms of detrusor overactivity. Several surgical therapies have been devised, but with the exception of procedures to relieve urethral obstruction, none abolishes the overactivity or restores normal micturition. In general, ablative neurosurgery is considered only in p...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.1996.10.213
更新日期:1996-06-01 00:00:00
abstract:PURPOSE:Percutaneous stone surgery can be challenging in spina bifida (SB) patients due to their body habitus and spinal cord anomalies. A safe surgical approach may necessitate acceptance of lower stone-free (SF) rates. We seek to determine if anatomic complexity, as measured by spinal cord curvature and torso length,...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2016.0769
更新日期:2017-04-01 00:00:00
abstract::Bisphosphonates bind renal calculi and inhibit calcium oxalate crystal growth in vitro. We evaluated their ability to inhibit calcium oxalate urolithiasis in a lithogenic rat model. Male Sprague-Dawley rats (four groups, eight rats each) were fed 1.0% ethylene glycol in their drinking water for 6 weeks. All rats had i...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1997.11.1
更新日期:1997-02-01 00:00:00
abstract:INTRODUCTION:Patients with ileal conduit urinary diversions are at an increased risk of long-term upper urinary tract (UUT) complications, including anastomotic strictures, infections, and urolithiasis. The reconstructed urinary system poses challenges for endoscopic manipulation. We present and describe our dual-cente...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2017.0271
更新日期:2017-09-01 00:00:00
abstract:: Objective: The aim of this study was to introduce the "ultrathin parenchyma" resection in a robot-assisted partial nephrectomy (RAPN) via the retroperitoneal approach, and to assess the feasibility, security, and effectiveness of this technique. Me...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0698
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Involvement of the bladder is seen in only 1% to 2% of patients with endometriosis. The diagnosis of vesical endometriosis is difficult to formulate, and it should be confirmed by cystoscopy with biopsy. However, this examination is often insufficient because of the submucosal-transmural location...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277902761403014
更新日期:2002-11-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Renal artery aneurysm (RAA) is an infrequently seen disease entity but one with the potential for significant morbidity and mortality. Complications related to RAA include pain, hematuria, hypertension, and, rarely, rupture. Management is often based on symptomatology or, if symptoms are not pres...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2009.0338
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Bleeding is a major concern during percutaneous nephrolithotomy (PCNL), especially with the use of multiple tracts. This prospective study aimed to identify factors affecting blood loss during PCNL. PATIENTS AND METHODS:Data were collected prospectively from 236 patients undergoing 301 PCNL proc...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2004.18.715
更新日期:2004-10-01 00:00:00
abstract::Abstract Since the first description of percutaneous nephrolithotripsy (PNL) over 30 years ago, the indications for this procedure in the management of upper tract urinary stones has greatly expanded. Despite recent advances in shock wave lithotripsy and ureteroscopic technologies, PNL maintains a dominant role in the...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2009.1518
更新日期:2009-10-01 00:00:00
abstract:: Introduction: Nephrolithiasis is a known risk factor for chronic kidney disease (CKD); however, it is unknown how CKD affects urinary parameters related to stone risk. The purpose of this study was to assess the relationship of diminishing glomerular filtration rate (GFR) ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0403
更新日期:2020-12-01 00:00:00