Cumulative Sum Analysis of the Learning Curve for Modified Retroperitoneoscopic Living-Donor Nephrectomy.

Abstract:

OBJECTIVES:To introduce our modified retroperitoneoscopic living-donor nephrectomy (RPLDN) techniques and estimate the learning curve. METHODS:We retrospectively evaluated 121 consecutive donors who underwent modified RPLDN performed by a single surgeon. While the surgeon controlled the renal vessels, one hand was inserted through an abdominal incision for assistance. The kidney was manually retrieved through the abdominal incision. The learning curve was evaluated using the cumulative sum (CUSUM) method, which was a graphical method showing changes in individual surgical performance. RESULTS:The mean operating time and warm ischemic time (WIT) were 129.4 min and 154.5 s, respectively. The mean estimated blood loss (EBL) was 44.4 mL. Regarding intraoperative complications, no open conversions or blood transfusions were required. The CUSUM learning curve included the following 3 unique phases: phase 1 (the initial 32 cases), representing the initial learning curve; phase 2 (the middle 38 cases), representing expert competence; and phase 3 (the final 51 cases), representing mastery. CONCLUSIONS:Our modified method has the advantages of a short operating time, an optimized WIT, a low EBL, and acceptable complication rates. The surgeon completed the initial learning phase of RPLDN after 32 cases and could effectively perform RPLDN after 70 cases.

journal_name

Urol Int

journal_title

Urologia internationalis

authors

Zhu D,Hong P,Zhu J,Ye X,Chen Y,Fan Y,Zhang Z,Shen C,Yu W,Jin J

doi

10.1159/000493765

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

425-436

issue

4

eissn

0042-1138

issn

1423-0399

pii

000493765

journal_volume

101

pub_type

杂志文章
  • Diagnostic Performance of Radiolabeled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Primary Lymph Node Staging in Newly Diagnosed Intermediate to High-Risk Prostate Cancer Patients: A Systematic Review and Meta-A

    abstract:INTRODUCTION:We aimed to assess the diagnostic accuracy of radiolabeled prostate-specific membrane antigen positron emission tomography (PSMA PET) or positron emission tomography/computed tomography (PET/CT) for primary lymph node (LN) staging in newly diagnosed intermediate to high-risk prostate cancer (PCa) patients....

    journal_title:Urologia internationalis

    pub_type: 杂志文章,meta分析

    doi:10.1159/000493169

    authors: Kim SJ,Lee SW,Ha HK

    更新日期:2019-01-01 00:00:00

  • High-intensity focused ultrasound and cryotherapy as salvage treatment in local radio-recurrent prostate cancer.

    abstract:BACKGROUND:Salvage high-intensity focused ultrasound (HIFU) and cryotherapy (CRYO) have emerged as interesting alternatives in the treatment of local radio-recurrent prostate cancer. Currently, recommendations concerning the use of CRYO and HIFU in the salvage setting are still evolving. AIM:The objective of this revi...

    journal_title:Urologia internationalis

    pub_type: 杂志文章,评审

    doi:10.1159/000339616

    authors: Autran-Gomez AM,Scarpa RM,Chin J

    更新日期:2012-01-01 00:00:00

  • Outcomes of radical prostatectomy in clinically locally advanced N0M0 prostate cancer.

    abstract:INTRODUCTION:Radical prostatectomy (RP) in patients with locally advanced (cT3) prostate cancer (PCa) is considered an optional therapy. AIM:To evaluate outcomes of surgery for cT3 disease and to compare results with those of patients treated for cT1-T2 PCa. PATIENTS AND METHODS:Data of 74 consecutive patients with c...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000316944

    authors: Mearini L,Zucchi A,Costantini E,Bini V,Nunzi E,Porena M

    更新日期:2010-01-01 00:00:00

  • [Role of endorphins in the function of the lower urinary tract].

    abstract::In order to investigate the influence of the endorphins on lower urinary tract function we antagonized the endogenous opiates with naloxone. We performed urodynamic examination in 17 incontinent women, administered intravenously 0.4 mg naloxone, and repeated the urodynamic examination. Bladder volume and pressure were...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000280969

    authors: Riss P,Spernol R,Pfersmann C

    更新日期:1984-01-01 00:00:00

  • Traumatic urethral diverticula: a rare malformation of the male urethra.

    abstract::Urethral diverticula are pouches opening into the urethral canal that may be either acquired or congenital. Diverticula of the female urethra are fairly common. However, diverticula of the male urethra are relatively uncommon abnormalities. Clinical manifestation is frequently described with irritative and/or obstruct...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000346321

    authors: Li X,Sa Y,Jin C,Xu Y

    更新日期:2013-01-01 00:00:00

  • Pressure evaluation of the antireflux ability of the rat ureterovesical junction.

    abstract::The bladder pressure necessary to cause vesicoureteral reflux (VUR) was measured in 16 female rats. Under general anesthesia, the ureters were exposed via an abdominal incision and a pressure catheter was placed near the ureterovesical junction. Values of bladder distension and bladder pressure increase to cause VUR w...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000281195

    authors: Vercesi LA,Constantinou CE

    更新日期:1986-01-01 00:00:00

  • Reduction of Bladder Volume after BCG Immunotherapy.

    abstract::Bacillus Calmette-Guérin (BCG) immunotherapy is the most effective treatment for carcinoma in situ and high-risk non-muscle invasive bladder cancer (NMIBC). However, it can also provoke diverse side effects. We found 1 patient with a significantly and rapidly reduced bladder volume after the instillation of BCG. Few s...

    journal_title:Urologia internationalis

    pub_type:

    doi:10.1159/000510167

    authors: Yang C,Lv Z,Li Y

    更新日期:2021-01-01 00:00:00

  • DNA methylation analysis in immature testicular sperm cells at different developmental stages.

    abstract::Testicular sperm extraction and intracytoplasmic sperm injection (TESE-ICSI) is a frequently used therapeutic option in azoospermic males. Genetic imprinting is a mechanism of gene regulation - mediated by the methylation of deoxyribonucleic acids (DNA) - by which only one of the parental copies of a gene is expressed...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000050972

    authors: Manning M,Lissens W,Weidner W,Liebaers I

    更新日期:2001-01-01 00:00:00

  • Relation between the vaginal introital and perianal flora in recurrent cystitis in women.

    abstract::15 patients with urinary infection were selected and analyzed in relation to infection in the vaginal and perianal areas. After treatment, 12 patients with urinary infection were cured, but bacterial organisms persisted in their vaginal and perianal areas. In spite of the persistence of the vaginal and perianal infect...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000280207

    authors: Netto NR Jr,Rangel PE,Da Silva RP,Lemos GC

    更新日期:1978-01-01 00:00:00

  • Cystine stones: the efficacy of percutaneous and shock wave lithotripsy.

    abstract::Cystinuria is a rare cause of renal calculi, whose management presents a complex problem mainly due to the hardness and high recurrence rate of cystine stones. During the period 1987-1991, 28 established cases of cystine calculi were treated by extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithot...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000282836

    authors: Cranidis AI,Karayannis AA,Delakas DS,Livadas CE,Anezinis PE

    更新日期:1996-01-01 00:00:00

  • Outcomes for Patients after Resection of Pulmonary Metastases from Clear Cell Renal Cell Carcinoma: 18 Years of Experience.

    abstract:INTRODUCTION:Clear cell renal cell carcinoma (ccRCC) is the most common kidney tumor. If feasible, metastasectomy is preferably indicated in metastatic disease. OBJECTIVE:The aim of this study was to determine the outcome of patients after pulmonary metastasectomy (PM). METHODS:PM for ccRCC was performed in 35 patien...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000502493

    authors: Procházková K,Vodička J,Fichtl J,Krákorová G,Šebek J,Roušarová M,Hošek P,Brookman May SD,Hes O,Hora M,Třeška V

    更新日期:2019-01-01 00:00:00

  • Abacterial cystitis in urinary incontinent females.

    abstract::Among the number of urological symptoms in women complaining of incontinence more specific symptoms are often overlooked. Frequency, urge, suprapubic pain, nocturia, etc., are typical for bladder wall disorders, but also often misleading as part of the incontinence symptomatology. The final diagnosis of bladder wall d...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000281652

    authors: Jensen H,Nielsen K,Frimodt-Møller C

    更新日期:1990-01-01 00:00:00

  • Immunotherapy of metastasizing renal cell carcinoma. Results of a multicentered trial.

    abstract::119 patients with stage-IV renal cell carcinoma were treated using immunotherapy with autologous tumor vaccine. The immunization was carried out at monthly intervals, the patients were restaged every 3 months using X-ray, ultrasound scanning or computed tomography as well as bone scintigraphy in the follow-up. The pat...

    journal_title:Urologia internationalis

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1159/000281439

    authors: Schärfe T,Müller S,Riedmiller H,Jacobi GH,Hohenfellner R

    更新日期:1989-01-01 00:00:00

  • Is It Safe to Offer Radical Cystectomy to Patients above 85 Years of Age? A Long-Term Follow-Up in a Single-Center Institution.

    abstract:PURPOSE:With a median age at diagnosis of 73 years, bladder cancer has the highest median age of all cancers. Age alone seems to be an independent risk factor for developing the disease with peak age advancing into the range of 85 years. As demographic changes will lead to an ever more aging population in western count...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000510137

    authors: Tamalunas A,Volz Y,Schlenker BA,Buchner A,Kretschmer A,Jokisch F,Rodler S,Schulz G,Eismann L,Pfitzinger P,Stief CG,Grimm T

    更新日期:2020-01-01 00:00:00

  • Performing radical cystectomy and urinary diversion in regional anesthesia: potential risk reduction in the treatment of bladder cancer.

    abstract:OBJECTIVE:To assess the feasibility and performance of radical cystectomy with urinary diversion using exclusively regional anesthesia (i.e. combined spinal thoracic epidural anesthesia, CSTEA), avoiding the adverse effects of general anesthesia. MATERIALS AND METHODS:In our hospital, radical cystectomy with extended ...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000348542

    authors: Friedrich-Freksa M,Schulz E,Nitzke T,Wenzel O,Popken G

    更新日期:2013-01-01 00:00:00

  • Effect of mineral water containing calcium and magnesium on calcium oxalate urolithiasis risk factors.

    abstract::Calcium oxalate kidney stone formers are invariably advised to increase their fluid intake. In addition, magnesium therapy is often administered. Recently, a prospective study showed that a high dietary intake of calcium reduces the risk of symptomatic kidney stones. The present study was performed to test whether sim...

    journal_title:Urologia internationalis

    pub_type: 临床试验,杂志文章

    doi:10.1159/000282958

    authors: Rodgers AL

    更新日期:1997-01-01 00:00:00

  • Chlamydia trachomatis infection in the semen of asymptomatic infertile men: detection of the antigen by in situ hybridization.

    abstract::The prevalence of Chlamydia trachomatis and other microbes was studied in 94 semen samples from asymptomatic infertile males. Simultaneously, we sought evidence for inflammation of the genital tract by determining the polymorphonuclear granulocyte (PMN)-elastase concentration in the seminal plasma. The C. trachomatis ...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000282675

    authors: Yoshida K,Kobayashi N,Negishi T

    更新日期:1994-01-01 00:00:00

  • Characteristics and usage of different ureteral stent catheters.

    abstract::Presuming that complications associated with ureteral stenting vary in type and occurrence depending on the material and cross-section of the stent, six types of stents immersed in 48 different preparations of artificial urine for 1 month to observe surface changes with a scanning electron microscope. As a result, the...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000282206

    authors: Kohri K,Yamate T,Amasaki N,Ishikawa Y,Umekawa T,Imanishi M,Katayama Y,Kodama M,Iguchi M,Yachiku S

    更新日期:1991-01-01 00:00:00

  • A DNA Hypermethylation Profile Independently Predicts Biochemical Recurrence Following Radical Prostatectomy.

    abstract:PURPOSE:Detection of DNA hypermethylation is emerging as a novel molecular biomarker for different malignancies. We intend to define whether a hypermethylation profile of patients with prostate cancer (PCa) predicts biochemical recurrence (BCR) after radical prostatectomy (RP). MATERIAL AND METHODS:Genome-wide methyla...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000446446

    authors: Angulo JC,Lopez JI,Dorado JF,Sanchez-Chapado M,Colas B,Ropero S

    更新日期:2016-01-01 00:00:00

  • Guidelines for the diagnosis and therapy of testicular cancer and new developments.

    abstract::The guidelines of testicular cancer were elaborated and agreed upon interdisciplinarily. Standard therapy of stage I seminoma is infradiaphragmatic radiotherapy. Possible alternatives are adjuvant carboplatin therapy (still in test procedure) and, in case of lacking risk factors, the watch-and-wait strategy. If small ...

    journal_title:Urologia internationalis

    pub_type: 杂志文章,评审

    doi:10.1159/000030418

    authors: Weissbach L

    更新日期:1999-01-01 00:00:00

  • Radical cystectomy for bladder cancer in the 70+ population: a nation-wide registry analysis of 845 patients.

    abstract:AIM:To analyze demographics, perioperative mortality and overall survival of radical cystectomy (RC) in patients aged 70+ years in Austria in a nation-wide registry cohort. PATIENTS AND METHODS:All patients >69 years who underwent RC in public hospitals (covering >95% of all surgical procedures) in Austria between 199...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000316100

    authors: Madersbacher S,Bauer W,Willinger M,Wehrberger C,Berger I,Brössner C

    更新日期:2010-01-01 00:00:00

  • Vacuum-assisted closure for the treatment of Fournier's gangrene.

    abstract:BACKGROUND:Fournier's gangrene (FG) is a very aggressive necrotizing fasciitis involving subcutaneous fat and skin of scrotal and perineal regions. Vacuum-assisted closure (VAC) is a well-known method used to treat complex wounds. The authors for the first time enhance a multimodal strategy to treat the FG using VAC, r...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000218532

    authors: Cuccia G,Mucciardi G,Morgia G,Stagno d'Alcontres F,Galì A,Cotrufo S,Romeo M,Magno C

    更新日期:2009-01-01 00:00:00

  • Human factors in surgery: from Three Mile Island to the operating room.

    abstract::Human factors is a definition that includes the science of understanding the properties of human capability, the application of this understanding to the design and development of systems and services, the art of ensuring their successful applications to a program. The field of human factors traces its origins to the ...

    journal_title:Urologia internationalis

    pub_type: 杂志文章,评审

    doi:10.1159/000241662

    authors: D'Addessi A,Bongiovanni L,Volpe A,Pinto F,Bassi P

    更新日期:2009-01-01 00:00:00

  • Combination therapy of imipramine with oxybutynin in children with enuresis nocturna.

    abstract:PURPOSE:The treatment approach for enuresis is controversial due to the lack of consensus as to the exact causes of nocturnal enuresis. Despite various treatment modalities, pharmacotherapy still appears to be the common choice. The aim of this prospective study was the evaluation of the efficacy of combination therapy...

    journal_title:Urologia internationalis

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1159/000064858

    authors: Tahmaz L,Kibar Y,Yildirim I,Ceylan S,Dayanç M

    更新日期:2000-01-01 00:00:00

  • Germ cell tumors of the testicle or 'orchidomata'.

    abstract::An unusual case of a double testicular tumor, with different histology and the same marker chromosome, led to a search of the literature for cases of testicular tumors that were double, bilateral, or familial. The literature on abnormal chromosomes in tumors of the testis is also reviewed. After a discussion of the fa...

    journal_title:Urologia internationalis

    pub_type: 杂志文章,评审

    doi:10.1159/000281443

    authors: Haddad FS,Sorini P,Somsin AA,Nathan H

    更新日期:1989-01-01 00:00:00

  • Subjective pain scale and the need for analgesia during shock wave lithotripsy.

    abstract:OBJECTIVE:To investigate patients' opinions on the degree of pain during shock wave lithotripsy, and the need for analgesics in patients with urinary stone. METHODS:A prospective questionnaire study involving subjective pain assessment during and just after shock wave lithotripsy was performed in consecutive patients ...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000082710

    authors: Oh SJ,Ku JH,Lim DJ,Byun SS,Kim HH

    更新日期:2005-01-01 00:00:00

  • Effects of antiproteases (aprotinin and gabexate-mesilate) on the postischemic vascular response of the kidney.

    abstract::Both under physiologic conditions and after short-term ischemia (1-3 min) kallikrein and locally synthesized prostaglandins contribute to control renal blood flow. In the present experiment the antiproteases aprotinin and gabexate-mesilate were administered to rabbits in an attempt to show whether the hemodynamic chan...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000280880

    authors: Pflüger H,Maier M,Binder BR

    更新日期:1983-01-01 00:00:00

  • Electrostimulation and penile erection.

    abstract::Electrostimulation was used to study the neuroanatomy and physiology of penile erection in dogs and monkeys. The canine spinal nuclei responsible for penile erection, identified by the retrograde horseradish peroxidase transport technique after verification of the cavernous nerves with neurostimulation, were mediolate...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000281034

    authors: Lue TF,Schmidt RA,Tanagho EA

    更新日期:1985-01-01 00:00:00

  • Renal toxicity following zoledronic acid reversed with ibandronate in a prostate cancer patient with bone metastases.

    abstract::Bisphosphonates are a standard treatment for metastatic bone disease, although agents vary in their potential for renal toxicity. This case report describes the reversal of zoledronic acid-induced renal toxicity by switching treatment to ibandronate in a patient with hormone-refractory prostate cancer and bone metasta...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000132707

    authors: Joensuu TK

    更新日期:2008-01-01 00:00:00

  • Extraperitoneal inguinoscrotal herniation of the ureter: a rare case of recurrence after hernia repair.

    abstract::Inguinoscrotal herniation of the ureter is a rare finding with the potential for serious surgical complications. Two anatomic forms are defined. In the more common paraperitoneal variant, the herniating peritoneal sac drags the ureter and sometimes other abdominal structures with it. The uncommon variant--extraperiton...

    journal_title:Urologia internationalis

    pub_type: 杂志文章

    doi:10.1159/000224879

    authors: Golgor E,Stroszczynski C,Froehner M

    更新日期:2009-01-01 00:00:00