Abstract:
OBJECTIVE:To assess the frequency of minimally invasive radical cystectomy (MIRC) conversion to open surgery, what factors influence conversion, whether or not the benefits of MIRC vs open radical cystectomy (ORC) persist after conversion, and compare ORC and MIRC outcomes. MATERIALS AND METHODS:We performed a retrospective cohort study from the National Cancer Data Base (2010 to 2013) analyzing patients who underwent completed MIRC (n = 5750), converted MIRC (n = 245), and ORC (n = 12,053) without prior radiotherapy. Multivariable logistic and linear regression analyses were used to assess the association between covariates, open conversion as well as surgical approach, and secondary outcomes such as positive surgical margins (PSMs), use of lymphadenectomy, lymph node yield, hospital length of stay (LOS), and 30-day readmission. RESULTS:Rates of conversion were independent of patient factors such as race, sex, use of neoadjuvant chemotherapy, and clinical stage. Conversion occurred in 245 of 5750 MIRCs (4.3%) and declined over time (5.8% in 2010 vs 3.2% in 2013, odds ratio [OR] 0.50, 95% confidence interval [CI] 0.34-0.75, p = 0.001). MIRC was associated with fewer positive margins, higher lymph node yield, shorter LOS, and fewer readmissions compared with ORC, however, patients requiring open conversion had longer median hospital stays (8 days vs 7 days, p = 0.013), lower median lymph node yields (14 vs 17, p = 0.007), more PSMs (17% vs 11%, p = 0.006), and more 30-day readmissions (14% vs 9%, p = 0.008) compared to nonconverted. Converted MIRC had similar hospital LOS and 30-day readmission rates compared to ORC. CONCLUSION:Open conversion during MIRC is uncommon and has decreased in recent years despite the rising use of MIRC. MIRC had better short-term outcomes compared with ORC. These benefits were negated with open conversion; however, outcomes were similar compared to planned ORC.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Ko OS,Weiner AB,Smith ND,Meeks JJdoi
10.1089/end.2018.0079subject
Has Abstractpub_date
2018-06-01 00:00:00pages
488-494issue
6eissn
0892-7790issn
1557-900Xjournal_volume
32pub_type
杂志文章abstract:PURPOSE:To create a protocol for providing real-time operating room (OR) cost feedback to surgeons. We hypothesize that this protocol will reduce costs in a responsible way without sacrificing quality of care. METHODS:All OR costs were obtained and recorded for robot-assisted partial nephrectomy and laparoscopic donor...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0858
更新日期:2015-08-01 00:00:00
abstract:PURPOSE:To review the outcome of transperitoneal laparoscopic dismembered pyeloplasty (LDP) in our institution. PATIENTS AND METHODS:From April 2001 to April 2005, 36 men and 34 women underwent LDP for symptomatic and radiologically proved ureteropelvic junction (UPJ) obstruction. A successful outcome was defined clin...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.20.1050
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND AND PURPOSE:The use of flexible ureteroscopy for diagnosis and management of upper urinary tract diseases is limited both by loss of maximum active deflection through the inserted working probes and a high frequency of damage with consequent costs. A newly developed ureteroscope (Flex-X, Karl Storz) with a m...
journal_title:Journal of endourology
pub_type: 杂志文章,随机对照试验
doi:10.1089/end.2006.0291
更新日期:2007-12-01 00:00:00
abstract:: Introduction and Objective: Despite the adoption of robotic donor nephrectomy, the steep learning curve of robotic recipient transplantation has hindered the implementation of a complete robot-assisted kidney transplantation (RAKT). We sought to develop a high-fidelity per...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2020.0441
更新日期:2020-10-01 00:00:00
abstract::The identification of calcium-binding proteins in urine and kidney stones has led to a closer look at the role of matrix proteins in urolithiasis. We analyzed five struvite stones for protein content and identified two bands (8 and 14 KDa) that were confirmed by gel electrophoresis and amino acid sequencing to be calg...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1994.8.95
更新日期:1994-04-01 00:00:00
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:To review the management approach to and results of severely encrusted retained ureteral stents and analyze predictive risk factors. PATIENTS AND METHODS:Medical records from January 1996 to March 2006 were reviewed for Double-J stent complications and their final outcome. A total of 876 stents were inserted i...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.0250
更新日期:2007-06-01 00:00:00
abstract:PURPOSE:Telemedicine has become a common method for the transmission of images and patient data across long distances. Our goal was to assess the efficiency and accuracy of Photomailer MD software, a store-and-forward telemedicine system, in the urologic setting. METHODS:Photomailer MD software was loaded on two compu...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1089/end.1999.13.141
更新日期:1999-04-01 00:00:00
abstract::After urinary diversion, access to the distal ureter for either resection or repair, especially in patients with history of infection, extravasation, radiation, or other abdominal surgery, can be hazardous. We report two cases where the endoscopic placement of a coaxial balloon dilating catheter prior to open explorat...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1996.10.57
更新日期:1996-02-01 00:00:00
abstract:BACKGROUND AND PURPOSE:In laparoscopy, the term "mirror imaging" is used to describe a visual illusion resulting in paradoxical movements when a surgeon is positioned opposite the laparoscope. Mirror imaging is a common problem, creating difficulty in ergonomics and task performance. We introduce the use of a video ima...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/089277903322145521
更新日期:2003-06-01 00:00:00
abstract:: Aim: We sought to compare the outcomes of patients who underwent an open vs robotic ureteroneocystostomy for ureteral obstruction. Methods: Retrospective review was performed on adult patients who underwent primary ureteroneocy...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0715
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Renal mass protocol CT (RMP-CT) using multiphase abdomen and pelvis CT imaging is the mainstay for diagnosis, characterization, and follow-up for renal masses; however, it is associated with ionizing radiation to the patient. We sought to quantify the effective dose associated with RMP-CT and to ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2013.0111
更新日期:2013-09-01 00:00:00
abstract:PURPOSE:To report the use of the hand-assisted laparoscopic (HAL) technique for removal of a horseshoe kidney in a patient with autosomal dominant polycystic kidney disease (ADPKD). CASE REPORT:Hospital and outpatient records were reviewed for a 65-year-old man with end-stage renal disease secondary to ADPKD who under...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2006.20.397
更新日期:2006-06-01 00:00:00
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: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:BACKGROUND AND PURPOSE:Robot-assisted partial nephrectomy has emerged as a viable surgical treatment for patients with certain renal tumors. We hypothesized that extirpation of more complex tumors, as graded with the nephrometry score, would result in worse operative and postoperative outcomes when compared with tumors...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2011.0003
更新日期:2011-10-01 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:: 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::Although the supracostal approach is thought to increase the difficulties and patient morbidity of PCNL, it facilitates the management of certain urinary infirmities, such as UPJ obstruction, staghorn stone, upper pole stone, proximal ureteral abnormalities, impacted UPJ stone and upper calix diverticulum. Hereby the ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2009.1531
更新日期:2009-10-01 00:00:00
abstract:INTRODUCTION:Radical prostatectomy undoubtedly causes inflammatory damage to surrounding neuromuscular tissues (i.e., bladder, urethra, and nerves) that may contribute to urinary incontinence. We report the use of local hypothermia during robot-assisted laparoscopic prostatectomy to attenuate this injury. METHODS:Regi...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.2009.0411
更新日期:2009-09-01 00:00:00
abstract:PURPOSE:We present a series of cystinuric patients with renal cystine calculi between 1.5 and 3.0 cm treated with retrograde renoscopy and intracorporeal lithotripsy and report our results, complications, and inpatient utilization with this approach. PATIENTS AND METHODS:The hospital and office charts of five consecut...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
doi:10.1089/end.1999.13.483
更新日期:1999-09-01 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:We have developed novel iron-based microparticles (Fe-MP) that bind to calcium oxalate stone fragments, rendering them paramagnetic. Previously, we demonstrated enhanced efficiency of stone extraction in an inanimate model using magnetic instrumentation. Before in vivo stone extraction studies, w...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2010.0419
更新日期:2011-07-01 00:00:00
abstract:PURPOSE:We evaluated complications of urologic laparoscopic surgery at our institution. PATIENTS AND METHODS:From December 1991 to January 2009, 1017 urologic laparoscopic surgical procedures were performed in Kansai Medical University, including 277 radical prostatectomies, 13 donor nephrectomies, 74 partial nephrect...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2009.0322
更新日期:2010-02-01 00:00:00
abstract:: Objective: To evaluate the learning curve in an untrained resident surgeon for the initial case series of tension-free vaginal tape-obturator (TVT-O) to treat stress urinary incontinence. Materials and Methods: A retrospective ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2019.0571
更新日期:2020-02-01 00:00:00
abstract::Water-Induced Thermotherapy (WIT trade mark ) was developed to treat lower urinary tract symptoms (LUTS) and to reduce bladder outlet obstruction (BOO) secondary to benign prostatic hyperplasia (BPH). The principle is to produce heat-induced coagulative necrosis and secondary ablation of the obstructing hyperplastic t...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/089277903322518617
更新日期:2003-10-01 00:00:00
abstract:INTRODUCTION:The current experimental study aimed at evaluating the temperature raise of the irrigation fluid caused by the use of the thulium (Tm:YAG) and holmium laser (Ho:YAG) in the upper urinary tract (UT) of pigs. MATERIALS AND METHODS:An experimental setting was designed for the investigation of differences in ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2015.0768
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVES:To determine predictors of fluoroscopy time (FT) during percutaneous nephrolithotomy (PCNL) and assess the impact of urology postgraduate trainees (PGTs) and S.T.O.N.E. nephrolithometry score. METHODS:A retrospective review of patients undergoing PCNL between 2010 and 2013 at a tertiary healthcare center wa...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0800
更新日期:2015-05-01 00:00:00
abstract:PURPOSE:To determine whether on-clamp partial nephrectomy (ON-PN) has any significant impact on long-term renal function in a two kidney model. PATIENTS AND METHODS:From November 1999 to July 2013, 607 patients underwent PN at our institution. After excluding patients with solitary kidneys, multiple renal masses, and ...
journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.2014.0476
更新日期:2015-04-01 00:00:00
abstract::In this review, a simplified straightforward algorithmic approach to the metabolic evaluation and treatment of the at-risk or recurrent urolithiasis patient is provided. Eight diagnoses and eight therapies are provided, which cover over 95% of renal stone disease. ...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
doi:10.1089/end.2017.0541
更新日期:2018-05-01 00:00:00