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Literature reporting on the outcomes of the different procedures of nephrectomies (open vs laparoscopic vs robotic) in Saudi Arabia remains limited. Compare surgical and oncological outcomes between open and minimally invasive nephrectomies. A retrospective cohort study. The present study included all adult patients who underwent nephrectomies between January 1, 2015 and January 31, 2023. We collected demographic, preoperative, intraoperative, and postoperative data on 408 adult cancer patients who underwent nephrectomies at our center between January 2015 and January 2023. Statistical differences were calculated between procedure types. Overall survival was calculated using Kaplan-Meier curves with log-rank tests. P<0.05 was considered statistically significant. Measures of operative success (intraoperative blood loss, intraoperative and postoperative complications, and hospital stay) and oncological outcomes (local recurrence, metastatic progression, and chemotherapy use) between different procedure and nephrectomy types for cancer patients. A total of 408 cancer patients underwent nephrectomies. In cancer patients, open nephrectomy was associated with significantly higher intraoperative blood loss (p<0.001), incidence of blood transfusions (p<0.001), hospital stay (p<0.001), intraoperative complications (p=0.027 and p=0.001, respectively), local recurrence (p<0.001), metastatic progression (p=0.001), and chemotherapy (p=0.001) than minimally invasive surgery, but survival differences across procedure types were not statistically significant (log-rank p-value = 0.054). Regarding nephrectomy type, significant differences were observed in tumor size (p < 0.001), initial procedure type (p<0.001), operation time (p<0.001), blood transfusion (p=0.033), length of hospital stay (p=0.004), intraoperative complications (p=0.020), postoperative complications (p=0.025), Clavien classification (p=0.003), mortality (p=0.022), metastatic progression (p<0.001), and chemotherapy use (p=0.001) between simple/total nephrectomy, radical nephrectomy (RN), partial nephrectomy (PN), and nephroureterectomy. Survival differences between the four nephrectomy types were statistically significant (log-rank p value = 0.001). Minimally invasive nephrectomies reduce inpatient morbidity while conferring equivalent oncological and surgical outcomes.
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This retrospective study aims to describe the characteristics of renal cell carcinoma (RCC) in Saudi Arabia, in terms of epidemiology, clinical presentation, tumor subtype, Fuhrman grade, tumor size and stage, and overall survival. A total of 431 adult patients with a histopathological diagnosis of RCC between 2015 and 2023 were included in the analysis. Most patients (72.4%) had clear cell tumors, followed by chromophobe (15.1%) and papillary (12.5%) subtypes. In males, papillary RCC (85.2%) was more common compared to clear cell (59.8%) and chromophobe (67.7%) subtypes. Significant differences were observed in median body mass index (BMI) across tumor subtypes, and papillary tumor patients exhibited the highest incidence of hematuria (33.3%) compared to other subtypes. The Fuhrman grade also varied significantly among RCC types. Survival times were found to be lower for patients with papillary tumors. No significant difference was observed based on patients' nationality. This study can inform clinical decision-making on patient prognosis and management as well as public health efforts aimed at reducing the alarming rise of RCC incidence.
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The utility of partial nephrectomy (PN) in locally advanced, stage T3 renal cell carcinoma (RCC) is controversial. This retrospective study aimed to review the oncological and functional outcomes of patients with T3a RCC who underwent PN. We included all patients with pT3a stage RCC undergoing either open, laparoscopic, or robotic PN at our center between January 2015 and 2023. A Wilcoxon rank sum test was utilized to compare nephrectomy types (radical nephrectomy [RN] vs PN). Survival analysis was conducted using Kaplan-Meier plots and a log-rank test. P-value < 0.05 indicated statistical significance. There were no significant differences in demographic characteristics between the RN and PN groups, except age (53.0 vs 6.5, respectively; P = 0.012) and body mass index (28.7 vs 34.3, respectively; P = 0.020). Furthermore, there were also no significant differences in the rates of local recurrence (P = 0.597), metastatic progression (P = 0.129), and chemotherapy use (P = 0.367) between nephrectomy types. Patient survival did not differ significantly based on the type of nephrectomy (log-rank P-value = 0.852). Together, our findings indicated that PN and RN yield near-equivalent oncological outcomes in terms of local recurrence, metastasis, and overall survival rates among pT3a RCC patients during a nearly 3-year follow-up period.
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Cryptorchidism is a common condition among children; however, it is rare in adults and is associated with an increased risk of malignancy. The development of secondary undescended testes is recognized as a complication following inguinal surgeries such as hernia repair and orchidopexy. Herein, we describe the case of a 64-year-old male with a known past surgical history of right indirect inguinal hernia repair complaining of penile swelling. The patient was diagnosed with a penile fracture, and a genital examination further revealed a right undescended testis. The patient underwent penile fracture repair and right orchiectomy. Histopathology examinations showed classic seminoma. These findings show that the position of each testis should always be documented before, during, and after inguinal hernia repair due to the increased risk of undescended testis. Histopathological confirmation is necessary for such patients so that malignancy can be identified in its early stages and cured subsequently.
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Bladder perforation due to indwelling catheters is regarded to be a very rare incident. Most cases of catheter-induced rupture were in patients with chronic catheterization due to chronic bladder diseases. An 80-year-old male with neurogenic bladder on chronic catheterization presented to the emergency room with abdominal pain and anuria. On CT, the tip of the catheter was eroding through the bladder into the peritoneum. The patient underwent a laparotomy with adhesiolysis. The tip of the Foley catheter was seen eroding through the bladder dome. A new open tip catheter was inserted per urethra to prevent the catheter tip from eroding again through the bladder wall. Bladder erosion or rupture is associated with high morbidity and mortality. Our case demonstrates the deleterious effects of chronic catheterization and the need for a high level of suspicion when dealing with such cases.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been linked to thromboembolic complications. Priapism has been reported only once in link to SARS-CoV2. Here we report the second case of priapism in a patient with SARS-CoV2; our case is unique in being that the patient had priapism for 10 days while being hospitalized. We discuss potential causes and possible prevention strategies. The patient was managed by aspiration and Phenylephrine injection and achieved detumescence and reported normal erection at 2 weeks follow-up.
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Introduction Complementary medicine (CM) consumption is a common practice worldwide. The objective of this study is to find the prevalence of parents visiting the neurology clinic who utilize CM to treat their children. Methods This is a cross-sectional study that was done at King Abdullah Specialized Children Hospital (KASCH), Riyadh, Saudi Arabia between 2018 and 2019. By using a self-administered questionnaire, data were collected to recognize the prevalence of using CM and to identify the commonest type or method. Results A total of 352 parents were given the questionnaire. The prevalence of CM usage among participant was 42%, the most common type of CM was Quran recitation at 66%, followed by herbal medicine at 30% and cautery at 26%. Conclusion Almost half of the parents who visited the neurology clinic at KASCH have used complementary medicine for their children, and nearly three-quarters of the parents who never used CM have thought about using it. Therefore, CM is common in the Saudi Arabian culture.
