Clip or staple in laparoscopic live donor nephrectomy? A systematic literature review.

INTRODUCTION: Ligation of the renal pedicle is a crucial step in laparoscopic renal harvesting. Currently, two devices are widely used: Hem-o-Lok® clips and staplers. Each has its advantages and disadvantages. METHODS: A systematic literature review was conducted following the PRISMA methodology on PubMed, EMBASE, and Cochrane databases with no time restrictions. Registered in the PROSPERO database (CRD42023460585), the study's primary outcome measures include the failure rate of the ligation tool, conversion to open surgery, rate of severe bleeding, and device-related death. Other secondary variables are also explored. An assessment of the quality of included comparative studies was performed using the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) tool. RESULTS: Out of 393 articles identified using our keywords, 32 were included. Overall, clips have a lower failure rate during application, elongate graft vessel length, and are more cost-effective. Staples are associated with a shorter warm ischemia time and lower blood loss. There is no significant difference between the two devices in terms of conversion, severe bleeding, death, and blood transfusion. CONCLUSION: There is no perfect modality for renal pedicle control during laparoscopic harvesting, as each instrument has its pros and cons. Hem-o-Lok® clips are a safe and cost-effective option, particularly suitable for right-sided harvesting or in cases of vascular variations. However, they are still associated with a risk of secondary displacement with potentially serious consequences. Certain technical tricks can mitigate this risk.

Emphysematous pyelonephritis and emphysematous cystitis in a patient with neurogenic bladder: A case report.

Emphysematous pyelonephritis and cystitis, rare and potentially life-threatening infections marked by gas accumulation in the urinary tract, are described in a 32-year-old male with a history of myelomeningocele and a neurogenic bladder managed by a Benchekroune valve. Clinical and radiological findings confirmed emphysematous pyelonephritis and cystitis. A conservative approach, including urinary drainage and four-week antibiotic treatment (ceftriaxone and metronidazole), led to rapid clinical improvement. This case underscores the successful management of emphysematous infections in a neurogenic bladder patient, emphasizing the effectiveness of conservative treatment.

Retrovesical hydatid cyst: A rare presentation of echinococcosis - A case report.

This case details a 42-year-old farmer experiencing ten months of lower abdominal pain, diagnosed with a retrovesical hydatid cyst (RVHC). Imaging, including ultrasound and CT scans, categorized the cyst as Gharbi type 3. Serological tests confirmed echinococcal antibodies. Surgical intervention comprised the resection of the cyst's prominent dome, following one month of albendazole therapy. The importance of a multidisciplinary approach is highlighted, emphasizing collaboration among urologists, radiologists, and parasitologists for optimal outcomes. This case discussion contributes to the existing literature, providing insights into the management of this rare manifestation of echinococcosis.

Emphysematous cystitis: A rare and life-threatening condition in patients with uncontrolled diabetes mellitus.

Emphysematous cystitis is a rare and potentially life-threatening condition characterized by gas formation within the bladder due to bacterial infection. This article presents a case study of emphysematous cystitis in a 74-year-old male patient with uncontrolled diabetes mellitus and recurrent urinary tract infections. The patient had lower abdominal pain, signs of infection, and urinary symptoms. Imaging revealed bladder wall thickening and gas bubbles. Prompt diagnosis and broad-spectrum antimicrobial therapy were initiated, with intensive care monitoring. After a 14-day treatment, significant improvement occurred, leading to the patient's discharge after 20 days. This case emphasizes early recognition and aggressive management for optimal outcomes.

Management of the Uncommon Bladder Cancers: A Single-Center Experience over 10 Years.

BACKGROUND: Under the name of uncommon bladder cancers are gathered rare histological entities which represent less than 5% of bladder tumors. There is not a clear and consensual therapeutic management for these entities. PURPOSE: To review a single-institution 10-year experience with rare form of bladder cancers detailing the diagnosis, treatment, and patient outcome. MATERIALS AND METHODS: We performed a retrospective review of 27 medical records of rare bladder cancer form treated at our center between February 2006 and February 2015. The clinicopathologic features are reported with emphasis on treatment and survival. RESULTS: Mean patient age was 65.5 ± 20 yr and 70% of patients were males. Smoking background was found in 16 cases, chronic bladder irritation factors were found in 12 cases, and past urinary tract infection was found in 11 cases. The main symptom was total hematuria (93%) causing an anemia in 16 cases. The two mean histological forms were epidermoid carcinoma (37%) and adenocarcinoma (22%). 26% of patients were found to have extended invasive tumors (T4) at diagnosis. Metastatic disease was confirmed in 8 cases. Our patients were managed by a wide range of therapeutic modalities as total cystectomy with bilateral lymph node dissection (63%), palliative chemotherapy (30%), or concomitant radiochemotherapy (7%). 55.6% of patients were alive one year after diagnosis. Epidermoid carcinoma has the best prognosis followed by leiomyosarcoma and sarcomatoid carcinoma. Neuroendocrine carcinoma has the worst outcome. The overall 5-year survival rate is 33.3%. CONCLUSION: The rarity and small size of these tumors justify the absence of clear and consensual therapeutic management. No role of total cystectomy concerning the conclusions could be drawn but elements suggest this may be the treatment of choice. The highly aggressive nature of those lesions justifies an aggressive and fast therapy when feasible which gives the best outcomes.

[Squamous cell carcinoma of the bladder: a retrospective study conducted in a Moroccan University Hospital and literature review]. / Carcinome épidermoïde de la vessie: expérience rétrospective dans un hôpital universitaire marocain et revue de la littérature.

Squamous cell carcinoma of the bladder is a rare form of bladder tumor, accounting for less than 5% of bladder cancers. Sex ratio is balanced and the black population is more affected by this disease. It manifests with non-specific clinical symptoms and it is dominated by haematuria. Diagnosis is based on endoscopic resection of the bladder with anatomopathological examination. Treatment remains controversial because of the rarity of cases reported in the literature. However, radical cystectomy with extensive lymph node dissection is the treatment of choice. We here report a series of 10 cases of squamous cell carcinoma treated and followed up in our department. Our study highlights the epidemiological, clinical, anatomopathological, therapeutic and evolutionary features of squamous cell carcinoma as well as its prognostic factors.