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1.
Indian J Urol ; 40(2): 121-126, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38725898

RESUMEN

Introduction: There is an unmet need for high-quality data for Robot-assisted partial nephrectomy (RAPN) in the Indian population. Indian study group on partial nephrectomy (ISGPN) is a consortium of Indian centers contributing to the partial nephrectomy (PN) database. The current study is a descriptive analysis of perioperative and functional outcomes following RAPN. Methods: For this study, the retrospective ISGPN database was reviewed, which included patients who underwent RAPN for renal masses at 14 centers across India from September 2010 to September 2022. Demographic, clinical, radiological, perioperative, and functional data were collected and analyzed. Ethics approval was obtained from each of the participating centers. Results: In this study, 782 patients were included, and 69.7% were male. The median age was 53 years (interquartile range [IQR 44-62]), median operative time was 180 min (IQR 133-240), median estimated blood loss was 100 mL (IQR 50-200), mean warm ischemia time was 22.7 min and positive surgical margin rates were 2.5%. The complication rate was 16.2%, and most of them were of minor grade. Trifecta and pentafecta outcomes were attained in 61.4% and 60% of patients, respectively. Conclusions: This is the largest Indian multi-centric study using the Indian Robotic PN Collaborative database to evaluate the outcomes of robot-assisted PN, and has proven its safety and efficacy in the management of renal masses.

2.
Surg Open Sci ; 14: 66-67, 2023 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-37533881

RESUMEN

Background: Urinary catheter insertion is one of the basic techniques used in patient care to drain the bladder. Around 30 million urinary catheters are inserted annually in the USA alone.2 Often, when inserting a urinary catheter, it is noticed that urine does not drain right away. Method: This article will discuss the 'urinary catheter squeeze' technique that can help healthcare providers resolve this problem. Results: We have a simple solution called the 'catheter squeeze technique' to address the problem of urine not draining. The clinician who inserts the catheter can assess the outcome of this technique immediately, as it provides immediate results. Conclusion: There are several theories regarding why urine may not properly drain into a catheter after it is inserted, and various methods are employed to address this issue. Our "catheter squeeze technique" is a simple approach that requires no tools or assistance, and its effectiveness can be observed immediately after insertion.

3.
Urologia ; 89(3): 430-436, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35634982

RESUMEN

INTRODUCTION: Minimal invasive surgeries (MIS) for large size adrenal tumors are still debatable. The objective is to evaluate the contemporary peri- and post-operative outcomes of patients undergoing (open = OA, laparoscopic = LA, and robotic = RA) adrenalectomies in three institutions. MATERIALS AND METHODS: Retrospectively gathered peri- and post-operative data of 235 patients, underwent adrenalectomy at three Institutions over a 7-year period (2013-2020) were analyzed. All patients underwent thorough radiological and endocrine workup. RESULTS: Two hundred and thirty five patients who underwent adrenalectomy (OA (n = 29), LA (n = 146), and RA (n = 60)) were assessed. OA (n = 29) versus Minimally invasive surgery (n = 206) showed significant differences (median, p value) in larger tumour size, cm (9.4 vs 5, (p = 0.0001)), longer operative time, mins (240 vs 100, (p = 0.0001)), longer hospital stay, days (8 vs 3,(p = .0001)), Higher readmission rates (14% vs 1.9%), higher blood loss, ml (400 vs 100, (p = 0.0001)) requiring blood transfusion (14% vs 4.3%) (p = 0.03), higher intraoperative complication (21% vs 6%) (p = 0.0004), and post op complications (17% vs 5.3%) (p = 0.01). Amongst the MIS (RA vs LA), RA appeared be have better outcomes in terms of shorter operative time, less blood loss and less intra operative complications with a p value <0.05. These results were consistent for the assessment of patients who had ⩾6 cm tumor size. The postoperative complication rates were lowest with RA (3.3%) compared to OA (17%) and LA (6.1%). CONCLUSIONS: Contemporary practice of adrenalectomy shows that robotic adrenalectomy is safe and effective irrespective of the tumor size.


Asunto(s)
Neoplasias de las Glándulas Suprarrenales , Laparoscopía , Robótica , Neoplasias de las Glándulas Suprarrenales/patología , Neoplasias de las Glándulas Suprarrenales/cirugía , Adrenalectomía/métodos , Humanos , Complicaciones Intraoperatorias/etiología , Laparoscopía/métodos , Tiempo de Internación , Estudios Retrospectivos , Resultado del Tratamiento
4.
Neurourol Urodyn ; 29(7): 1301-5, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20879000

RESUMEN

AIMS: The aim of our study was to access the variability of maximum flow rate (Q(max)), average flow rate (Q(av)) and flow pattern while varying the point of impact of flow on the flowmeter. METHODS: Water was delivered through a motorised tube holder in a standardised experimental set up. Flow was directed in 4 different directions on the funnel; 1) Periphery, 2) Base, 3) Centre and, 4) in a cruising motion from the periphery of the funnel to the centre and back again. The variation in the Q(max), Q(av) and the flow pattern were studied at 4 different flow rates. The variables recorded when the flow was directed at the centre of the funnel was taken as baseline. RESULTS: There was a significant difference in the Q(max) and Q(av)when the point of impact was at the periphery or in a cruising motion compared to the centre. The difference was more marked with cruising motion with a characteristic flow pattern. The maximum percentage difference in Q(av) was 4.1%, whereas the difference in Q(max) was higher at 16.6% on comparing crusing motion with the values from the centre. CONCLUSION: We have demonstrated a significant variation in Q(max), Q(av) and flow pattern with change in the point of impact on the flowmeter. Though the changes in Q(av) were statistically significant, the alteration in the recorded Q(max) values was more striking. Our study emphasizes the importance of combining Q(av) and flow pattern along with Q(max) in interpretation of results of uroflowmetry.


Asunto(s)
Artefactos , Flujómetros , Reología/instrumentación , Urodinámica , Calibración , Diseño de Equipo , Flujómetros/normas , Ensayo de Materiales , Reproducibilidad de los Resultados , Reología/normas
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