[Our initial experience with robot-assisted partial nephrectomy]. / Robotasszisztált parciális nefrektómia mutétekkel szerzett kezdeti tapasztalataink.

The aim of our study was to summarize our initial experience with robot-assisted partial nephrectomy (RAPN) surgeries. Our data were obtained retrospectively by analyzing the data from the first RAPN surgeries performed at University of Pécs Clinical Centre. Between October 2022 and April 2024, we performed 53 robot-assisted partial nephrectomies. Due to our specific circumstances, including the lack of funding from the National Health Insurance Fund (OEP), we performed only 16 surgeries in the first eight months and 37 in the subsequent nine months. According to the PADUA score, 55% of the surgeries were categorized as simple, 36% as moderate, and 9% as highly complex. The average console time was 134 minutes, showing a decreasing trend with increased practice. The average warm ischemia time was 12 minutes. There were no conversions to open surgery, but one radical nephrectomy was performed due to peritoneal tumor infiltration. Our patients were discharged on the third postoperative day. The introduction of RAPN in our clinic, as the first provincial centre, was successful. The transition from laparoscopic partial nephrectomy quickly yielded good results despite performing only a few surgeries in the first eight months due to the lack of OEP funding. Nevertheless, our results clearly show that performing 20-30 robot-assisted surgeries per year per surgeon, as described in the literature, is minimally necessary.

Regulatory role of capsaicin-sensitive peptidergic sensory nerves in the proteoglycan-induced autoimmune arthritis model of the mouse.

OBJECTIVE: The regulatory role of capsaicin-sensitive peptidergic sensory nerves has been shown in acute inflammation, but little is known about their involvement in T/B-cell driven autoimmune arthritis. This study integratively characterized the function of these nerve endings in the proteoglycan-induced chronic arthritis (PGIA), a translational model of rheumatoid arthritis. METHODS: Peptidergic afferents were defunctionalized by resiniferatoxin (RTX) pretreatment in BALB/c mice, PGIA was induced by repeated antigen challenges. Hind paw volume, arthritis severity, grasping ability and the mechanonociceptive threshold were monitored during the 17-week experiment. Myeloperoxidase activity, vascular leakage and bone turnover were evaluated by in vivo optical imaging. Bone morphology was assessed using micro-CT, the intertarsal small joints were processed for histopathological analysis. RESULTS: Following desensitization of the capsaicin-sensitive afferents, ankle edema, arthritis severity and mechanical hyperalgesia were markedly diminished. Myeloperoxidase activity was lower in the early, but increased in the late phase, whilst plasma leakage and bone turnover were not altered. Desensitized mice displayed similar bone spurs and erosions, but increased trabecular thickness of the tibia and bony ankylosis of the spine. Intertarsal cartilage thickness was not altered in the model, but desensitization increased this parameter in both the non-arthritic and arthritic groups. CONCLUSION: This is the first integrative in vivo functional and morphological characterization of the PGIA mouse model, wherein peptidergic afferents have an important regulatory function. Their overall effect is proinflammatory by increasing acute inflammation, immune cell activity and pain. Meanwhile, their activation decreases spinal ankylosis, arthritis-induced altered trabecularity, and cartilage thickness in small joints.