Is Ablation Suitable For Small Renal Masses (SRMs)? A Meta-Analysis.

RATIONALE AND OBJECTIVES: To compare perioperative and oncology outcomes of ablation and partial nephrectomy in small renal masses (SRMs). METHODS: We conduct this meta-analysis strictly according to the PRISMA standard, and the quality evaluation follows the AMSTAR standard. Four databases, Embase, PubMed, Cochrane Library, and Web of Science, were systematically searched. The search time range is from database creation to November 2023. Stata16 statistical software was used for statistical analysis. Weighted mean difference (WMD) represented continuity variables, odds ratio or relative risk (OR/RR) represented dichotomies variables, and 95% confidence intervals (95%CI) were calculated. RESULTS: A total of 27 studies, including 6030 patients. Results showed that patients undergoing partial nephrectomy were younger (WMD = -5.45 years, 95%CI [-7.44, -3.46], P < 0.05), had longer operation time (WMD = 64.91 min, 95%CI [44.47, 85.34], P < 0.05), had longer length of stay (WMD = 2.91 days, 95%CI [2.04, 3.78], P < 0.05), and had more estimated blood loss (WMD = 97.76 ml, 95%CI [69.48, 126.04]. P < 0.05), the overall complication rate was higher (OR = 1.84, 95%CI [1.48, 2.29], P < 0.05), the major complication rate was higher (OR = 1.98, 95%CI [1.36, 2.88], P < 0.05), and the recurrence rate was lower (OR = 0.32, 95%Cl [0.20, 0.50], P < 0.05). However, there were no differences between ablation and partial nephrectomy in cancer-specific survival (CSS) (HR = 2.07, 95%CI [0.61, 7.04], P > 0.05), overall survival (OS) (HR = 1.24, 95%CI [0.58, 2.65], P > 0.05), and recurrence-free survival (RFS) (HR = 2.68, 95%CI [0.91, 7.88], P > 0.05). CONCLUSION: Patients undergoing partial nephrectomy are younger, have longer operation time and length of stay, and have higher complication rate. However, there was no significant difference in CSS, OS, and RFS between partial nephrectomy and ablation, but more well-designed, high-quality studies are needed to confirm this.

Comparing the safety and effectiveness of minimally invasive surgery and open inguinal lymph node dissection in penile cancer: A systematic review and meta-analysis.

OBJECTIVE: To compare the safety and effectiveness of minimally invasive surgery (MIS) with open inguinal lymph node dissection (O-ILND) in penile cancer. METHODS: We performed a systematic reviews and cumulative meta-analyses of primary results of interest according to PRISMA criteria, and quality assessment followed AMSTAR. The system searched five databases, including Zhiwang, Embase, PubMed, Cochrane Library and Web of Science. The search period ranged was from database creation until September 2023. The statistical analysis software used Stata16. RESULTS: A total of 16 studies, including 898 patients. Compared to O-ILND, MIS is superior in length of stay (WMD = -2.96, 95%CI [-4.38, -1.54], P < 0.05), drainage time (WMD = -3.24, 95%CI [-4.70, -1.78], P < 0.05) and estimated blood loss (WMD = -35.70, 95%CI [-46.27, -25.14], P < 0.05), while operation time, recurrence rate and 5-year overall survival rate are the same. The number of lymph nodes dissection between the two groups are not statistically significant. Subgroup analyses found that there are more lymph nodes dissection in robotic-assisted inguinal lymph nodes dissection (WMD = 0.50, 95%CI [0.20, 0.80], P < 0.05). The overall complication rate of MIS was lower (OR = 0.26, 95%CI [0.09, 0.70], P < 0.05). CONCLUSION: Minimally invasive inguinal lymph nodes dissection appears to be a better option for penile cancer cases. But more large samples and multicenter studies are needed to further confirm.

Perioperative and Oncological Outcomes of Partial Versus Radical Nephrectomy for Complex Renal Tumors (RENAL Score ≥ 7): Systematic Review and Meta-Analysis.

OBJECTIVE: Which is superior, partial nephrectomy (PN) or radical nephrectomy (RN), for the treatment of complex renal tumours (RENAL or score ≥ 7)? METHODS: This systematic review and meta-analysis was conducted in accordance with the PRISMA statement. A systematic search of the literature published before November 2023 was conducted using Pubmed, Embase, Cochran, and Web of Science libraries. We included studies comparing perioperative and oncologic outcomes of partial nephrectomy and radical nephrectomy for complex renal tumors. RESULTS: A total of 2602 patients from six studies meeting the criteria were included. The PN group had a longer operative time, increased estimated blood loss, and major complications but a smaller reduction in renal function. There were no significant differences in complications, length of hospital stay, and blood transfusion. In terms of oncological outcomes, the PN group had longer OS, CSS, and no significant difference in RFS. CONCLUSIONS: For complex renal tumours, PN requires more operative time and has a higher chance of complications in the short term. However, in long-term follow-up, PN has a small decrease in renal function with longer OS and CSS.

Coating-Free Superhydrophobic Hard Surfaces by Electric Discharge Machining with a Magnetic-Assisted Self-Assembly Sheet Electrode.

Artificial superhydrophobic surfaces hold significant potential in various domains, encompassing self-cleaning, droplet manipulation, microfluidics, and thermal management. Consequently, there is a burgeoning demand for cost-effective, mass-producible, and easily fabricated superhydrophobic surfaces for commercial and industrial applications. This research introduces an efficient, uncomplicated method for constructing hierarchical structures on hard substrates such as binderless tungsten carbide (WC) and glass substrates. The WC substrates were processed by using electrical discharge machining (EDM) with a magnetic-assisted self-assembly sheet electrode. The resultant surfaces comprised micropillars/microgrooves and diminutive craters formed by discharge and ablation, respectively. These surfaces exhibited superior hydrophobic properties, which can be attributed to the modified surface energy and surface texture construction. Our study indicates that a superhydrophobic surface can be achieved on a textured binderless WC. The maximum contact angle and minimum roll-off angle of the hierarchical structure induced by EDM with a magnetic-assisted self-assembly sheet electrode are about 158 and 5°, respectively. The advancing and receding angles are about 161° ± 2 and 157° ± 3, respectively, when the base is tilted at 3°. Furthermore, we have successfully replicated this superhydrophobic structured surface on glass substrates utilizing glass molding technology. This innovative approach to creating superhydrophobic surfaces on hard materials paves the way for the mass production of functional structures on other materials, such as metallic glass, titanium alloy, and mold steel. Most crucially, the proposed fabrication technique offers a straightforward, cost-effective route for creating functional surfaces, rendering it attractive for large-scale industrial production due to its considerable application prospects.

Mayo Adhesion Probability Score Predicts Perioperative Outcome of Partial Nephrectomy: A Systematic Review and Meta-Analysis.

Objective: Assessing whether Mayo adhesive probability (MAP) levels affect perioperative outcomes after partial nephrectomy (PN). Methods: This systematic review and meta-analysis were conducted in accordance with the PRISMA statement. A systematic search of the literature published before February 1, 2023 was conducted using Pubmed, Embase, Cochran, and Web of Science libraries. We included all articles evaluating adherent perirenal fat by MAP during PN. Results: A total of 1807 patients from 7 studies meeting the criteria were included. In the high MAP group, the operation time was longer, and the estimated blood loss and postoperative complications were increased. There was no significant difference in positive surgical margin, warm ischemia time, and hospitalization time. Conclusions: As a simple and easy scoring method, MAP can predict the perioperative outcome of PN patients, especially when ≥3 is the boundary. However, more cohort studies are still needed to determine the optimal cutoff point of MAP.

Comparing the safety and efficacy of single-port versus multi-port robotic-assisted techniques in urological surgeries: a systematic review and meta-analysis.

OBJECTIVE: Comparing the safety and efficacy of single-port (SP) versus multi-port (MP) robotic-assisted techniques in urological surgeries. METHODS: A systematic review and cumulative meta-analysis was performed using PRISMA criteria for primary outcomes of interest, and quality assessment followed AMSTAR. Four databases were systematically searched: Embase, PubMed, The Cochrane Library, and Web of Science. The search time range is from database creation to December 2022. Stata16 was used for statistical analysis. RESULTS: There were 17 studies involving 5015 patients. In urological surgeries, single-port robotics had shorter length of stay (WMD = - 0.63, 95% Cl [- 1.06, - 0.21], P < 0.05), less estimated blood loss (WMD = - 19.56, 95% Cl [- 32.21, - 6.91], P < 0.05), less lymph node yields (WMD = - 3.35, 95% Cl [- 5.16, - 1.55], P < 0.05), less postoperative opioid use (WMD = - 5.86, 95% Cl [- 8.83, - 2.88], P < 0.05). There were no statistically significant differences in operative time, positive margins rate, overall complications rate, and major complications rate. CONCLUSION: Single-port robotics appears to have similar perioperative outcomes to multi-port robotics in urological surgery. In radical prostatectomy, single-port robotics has shown some advantages, but the specific suitability of single-port robots for urological surgical types needs to be further explored.

Fabrication of Dimples by Jet-ECM of Zr-Based Bulk Metallic Glasses with NaCl-Ethylene Glycol Electrolyte.

Zr-based bulk metallic glasses (BMGs) possess unique mechanical and biochemical properties, which have been widely noticed. Jet electrochemical machining (jet-ECM), characterized by a high-speed jet, is a non-contact subtractive method with a high resolution and a high material removal rate (MRR). Past work on the electropolishing of Zr-based BMGs has indicated the feasibility of the NaCl-Ethylene Glycol (EG) electrolyte. In this research, the jet-ECM of Zr-based BMGs in the NaCl-EG electrolyte was studied to explore the dissolving mechanisms and surface integrity according to the voltage, pulse-on time and effective voltage time. The diameter, depth and surface morphologies of dimples were evaluated. The results showed that using this alcohol-based electrolyte led to a desirable surface morphology. The diameter and depth of the dimples varied with the voltage and the effective voltage time in a significantly positive proportional manner. Additionally, cases based on multiple parameter sets exhibited different stray corrosion severity. Afterward, machining performance can be enhanced in the next stage by tuning machining parameters to obtain microscale dimples with better quality.