Preoperative risk factors for venous thromboembolism in major urologic cancer surgeries.

Purpose: Venous thromboembolism (VTE) is a serious complication of urologic cancer surgeries. Incidence varies by procedure, with cystectomy carrying the highest risk. Our study aims to explore the preoperative risk factors for VTE development in major urologic cancer surgeries.

The impact of AirSeal on complications and pain management during robotic-assisted radical prostatectomy: a single-tertiary center study.

Purpose: We aimed to compare perioperative outcomes, post-operative complications, and opioid use between AirSeal and non-AirSeal robotic-assisted radical prostatectomy (RARP).

Methods: We retrospectively collected data on 326 patients who underwent elective RARP at our institution either with or without AirSeal. The first 60 cases were excluded accounting for the institutions' learning curve of RARP.

Preoperative predictors of prolonged length of stay in radical cystectomy: a retrospective study using the American College of Surgeons-National Surgical Quality Improvement Program Dataset.

Background: Radical cystectomy (RC) is considered a complex procedure that entails significant morbidity and mortality.

Objectives: We aimed to determine pre-operative patient characteristics that help predict a prolonged length of hospital stay (PLOS) following RC.

Design And Methods: The American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database was used to select patients who underwent RC between the years 2011 and 2020.

Robotic-assisted radical prostatectomy is pushing the boundaries: a national survey of frailty using the national surgical quality improvement program.

Background: Robotic-assisted radical prostatectomy (RARP) has been found to be comparable and, in some cases, favorable to open surgical approaches, while being used in a frailer population.

Objectives: We aimed to illustrate the trend in population frailty and compare morbidity and mortality postoperatively in patients who underwent RARP.

Design And Methods: The National Surgical Quality Improvement Program data set was used to select patients who underwent RARP between the years 2011-2019.

Comparison of Postoperative Outcomes of Trans-urethral Resection of the Prostate, Laser Vaporization, and Laser Enucleation: A Double Propensity Score Matched Analysis.

Objective: To compare postoperative outcomes of 3 types of endourologic surgeries (trans-urethral resection of the prostate [TURP], laser vaporization [LVP], and laser enucleation [LEP]) for benign prostatic hypertrophy (BPH) treatment using the ACS-NSQIP database.

Methods: The ACS-NSQIP database was queried for men who underwent TURP, PVP, and LEP for treatment of BPH from 2011 till 2019. Demographics, clinical, operative characteristics, and 30-day outcomes were compared.

Modified GLIM Status as a Predictor of Morbidity and Mortality After Radical Cystectomy: A Propensity Matched Analysis.

Introduction: To assess the modified Global Leadership Initiative on Malnutrition (mGLIM) status as a predictor of postoperative mortality and morbidity in patients undergoing Radical Cystectomy (RC).

Methods And Materials: The American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) dataset was used to select patients who underwent RC between the years 2011 to 2020. A positive mGLIM status includes patients with preoperative albumin levels < 3.

The 5-item frailty index predicts 30-day morbidity and mortality in radical nephrectomy patients: A propensity matched analysis.

Purpose: To assess the ability of the 5-item frailty index (5-IFi) score to predict 30-day morbidity and mortality post-radical nephrectomy (RN).

Methods: ACS-NSQIP database was used to select patients who underwent RN from 2011 to 2020. 5-IFi score was calculated by assigning a point for each of the following comorbidities: chronic obstructive pulmonary disease or pneumonia, congestive heart failure, dependent functional status, hypertension, and diabetes.

A novel nephrectomy-specific respiratory failure index using the ACS-NSQIP dataset.

Purpose: Post-operative pulmonary failure is a major complication of nephrectomy that may lead to severe morbidity and mortality. Hence, we aimed to derive a nephrectomy-specific post-operative respiratory failure index.

Methods: Our cohort was derived from The American College of Surgeons-National Surgical Quality Improvement Program database between 2005 and 2019.

Sedation as an alternative anesthetic technique for frail patients in transurethral resection of the prostate.

Background: Transurethral resection of the prostate (TURP) under Monitored Anesthesia Care MAC/Sedation (macTURP), as compared with TURP under general (genTURP) or spinal (spTURP) anesthesia, is a safer and infrequently used technique reserved for high-risk patients.

Objectives: The aim of this study is to compare 30-day postoperative outcomes of TURP using the three types of anesthesia techniques.

Design And Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients who underwent TURP between 2008 and 2019.

Surgical Complications Requiring Reoperation in Open Versus Minimally Invasive Radical Nephrectomy: A Contemporary Analysis of the National Surgical Quality Improvement Program.

Background: To explore reoperation rates for different radical nephrectomy (RN) approaches that are experiencing a shift from open radical nephrectomy (ORN) toward minimally invasive surgery (MIS), we aimed to compare reoperation rates along with their culprit etiologies between the different types of surgical approaches for RN.

Methods: The national surgical quality improvement program dataset was used to select patients who underwent RN between the years 2012-2019. A 1:1 propensity score matched analysis was used.

Preoperative MELD score predicts mortality and adverse outcomes following radical cystectomy: analysis of American College of Surgeons National Surgical Quality Improvement Program.

Background: The model for end-stage liver disease (MELD) has been widely used to predict the mortality and morbidity of various surgical procedures.

Objectives: We aimed to correlate a high preoperative MELD score with adverse 30-day postoperative complications following radical cystectomy.

Design And Methods: Patients who underwent elective, non-emergency radical cystectomy were identified from the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2017.

Early Detection and Correction of Cerebral Desaturation With Noninvasive Oxy-Hemoglobin, Deoxy-Hemoglobin, and Total Hemoglobin in Cardiac Surgery: A Case Series.

Regional cerebral oxygen saturation (rS o2 ) obtained from near-infrared spectroscopy (NIRS) provides valuable information during cardiac surgery. The rS o2 is calculated from the proportion of oxygenated to total hemoglobin in the cerebral vasculature. Root O3 cerebral oximetry (Masimo) allows for individual identification of changes in total (ΔcHbi), oxygenated (Δ o2 Hbi), and deoxygenated (ΔHHbi) hemoglobin spectral absorptions.

A novel radical prostatectomy specific index (PSI) for the prediction of major cardiovascular events following surgery.

Purpose: Prostate cancer patients tend to be older with multiple comorbidities and are thus at increased risk for postoperative cardiovascular events after radical prostatectomy (RP). Thus, proper patient selection strategies are essential to decide for or against a surgical approach. We aimed to derive a prostatectomy specific index (PSI) for patients undergoing RP and compare its performance to universally used indices.

Telemedicine and Telementoring in Urology: A Glimpse of the Past and a Leap Into the Future.

Telemedicine is the process of utilizing telecommunications and digital relay to perform, teach, or share medical knowledge. The digital era eased the incorporation of telemedicine to different areas of medical care, including the surgical care of Urologic patient mainly through telementoring, telesurgery, and telerobotics. Over the years, Telemedicine has played an integral part in a physicians' ability to provide high quality medical care to remote patients, as well as serve as an educational tool for trainee physicians, in the form of telementoring.

Risk factors for wound dehiscence following radical cystectomy: a prediction model.

Objectives: Radical cystectomy (RC) is a complex urologic procedure performed for the treatment of bladder cancer and causes significant morbidity. Wound dehiscence (WD) is a major complication associated with RC and is associated with multiple risk factors. The objectives of this study are to identify clinical risk factors for incidence of WD and develop a risk-prediction model to aid in patient risk-stratification and improvement of perioperative care.

Intra-abdominal pressure during and after cardiac surgery: a single-centre prospective cohort study.

Purpose: While intra-abdominal hypertension (IAH) has been associated with adverse outcomes in multiple settings, the epidemiology and clinical implications of IAH in the context of cardiac surgery are less known. In this study, we aimed to describe the prevalence of IAH in patients undergoing cardiac surgery and determine its association with patient characteristics and postoperative outcomes.

Methods: We conducted a single-centre prospective cohort study in which intra-abdominal pressure was measured in the operating room after general anesthesia (T1), after the surgical procedure (T2), and two hours after intensive care unit (ICU) admission (T3) in a subset of patients.

Myocardial Protection in Minimally Invasive Mitral Valve Surgery: Retrograde Cardioplegia Alone Using Endovascular Coronary Sinus Catheter Compared With Combined Antegrade and Retrograde Cardioplegia.

Objective: To compare myocardial protection with retrograde cardioplegia alone with antegrade and retrograde cardioplegia in minimally invasive mitral valve surgery (MIMS).

Design: Retrospective study.

Setting: Tertiary care university hospital.

Perioperative Right Ventricular Pressure Monitoring in Cardiac Surgery.

Right ventricular (RV) dysfunction is a cause of increased morbidity and mortality in both cardiac surgery and noncardiac surgery and in the intensive care unit. Early diagnosis of this condition still poses a challenge. The diagnosis of RV dysfunction traditionally is based on a combination of echocardiography, hemodynamic measurements, and clinical symptoms.

Myocardial Protection in Mitral Valve Surgery: Comparison Between Minimally Invasive Approach and Standard Sternotomy.

Objective: To compare antegrade and retrograde cardioplegia administration in minimally invasive mitral valve surgery (MIMS) and open mitral valve surgery (OMS) for myocardial protection.

Design: Retrospective study.

Setting: Tertiary care university hospital.

Subclavian and axillary vessel anatomy: a prospective observational ultrasound study.

Purpose: The primary objective of this study was to define the ultrasound-derived anatomy of the axillary/subclavian vessels. As a secondary objective, we evaluated the relationship between the vascular anatomy and demographic, anthropometric, and hemodynamic data of patients.

Methods: This observational anatomical study used bedside ultrasound with 150 cardiac surgical patients in the operating room.

Low-Dose Versus High-Dose Tranexamic Acid Reduces the Risk of Nonischemic Seizures After Cardiac Surgery With Cardiopulmonary Bypass.

Objective: The incidence of postoperative nonischemic seizures associated with the use of tranexamic acid (TXA) and the possibility of prevention with a low-dose regimen of TXA were evaluated.

Design: Retrospective study.

Setting: Tertiary care university hospital.

Innovative approaches in the perioperative care of the cardiac surgical patient in the operating room and intensive care unit.

Perioperative care for cardiac surgery is undergoing rapid evolution. Many of the changes involve the application of novel technologies to tackle common challenges in optimizing perioperative management. Herein, we illustrate recent advances in perioperative management by focusing on a number of novel components that we judge to be particularly important.

Pulmonary production of osteopontin in humans: effects of left ventricular systolic dysfunction and cardiopulmonary bypass.

Background: We evaluated pulmonary production of osteopontin (OPN) in left ventricular systolic dysfunction (LVSD) and after cardiopulmonary bypass surgery (CPB). OPN is a phosphoglycoprotein involved in inflammation and remodeling. In subjects with LVSD, plasma OPN correlates with prognosis but its origin is unknown.