Publications by authors named "Fernando Kim"

Article Synopsis
  • The trauma mortality rate is higher in elderly patients due to age-related physiological changes and frailty, necessitating specialized management guidelines to improve outcomes and minimize unnecessary procedures.
  • Expert surgeons reviewed literature and developed evidence-based recommendations for geriatric trauma care, focusing on frailty assessment, early activation of trauma protocols, and multimodal pain management.
  • Key practices include administering antibiotics selectively for certain traumatic injuries, ensuring timely venous thromboembolism prevention, and involving palliative care teams to address end-of-life discussions with a holistic approach.
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Background: Stone nomogram by Micali et al., able topredict treatment failure of shock-wave lithotripsy (SWL), retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PNL) in the management of single 1-2 cm renal stones, was developed on 2605 patients and showed a high predictive accuracy, with an area under ROC curve of 0.793 at internal validation.

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Introduction: A 70-year-old male with prior total colectomy for ulcerative colitis was referred for elevated prostate specific antigen (PSA) (8.01) with PIRADS 4 lesion on magnetic resonance imaging (MRI). Described is a novel technique using pre-operative multi-parametric prostate MRI and intraoperative computed tomography (CT) 3D/3D fusion for systematic and targeted prostate biopsy in a patient lacking a rectum.

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Article Synopsis
  • - Iatrogenic urinary tract injury (IUTI) is a serious complication that can arise from emergency digestive surgery, leading to increased health risks and long-term quality of life issues for patients.
  • - The incidence of IUTIs varies from 0.3% to 1.5%, highlighting the need for clear strategies for prevention and management, especially given the high number of these surgeries done globally.
  • - The World Society of Emergency Surgery (WSES) has developed guidelines based on extensive literature review and expert consultations, focusing on effective prevention measures, detection methods, and management strategies—including antibiotic use—pertaining to IUTIs in emergency settings.
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Article Synopsis
  • Cystine stones are a genetic condition linked to mutations in the SLC3A1 or SLC7A9 genes, and this study explored the genetic prevalence compared to clinical reports.
  • Researchers analyzed genetic variants from the 1000 Genomes project and the Human Gene Mutation Database, identifying 9 SLC3A1 and 5 SLC7A9 pathogenic variants among carriers, estimating a genetic prevalence of 1 in 30,585.
  • The study found that the clinical prevalence of cystine stones is higher at 1 in 7,000, indicating that the disease's causes may involve more factors than just genetics, such as undiscovered mutations and environmental influences.
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Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking.

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Context: Whole-gland ablation is a feasible and effective minimally invasive treatment for localized prostate cancer (PCa). Previous systematic reviews supported evidence for favorable functional outcomes, but oncological outcomes were inconclusive owing to limited follow-up.

Objective: To evaluate the real-world data on the mid- to long-term oncological and functional outcomes of whole-gland cryoablation and high-intensity focused ultrasound (HIFU) in patients with clinically localized PCa, and to provide expert recommendations and commentary on these findings.

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Background: Retained surgical sharps (RSS) is a "never event" that is preventable but may still occur despite of correct count and negative X-ray. This study assesses the feasibility of a novel device ("Melzi Sharps Finder®" or MSF) in effective detection of RSS.

Methods: The first study consisted of determination of the presence of RSS or identification of RSS in an ex-vivo model (a container with hay in a laparoscopic trainer box).

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Background: The Gleason grading system is an important clinical practice for diagnosing prostate cancer in pathology images. However, this analysis results in significant variability among pathologists, hence creating possible negative clinical impacts. Artificial intelligence methods can be an important support for the pathologist, improving Gleason grade classifications.

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To compare outcomes of robot-assisted partial nephrectomy (RAPN) and percutaneous tumor ablation (PTA) for completely endophytic renal masses. Data of patients who underwent RAPN or PTA for treatment of completely endophytic (three points for "E" domain of R.E.

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Background: Ablative techniques emerged as effective alternative to nephron-sparing surgery for treatment of small renal masses. Radiofrequency ablation (RFA) and cryoablation (CRYO) are the two guidelines-recommended techniques. Microwave ablation (MWA) represents a newer technology, less described.

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Article Synopsis
  • The study compares outcomes of robot-assisted partial nephrectomy (RAPN) and percutaneous thermal ablation (PTA) in patients with renal cell carcinoma in a solitary kidney.
  • Results showed both methods had similar complication rates, but the recurrence-free survival (RFS) rate was higher with RAPN (96.1%) compared to PTA (86.8%).
  • The authors suggest PTA is a viable option for treating kidney cancer in frailer patients, despite a potential higher recurrence risk, due to its ability to allow for re-treatment if necessary.
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Background: To describe our experience with outpatient transperineal biopsy (TPB) without antibiotics compared to transrectal biopsy (TRB) with antibiotics and bowel preparation. The literature elicits comparable cancer detection, time, and cost between the two. As antibiotic resistance increases, antimicrobial stewardship is imperative.

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Introduction: A retained surgical sharp (RSS) is a never event and defined as a lost sharp (needle, blade, instrument, guidewire, metal fragment) that is not recovered prior to the patient leaving the operating room. A "near-miss" sharp (NMS) is an intraoperative event where there is a lost surgical sharp that is recovered prior to the patient leaving the operating room. With underreporting of such incidents, it is unrealistic to expect aggressive development of new prevention and detection strategies.

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Introduction: Intraoperative surgical outcomes are influenced by a wide variety of environmental, provider and institutional factors. There is little in the current literature that provides guidance for practitioners interested in adapting these factors to improve the quality of the urological care they provide.

Methods: A multidisciplinary panel of subject matter experts (urologists, nurses, anesthesiologists) was convened to evaluate the existing literature, create a white paper, and disseminate this to providers and institutions to fuel quality improvement efforts in urological surgery.

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Renal and urogenital injuries occur in approximately 10-20% of abdominal trauma in adults and children. Optimal management should take into consideration the anatomic injury, the hemodynamic status, and the associated injuries. The management of urogenital trauma aims to restore homeostasis and normal physiology especially in pediatric patients where non-operative management is considered the gold standard.

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Background: Pelvic fracture urethral injuries (PFUI) occur in up to 10% of pelvic fractures. It remains controversial whether initial primary urethral realignment (PR) after PFUI decreases the incidence of urethral obstruction and the need for subsequent urethral procedures. We present methodology for a prospective cohort study analyzing the outcomes of PR versus suprapubic cystostomy tube (SPT) after PFUI.

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Transitional cell carcinoma is the most common type of bladder cancer in the United States. This case report discusses the finding of primary bladder carcinoid tumor (also called well-differentiated neuroendocrine tumor) in a woman with gross hematuria. With only 15-20 reported cases, primary bladder carcinoid is rare and the approach to treatment is unclear.

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Background: There is no clear consensus as to the optimal method of entry in laparoscopic renal surgery and no reports have compared them in Urology. To analyze contemporary practice patterns in entry technique and port placement for laparoscopic kidney surgery.

Methods: We identified 60 high volume urological laparoscopic centers.

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Introduction: Regulations and guidelines are essential components of maintaining safety in multiple industries. In health care these processes exist to help distinguish weaknesses in patient care and identify adverse events. We review the processes that have been established in health care to promote the culture of patient safety.

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The objective of this study was to compare the surgical, oncological, and functional outcomes of laparoscopic and percutaneous cryoablation for the treatment of small renal masses. A systematic review of the literature was performed through March 2016 using PubMed, Scopus, and Ovid databases. Article selection proceeded according to the search strategy on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria.

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