Publications by authors named "Jun Kamei"
Introduction Lymphocele is a typical complication of pelvic lymph node dissection (PLND) in robot-assisted radical prostatectomy (RARP). This study aimed to compare postoperative lymphatic leakage between the polymer ligation clip and vessel sealer, and evaluated the costs associated with the former. Methods The study enrolled patients who underwent RARP with PLND at our institution between April 2018 and March 2023 and were treated with a vessel sealer (LigaSure Blunt Tip 44 NC; Medtronic, Dublin, Ireland) until September 2021, and Hem-o-lok polymer ligation clips(Teleflex, Wayne, PA, USA) thereafter.
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- A study reviewed 106 patients with advanced urothelial carcinoma treated with the antibody-drug conjugate enfortumab vedotin (EV) between 2021 and 2023 to evaluate the impact of treatment-related adverse events (trAEs) on survival outcomes.* -
- The results indicated that 88.7% of patients experienced some form of trAEs, with skin and gastrointestinal issues being the most common, and a landmark analysis suggested that trAEs were linked to longer overall survival, particularly physical trAEs.* -
- The study concluded that managing trAEs and understanding their prognostic value is important for improving the outcomes of EV therapy in these patients, highlighting that physical trAEs were
Objective: Surgical treatment for renal cell carcinoma (RCC) has drastically evolved for the past 30 years. However, survival outcomes of RCC according to times have not been fully elucidated, especially in the real-world setting. This study aimed to assess the survival improvement over time in RCC treated with nephrectomy by analyzing a longitudinal cohort using propensity score matching (PSM).
View Article and Find Full Text PDFBackground: The aim of this study is to describe the first series of six patients undergoing Retzius-sparing robot-assisted radical prostatectomy (rs-RARP) using the hinotori surgical robot system (hinotori SRS) and to compare the treatment outcomes with those achieved with the da Vinci surgical platform.
Methods: This study included 20 cases involving the rs-RARP procedure (hinotori: N = 6; da Vinci: N = 14) that were performed between May 2021 and April 2024 in a single institution.
Results: No significant differences were observed between the hinotori and da Vinci groups regarding the preoperative findings.
Background: Salvage robot-assisted radical prostatectomy (sRARP) after PSA failure in patients who underwent initial radiotherapy or focal therapy has rarely been reported in Japan. We aimed to report the oncologic and functional outcomes of the first 10 cases of sRARP.
Methods: Ten patients underwent sRARP after failing to respond to initial radiotherapy or focal therapy.
Article Synopsis
- The study aimed to compare the effectiveness of deep wound cultures versus superficial swab cultures in identifying pathogens in patients with Fournier's gangrene, as well as how these microorganisms relate to blood or urine samples.
- Researchers analyzed data from 25 patients who underwent debridement between 2006 and 2023, finding that deep wound cultures detected more anaerobic bacteria compared to superficial swabs and had a low concordance rate.
- The results indicated that superficial swab cultures are not a reliable stand-in for deep wound cultures, but blood and urine cultures can help guide antibiotic treatment, despite their lower positivity rates.
Objectives: Inguinal hernia (IH) is a common postoperative complication after robot-assisted radical prostatectomy (RARP). We developed a novel clipping technique for the prevention of IH developing after RARP.
Methods: This cohort included 759 consecutive patients who underwent RARP for prostate cancer at the University of Tokyo Hospital between January 2011 and December 2018.
Background: The association between surgical performance ratings and clinical outcomes in robotic surgery is poorly understood. Additionally, no studies have reported on the relationship between the surgeon's initial case-skill evaluation and the learning curve in robot-assisted surgery. We evaluated whether an objective surgical technique evaluation score for initial robot-assisted radical prostatectomy (RARP) was associated with clinical outcomes and surgeons' learning curves.
View Article and Find Full Text PDFBackground: Although photodynamic-diagnosed transurethral resection of bladder cancer (PDD-TURBT) and Bacillus Calmette-Guérin (BCG) intravesical instillation are the two representative therapies for non-muscle invasive bladder cancer (NMIBC), no studies directly compare their efficacy. We evaluated the outcome of PDD-TURBT alone compared with white light TURBT with intravesical BCG therapy and analyzed the efficacy of both therapies depending on the characteristics of the tumors.
Methods: We retrospectively analyzed intermediate- and high-risk NMIBC patients treated with PDD-TURBT alone (the PDD group) or white light TURBT with BCG therapy (the white light group) using propensity score matched analysis.
Upper extremity complications are often a problem in robot-assisted pelvic surgery (RAPS) with the lithotomy-Trendelenburg position (LT-position). This study focused on upper extremity contact pressure (UEP) and examined the relationship between UEP and upper extremity complications. From May 2020 to April 2022 at the University of Tokyo Hospital, UEP was measured in 155 patients undergoing RARP and 20 patients undergoing RARC.
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- The study analyzed antimicrobial susceptibility patterns of 793 bacterial strains from patients with complicated urinary tract infections across eight species, using national surveillance data collected in Japan from July 2020 to December 2021.
- Fluoroquinolone resistance, particularly among Escherichia coli and Pseudomonas aeruginosa, has risen over the years, with levofloxacin resistance in E. coli increasing from 28.6% in 2008 to 44.5% in 2021, while MRSA vancomycin susceptibility decreased significantly.
- Extended-spectrum β-lactamase-producing strains were identified in notable proportions, with E. coli (24.8%) and Klebsiella pneumoniae (16
A total of 739 patients underwent RARP as initial treatment for PCa from November 2011 to October 2018. Data on BCR status, clinical and pathological parameters were collected from the clinical records. After excluding cases with neoadjuvant and/or adjuvant therapies, presence of lymph node or distant metastasis, and positive SM, a total of 537 cases were eligible for the final analysis.
View Article and Find Full Text PDFIntroduction: This study aimed to identify cases that require a three-dimensional-printed kidney model in robot-assisted partial nephrectomy.
Methods: We enrolled 93 patients undergoing robot-assisted partial nephrectomy for renal tumors at a single institution between November 2018 and May 2021. The endpoints were how often and how long the surgeon consulted the three-dimensional-printed model, determined using intraoperative video.
Total pelvic exenteration (TPE) is a highly invasive surgery associated with high rates of perioperative morbidity and mortality and is commonly performed for several types of locally advanced or recurrent pelvic cancers. It involves multivisceral resection, including the rectum, sigmoid colon, bladder, prostate, uterus, vagina, or ovaries, and urologists normally perform radical cystectomy or radical prostatectomy and urinary diversion in collaboration with colorectal surgeons and gynecologists. In the urological field, robot-assisted surgeries have been widely performed as one of the main minimally invasive procedures because of their superior perioperative or oncological outcomes compared to open or laparoscopic surgeries.
View Article and Find Full Text PDFBackground: In recent years, site-directed therapies (SDTs) targeting progressive lesions in patients with oligometastatic prostate cancer have attracted attention. However, whether they effectively treat oligoprogressive castration-resistant prostate cancer (CRPC) remains unclear. Here, we investigated the efficacy of SDT in patients with oligoprogressive CRPC and identified prognostic factors.
View Article and Find Full Text PDFObjectives: We investigated the correlation between surgical outcomes and postoperative urinary continence recovery in robot-assisted radical prostatectomy (RARP).
Methods: Patients who underwent RARP in our institution (n = 195) were included in this study. Preserved urethral length (PUL) was assessed during the procedure.
Background: Although robot-assisted radical prostatectomy (RARP) and intensity-modulated radiotherapy are the leading respective techniques of prostatectomy and radiotherapy for localized prostate cancer, almost no study has directly compared their outcomes; none have compared mortality outcomes.
Methods: We compared 6‑year outcomes of RARP (n = 500) and volumetric modulated arc therapy (VMAT, a rotational intensity-modulated radiotherapy, n = 360) in patients with cT1-4N0M0 prostate cancer. We assessed oncological outcomes, namely overall survival (OS), cancer-specific survival (CSS), radiological recurrence-free survival (rRFS), and biochemical recurrence-free survival (bRFS), using propensity score matching (PSM).
Objectives: To compare the incidence of surgical site infections (SSI) between robot-assisted and open radical cystectomies and investigate the risk factors for SSI after radical cystectomies.
Methods: Consecutive patients who underwent radical cystectomy between July 2008 and December 2022 were retrospectively reviewed. The prevalence and characteristics of SSI after open and robot-assisted radical cystectomies were compared, and the risk factors for SSI were investigated using propensity score matching.
Article Synopsis
- Sepsis can cause organ dysfunction, particularly acute kidney injury, which significantly increases the risk of death in affected patients.
- Kidney replacement therapy helps address issues related to metabolic, electrolyte, and fluid imbalances from acute kidney injury, but its benefits in sepsis are still under-researched.
- Blood purification therapy shows potential in reducing inflammation and improving blood flow in sepsis, yet more studies are needed to confirm its effectiveness in lowering mortality rates.
Objective: Enfortumab vedotin (EV) was approved for advanced urothelial carcinoma (UC) in 2021 after the EV-301 trial showed its superiority to non-platinum-based chemotherapy as later-line treatment after platinum-based chemotherapy and immune checkpoint inhibitors including pembrolizumab. However, no study has compared EV with rechallenging platinum-based chemotherapy (i.e.
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- - Tube thoracostomy, while generally safe, can occasionally lead to serious bleeding complications from vascular injuries in the chest wall, particularly involving less commonly recognized arteries like the thoracodorsal artery.
- - A case study detailed a 58-year-old man with liver cirrhosis who developed a spontaneous hemopneumothorax and faced complications including ongoing bleeding after chest tube placement due to an injury to the thoracodorsal artery.
- - Emergency physicians need to be cautious as the thoracodorsal artery supplies muscles in the chest area where tubes are often placed, indicating that even in the "triangle of safety," serious bleeding can still occur, necessitating careful monitoring post-procedure. *
Introduction: We present a case of mucinous adenocarcinoma of the prostate with testicular and lung metastases following robot-assisted radical prostatectomy, androgen deprivation therapy, and radiotherapy.
Case Presentation: A 73-year-old man with a prostate-specific antigen level of 4.3 ng/mL was diagnosed with prostate cancer.
Article Synopsis
- Delirium is a common issue in critically ill patients, and this study aims to compare the effectiveness of dexmedetomidine against haloperidol for treating hyperactive delirium in non-intubated patients, hypothesizing that dexmedetomidine is superior.
- The study is a randomized controlled trial that will include 100 non-intubated patients in high dependency units, who will be allocated to receive either dexmedetomidine or haloperidol when they exhibit symptoms of hyperactive delirium.
- Primary outcomes will measure sedation levels achieved two hours after drug administration, while secondary outcomes will assess delirium prevalence and safety of the treatments the following day.
To validate a 'drug score' that stratifies patients receiving immunotherapy based on concomitant medications (antibiotics/proton pump inhibitors/corticosteroids) in urothelial carcinoma (UC). We assessed oncological outcomes according to the drug score in 242 patients with advanced UC treated with pembrolizumab. The drug score classified patients into three risk groups with significantly different survivals.
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