Publications by authors named "Seiji Moroi"

We retrospectively analyzed the safety and surgical outcomes of laparoscopic sacrocolpopexy (LSC) by the novice surgeon (performed <5 laparoscopic surgery). Between November 2017 and December 2020, there were 15 cases in which the novice surgeon performed part of LSC, 8 cases in which the novice performed all of LSC, and 50 cases in which the experienced surgeon (performed >100 laparoscopic surgery) performed all of LSC. We compared surgical outcome of the 50 cases operated by the experienced surgeon and 23 cases operated by the novice.

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Background: This study aimed to investigate factors, including the degree of hydronephrosis, that may be associated with decreased renal function after radical nephroureterectomy (RNU).

Methods: This study included 252 patients who underwent laparoscopic RNU with an estimated glomerular filtration rate (eGFR) ≥ 30 ml/min/1.73 m in three institutions.

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Article Synopsis
  • This study focused on identifying risk factors for intravesical recurrence in patients with upper urinary tract urothelial carcinoma who underwent laparoscopic radical nephroureterectomy.
  • The analysis included 283 patients, revealing that 31.7% experienced recurrence, with a significant follow-up period of 33.3 months.
  • Results highlighted the importance of ureter tumors and multiple tumors as key predictors, leading to a three-tier risk classification system that can guide patient monitoring and treatment strategies post-surgery.
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To investigate the recurrence patterns and the atypical oncologic failure (AOF) defined as the presence of atypical recurrences, such as retroperitoneal carcinomatosis or port-site recurrence, after laparoscopic radical nephroureterectomy (LRNU). LRNU performed at three institutions were included in this retrospective study. The primary endpoints were the first recurrence site and recurrence-free survival.

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Background: This study aimed to compare the incidence of postoperative complications occurring within 30 days of surgery between octogenarians and younger patients and identify preoperative risk factors for the incidence of postoperative complications. Moreover, we also compared the oncological outcomes between octogenarians and younger patients.

Methods: This retrospective study included 283 patients who underwent laparoscopic radical nephroureterectomy for upper tract urothelial carcinoma from 2002 to 2020.

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Article Synopsis
  • The study examined the outcomes and recurrence patterns in clinically node-negative patients with renal pelvic and ureteral tumors who underwent a specific surgical approach combining retroperitoneal lymph node dissection (RPLND) and laparoscopic radical nephroureterectomy (LRNU).
  • A total of 283 patients from three Japanese institutions participated, with 47 matched pairs of patients undergoing RPLND and those who did not for fair comparison.
  • Results showed that the RPLND group had a significantly higher 5-year recurrence-free survival rate (86.8%) compared to the non-RPLND group (64.2%), suggesting that RPLND reduces distant recurrence effectively, although cancer-specific survival differences were not statistically significant.
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Objectives: To describe the detailed perioperative complications and their management after retroperitoneal lymph node dissection with retroperitoneal laparoscopic radical nephroureterectomy for patients with upper tract urothelial carcinoma at three institutions.

Methods: Retroperitoneal lymph node dissection was performed on patients with upper tract urothelial carcinoma located at the pelvis and/or upper or middle ureter, and its template included the renal hilar and para-aortic lymph nodes (left side) and the renal hilar, paracaval, retrocaval, and intra-aortocaval lymph nodes (right side). The lymph nodes and kidneys were removed en bloc.

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To identify which patients will have difficulty during morcellation in holmium laser enucleation of the prostate (HoLEP), we analyzedthe association of preoperative factors with morcellation efficiency retrospectively. Between March 2015 andMay 2019, 129 patients with benign prostatic hyperplasia (BPH) underwent HoLEP at our institution. Based on the morcellation efficiency (morcellation volume per minute), they were classifiedinto easy (≥3 g/min, n=81) andd ifficult (<3 g/min, n=48) groups.

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Objectives: To assess the effect of optimal neoadjuvant chemotherapy of at least three cycles of cisplatin-based regimen on oncological outcomes of clinical stage T3 or higher bladder cancer treated with laparoscopic radical cystectomy.

Methods: Laparoscopic radical cystectomies carried out at 10 institutions were included in this retrospective study. The outcomes of patients who received optimal neoadjuvant chemotherapy and those who did not receive neoadjuvant chemotherapy were compared using propensity score matching in clinical stage T3-4 or T2 cohorts, separately.

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Objectives: To compare the perioperative and oncological outcomes of pure laparoscopic intracorporeal ileal conduit urinary diversion versus extracorporeal ileal conduit urinary diversion after laparoscopic radical cystectomy for bladder cancer in a multicenter cohort in Japan.

Method: A total of 455 patients who underwent laparoscopic radical cystectomy carried out at 10 institutions were included in this retrospective study. The perioperative data of the intracorporeal ileal conduit urinary diversion and extracorporeal ileal conduit urinary diversion groups were compared using the propensity score matching method.

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Objective: To investigate oncological outcomes and recurrence patterns after laparoscopic radical cystectomy for bladder cancer in a Japanese multicenter cohort, and to explore the risk factors associated with recurrences due to tumor dissemination.

Method: Laparoscopic radical cystectomies carried out at 10 institutions were included in this retrospective study. Multivariate analyses were carried out to identify the clinical parameters associated with overall recurrences together with specific recurrence types.

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A74-year-old man was referred to the department of general surgery in our hospital because of a painless right scrotal swelling persisting for three months. On physical examination, the patient was found to have an inguinal hernia. The patient underwent laparoscopic transabdominal preperitoneal repair, but no inguinal hernia was detected.

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We evaluated the safety of laparoscopic radical cystectomy (LRC) during initial phases and its learning curve in a Japanese multicenter cohort by studying 436 patients who underwent LRC with no robot assistance at 10 institutions in Japan. We divided the patients into three groups according to cumulative surgical volume at each institution (first 10 cases, 11-30 cases, after 31 cases in each institution), and compared perioperative and pathologic variables among the three groups. The first, second, and third groups included 100, 166, 170 patients, respectively.

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Objective: To evaluate the predictive value of preoperative hydronephrosis for pathological outcome and prognosis in patients with upper tract urothelial carcinoma treated with nephroureterectomy.

Methods: 167 patients with UTUC treated with nephroureterectomy at our two institutions in Japan between 2002 and 2017 were retrospectively analyzed. Preoperative computed tomography scans were evaluated for the presence of ipsilateral hydronephrosis.

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Objective: To describe our en bloc technique of retroperitoneal lymph node dissection (RPLND) during retroperitoneal laparoscopic radical nephroureterectomy for upper urinary tract urothelial carcinoma and evaluate perioperative outcomes.

Methods: From 2002 to 2015, 114 patients with urinary tract urothelial carcinoma located at the pelvis or upper or middle ureter underwent retroperitoneal laparoscopic radical nephroureterectomy at 2 institutions. Performance of RPLND began in February 2009.

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Article Synopsis
  • The study focused on the effectiveness of combining external-beam radiotherapy (EBRT) with neoadjuvant androgen deprivation therapy (NeoADT) for patients with high-risk prostate cancer, as categorized by NCCN guidelines.
  • A total of 70 high-risk patients received treatment from 2002 to 2013, with follow-up showing that biochemical progression-free survival (bPFS) rates were significantly affected by the number of risk factors and pre-treatment PSA levels.
  • After a median follow-up of 4.8 years, the results indicated a 5-year bPFS of 63% and an 8-year overall survival (OS) rate of 91
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Purpose: We investigated the impact of lower urinary tract symptoms (LUTS) on generic health-related quality of life (HRQOL) in male patients without co-morbidity.

Patients And Method: From 2003 to 2011, a total 567 men who presented out urological department completed the questionnaires including International Prostate Symptom Score (IPSS), incontinence-frequency score (IFS) from the UCLA prostate cancer index, MOS 36-Item Short-Form Health Survey (SF-36). Among 230 patients with no coexisting morbidity, the relations between each LUTS score of IPSS indices and IFS and 8 domain scores of SF-36 were analyzed by Pearson's product-moment correlation and stepwise multiple regression analysis.

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We report a case of penile strangulation by a metal ring. An 81-year-old man visited our hospital with a complaint of penile swelling and urinary retention caused by a ring placed around the penile root to control the patient's sexual desire; the ring had been placed some days prior to presentation. We could not release the penile strangulation by hand or with a ring cutter in the emergency room.

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Two patients underwent resection of renal malignant tumors involving vena cava. Such tumors occasionally extend to the inferior vena cava with tumor thrombus and invasion to the lymph nodes and adjacent organs. Perioperative management of patients with these tumors is difficult because of the risk of pulmonary embolism and massive bleeding, and requires appropriate cooperation among the surgical team.

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A 71-year-old man was admitted with a swelling of the left scrotum where Galium scintigraphy was positive. He had a history of malignant lymphoma of the right testis and had undergone an orchitectomy, with adjuvant CHOP (cyclophosphamide, doxorubicin, vincristine, predonisolone) chemotherapy and radiotherapy to the post-orchitectomy site and opposite testis. An open biopsy of his scrotum and left testis revealed relapse of the malignant lymphoma in the left scrotal skin.

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We conducted a multi-institute survey on the conditions related to urologic management of severe voiding dysfunction after hysterectomy for uterine cancer with or without postoperative irradiation. Our first study population was a group of adult female patients currently managed by urologists, using clean intermittent catheterization (CIC). Of the 287 patients in this group, 99 (34%) had suffered from uterine cancer.

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The efficacy of an all-in-one clinical pathway for retropubic radical prostatectomy (RRP) was assessed. A total of 60 patients were enrolled, including 33 before the introduction of the pathway (mean age 67.3) and 27 after the introduction (mean age 66.

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Between October 2004 and August 2005, 43 patients with the mean age of 70.9 (ranging 57-83) years, who had lower urinary tract symptoms underwent holmium laser enucleation of the prostate (HoLEP) at our hospital. The mean operative time, change in hemoglobin and resected tissue weight were 193 (83-390) minutes, -2.

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