Urinary Leakage after Robot-Assisted Radical Prostatectomy: Is Always Predictive of Functional Results?

Introduction: The aim of the study was to evaluate if and when the presence of radiological urinary leakages of vesico-urethral anastomosis, after robotic radical prostatectomy, could provoke urethral strictures or affect continence recovery.

Methods: We enrolled 216 patients, undergoing robot-assisted radical prostatectomy between January 2020 and December 2022 in three high-volume referenced centres for robotic surgery. Before removal of the bladder catheter, all patients underwent a cystourethrography in which the presence/absence of leakage was assessed at level of vesico-urethral anastomosis.

Treatment of 2-4 cm kidney stones: multicentre experience. Comparison of safety, efficacy, and costs of percutaneous nephrolithotomy and retrograde intrarenal surgery.

Introduction: The objective of this study is to compare the safety and efficacy, through the stone-free rate (SFR), as well as the costs, between retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL), for 2-4 cm kidney stones.

Material And Methods: We analysed the data relating to RIRS and PCNL performed in 3 reference centres for kidney stones, in the period between 1/2019 and 12/2021. The total number of procedures was 130 (63 RIRS and 67 PCNL).

Impact of positive surgical margins (PSMs) after robotic prostatectomy on biochemical recurrence (BCR): Multicenter analysis.

Objective: To study and analyze any correlations between positive surgical margins after RARP and biochemical recurrence.

Methods: We enrolled 105 patients who underwent robot-assisted radical prostatectomy (RARP) from 2016-2020 with PSMs on final pathology, all performed or supervised by a senior surgeon in two tertiary referral center. Pathology has been described indicating also the area (apical, base, mediolateral, anterior, or multiple) and the extent of PSMs: focal (≤3 mm) or extensive (>3 mm).

Learning curve in robot-assisted partial nephrectomy: comparison between an expert surgeon and a team in training in single-center experiences.

Introduction: An important issue in robotic surgery is the training of urologists and the learning curve to perform a robot-assisted partial nephrectomy (RAPN), especially for those procedures that require vascular clamping.

Material And Methods: We retrospectively enrolled 333 patients, undergoing RAPN in the period between 01/2014 and 12/2020. Surgical complexity, surgery duration, perioperative complications, and clamping were evaluated for each patient.

Regional cerebral saturation versus transcranial Doppler during carotid endarterectomy under regional anaesthesia.

Background And Objective: The aim of this study was to compare a cerebral oximeter with transcranial Doppler (TCD) as a neurological monitor in patients undergoing carotid endarterectomy under regional anaesthesia.

Methods: Forty patients were enrolled for this prospective study. We recorded every adverse neurological event after arterial clamping and variations in parameters evaluated by the two monitoring systems in order to determine whether there was any correlation between TCD data and those obtained by regional cerebral saturation, the timing of detection of the adverse event in both clinical examination and instrumental data and the presence of any false positives or negatives in any of the two monitoring systems.

Clinical effects of direct hemoperfusion using a polymyxin-B immobilized column in solid organ transplanted patients with signs of severe sepsis and septic shock. A pilot study.

Background: Polymyxin B (PMX-B) is a polycationic antibiotic, known to bind the lipid A portion of endotoxin, a cell wall component found exclusively in gram negative bacteria (GNB). An extracorporeal hemoperfusion device (TORAYMYXIN) has been developed: PMX is covalently bound on the surface of an insoluble carrier material so that the endotoxin can be inactivated in the blood without exerting its toxicity on the brain and kidney. The aim of this study was to clarify the efficacy, safety and clinical effects of direct hemoperfusion with an immobilized polymyxin-B fiber column (DHP-PMX) in solid organ transplanted patients with severe sepsis or septic shock.

Modifications of intracranial pressure after molecular adsorbent recirculating system treatment in patients with acute liver failure: case reports.

Unlabelled: Cerebral dysfunction may be fatal in patients with acute liver failure (ALF); intracranial pressure (ICP) monitoring may be mandatory to direct measures to prevent further cerebral edema. Recently the introduction of dialysis with the molecular adsorbent recirculating system (MARS) has improved the outcomes among patients with ALF. The aim of this study was to evaluate ICP changes after MARS treatment among patients with ALF.

Fenoldopam and gastric tonometry during orthotopic liver transplantation.

Unlabelled: The aim of this study was to evaluate the effects of continuous infusion of fenoldopam on splanchnic perfusion in orthotopic liver transplant (OLT) recipients.

Patients And Methods: We enrolled 40 patients of mean age 57+/-16 years who underwent (OLT). They were randomly divided into two double blinded groups; continuous fenoldopam (0.

Activated recombinant factor VII in orthotopic liver transplantation.

Unlabelled: Orthotopic liver transplantation (OLT) is affected by important alterations of hemostasis. The aim of this study was to evaluate the efficacy of recombinant factor VII activated (rFVIIa) to reduce intraoperative bleeding during OLT.

Methods: Twenty OLT patients were assigned in double-blind way to a rFVIIa group or a control group.

[Adenoid cystic carcinoma of the prostate. Clinical case].

The authors report an extremely rare case of adenoid cystic carcinoma of the prostate. No satisfactory clinical and pathological classification exists for this tumour, creating particular difficulties for therapeutic decisions and prognosis. Descriptions of cases with excellent survival rates are reported in the literature, to the extent that this is sometimes regarded as a low-malignancy tumour, but other reports also exist of massive diffusion of the pathology with fatal consequences.

[Fibrous pseudotumors of the tunica vaginalis testis. A clinical case].

A case of multiple fibrous pseudotumors of the tunica vaginalis is reported. Ultrasonography led to diagnosis 10 years previously and the patient underwent surgical exploration when the lesions were up to 6 cm in diameter.

Correlation between Gleason score of needle biopsy and radical prostatectomy tissue.

Gleason score has been identified as an important variable to predict disease extent and biologic behaviour of prostate cancer. However, the correlation between Gleason score of needle biopsy and surgical specimen is often poor. We studied 72 patients who underwent needle biopsy and radical prostatectomy to correlate Gleason score with PSA, clinical and pathological tumour stage.

[Prostatic endoprosthesis in the treatment of prostatic obstruction: preliminary experience with the new Trestle model].

The urethral stent is a relatively new treatment modality for benign prostatic hypertrophy ostruction. Although the ultimate prostatic endoprosthesis has yet to be developed, various stents have been produced and investigated with good results. We review the several currently available stents and we report the preliminary clinical experience with a new device (Trestle).

[Unusual development of urothelioma of the upper urinary tract].

A case of extrarenal spreading of transitional cell carcinoma caused by rupture of ureterohydronephrosis by ureteral transitional cell carcinoma is reported. Ultrasonography and CT revealed the presence of a severe right ureterohydronephrosis with large septa and a 2 cm diameter exophytic neoplasia of the middle ureter. Nephroureterectomy was performed with excision of a perirenal mass.

[Electrovaporization of the prostate].

Electrovaporization is a new and potentially useful modification of transurethral resection of the prostate which is rapidly becoming a treatment of choice for symptomatic benign prostatic hyperplasia. We report our experience with 22 patients treated using the Circon Acmi Grooved Vaportrode vaporization electrode. Procedures were carried out using the standard technique of electrovaporization with general or regional anaesthesia.

[Clarithromycin in pediatric age. Personal experience].

The authors report their experience on the use of oral suspension of Clarithromycin in respiratory infections in the pediatric age. Thirty-three patients affected by various infectious pathologies of the respiratory tract, treated with oral Clarithromycin at the dosage of 15 mg/kg/day, were studied. The therapeutic outcome was very encouraging, the drug well tolerated and without side effects.

[Clinical-therapeutic considerations in pertussis].

One-hundred and seventy-one cases of pertussis were observed at the Institute of Infections Diseases and at the 2nd Division of Infectious Diseases of the Policlinico Umberto I in Rome from January 1, 1987 to June 30, 1991. All subjects were treated according to a therapeutic protocol consisting of macrolides (erythromycin or myocamicin) at doses of 40-50 mg/die, betamethasone 0.1 mg/kg/die, specific immunoglobulin G at doses of 0.

Mycoplasma pneumoniae infection complicated by paroxysmal cold hemoglobinuria with anti-P specificity of biphasic hemolysin.

A 7-year-old boy with Mycoplasma Pneumoniae infection complicated by transitory paroxysmal cold haemoglobinuria (PCH) is described. The Donath-Landsteiner-antibody exhibited anti-P specificity; hemolytic activity was partially inhibited against papainized erythrocytes at 0 degrees C incubation temperature and increased from 8 degrees C upwards. The association of Mycoplasma pneumoniae infection with PCH has been described 4 times only and in one instance where specificity was stated it was anti-I.