Publications by authors named "Toru Kanno"

Objective: We aimed to compare the clinical outcomes of intravenous urography-assisted fluoroscopy-guided shockwave lithotripsy for radiolucent ureteral stones and standard shockwave lithotripsy for radiopaque ureteral stones.

Methods: We retrospectively reviewed 734 patients with ureteral stones treated by fluoroscopy-guided shockwave lithotripsy between March 2014 and March 2021. The primary outcome was a stone-free rate with one session within 30 days, defined as no residual stones without auxiliary treatment.

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Objectives: The impact of lymph node dissection (LND) on the efficacy of pembrolizumab in patients with urothelial carcinoma (UC) who develop metastasis after surgery remains unclear. This study aimed to investigate the efficacy of pembrolizumab in patients with metastatic UC who underwent primary tumor resection with LND.

Patients And Methods: This retrospective study included patients who initially underwent radical surgery with or without LND for non-metastatic UC and later received pembrolizumab for recurrent lesions.

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Purpose: Patients with ureteral stones and acute renal colic significantly impaired their quality of life (QOL). However, the factors that affect quality of life during conservative management, particularly medical expulsive therapy (MET), are not well understood. This study aimed to assess the determinant of QOL.

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Necrotizing fasciitis (NF) is a life-threatening disease that is diagnosed through an exploratory incision and typically requires surgical debridement. Reports of non-surgical cures are limited to specific cases, such as NF affecting only the head and neck regions. The two patients (a woman and a man) were both in their 70s and underwent maintenance dialysis for diabetic nephropathy.

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Article Synopsis
  • The study examined postoperative complication rates in elderly prostate cancer patients undergoing robot-assisted radical prostatectomy (RARP) across various age groups.
  • A total of 8,055 patients were analyzed, revealing similar complication rates for those under 70 and those aged 75 or older.
  • The conclusion indicated that age alone does not significantly increase the risk of complications after RARP in well-selected elderly patients, suggesting that surgery can be safely performed on older populations.
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Pelvic lymph node dissection (PLND) is important for accurate staging and prognosis of prostate and/or bladder cancer. Several guidelines recommend extended PLND for patients with these cancers. However, the therapeutic benefits of extended PLND are unclear.

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Vaginal cuff dehiscence after total hysterectomy or total cystectomy had been increasing since laparoscopic or robotic surgery became a common surgery among gynecologists and urologists. A 52-yearold woman underwent laparoscopic radical total cystectomy for muscle invasive bladder carcinoma at Rakuwakai Otowa Hospital. She was emergently admitted with a fist-sized lump protruding from her vagina four months after surgery.

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Purpose: To investigate the safety of transurethral ureteroscopy (URS) for urolithiasis in bedridden patients and to identify bedridden patient-specific risk factors for postoperative complications.

Methods: The patients who underwent URS for urolithiasis were divided into bedridden patients and good performance status (PS) patients, and the groups were compared regarding their clinical characteristics and postoperative complications. A multivariable logistic regression analysis was performed to evaluate independent predictors of postoperative febrile urinary tract infection (fUTI).

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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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In cases of rectal invasion by locally invasive prostate cancer (LAPC) leading to severe pain or bleeding, total pelvic exenteration (TPE) is necessary. Here, we present two cases of successful minimally invasive TPE: one performed laparoscopically for local recurrence with rectal bleeding after laparoscopic radical prostatectomy, and another done robotically for LAPC (clinical T4N1M0) accompanied by rectal bleeding. Medical treatments were ineffective in the latter case, and the tumor occupied a significant portion of the pelvis.

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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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Introduction: Segmental ureterectomy (SU) has been proven effective in cases of distal upper tract urothelial carcinoma (UTUC). Nonetheless, SU has been performed infrequently in the real world, and there is no consensus on the preferred surgical technique in laparoscopic surgery. We describe our first experience of laparoscopic segmental ureterectomy (LSU) with psoas hitch ureteral reimplantation.

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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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Purpose: Ultrasonography and computed tomography urography are two commonly used modalities to image the upper tracts for the evaluation of hematuria. This study evaluated the efficacy of ultrasonography for the detection of upper tract urothelial carcinoma compared to computed tomography urography as a standard reference.

Methods: This retrospective study included patients with urothelial carcinoma of the renal pelvis and/or ureter who were diagnosed using computed tomography urography and underwent surgical treatment.

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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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Objective: To examine the safety and efficacy of ureteroscopy (URS) for urolithiasis in octogenarians, and identify preoperative risk factors for the incidence of postoperative complications.

Methods: The patients who underwent URS for urolithiasis were divided into octogenarians and younger patients (age: <80 years), and the groups were compared regarding their clinical characteristics, intraoperative and postoperative complications, and stone-free rate. The predictors of postoperative complications were evaluated using logistic regression models.

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Objectives: To identify risk factors for infectious complication of ureteroscopy after obstructive acute pyelonephritis (OAPN).

Patients And Methods: This single-center, retrospective cohort study (#20200002, retrospectively registered in February 1st, 2020) included patients who underwent emergency drainage for OAPN and subsequently underwent ureteroscopic stone removal between January 2006 and December 2020. Multivariable analysis was conducted using demographic and stone-related factors to determine those that could predict postoperative febrile urinary tract infection (UTI).

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To elucidate and compare the efficacy and safety of the reduced (30 shocks/min with 1200 shocks/session) and standard protocols (60 shocks/min with 2400 shocks/session) of extracorporeal shockwave lithotripsy (SWL) for ureteral stones treatment. This study was a retrospective review of 2410 SWL procedures with reduced or standard protocols (groups R and S) in 1106 patients for ureteral stones between March 2014 and March 2021. The primary outcome was treatment success, defined as the absence of residual fragments on ultrasonography and plain radiography within 30 and 90 days.

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Recently, ureteroscopic lithotripsy remains the standard treatment for urolithiasis, with postoperative febrile upper urinary tract infection (fUTI) being one of its most significant complications. The current study sought to investigate the treatment outcomes of ureterorenoscopy (URS), morbidity and risk factors of postoperative fUTI at our hospital. A total of 1,235 patients who underwent URS (including those who underwent only semi-rigid URS) for upper urinary tract stones at our hospital between October 2011 and December 2019 were retrospectively analyzed.

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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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Article Synopsis
  • * A study of 1,235 TUL patients identified five cases of subcapsular hematoma, all managed conservatively without surgery, though one required a blood transfusion.
  • * The findings suggest that while subcapsular hematoma is rare (0.40%), careful monitoring is crucial to decide on timely medical interventions when needed.
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Synopsis of recent research by authors named "Toru Kanno"

  • - Toru Kanno's research primarily focuses on the advancements and methodologies in minimally invasive urological surgeries, particularly concerning the treatment of urolithiasis and cancers affecting the urinary tract. His studies include investigating procedural safety, surgical outcomes, and the efficacy of various techniques in urological operations.
  • - Recent findings indicate that extended pelvic lymph node dissection is a pertinent procedure for accurate staging in prostate and bladder cancer, though its therapeutic benefits require further clarification. Additionally, the safety and feasibility of ureteroscopy in bedridden patients underscore an ongoing examination of postoperative complications and risk factors for diverse patient populations.
  • - Kanno's work emphasizes the refinement in surgical techniques such as laparoscopic radical nephroureterectomy, segmental ureterectomy, and minimally invasive pelvic exenteration, asserting the significance of preoperative risk assessments and postoperative management to enhance patient outcomes across a range of urological disorders.

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