Publications by authors named "Yoshihito Higashi"

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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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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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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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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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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Introduction: Cross-fused renal ectopia is a rare congenital malformation, and few cases of urolithiasis have been treated by retrograde ureteroscopic lithotripsy. We report a case of urolithiasis in right-to-left and superior-type cross-fused renal ectopia, successfully treated by the retrograde approach.

Case Presentation: A 69-year-old woman with two 14-mm renal stones in cross-fused renal ectopia underwent retrograde ureteroscopic lithotripsy.

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A pathologic kidney with hydronephrosis is prone to rupture after minor trauma to the renal pelvis ; however, it is controversial whether drainage, such as nephrostomy and ureteral stenting, should be performed in this setting. Herein we report traumatic rupture of the renal pelvis in 2 patients with ureteropelvic junction stenosis at two centers. Case 1 : A 15-year-old boy sustained a blunt injury on his left back while playing football.

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Retrograde ureterorenoscopic lithotripsy is one of the first-line therapies for urolithiasis. In some cases, however, thisapproach may be difficult to adopt because of factorss uch asrenal/ureteral anatomic abnormalities or urinary diversion. This study aims to investigate the safety and efficacy of retrograde ureterorenoscopic lithotripsy in patients with the above-mentioned conditions.

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Introduction: Cystine stone development is relatively uncommon among patients with urolithiasis, and most studies have reported only on small sample sizes and short follow-up periods. We evaluated clinical courses and treatment outcomes of patients with cystine stones with long-term follow-up at our center.

Methods: We retrospectively analyzed 22 patients diagnosed with cystine stones between January 1989 and May 2019.

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Objectives: To evaluate the risk of repeat surgery and stone-related events after flexible ureteroscopy (fURS) for renal stones, and to identify their predictive factors.

Patients And Methods: This was a single-center, retrospective cohort study of patients (n = 664) who underwent fURS for renal stones with or without concomitant ureteral stones between January 2012 and December 2019. The primary outcomes were time to ipsilateral stone-related surgical intervention and any stone-related event (including ipsilateral renal colic, symptomatic ureteral calculi, obstructive urinary tract infection, and surgical intervention).

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Intraoperative indocyanine green (ICG) near-infrared fluorescence guidance is a type of optical imaging technology now available to facilitate a better understanding of surgical landmarks. This case describes use of this technique during lower-pole heminephrectomy for a patient with duplex kidney. A 50-year-old woman with a left duplex system and lower-pole kidney infection underwent a laparoscopic transperitoneal lower-pole heminephrectomy.

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Intraoperative indocyanine green near-infrared fluorescence guidance is an emerging optical imaging technology to facilitate better understanding of surgical landmarks. Herein, this technique was applied during the surgery for urachal carcinoma. A 50-year-old man with urachal carcinoma underwent laparoscopic partial cystectomy and pelvic lymph node dissection (PLND).

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Purpose: To compare the treatment success rate and safety of reduced (30 shocks/min, 1,200 shocks/session) versus standard (60 shocks/min, 2,400 shocks/session) extracorporeal shockwave lithotripsy for the management of renal stones.

Materials And Methods: We retrospectively analyzed 404 patients who underwent extracorporeal shockwave lithotripsy for 5-20-mm renal stones between April 2011 and March 2019. Patients selected the reduced or standard protocol (group R and S) after explaining the potential benefits and disadvantages.

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Objective: To compare follow-up outcomes of ureteroscopy (URS) and shockwave lithotripsy (SWL) for ureter calculi in the setting of asymptomatic renal calculi <15 mm.

Methods: This study included 789 patients who underwent URS (n = 301) or SWL (n = 488) as primary treatment for ureter calculi and who had ipsilateral renal calculi <15 mm between January 2012 and December 2019. For the URS group, all renal calculi were simultaneously treated unless contraindicated.

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Introduction: Encrusted cystitis and pyelitis are a rare urinary tract infection characterized by mold-like calcification of collecting system. Here, we show a case of encrusted cystitis proceeding to pyelitis during a 1-month delay in diagnosis.

Case Presentation: A 73-year-old man developed hematuria and pain during micturition while he was being treated for granulomatosis with polyangiitis and lung abscess.

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Internal hernia beneath the vascular structures after pelvic lymphadenectomy is a rare condition. Herein, we report a case of a strangulated internal hernia beneath the obturator nerve 38 months after laparoscopic radical cystectomy with extended pelvic lymphadenectomy. Computed tomography revealed dilated small bowels and a closed loop in the pelvis.

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To clarify the natural history of asymptomatic renal stones ≤5 mm in comparison with stones ≥5 mm. Calculi ≤5 mm are considered insignificant stones, but to what extent stone-related events can occur is unclear. In this retrospective study, 207 patients with asymptomatic renal stones confirmed by both CT and ultrasonography performed on the same day were enrolled.

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