Background: The aim of this study was to analyze the risk factors for hemorrhagic complications in patients who underwent robotic-assisted partial nephrectomy.
Methods: We retrospectively reviewed the records of 260 patients who underwent robotic-assisted partial nephrectomy. Hemorrhagic complications were defined as bleeding, hematoma, or arteriovenous fistula requiring hemostatic medication, blood transfusion, or therapeutic intervention. Hemorrhagic complications were graded according to the modified Clavien classification system, and the hemorrhagic complication group comprised only those complications with Clavien grade II or higher. Thereafter, we investigated the presence of any relevant association between perioperative factors and hemorrhagic complications.
Results: Of 260 patients included in the study, 32 (12.3%) had hemorrhagic complications. The postoperative hemoglobin level was significantly lower in the hemorrhagic complication group than in the group without complications. The hemorrhagic complication group had significantly more essential blood loss and a significantly longer length of hospital stay. In the univariate analysis, type 2 diabetes mellitus, Radius-scores tumor size as maximal diameter exophytic/endophytic properties of the tumor nearness of the deepest portion of the tumor to the collecting system or renal sinus anterior (a)/posterior (p) descriptor location relative to the polar line., sum of the renal size plus renal sinus involvement in the PADUA score is a simple anatomical system that can be used to predict the risk of surgical and medical perioperative complications in patients undergoing open NSS, prolonged console time (>180 minutes), prolonged warm ischemic time (>25 minutes), and method of pedicle control were statistically significant risk factors. In the multivariate logistic regression analysis, warm ischemic time >25 minutes was the only significant risk factor for hemorrhagic complications (odds ratio, 3.51; 95% confidence interval, 1.28-9.59; p = 0.01).
Conclusion: Patients who undergo robotic-assisted partial nephrectomy with a warm ischemic time >25 minutes are significantly more likely to have hemorrhagic complications and should hence receive careful perioperative follow-up.
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http://dx.doi.org/10.1097/JCMA.0000000000000857 | DOI Listing |
Hinyokika Kiyo
November 2024
The Department of Urology, Hiroshima Prefectural Hospital.
A 26-year-old male presented to a hospital with complaints of hemoptysis and right scrotal swelling. Computed tomography (CT) revealed right testicular swelling, multiple lung metastases, and small intestinal wall thickening. The patient's β-human chorionic gonadotropin, alpha-fetoprotein, lactate dehydrogenase, and hemoglobin levels were 103.
View Article and Find Full Text PDFEur J Med Res
December 2024
Mianyang Central Hospital, Affiliated to School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
Background And Aim: Recent Mendelian randomization and meta analysis suggest a controversial causality between C3-epimer of 25 hydroxyvitamin D3 (C3-epi-D3) and type 2 diabetes mellitus (T2DM). The clinical evidence regarding the impact of C3-epi-D3 on the progression of T2DM is currently insufficient. This study aims to investigate whether C3-epi-D3 has any effect on metabolic disorders of T2DM patients.
View Article and Find Full Text PDFJ Med Case Rep
December 2024
Division of Hematology Medical Oncology, Dr. Kariadi General Hospital Semarang/Faculty of Medicine Diponegoro University, Semarang, Indonesia.
Introduction: Breast cancer liver metastasis presents a significant challenge in clinical oncology, with limited treatment options and poor prognosis. This case series study explores the extended survival achieved in breast cancer patients with liver metastases through a combination of surgical and medical interventions.
Case Presentation: We present three cases of Javanese female patients with breast cancer (51 years old, 42 years old, and 55 years old) with liver metastases who underwent hepatic resection followed by systemic therapy.
J Orthop Surg Res
December 2024
Spinal Ward, The 900th Hospital of Joint Logistic Support Force, PLA, 156 Xierhuan Northern Road, FuZhou, 350025, China.
Background: There is currently no consensus on the surgical treatment of lumbar spondylolysis in young adults, and the nonunion rate remains relatively high even after surgery. Therefore, in this study, we proposed a modified intravertebral screw-rod fixation technique within a single vertebral segment and investigated the clinical efficacy of this modified fixation system combined with autologous cancellous bone grafting in the treatment of lumbar spondylolysis in young adults.
Methods: This study included 28 young adults with lumbar spondylolysis who were treated at our center between 2021 and 2023.
BMC Surg
December 2024
Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest, Hungary.
Background: Biliary leakage is a serious complication of hepato-pancreato-biliary operations, increasing morbidity and mortality, and challenging clinicians.
Objective: This study aims to evaluate the incidence of bilioenteric anastomotic leakage, treatment options, and their outcomes at a high-volume tertiary referral center.
Methods: A retrospective cohort study was conducted to analyze the outcomes of patients who underwent biliary anastomosis formation between 2016 and 2021.
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