Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, GRC n. 20 Lithiase Renale, 75013 Paris, France.
Published: July 2023
AI Article Synopsis
Article Abstract
Introduction: Thulium lasers (TLs), namely the Thulium fiber laser (TFL) and the Thulium:YAG (Tm:YAG), are being increasingly adopted for the conservative treatment of upper urinary tract urothelial carcinoma (UTUC). However, to date, the real clinical impact of TLs on UTUC management remains not well-characterized. We performed a review of the literature to summarize the current evidence on TLs for UTUC treatment.
Materials And Methods: We performed a systematic review in January 2023 using the Embase and Medline online databases, according to the PRISMA recommendations and using the PICO criteria. Outcomes of interest were: (i) to assess the safety and feasibility of TLs in the treatment of UTUC, and (ii) to evaluate the oncological outcomes in terms of tumor recurrence and conservative treatment failure. Moreover, we described TL characteristics and its interaction with soft tissue.
Results: a total of 458 articles were screened, and six full texts including 273 patients were identified. All the included studies were retrospective series. Mean patient age ranged from 66 to 73 years. The indication of a conservative treatment was elective and imperative in 21.7-85% and 15-76% of cases, respectively. Laser power settings varied from 5 to 50 W. No intraoperative complications were reported, and all the procedures were successfully performed. The tumor recurrence rate was 17.7-44%, and the indication to radical nephroureterectomy was 3.7-44% during a follow-up of 6-50 months. Most of the postoperative complications were mild and transient, and ureteral strictures were reported in two studies. Major limitations were the retrospective nature of the studies, the small sample sizes, and the short follow-up.
Conclusions: TL is an effective and safe technology for endoscopic UTUC treatment. However, current available literature lacks prospective and multicentric studies with large population sizes and long-term follow-up.
Objective: To describe a patient conceiving with fertilization and embryo transfer(IVF-ET) after conservative treatment of early stage endometrial cancer.
Patient: A 31-year-old multiparous woman diagnosed with highly-differentiated (G1) endometrial adenocarcinoma (grade IA).
Interventions: After four courses of conservative treatment each followed by hysteroscopic biopsy and endometrial curettage,assisted reproductive technology was performed.
Purpose Adjuvant chemotherapy (AC) following limb-sparing surgery with endoprosthesis is the gold standard treatment for osteosarcoma (OS). However, AC can impair wound healing, leading to endoprosthesis exposure, making the decision to continue or pause AC important. We propose standard guidelines for managing this situation.
Introduction: The results of patients at one hospital who were judged eligible for conservative care of abdominal aortic aneurysms (AAA) are examined in this research. Optimizing patient care and management tactics requires an understanding of the mortality trends and causes of death within this group.
Methodology: Sunderland Royal Hospital carried out a single-center retrospective analysis between May 2018 and January 2024.
Up to 10% of uveitis cases occur in children, with notable implications due to the risk of chronicity and vision loss. It can result from infections, autoimmune and autoinflammatory diseases, trauma, or masquerade syndromes. Primary care providers are vital in early detection, symptom management, and timely specialist referral.
This case study presents the successful treatment of a 26-year-old male who experienced profuse bleeding from a gunshot wound to his thigh 4 days after the initial injury. The patient underwent surgery performed by a military vascular surgeon, during which previously undetected injuries to the femoral artery and vein were identified. The surgeon conducted a femoral artery alloprosthesis and sutured the damaged femoral vein.
