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Pyéloplastie pour syndrome de jonction pyélo-urétérale : étude comparative de la voie ouverte, laparoscopique et laparoscopique robot-assistée sur une population adulte et pédiatrique
Authors: --- --- ---
Year: 2017 Publisher: Bruxelles: UCL. Faculté de médecine et de médecine dentaire,

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Background: Open pyeloplasty surgery has historically been the gold standard in the treatment of the ureteropelvic junction obstruction. The evolution of technology in recent decades has allowed the emergence of laparoscopies pyeloplasty then the robot-assisted laparoscopy. In this study we compare the way open pyeloplasty, pyeloplasty laparoscopically and robot-assisted pyeloplasty laparoscopically in the treatment of pyelo-ureteric junction syndrome both in the pediatric and adult patient. Materials and methods: We identified all pyeloplasties conducted at the «Cliniques Universitaires St Luc" from January 2002 to December 2015. 359 patients were selected. We first divided into two groups: adult and pediatric. Each group was subsequently divided into 3 groups depending on the surgical approach: open surgery, laparoscopic and robot-assisted laparoscopic surgery. We finally compare these three surgical methods in terms of age, operative time, and length of hospitalization, development of postoperative pyelon outcome, received painkillers, and the need for conversion in another method .Results:1- Pediatric: Before realize statistical analysis we note that, the average age of open pyeloplasty is 3.05 years against 11.28 years for laparoscopic pyeloplasty and 13.84 for assisted laparoscopy pyeloplasty. The operative time was 115.62 minutes, 156.42 minutes and 125.87 minutes respectively for these three methods. We observe 1 conversion from laparoscopic method to open method. The hospitalization stay was respectively 8, 6.28 and 4.25 days using open, laparoscopic and assisted robot laparoscopic method. We observe more than 90% of success using each method. Talking about complication, we have 7.89% for open method, 16% for laparoscopic method and 25% for assisted robot laparoscopic method.2.-Adult: The operatory time was 149.65 minutes, 143.22 minutes and 168.15 minutes respectively for open, laparoscopic and assisted robot laparoscopic method. The hospitalization duration was respectively 9.8, 6.25 and 5 days using open, laparoscopic and assisted robot laparoscopic method. We observe more than 90% of success using each method in radiology control. Concerning complication, we have 14% for open method, 25% for laparoscopic method and 20% for assisted robot laparoscopic method. Conclusion : the minimally invasive techniques have helped to reduce the length of hospital stay and postoperative pain while keeping a good percentage of success without the increased of postoperative complications. Although robot-assisted laparoscopy is recent, it should be recommended both in children and adult because of its good result. Contexte: La pyéloplastie par voie ouverte a toujours été historiquement le gold standard dans le traitement des syndromes de jonction. L’évolution de la technologie ces dernières décennies a permis l’émergence de la pyéloplastie laparoscopique puis de la laparoscopie robot-assistée. Dans cette étude nous comparons la pyéloplastie par voie ouverte, la pyéloplastie par voie laparoscopique et la pyéloplastie par voies laparoscopique robot-assistée dans le traitement du syndrome de jonction tant dans la population adulte que dans une population pédiatrique. Matériels et méthodes : Nous avons recensé toutes les pyéloplasties réalisées à la clinique universitaire St-Luc de janvier 2002 à décembre 2015 soit 359 pyéloplasties. Nous les avons divisés en deux populations : adulte et pédiatrique. Chaque population a été divisée par après en 3 groupes en fonction de la voie d’abord, voie ouvert, voie laparoscopique et voie laparoscopie robot-assisté. Dans chaque population les différentes voies ont été comparées en termes d’âge, de temps opératoire, de durée d’hospitalisation, d’évolution du pyélon post-opératoire, d’antalgiques reçus, de la nécessité de conversion. Résultats: 1.Pédiatrique : L'âge moyen par voie ouverte est de 3.05 ans contre 11.28 ans par voie laparoscopique et 13.84 ans par voie robot-assistée. La durée opératoire est de 115.62 minutes par voie ouverte contre 156.42 minutes par voie laparoscopie et 125.87 minutes par voie laparoscopique robot-assistée. 1 conversion observée en voie laparoscopique. La durée d'hospitalisation est de 8 jours par voie ouverte, de 6.28 jours par voie laparoscopique et 4.25 jours par voie robot-assistée. Plus de 90 % de disparition de l'hydronéphrose par les 3 voies. 7.89% de complications par voie ouverte contre 16% par voie laparoscopique et 25% (2/8) par voie robot-assistée.2. Adultes : Les âges sont équilibrés. Le temps opératoire est de 149.65 minutes par voie ouverte contre 143.22 par voie laparoscopique et 168.15 par voie robot-assistée. Pas de nécessité de conversion. La durée d'hospitalisation est de 9.28 jours par voie ouverte, de 6.25 jours par voie laparoscopique et 5 jours par voie laparoscopique robot-assistée.14% de patients ont présenté des complications post opératoires par voie ouverte contre 25% par voie laparoscopique et 20% par voie laparoscopique robot-assistée. Nous avons plus de 90% de bonne évolution du pyélon à l'imagerie. Conclusion : les techniques minimales invasives ont permis de diminuer la durée d'hospitalisation ainsi que la douleur post opératoire tout en gardant un bon pourcentage de réussite et sans majorée les complications post opératoire. Bien qu'assez ressente la voie laparoscopique robot assistée se présente comme une technique assez sure et à recommander tant dans la population adulte que pédiatrique.


Book
Renal angiography during and after unilateral ureteric occlusion : a long-term experimental study in dogs
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Year: 1958 Publisher: Stockholm : s.n.,

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Book
Urine blockage in newborns : National Kidney and Urologic Diseases Information Clearninghouse.
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Year: 2006 Publisher: Bethesda, MD : National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK),

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Dissertation
Structural changes of proximal tubules and cortical interstitium in chronic renal disease : light and electron microscopic analyses with particular reference to the pathogenesis of proximal tubular atrophy in hydronephrosis
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Year: 1987 Publisher: S.l. s.n.

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Book
Urine blockage in newborns : National Kidney and Urologic Diseases Information Clearninghouse.
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Year: 2006 Publisher: Bethesda, MD : National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK),

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Book
Les troubles hydro-électrolytiques faciles
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ISBN: 2294764277 9782294764271 Year: 2019 Publisher: Issy-les-Moulineaux : Elsevier Masson,

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"Les désordres hydro-électrolytiques et les anomalies que l'on peut découvrir sur des examens sanguins et urinaires de routine sont fréquemment rencontrés en pratique clinique et parfois en situation d'urgence. Leur description clinique et l'analyse de leur mécanisme, avec l'aide de quelques examens simples – tels que ionogrammes sanguin et urinaire, gazométrie – permettent leur approche diagnostique. Les multiples facteurs à l'origine de ces troubles rendent le diagnostic et le traitement parfois difficiles à déterminer. Peu d'ouvrages francophones récents ont pour thème central l'analyse de ces désordres hydro-électrolytiques et acido-basiques. L'objectif de ce livre est de rappeler tout ce qu'il convient de savoir sur ces anomalies pour une meilleure prise en charge clinique et une orientation thérapeutique adaptée. Pour chaque trouble, on trouvera : les bases physiologiques, des exercices d'application clinique, des explications physiopathologiques, le traitement."


Book
Minimally Invasive Urological Procedures and Related Technological Developments
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Year: 2021 Publisher: Basel, Switzerland MDPI - Multidisciplinary Digital Publishing Institute

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The landscape of minimally invasive urological intervention is changing. A lot of new innovations and technological developments have happened over the last 3 decades. Laparoscopy and robotic surgery have revolutionised kidney and prostate cancer treatment, with more minimally invasive procedures now being carried out than ever before. At the same time, technological advancements and the use of laser have changed the face of endourology. Several new innovative treatments are now commonplace for benign prostate enlargement (BPE). Management of prostate cancer now involves procedures such as robotic prostatectomy, brachytherapy, radiotherapy, cryotherapy and HIFU. Robotic partial nephrectomy and cryotherapy have changed the face of renal cancer. En-bloc resection of bladder cancer is challenging the traditional management of non-muscle invasive bladder cancer and becoming commonplace, while robotic cystectomy is also gaining popularity for muscle invasive bladder cancer. Newer surgical intervention related to BPE includes laser (holmium, thulium and green light), water-based treatment (Rezum, Aquablation) and other minimally invasive procedures such as prostate artery embolisation (PAE) and Urolift. Endourological procedures have incorporated newer laser types and settings such as moses technology, disposable ureteroscopes (URS) and minimisation of percutaneous nephrolithotomy (PCNL) instruments. All these technological innovations and improvements have led to shorter hospital stay, reduced cost, potential reduction in complications and improvement in the quality of life (QoL).

Keywords

Medicine --- Surgery --- partial nephrectomy --- single site surgery --- sutureless --- CEUS --- contrast-enhanced ultrasound --- renal ultrasound --- image quality --- small renal mass (3–5) --- kidney stones --- metabolic syndrome --- urolithiasis --- nephrolithiasis --- kidney calculi --- diabetes mellitus --- acute kidney injury --- percutaneous nephrolithotomy --- urology --- artificial intelligence --- machine learning --- urinary incontinence --- kidney stone disease --- fertility --- reproductive urology --- renal cell carcinoma --- hydronephrosis --- urinary reflux --- endourology --- pediatric urology --- prostate cancer --- bladder cancer --- nephrostomy --- quality of life --- survival --- decision making --- ureteroscopy --- laser --- RIRS --- Moses --- holmium --- mineral water --- mineral composition --- drinking water --- still water --- sparkling water --- Ho:YAG laser --- thulium fiber laser --- laser fiber --- lithotripsy --- chronic prostatitis --- chronic pelvic pain syndrome --- extracorporeal shockwave therapy --- ESWT --- NIH-CPSI --- EHS --- IIEF-5 --- QoL --- urosepsis --- laser lithotripsy --- predictor factors --- PCNL --- renal tumour --- AI --- TFL --- partial nephrectomy --- single site surgery --- sutureless --- CEUS --- contrast-enhanced ultrasound --- renal ultrasound --- image quality --- small renal mass (3–5) --- kidney stones --- metabolic syndrome --- urolithiasis --- nephrolithiasis --- kidney calculi --- diabetes mellitus --- acute kidney injury --- percutaneous nephrolithotomy --- urology --- artificial intelligence --- machine learning --- urinary incontinence --- kidney stone disease --- fertility --- reproductive urology --- renal cell carcinoma --- hydronephrosis --- urinary reflux --- endourology --- pediatric urology --- prostate cancer --- bladder cancer --- nephrostomy --- quality of life --- survival --- decision making --- ureteroscopy --- laser --- RIRS --- Moses --- holmium --- mineral water --- mineral composition --- drinking water --- still water --- sparkling water --- Ho:YAG laser --- thulium fiber laser --- laser fiber --- lithotripsy --- chronic prostatitis --- chronic pelvic pain syndrome --- extracorporeal shockwave therapy --- ESWT --- NIH-CPSI --- EHS --- IIEF-5 --- QoL --- urosepsis --- laser lithotripsy --- predictor factors --- PCNL --- renal tumour --- AI --- TFL


Book
Minimally Invasive Urological Procedures and Related Technological Developments
Author:
Year: 2021 Publisher: Basel, Switzerland MDPI - Multidisciplinary Digital Publishing Institute

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Abstract

The landscape of minimally invasive urological intervention is changing. A lot of new innovations and technological developments have happened over the last 3 decades. Laparoscopy and robotic surgery have revolutionised kidney and prostate cancer treatment, with more minimally invasive procedures now being carried out than ever before. At the same time, technological advancements and the use of laser have changed the face of endourology. Several new innovative treatments are now commonplace for benign prostate enlargement (BPE). Management of prostate cancer now involves procedures such as robotic prostatectomy, brachytherapy, radiotherapy, cryotherapy and HIFU. Robotic partial nephrectomy and cryotherapy have changed the face of renal cancer. En-bloc resection of bladder cancer is challenging the traditional management of non-muscle invasive bladder cancer and becoming commonplace, while robotic cystectomy is also gaining popularity for muscle invasive bladder cancer. Newer surgical intervention related to BPE includes laser (holmium, thulium and green light), water-based treatment (Rezum, Aquablation) and other minimally invasive procedures such as prostate artery embolisation (PAE) and Urolift. Endourological procedures have incorporated newer laser types and settings such as moses technology, disposable ureteroscopes (URS) and minimisation of percutaneous nephrolithotomy (PCNL) instruments. All these technological innovations and improvements have led to shorter hospital stay, reduced cost, potential reduction in complications and improvement in the quality of life (QoL).


Book
Minimally Invasive Urological Procedures and Related Technological Developments
Author:
Year: 2021 Publisher: Basel, Switzerland MDPI - Multidisciplinary Digital Publishing Institute

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Abstract

The landscape of minimally invasive urological intervention is changing. A lot of new innovations and technological developments have happened over the last 3 decades. Laparoscopy and robotic surgery have revolutionised kidney and prostate cancer treatment, with more minimally invasive procedures now being carried out than ever before. At the same time, technological advancements and the use of laser have changed the face of endourology. Several new innovative treatments are now commonplace for benign prostate enlargement (BPE). Management of prostate cancer now involves procedures such as robotic prostatectomy, brachytherapy, radiotherapy, cryotherapy and HIFU. Robotic partial nephrectomy and cryotherapy have changed the face of renal cancer. En-bloc resection of bladder cancer is challenging the traditional management of non-muscle invasive bladder cancer and becoming commonplace, while robotic cystectomy is also gaining popularity for muscle invasive bladder cancer. Newer surgical intervention related to BPE includes laser (holmium, thulium and green light), water-based treatment (Rezum, Aquablation) and other minimally invasive procedures such as prostate artery embolisation (PAE) and Urolift. Endourological procedures have incorporated newer laser types and settings such as moses technology, disposable ureteroscopes (URS) and minimisation of percutaneous nephrolithotomy (PCNL) instruments. All these technological innovations and improvements have led to shorter hospital stay, reduced cost, potential reduction in complications and improvement in the quality of life (QoL).


Book
Interdisciplinary Medicine
Author:
Year: 2021 Publisher: Basel, Switzerland MDPI - Multidisciplinary Digital Publishing Institute

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Dear Colleagues, The rapidly changing field of medicine and healthcare is increasingly adopting scientific and technological innovations, making interdisciplinary collaborations especially important. In this context, medical disciplines are becoming increasingly interlinked with other specialities and fields. A more interdisciplinary approach to the patient is needed, especially for complex patients with numerous comorbidities, most of whom are usually elderly and fragile. The greatest challenges to human health lie at the intersection of different medical fields. An interdisciplinary medical team is increasingly necessary with the rapid expansion of medical knowledge. Given the importance of interdisciplinarity in the field of medicine and research, the international journal Medicina-Lithuania has launched this Special Issue. The Special Issue has attracted the interest of different groups of researchers, and very interesting articles from different countries. Reviews or original articles dealing with interdisciplinary medical problems, as well as articles providing an up-to-date overview of the diagnostic protocols and treatments for patients with multiple comorbidities have been published. I thank all the authors for sharing their research and wish all readers a fruitful and stimulating read! Assoc. Prof. Dr. Camelia DIACONU Guest Editor

Keywords

Medicine --- ectopic kidney --- locally advanced cervical cancer --- nephrectomy --- skin cancer --- squamous cell carcinoma --- basal cell carcinoma --- malignant melanoma --- surgery --- quality of life --- breast reconstruction --- timing --- mastectomy --- adjuvant therapy --- fertility preservation --- cryo-preservation --- vitrification --- breast cancer --- dietary attitude --- type 2 diabetes mellitus --- diabetes self-management --- empowerment approach --- dietary behavior --- early stage --- ovarian cancer --- para-aortic lymph node metastases --- synchronous malignancies --- cervical adenocarcinoma --- serous ovarian adenocarcinoma --- PSFT --- resection --- pulmonary adenocarcinoma --- Krukenberg tumors --- ureteral stenosis --- chronic kidney disease --- preeclampsia --- hypertension --- proteinuria --- type 2 diabetes --- hemoglobin A1c --- matrix metalloproteinases-2 and -9 --- anti-elastin antibodies --- anti-collagen IV antibodies --- diabetic retinopathy --- diabetic nephropathy --- macrovascular complications --- nephrotic syndrome --- thrombosis --- inherited risk factors --- mutation --- anticoagulation --- medical malpractice --- doctor-patient relationship --- communication --- complications --- diagnostic error --- preventive measures --- retrospective study --- children --- self-medication --- risks --- beliefs --- Mayer-Rokitansky-Küster-Hauser syndrome --- primary amenorrhea --- surgical management --- vaginal reconstruction --- plastic surgery --- oral graft versus host disease --- topical corticosteroids --- dexamethasone --- clobetasol --- budesonide --- tuberous sclerosis --- angiomyolipomatosis --- uretero-hydronephrosis --- angiofibromas --- VCAM-1 --- E-selectin --- psoriasis --- methotrexate --- adalimumab --- colosalpingeal fistula --- enterotubal fistula --- diverticular fistulation --- diagnosis --- hysteroscopy management --- pregnancy-associated breast cancer --- Romania --- primary --- pleural --- hydatidosis --- Albendazole --- echinoccocus --- caudal duplication syndrome --- colorectal duplication --- genitourinary duplication --- congenital malformation --- pediatric surgery --- SARS-CoV-2 --- COVID-19 --- SIADH --- dyselectrolytemia --- hyponatremia --- Silesian Voivodeship --- gold hour --- cardiovascular diseases --- Medical Emergency Team --- acute cholecystitis --- laparoscopic cholecystectomy --- elderly --- safety --- young lung cancer --- depression --- anxiety --- multiple correspondence analysis --- k-means clustering --- ectopic kidney --- locally advanced cervical cancer --- nephrectomy --- skin cancer --- squamous cell carcinoma --- basal cell carcinoma --- malignant melanoma --- surgery --- quality of life --- breast reconstruction --- timing --- mastectomy --- adjuvant therapy --- fertility preservation --- cryo-preservation --- vitrification --- breast cancer --- dietary attitude --- type 2 diabetes mellitus --- diabetes self-management --- empowerment approach --- dietary behavior --- early stage --- ovarian cancer --- para-aortic lymph node metastases --- synchronous malignancies --- cervical adenocarcinoma --- serous ovarian adenocarcinoma --- PSFT --- resection --- pulmonary adenocarcinoma --- Krukenberg tumors --- ureteral stenosis --- chronic kidney disease --- preeclampsia --- hypertension --- proteinuria --- type 2 diabetes --- hemoglobin A1c --- matrix metalloproteinases-2 and -9 --- anti-elastin antibodies --- anti-collagen IV antibodies --- diabetic retinopathy --- diabetic nephropathy --- macrovascular complications --- nephrotic syndrome --- thrombosis --- inherited risk factors --- mutation --- anticoagulation --- medical malpractice --- doctor-patient relationship --- communication --- complications --- diagnostic error --- preventive measures --- retrospective study --- children --- self-medication --- risks --- beliefs --- Mayer-Rokitansky-Küster-Hauser syndrome --- primary amenorrhea --- surgical management --- vaginal reconstruction --- plastic surgery --- oral graft versus host disease --- topical corticosteroids --- dexamethasone --- clobetasol --- budesonide --- tuberous sclerosis --- angiomyolipomatosis --- uretero-hydronephrosis --- angiofibromas --- VCAM-1 --- E-selectin --- psoriasis --- methotrexate --- adalimumab --- colosalpingeal fistula --- enterotubal fistula --- diverticular fistulation --- diagnosis --- hysteroscopy management --- pregnancy-associated breast cancer --- Romania --- primary --- pleural --- hydatidosis --- Albendazole --- echinoccocus --- caudal duplication syndrome --- colorectal duplication --- genitourinary duplication --- congenital malformation --- pediatric surgery --- SARS-CoV-2 --- COVID-19 --- SIADH --- dyselectrolytemia --- hyponatremia --- Silesian Voivodeship --- gold hour --- cardiovascular diseases --- Medical Emergency Team --- acute cholecystitis --- laparoscopic cholecystectomy --- elderly --- safety --- young lung cancer --- depression --- anxiety --- multiple correspondence analysis --- k-means clustering

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