Open Partial Nephrectomy in the Management of Small Renal Masses

Introduction. Most of the kidney masses are being detected incidentally with smaller size due to widespread use of imaging modalities leading to increased RCC incidence worldwide with an earlier stage. This article reviews the role of open partial nephrectomy (PN) in the management of small renal masses. Material and Methods. Review of the English literature using MEDLINE has been performed between 1963–2008 on small renal masses, partial nephrectomy, kidney cancer, nephron sparing surgery (NSS), radical nephrectomy, laparoscopy, and surgical management. Special emphasis was given on the indications of NSS, oncological outcomes and comparison with open and laparoscopic PN. Results. Overall 68 articles including 31 review papers, 35 human clinical papers, 1 book chapter, and 1 animal research study were selected for the purpose of this article and were reviewed by the authors. Conclusions. Currently, open NSS still remains as the gold standard surgical treatment modality in patients with small renal masses

Ureteric Duplication is not a Contraindication for Robot-Assisted Laparoscopic Radical Cystoprostatectomy and Intracorporeal Studer Pouch Formation

The authors found that duplicated ureters was not a contraindication to robot-assisted laparoscopic radical cystoprostatectomy in this case

COVİD-19 pandemisi döneminde ilk online üroonkoloji kongresi: 10. Online Avrasya Üroonkoloji Kongresi

Objective: COVID-19 has rapidly spread and has become a pandemic by affecting the whole world. During this period, many scientific congresses and educational meetings had to be canceled because of preventive measures. In this report, we aimed to share our first live virtual congress experience, described its process of transformation from face to face to virtual congress and report the attendees and speakers’ satisfaction. Material and Methods: Eurasian Uro-oncological Association (EUA) decided to organize the 10th Eurasian Uro-oncology congress in June 2020 at Göbeklitepe, Şanlıurfa in Turkey. However, due to the COVID-19 pandemic, the organizing committee decided to organize the first virtual scientific congress in Turkey. The planned duration of the congress was reduced from 4 days to 2 days and each speaker was planned to give the speech online during the presentation via ZOOM program (San Jose, CA). Results: A total of 704 persons registered to the congress. It was the highest number of participants among whole congresses that was organized by EUA. In this congress, there were 199 oral presentations, 25 interactive e-posters and 12 video presentations. During the congress, each participant attended the congress for an average of 387 minutes. It was identified that the majority of the participants were quite satisfied with the program offered. In general, participants were fairly satisfied with the quality of images and sound, chat functionality, questions & answers section and technical support In this report, we shared the outcomes of our first virtual congress experience in Turkey through the 10th Eurasian Uro-oncology Congress. Today, virtual congresses have become the “new normal” and offer cheaper events with larger participation in the comfort of home.Amaç: COVİD-19 hızlıca yayılarak kısa sürede tüm dünyayı etkileyen bir pandemi haline gelmiş ve bu süreçte koruyucu önlemler nedeniyle birçok bilimsel kongre ve eğitim toplantısı iptal edilmek zorunda kalınmıştır. Bu çalışmada, ilk canlı, online kongre deneyimimizi paylaşmayı, yüz yüze geleneksel kongreden online kongreye geçiş sürecini anlatmayı ve katılımcı ve konuşmacıların memnuniyetlerini ortaya koymayı amaçladık. Gereç ve Yöntemler: Avrasya Üroonkoloji Derneği (AÜD), 10. Avrasya Üroonkoloji Kongresi’ni Haziran 2020’de Şanlıurfa-Göbeklitepe, Türkiye’de düzenlemeye karar vermişti. Ancak organizasyon komitesi COVİD-19 pandemisi nedeniyle Türkiye’deki ilk online kongreyi düzenlemeye karar verdi. Planlanan kongre süresi 4 günden 2 güne düşürüldü ve her konuşmacının sunumlarını ZOOM programı (San Jose, CA) üzerinden yapmaları planlandı. Bulgular: Toplam 704 kişi kongreye kayıt yaptırdı. Bu sayı ile AÜD tarafından düzenlenen tüm kongreler arasında en fazla katılımcı sayısına sahip kongre bu kongre oldu. Kongrede 199 sözlü sunum, 25 interaktif e-poster ve 12 video sunumu yer aldı. Kongre süresince her katılımcı ortalama 387 dakika kongreye katıldı. Katılımcıların çoğunluğunun sunulan programdan oldukça memnun olduğu tespit edildi. Katılımcıların genel olarak görüntü ve ses kalitesinden, sohbet fonksiyonundan, soru-cevap bölümünden ve teknik destekten oldukça memnun olduğu saptandı. Sonuç: Bu makalede, Türkiye’deki ilk online kongre deneyimimizin sonuçlarını 10. Avrasya Üroonkoloji Kongresi ile sunduk. Günümüzde online kongreler “yeni normal” haline gelmiş durumdadır ve ev konforunda daha fazla katılımcı ile daha az maliyetli etkinlikler sunmaktadır

What if the Hand Piece Spring Disassembles During Robotic Radical Prostatectomy?

These authors report on the successful management of a disassembled hand piece spring during robotic radical prostatectomy

The Incidence and Management of Pleural Injuries Occurring during Open Nephrectomy

Objective. To evaluate the incidence, management, and risk factors of pleural injuries occurring during open nephrectomy. Methods. Between June 2004/and June 2008, 165 patients (167 renal units) underwent open simple (n = 37, 22.2%), partial (n = 39, 23.4%) or radical (n = 91, 54.5%) nephrectomy in our institution. Results. Flank, Chevron, and abdominal midline incisions were used in 148(88.6%), 17(10.2%), and in 2(1.2%) surgical procedures, respectively. Ribs were excised in 109(65.3%) procedures (11th rib, 10th-11th ribs, and 11th-12th ribs). Intraoperative pleural injuries were detected in 20(12%) procedures, 16(80%) were treated successfully with simple evacuation technique, and 4 required chest tube insertion. Age, sex, surgery type, incision type, and surgery site were not associated with pleural injury occurrence (P > .05). Rib resection was the only parameter associated with pleural injury occurrence. Conclusion. Pleural injuries occur in 12% of open nephrectomy procedures, and 80% can be repaired successfully. Few of them (2.4%) need chest tube insertion. Performing rib resection is a significant risk factor for pleural injury occurrence during nephrectomies

Современные подходы к лечению почечно-клеточного рака

Surgery is the only effective method for the treatment of localized renal cell carcinoma (RCC). Today nephron sparing surgery (NSS) cures the majority of patients with early stage disease. Open radical nephrectomy (RN) is performed mainly in patients with large tumors and in cases complicated by the tumor thrombus extension into the vena cava. Laparoscopy is now more and more often used for RCC treatment. Laparoscopic RN (LRN) is now recommended for the treatment of early stage RCC, when NSS cannot be used. LRN seems to provide longterm cancer control comparable to open RN. RCC is now often diagnosed when the tumors are still small and can be often cured by NSS providing excellent local cancer control. Tumor size, location, multiple foci, surgical margin, and pathological variants are significant for cancer outcome in selective NSS. Laparoscopic partial nephrectomy (LPN) is now gaining popularity as an effective minimally invasive treatment in patients with relatively small and peripheral renal tumors. Recently minimally invasive ablative techniques were introduced for the treatment of RCC. These methods involve little complications if used for the treatment of small renal tumors. The currently used best therapy for metastatic RCC is inadequate and surgery is an important component of combined treatment including immunochemotherapy. Combinations of interferon-alpha, interleukin-2, and 5-fluorouracyl are now used for the treatment of metastatic RCC. Nephrectomy can be recommended for patients with good performance status before immunotherapy. Modern research is focused on identification of novel agents and treatment modalities with better antitumor activity.

Retroperitoneal Extragonadal Nonseminomatous Germ Cell Tumor with Synchronous Orbital Metastasis

A huge retroperitoneal tumor with a right orbital mass was detected and proved to be an extragonadal nonseminomatous germ cell tumor on biopsy. BEP chemotherapy caused some regression in orbital mass however no change in retroperitoneal tumor size as well as serum tumor marker levels occurred. Herein, we present a rarely seen entity of extragonadal retroperitoneal nonseminomatous germ cell tumor with synchronous orbital metastases and discuss its diagnosis and management

Impact of the COVID-19 Pandemic on Inherited Metabolic Diseases: Evaluation of Enzyme Replacement Treatment Adherence with Telemedicine

Aim:During the coronavirus disease-2019 (COVID-19) pandemic, visiting the hospital and getting regular infusions can be difficult for patients with chronic illnesses. Telemedicine may offer a good option for the management of chronic diseases such as lysosomal storage diseases (LSD).Materials and Methods:LSD patients at the Unit of Metabolic Diseases of Ege University were contacted by phone between April, 2020 and March, 2021 during the COVID-19 pandemic. Telemedicine appointments were performed at intervals every month or three months, depending on the patients’ compliance with their treatment.Results:Ninety-two LSD patients [Mucopolysaccharidosis (MPS) I, MPS II, MPS IVA, MPS VI, MPS VII, Gaucher, Fabry, and Pompe] were included in this study. The total skipped treatment rate within one year was 17.1%. Most of the months of interruption were consonant with the time of social isolation. The treatment interruption in patients under 18 years was lower than in patients over 18 years. A positive correlation was detected between the age of patients and the interruption of treatment.Conclusion:The curfew periods might be one of the causes of missed treatment sessions. Telemedicine is a good method to improve the continuity of treatment. This study showed that the number of interrupted enzyme replacement treatments could be decreased via ongoing telemedicine appointments