Comparison of long-term kidney functions after radical nephrectomy and simple nephrectomy

Objective To determine if there is a difference in proceeding to CKD between patients who had undergone radical nephrectomy (RN) and simple nephrectomy (SN) for different indications by comparing the short- and long-term renal function. Materials and Methods We retrospectively analyzed the records of all patients who underwent nephrectomy (either for malign or benign indications) in our clinic between January 2007 and September 2017. The patients were divided into 2 groups according the type of surgery: 1) Radical nephrectomy Group, 2) Simple Nephrectomy Group. Renal function was evaluated with Glomerular Filtration Rate (GFR) calculated using the MDRD formula. Results A total of 276 patients were included in the study. There were 202 patients in RN Group and 74 patients in SN Group. The mean age of the patients in RN Group and SN Group were age 59,2 ± 11,5 and 49,9 ± 15,1 years, respectively (p = 0.001). GFR levels of patients in RN Group versus SN Group were as follows: Preoperative period: 84.9 vs. 81 mL/min/1.73 m2; postoperative 1st day: 60.5 vs. 84.4 mL/min/1.73 m2, postoperative 1st month 58.9 vs. 76 mL/min/1.73 m2, postoperative 1st year: 59.5 vs. 74.1 mL/min/1.73 m2; at last control 60.3 and 76.1 mL/min/1.73 m2. While preoperative GFR was found to be similar in two groups (p = 0.26), postoperative GFR values were found to be significantly lower in Group RN (p < 0.001). In comparison of the decrease in GFR in two groups at last follow-up, significantly higher decrease was observed in RN Group, 29% vs. 6%, (p < 0.05). Conclusion The decrease in GFR exists more common and intensive after RN compared to SN. In long-term, compensation mechanisms that develop after sudden nephron loss like radical nephrectomy deteriorates kidney function more than gradual nephron loss as in benign etiologies which indicates simple nephrectomy

Results of our laparoscopic partial nephrectomy without ischemia: the first ten cases

Laparoscopic partial nephrectomy (LPN) without ischemia is a new method that can only be performed in selected cases. We presented results of patients who underwent LPN without ischemia for renal mass in our clinic. The demographic characteristics, perioperative and postoperative surgical results, complications and renal functions were retrospectively reviewed for patients who underwent LPN without ischemia between March 2014 and September 2015. Renal function was assessed using the estimated glomerular filtration rate (GFR) calculated by the Modification of Diet in Renal Disease (MDRD) equation. Complications was assessed according to modified Clavien classification. Ten cases of LPN without ischemia were performed. The mean age was (year) 50.6 ± 8.6, the mean mass size (mm) 37.9 ± 23, the mean RENAL score was 6.4 ± 1.2. The mean operation time (minute) 110.5 ± 41, the mean bleeding amount (ml) 191 ± 198, the mean hemoglobilin (mg/dl) preoperative 13.86 ± 1.28, postoperative 12.2 ± 1.2, the mean creatinine (mg/dl) preoperative 0.95 ± 0.19, postoperative 0.85 ± 0.2, 1.Year 0,91±0,1, GFR (ml/min) preoperative 77.6, postoperative 1.day 79.6, 1.Year 81.2, hospitalization duration (day) 2.9 ± 0.7. Two patients underwent blood transfusion (According to modified Clavien classification grade 2). LPN without ischemia is a new method that can only be performed in selected cases in experienced clinics. [Med-Science 2018; 7(2.000): 402-5

Effects of Chronic Renal Failure on Surgical Outcomes of Laparoscopic Nephrectomy for Benign Diseases? A Comparative Study

Objective: The aim of this study was to compare surgical outcomes of laparoscopic nephrectomy (LN) for benign diseases in patients with chronic renal failure (CRF) undergoing hemodialysis with their non-CRF counterparts

Ureteral access sheath use in retrograde intrarenal surgery

Objective: To determine if there is a difference between postoperative urinary infection rates after retrograde intra-renal surgery (RIRS) when ureteral access sheath (UAS) was used or not used

Comparison of long-term kidney functions after radical nephrectomy and simple nephrectomy

Objective. To determine if there is a difference in proceeding to CKD between patients who had undergone radical nephrectomy (RN) and simple nephrectomy (SN) for different indications by comparing the short- and long-term renal function

Relationship between immunohistochemical staining extent of CD47 and histopathologic features of bladder tumor

WOS: 000418412900003PubMed ID: 29410884Introduction It has been shown that CD47 is an important diagnostic and prognostic marker in many cancer types. However, the relationship between CD47 and bladder tumor stage has not been shown in previous studies. To the best of our knowledge, this is the first study investigating the association of CD47 with stages of bladder cancer. Material and methods Surgical specimens of 175 patients were included in the study. The CD47 staining assessment was performed in the following categories; none, focal, moderate and diffuse. The statistics of the study were tested using t-test and analysis of variance. Results We demonstrated much less CD47 staining extent in Ta tumor pathology compared to T1 and T1+T2+T3+T4 tumor pathology (p = 0.034 and p = 0.016, respectively). We also showed that the average value of CD47 staining extent with CIS+ was significantly higher compared to CIS-among NMIBC p = 0.0248). However, no significant differences in CD47 staining pattern were observed in the following study groups: high vs. low-grade tumors in non-muscle invasive bladder cancer (NMIBC); MIBC (T2-T4) vs. NMIBC; lymph node involvement (N1-N3) vs. non- lymph node involvement (N0) in MIBC (T2-T4). Conclusions Our study demonstrated that CD47 might have a critical role in the progression of Ta to T1 stage. Furthermore, we showed that CD47 is highly expressed in CIS+ NMIBC compared to CIS-NMIBC. Thus, differentiating stages with the help of this new potential marker may help clinicians treat bladder tumors better. Future studies to determine the role of CD47 on pathophysiology, diagnosis and prognosis of bladder tumor are warranted

Clinical predictors and significance of adherent periadrenal fat in laparoscopic adrenalectomy

Abstract Background Adrenalectomy requires the anatomic preparation of the adrenal gland in the fat-rich retroperitoneal space. In the literature, it was shown that the retroperitoneal fat area affects surgical outcomes in laparoscopic adrenalectomy (LA). Besides the quantity of retroperitoneal fat, its qualitative properties play hypothetically a significant role in the safety profile and perioperative parameters of LA. In this study, we aimed to evaluate the factors associated with adherent periadrenal fat. Methods The prospectively obtained demographic, preoperative, intraoperative, and postoperative data of 44 patients who underwent laparoscopic adrenalectomy in our clinic were analyzed retrospectively. The patients were divided into two groups as adherent periadrenal fat (APAF) and non-APAF group. Periadrenal fat tissue was defined as adherent or non-adherent by the attending surgeon according to the difficulty in dissection of the adrenal gland from the surrounding fat tissue during the operation. Results The rate of female gender and presence of diabetes mellitus (DM) was higher in the APAF group (respectively, p = 0.038 and p = 0.001). A ROC curve analysis showed that the cut-off point was − 97 HU for APAF. On multivariable analysis using a stepwise regression model, we identified the presence of DM (OR = 5.073; 95% Cl = 2.192–12.387; p = 0.006) and ARFD > -97 HU (OR = 3.727; 95% Cl = 1.898–11.454; p = 0.008) as an independent predictor of APAF. Conclusion APAF seems to affect the perioperative outcomes of LA in terms of operation duration but not perioperative complications