32 research outputs found
Achaiki Iatriki : official publication of the medical society of western Greece and Peloponnesus
In the current issue, the editorial by Cauchi et al.
argues for eco-friendly measures in endoscopy and
emphasies the role of healthcare providers in reducing waste. The editorial adeptly employs the three Rs
(Reduce, Reuse, Recycle) framework to tackle waste
management, offering practical solutions. The editorial by Milionis et al. focuses on the reverse cascade
screening for paediatric familial hypercholesterolaemia
(FH), which is an upcoming tool for public health. Advantages, practices, and challenges regarding FH are
thoroughly discussed. Lastly, the editorial by Fousekis
et al. presents the main aspects of a chronic immune-mediated cutaneous disease, dermatitis herpetiformis
(DH), which constitutes an extraintestinal manifestation
of celiac disease, including its diagnosis, pathogenesis,
and management.
Moreover, this issue includes three review articles.
The review article by Krontira et al. discusses the evolving data on the epidemiology, diagnostic approach and
appropriate management of foreign body and caustic
substance ingestion, based on updated guidelines
published by gastroenterological and endoscopic societies. The review by Halliasos et al. provides data on the
clinical presentation, diagnosis, and management of
metastatic acute spinal cord compression, focusing on
the importance of a multidisciplinary team approach,
including spine surgeons, radiation oncologists, medical
oncologists, palliative care clinicians, physiotherapists,
and psychologists. Lastly, the review by Schinas et al.
outlines the potential of immune modulation in the
treatment of infections and the need for individualised approaches in the modern world of personalised
medicine by examining some of the key strategies and
immune-based therapies being developed to combat
infectious diseases.peer-reviewe
Clinical experience with ureteral metal stents
Ureteral metal stents (MSs) present a minimally invasive tool to preserve the drainage of renal pelvis whenever ureteral patency is at risk to be obstructed due to extrinsic or intrinsic etiologies. Clinical experience with these stents demonstrates that they impose a promising alternative treatment option in ureteral pathologies that are difficult to be treated via common polymeric stents. Current application of MSs in the treatment of both benign and malignant ureteral obstruction reveals quite promising results. Nevertheless, the ideal MS that would provide uncomplicated long-term effectiveness is still lucking and current MS usage is facing several adverse effects between which stent obstruction, encrustation, infection, migration, and patient discomfort. Ongoing attempts to create more inert stent with sophisticated novel designs are expected to improve current MS efficiency. MSs will play a major role in the future as a routine management of a variety of ureteral pathologies
Laparoendoscopic single-site surgery and cancer
Objectives: To perform a survey of the current state of laparoendoscopic single-site surgery (LESS) and its implementation in the treatment of malignant disease of the urinary tract. Although it is a recent development in the field of laparoscopic surgery with still unproven long-term results, LESS may prove to be more commonly performed in the coming years while managing urologic cancer patients.
Materials and Methods: A PubMed search was conducted using the key words laparoendoscopic single-site surgery, LESS, urologic cancer. Relevant articles were reviewed for data on the management of urologic malignancy with LESS.
Results: The first articles describing LESS for urologic cancers were published in 2007. Since then, published experience with this technique has increased. LESS has been implemented as an alternative to conventional laparoscopic surgery and open surgery for the treatment of major urologic cancers. The proposed advantages of LESS are the aesthetic benefit of a single incision and a quicker and less painful recovery. Disadvantages are the lack of instrument triangulation, instrument clashing and the steeper learning curve. As this is a fairly recent technical innovation, long-term functional and oncological results for LESS have not yet been published.
Conclusions: LESS is a novel technical advance over conventional laparoscopic surgery, and it can be successfully used in the treatment of patients with urologic cancers. Published data support the feasibility and safety of LESS interventions for major urologic cancers, and newer data may assist in finding LESS′s ultimate position among therapeutic options for patients with urologic malignancies
Anatomical landmarks of radical prostatecomy
Introduction: In the present study, we review current literature and
based on our experience, we present the anatomical landmarks of open and
laparoscopic/endoscopic radical prostatectomy.
Methods: A thorough literature search was performed with the Medline
database on the anatomy and the nomenclature of the structures
surrounding the prostate gland. The correct handling of puboprostatic
ligaments, external urethral sphincter, prostatic fascias and
neurovascular bundle is necessary for avoiding malfunction of the
urogenital system after radical prostatectomy.
Results: When evaluating new prostatectomy techniques, we should always
take into account both clinical and final oncological outcomes. The
present review adds further knowledge to the existing
“postprostatectomy anatomical hazard” debate. It emphasizes upon the
role of the puboprostatic ligaments and the course of the external
urethral sphincter for urinary continence. When performing an
intrafascial nerve sparing prostatectomy most urologists tend to
approach as close to the prostatic capsula as possible, even though
there is no concurrence regarding the nomenclature of the surrounding
fascias and the course of the actual neurovascular bundles. After
completion of an intrafascial technique the specimen does not contain
any periprostatic tissue and thus the detection of pT3a disease is not
feasible. This especially becomes problematic if the tumour reaches the
resection margin.
Discussion: Nerve sparing open and laparoscopic radical prostatectomy
should aim in maintaining sexual function, recuperating early continence
after surgery, without hindering the final oncological outcome to the
procedure. Despite the different approaches for radical prostatectomy
the key for better results is the understanding of the anatomy of the
bladder neck and the urethra. (c) 2006 European Association of Urology.
Published by Elsevier B.V. All rights reserved