DOES THE USE OF FLUOROSCOPY REALLY AFFECT THE SUCCESS RATE OF RETROGRADE INTRARENAL SURGERY?

INTRODUCTION: Fluoroscopy is used for access sheath insertion and postoperative control during retrograde intrarenal surgery(RIRS) operation but with this technique both patient and operation team are exposed to radiation. The use of fluoroscopy is disadvantage for both patient and surgeon. Considering results of recent studies, it is clearly seen that fluoroscopy doesn't affect the success and complication rates of RIRS. In this study, we aimed to compare the results of both fluoroscopy and fluoroscopy-free groups, to show if there is a significant difference

Evaluation of Sleep Quality and Quantity of Patients with Benign Prostatic Hyperplasia Using the Medical Outcomes Study-sleep Scale

Objective: This study aimed to evaluate the sleep quality and quantity of patients with benign prostate hyperplasia (BPH) and compare them with that of a control group using the Medical Outcomes Study-sleep scale (MOS-SS)

Is routine ureteral stenting really necessary after retrograde intrarenal surgery?

Objectives: To investigate the situations in which ureteral double-J stent should be used after retrograde intrarenal surgery (RIRS). Patients and Methods: Patients with no ureteral double-J stent after RIRS constituted Group 1, and those with double- J stent after RIRS constituted Group 2. Patients’ age and gender, renal stone characteristics (location and dimension), stone-free status, VAS score 8 hours after surgery, post-procedural renal colic attacks, length of hospitalization, requirement for re-hospitalization, time to rehospitalization and secondary procedure requirements were analyzed. Results: RIRS was performed on 162 renal units. Double-J stent was used in 121 (74.6%) of these after RIRS, but not in the other 41 (25.4%). At radiological monitoring at the first month postoperatively after RIRS, complete stone-free status was determined in 122 (75.3%) renal units, while residual stone was present in 40 (24.6%). No significant differences were observed between the groups in terms of duration of fluoroscopy (p = 0.142), operation (p = 0.108) or hospitalization times (p = 0.798). VAS values determined routinely on the evening of surgery were significantly higher in Group 1 than in Group 2 (p = 0.025). Twenty-eight (17.2%) presentations were made to the emergency clinic due to renal colic within 1 month after surgery. Double-J catheter was present in 24 (85.7%) of these patients. Conclusions: Routine double-J stent insertion after RIRS is not essential since it increases costs, morbidity and operation time

Risk Factors of Infectious Complications after Flexible Uretero-renoscopy with Laser Lithotripsy.

To determine the perioperative risk factors for postoperative infections among patients undergoing flexible uretero-renoscopy with laser lithotripsy (FURSLL). In addition, the resistance patterns of pathogens isolated from positive preoperative urine cultures were investigated

Risk Factors of Infectious Complications after Flexible Uretero-renoscopy with Laser Lithotripsy

Purpose: To determine the perioperative risk factors for postoperative infections among patients undergoing flexible uretero-renoscopy with laser lithotripsy (FURSLL). In addition, the resistance patterns of pathogens isolated from positive preoperative urine cultures were investigated. Materials and Methods: We retrospectively reviewed data from 492 consecutive patients who had undergone FURSLL for stone disease in our department. Postoperative infection was defined as fever (>= 38 degrees C) with pyuria (>= 10 white blood cells per high power field), or systemic inflammatory response syndrome, or sepsis. Pre-operative and intra-operative characteristics between patients with and without postoperative infectious complications were compared using univariate analyses. Significant variables on univariate analyses were included in a multivariate logistic regression analysis to evaluate risk factors associated with postoperative infection following FURSLL. Results: 42 (8.5\%) of 492 patients had postoperative infectious complications after FURSLL. 59 (12\%) of 492 patients had a positive preoperative urine culture. 19 (32.2\% of 59) patients had multidrug resistance (MDR) isolates recovered from positive preoperative urine cultures. 75\% (9/12 cultures) of the positive preoperative urine cultures of patients in whom a postoperative infectious complication developed consisted of gram-negative pathogens. On multivariate analysis positive preoperative MDR urine culture (OR:4.75;95\%C1:1.55-14.56; P = .006) was found to be significant with the dependent variable as the postoperative infectious complications despite appropriate preoperative antibiotic therapy. Conclusion: We found that positive preoperative MDR urine culture is a significant risk factor for infectious complications after FURSLL. Our findings point to the need for further research on assessment of risk factors for MDR infections to reduce the rate of postoperative infectious complications

Real life experience of patients with locally advanced gastric and gastroesophageal junction adenocarcinoma treated with neoadjuvant chemotherapy: a Turkish oncology group study

Neoadjuvant chemotherapy (NACT) in gastroesophageal junction (GEJ) and gastric cancer (GC) was shown to improve survival in recent studies. We aimed to share our real-life experience of patients who received NACT to compare the efficacy and toxicity profile of different chemotherapy regimens in our country. This retrospective multicentre study included locally advanced GC and GEJ cancer patients who received NACT between 2007 and 2021. Relation between CT regimens and pathological evaluation were analysed. A total of 794 patients from 45 oncology centers in Turkey were included. Median age at the time of diagnosis was 60 (range: 18-86). Most frequent NACT regimens used were FLOT (65.4%), DCF (17.4%) and ECF (8.1%), respectively. In the total study group, pathological complete remission (pCR) rate was 7.2%, R0 resection rate 86.4%, and D2 dissection rate was 66.8%. Rate of pCR and near-CR (24%), and R0 resection (84%) were numerically higher in FLOT arm (p > 0.05). Patients who received FLOT had also higher chemotherapy-related toxicity rate compared to patients who received other regimens (p > 0.05). Median follow-up time was 16 months (range: 1-154 months). Estimated median overall survival (OS) was 58.4months (95% CI: 35.2-85.7) and disease-free survival (DFS) was 50.7 months (95% CI: 25.4-75.9). The highest 3-year estimated OS rate was also shown in FLOT arm (68%). We still do not know which NACT regimen is the best choice for daily practice. Clinicians should tailor treatment regimens according to patients' multifactorial status and comorbidities for to obtain best outcomes. Longer follow-up period needs to validate our results