Constraining depositional evolution and reservoir compartmentalization in a mixed carbonate-siliciclastic lacustrine system: The Yacoraite formation, Salta Group, NW Argentina

The mixed carbonate-siliciclastic Yacoraite Formation, Salta Group in northern Argentina has been interest of recent studies searching for potential analogues for the South Atlantic pre-sal carbonates. Microbial lacustrine carbonates are important reservoir systems and their characteristics and stratigraphic packaging are a major factor impacting compartmentalization. This study provides sedimentological and facies analyses combined with petrographical, isotope geochemical and petrophysical analyses of lacustrine clastics and carbonates using an example from the Yacoraite Formation (Salta Group) in northern Argentina (Tres Cruces sub-basin). The Yacoraite Formation records the evolution of a lacustrine system responding to basin scale tectonic processes and climatic conditions and is interpreted as a microbially-related mixed carbonate clastic lacustrine system comprising 8 main Facies types, deposited in either a perennial or an ephemeral system. The most dominant architectural elements are: Sandstones with interbedded shales (F1), Shales with interbedded sandstones and siltstones (F2), Thick-bedded oolitic grainstone (F5), Thin-bedded oolitic grainstone-packstone (F6) and Stromatolite boundstone (F8). These facies types allow to differentiate two types of lacustrine environments: Perennial (Stage I) vs Ephemeral (Stage II) intercalated with episodes of continental plains deposition, arranged in three depositional sequences (Yacoraite I, II and III), each recording either transgressive or a regressive-transgressive trend. Carbonate and clastics are arranged in cycles during the Perennial l Stage suggesting that the depositional system responded in patterns attributable to reciprocal sedimentation, whereas, during the Ephemeral Stage 2, spatial coexistence of clastic and carbonate seem to be the case rather that cyclic vertical superposition. Thick-bedded oolitic grainstone and Stromatolites (F5 and F8 respectively) of the perennial lacustrine system show laterally continuous and thick beds with the best reservoir properties. Furthermore, the Sandstones with interbedded shales (F1) are characterized by intermediate values of porosity and permeability, which would not result in permeability barriers. On the other hand, Thin-bedded oolitic grainstone-packstone (F6) of the ephemeral lacustrine system are characterized by a high degree of heterogeneity due to their limited areal distribution and their complex spatial variability with Shales with interbedded sandstones and siltstones (F2).Fil: Mutti, Maria. Universitat Potsdam; AlemaniaFil: Vallati, Michele. Universitat Potsdam; AlemaniaFil: Tomás, Sara. Universitat Potsdam; AlemaniaFil: Galli, Claudia Inés. Universidad Nacional de Jujuy. Instituto de Ecorregiones Andinas. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Ecorregiones Andinas; ArgentinaFil: Bahniuk Rumbelsperger, Anelize Manuela. Universidade Federal do Paraná; BrasilFil: Maerz, Sven. Universitat Potsdam; AlemaniaFil: Coira, Beatriz Lidia Luisa. Universidad Nacional de Jujuy. Instituto de Ecorregiones Andinas. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta. Instituto de Ecorregiones Andinas; Argentin

“Ride the Green Light”: Indocyanine Green–marked Off-clamp Robotic Partial Nephrectomy for Totally Endophytic Renal Masses

Background: Complexity of robot-assisted partial nephrectomy (RAPN) mostly depends on tumor size and location. Totally endophytic renal masses represent a surgical challenge in terms of both intraoperative identification and anatomical dissection. Objective: To detail a novel technique for marking preoperatively endophytic renal tumors with transarterial superselective intrarenal mass delivery of indocyanine green (ICG)-lipiodol mixture, in order to enhance surgical margins control during purely off-clamp (OC) RAPN with the use of near-infrared fluorescence imaging. Design, setting, and participants: Between June and July 2017, 10 consecutive patients with totally endophytic renal masses underwent preoperative ICG tumor marking immediately followed by RAPN. Surgical procedure: Preoperative superselective transarterial delivery of a lipiodol-ICG mixture (1:2 volume ratio) into tertiary-order arterial branches feeding the renal mass prior to transperitoneal OC-RAPN. Measurements: Clinical data were prospectively collected in our institutional RAPN dataset. Perioperative, pathological, and functional outcomes of RAPN were assessed. Results and limitations: Median tumor size was 3 cm (interquartile range 2.3–3.8). The median PADUA score was 10 (9–11). Angiographic procedure was successful in all patients. Median operative time was 75 min (65–85); median estimated blood loss was 250 ml (200–350). No conversion to on-clamp PN or radical nephrectomy was needed. All patients had uneventful perioperative course; median hospital stay was 3 d (2–3). At discharge, median hemoglobin (Hgb) and percent estimated glomerular filtration rate (eGFR) drop were 3.3 g/dl (2.1–3.3) and 11% (10–20%), respectively. Surgical margins were negative in all cases. One-year median ipsilateral renal volume and 1-yr eGFR percent decreases were 11.7% (6–20.9%) and 12.2% (5.3–13.7%), respectively. Conclusions: We described a novel technique to simplify challenging RAPN based on ICG superselective transarterial tumor marking. Key benefits include quick intraoperative identification of the mass with improved visualization and real-time control of resection margins. Patient summary: Robot-assisted partial nephrectomy (RAPN) for totally endophytic renal masses is a technically demanding surgical procedure, sometimes requiring radical nephrectomy. This novel technique significantly simplified surgical complexity in our Institution. Further studies with larger cohorts are warranted to confirm whether this technique provides relevant intraoperative and functional advantages. According to our preliminary experience, off-clamp robot-assisted partial nephrectomy after preoperative superselective indocyanine green tumor marking appeared to be a safe and effective procedure for the surgical treatment of totally endophytic renal tumors, achieving full trifecta outcomes and excellent functional results. Further prospective studies are awaited

Transnephrostomic Indocyanine green guided Robotic Ureteral Reimplantation for Benign Uretero-ileal Strictures after Robotic Cystectomy and Intracorporeal Neobladder: step-by-step surgical technique, perioperative and functional outcomes

To describe our surgical technique of robotic uretero-ileal reimplantation for uretero-ileal anastomosis strictures with the use of near-infrared fluorescence imaging after transnephrostomic antegrade injection of indocyanine green in patients previously treated with robot-assisted radical cystectomy and intracorporeal orthotopic neobladder. Materials and Methods From March 2015 to December 2017, 10 consecutive patients underwent robotic uretero-ileal reimplantation in our tertiary referral center. All patients previously underwent percutaneous nephrostomy and at least one antegrade stenting and stricture dilatation attempt. Clinical data were prospectively collected into our institutional dataset. Perioperative and functional outcomes were both assessed

Metachronous Isolated Splenic Metastasis in a Young Patient With Renal Cell Carcinoma: Case Report and Literature Review

Splenic metastasis is uncommon and is usually associated with widespread disease.1,2 Isolated splenic metastases from renal cancer are also rarer and are often an incidental finding. This eventuality may turn into a dangerous scenario due to a spontaneous splenic rupture leading to sudden death.2,3 At the best of our knowledge, only few cases of metastasis from renal cell carcinoma (RCC) have been documented in the literature.4-11 We hereby present a literature review of these cases and report a case of isolated splenic metastasis in a young man on active follow-up for a clear cell RCC clear cell Renal Cell Carcinoma (ccRCC)

Combining Different Wearable Devices to Assess Gait Speed in Real-World Settings

Assessing mobility in daily life can provide significant insights into several clinical conditions, such as Chronic Obstructive Pulmonary Disease (COPD). In this paper, we present a comprehensive analysis of wearable devices’ performance in gait speed estimation and explore optimal device combinations for everyday use. Using data collected from smartphones, smartwatches, and smart shoes, we evaluated the individual capabilities of each device and explored their synergistic effects when combined, thereby accommodating the preferences and possibilities of individuals for wearing different types of devices. Our study involved 20 healthy subjects performing a modified Six-Minute Walking Test (6MWT) under various conditions. The results revealed only little performance differences among devices, with the combination of smartwatches and smart shoes exhibiting superior estimation accuracy. Particularly, smartwatches captured additional health-related information and demonstrated enhanced accuracy when paired with other devices. Surprisingly, wearing all devices concurrently did not yield optimal results, suggesting a potential redundancy in feature extraction. Feature importance analysis highlighted key variables contributing to gait speed estimation, providing valuable insights for model refinement

Cone-Beam CT-Guided Transarterial Tagging of Endophytic Renal Tumors with Indocyanine Green for Robot-Assisted Partial Nephrectomy

Endophytic renal tumors are difficult to identify and dissect during robot-assisted partial nephrectomy (RAPN). The objective of this study is to evaluate the safety, efficacy, and clinical impact of pre-operative selective embolization of endophytic renal tumors with the fluorescent dye indocyanine green (ICG) and lipiodol to allow identification of the endophytic lesions using near infrared fluorescent imaging (NIFI). Materials and Methods Patients with renal endophytic tumors eligible for RAPN and trans-arterial embolization with ICG and lipiodol were prospectively included. Technical success was defined as the completion of the embolization procedure. Iconographic success, defined as the lipiodol accumulation into the nodule, was classified as poor, moderate, good, and excellent based on post-embolization cone-beam CT. Surgical visibility of the tumors during RAPN with the use of NIFI was classified as: not visible, visible with blurred margins, and visible with well-defined margins. Results Forty-two patients underwent pre-operative selective embolization. Technical success was 100%. Lipiodol accumulation at cone beam CT was poor in 2/42 (4,8%), moderate in 6/42 (14,3%), good in 26/42 (61,9%), and excellent in 8/42 patients (19,0%). During RAPN with NIFI, tumors were visible with well-defined margins in 22/42 (52,4%), visible with blurred margins in 15/42 (35,7%) and not visible in 1/42 (2,4%) of cases. There were no adverse events following endovascular embolization. Conclusion Pre-operative trans-arterial super-selective embolization of endophytic renal tumors with ICG and lipiodol in patients undergoing RAPN is safe and effective, allowing accurate intraoperative visualization and resection of endophytic tumors. Conclusion Pre-operative trans-arterial super-selective embolization of endophytic renal tumors with ICG and lipiodol in patients undergoing RAPN is safe and effective, allowing accurate intraoperative visualization and resection of endophytic tumors