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41.
Rodríguez-Covarrubias F Larré S Dahan M De La Taille A Allory Y Yiou R Vordos D Hoznek A Abbou CC Salomon L 《BJU international》2009,103(6):758-761
OBJECTIVE
To assess the prognostic significance of microscopic bladder neck invasion (BNI+) after radical prostatectomy (RP).PATIENTS AND METHODS
From January 1988 to December 2006, 1480 patients with clinically localized prostate cancer were surgically treated at one tertiary university hospital. The risk of biochemical progression, defined as a prostate‐specific antigen (PSA) level after RP of >0.2 ng/mL, was assessed with univariate and multivariate analyses for clinical and pathological variables. We compared the biochemical progression‐free survival (bPFS) of patients with BNI+ vs stages pT2, pT3a, pT3b and positive lymph nodes (N+). In a second analysis, we evaluated the bPFS of patients in different stages associated with BNI+ and compared them with those in the same stages with no BNI.RESULTS
BNI+ was found in 132 (9%) patients; the 5‐year bPFS was 86%, 54%, 26% and 10% for stages pT2, pT3a, pT3b and N+, respectively, while it was 30% for BNI+ (P < 0.001). There was no difference in the 5‐year bPFS between stage pT2 and pT2 + BNI (P = 0.32). Stages pT3a and pT3b had a better 5‐year bPFS than stage pT3a + BNI (P = 0.003) and pT3b + BNI (P = 0.001), respectively. In the univariate analysis all variables were associated with BP. In the multivariate analysis, only BNI+ had no association with BP (odds ratio 1.14, 95% confidence interval 0.70–1.85; P = 0.59).CONCLUSIONS
Microscopic BNI+ in prostate cancer is not an independent risk factor for biochemical progression and should be regarded as a factor that worsens the prognosis of the underlying tumour stage. A longer follow‐up is necessary to confirm these findings. 相似文献42.
Dhonneur G Abdi W Ndoko SK Amathieu R Risk N El Housseini L Polliand C Champault G Combes X Tual L 《Obesity surgery》2009,19(8):1096-1101
Background We compared tracheal intubation characteristics and arterial oxygenation quality during airway management of morbidly obese
patients whose trachea was intubated under video assistance with the LMA CTrach™ (SEBAC, Pantin, France) or the Airtraq™ laryngoscope
(VYGON, écouen, France) with that of the conventional Macintosh laryngoscope.
Methods After standardized induction of anesthesia, 318 morbidly obese patients scheduled for elective morbid obesity surgery received
tracheal intubation with the LMA CTrach™, the Airtraq™ laryngoscope, or the conventional Macintosh laryngoscope. Duration
of apnea, time to tracheal intubation, and oxygenation quality during airway management were compared between the LMA CTrach™
and the laryngoscope groups.
Results Patients’ characteristics were similar in the three groups. The success rate for tracheal intubation was 100% with the LMA
CTrach™ and the Airtraq™ laryngoscope. One patient of the Macintosh laryngoscope group received LMA CTrach™ intubation because
of early arterial oxygen desaturation associated with unstable facemask ventilation. The duration of apnea was shorter with
the LMA CTrach™ than that of the Airtraq™ laryngoscope and the Macintosh laryngoscope. The duration tracheal intubation was
shorter with the Airtraq™ laryngoscope than with the Macintosh laryngoscopes and the LMA CTrach™. During airway management,
arterial oxygenation was of better quality with the LMA CTrach™ and the Airtraq™ laryngoscope than that of the Macintosh laryngoscope.
Conclusion Because LMA CTrach™ promoted short apnea time and the Airtraq™ laryngoscope allowed early definitive airway, both video-assisted
tracheal intubation devices prevented most serious arterial oxygenation desaturation evidenced during tracheal intubation
of morbidly obese patients with the conventional Macintosh laryngoscope.
Support was provided solely from department sources. LMA and PRODOL Companies promoted material support for the airways. 相似文献
43.
44.
Karakiewicz PI Trinh QD de la Taille A Abbou CC Salomon L Tostain J Cindolo L Artibani W Ficarra V Patard JJ 《European journal of cancer (Oxford, England : 1990)》2007,43(6):1023-1029
ObjectivesWe tested and compared the improvement in prognostic ability related to the consideration of either ECOG performance status (ECOGPS) and/or symptom classification (S-CLASS) in renal cell carcinoma specific mortality (RCC-SM) predictions.MethodsUnivariate and multivariate Cox regression analyses targeted RCC-SM in 2570 RCC patients treated with either partial or radical nephrectomy. The increment in predictive accuracy related to the addition of either ECOGPS, S-CLASS or both was quantified using Harrell’s concordance index.ResultsFollow-up ranged from 0.1 to 23 years (median 3.2) and 610 patients (23.7%) died of RCC. In multivariable analyses, ECOGPS and S-CLASS represented independent predictors of RCC-SM. The addition of ECOGPS to established RCC-SM predictors increased the predictive accuracy by 0.3% (p = 0.8) versus 0.6% (p = 0.5) for S-CLASS versus 0.6% (p = 0.5) for both.ConclusionsNeither ECOGPS nor S-CLASS improves the ability to predict RCC-SM. Therefore, these variables may be safely omitted when RCC-SM risk is quantified. 相似文献
45.
Haese A de la Taille A van Poppel H Marberger M Stenzl A Mulders PF Huland H Abbou CC Remzi M Tinzl M Feyerabend S Stillebroer AB van Gils MP Schalken JA 《European urology》2008,54(5):1081-1088
Background
The Prostate CAncer gene 3 (PCA3) assay has shown promise as an aid in prostate cancer (pCA) diagnosis in identifying men with a high probability of a positive (repeat) biopsy.Objective
This study evaluated the clinical utility of the PROGENSA PCA3 assay.Design, setting, and participants
This European prospective, multicentre study enrolled men with one or two negative biopsies scheduled for repeat biopsy.Measurements
After digital rectal examination (DRE), first-catch urine was collected to measure PCA3 mRNA concentration and to calculate the PCA3 score. The PCA3 score was compared to biopsy outcome. The diagnostic accuracy of the PCA3 assay was compared to percent of free prostate-specific antigen (%fPSA).Results and limitations
In 463 men, the positive repeat biopsy rate was 28%. The higher the PCA3 score, the greater the probability of a positive repeat biopsy. The PCA3 score (cut-off of 35) had a greater diagnostic accuracy than %fPSA (cut-off of 25%). The PCA3 score was independent of the number of previous biopsies, age, prostate volume, and total prostate-specific antigen (PSA) level. Moreover, the PCA3 score was significantly higher in men with high-grade prostate intraepithelial neoplasia (HGPIN) versus those without HGPIN, clinical stage T2 versus T1, Gleason score ≥7 versus <7, and “significant” versus “indolent” (clinical stage T1c, PSA density [PSAD] <0.15 ng/ml, Gleason score in biopsy ≤6, and percent positive cores ≤33%) pCA.Conclusions
The probability of a positive repeat biopsy increases with rising PCA3 scores. The PCA3 score was superior to %fPSA for predicting repeat prostate biopsy outcome and may be indicative of clinical stage and significance of pCa. 相似文献46.
Results of pyeloureterostomy after ureterovesical anastomosis complications in renal transplantation 总被引:3,自引:0,他引:3
Salomon L Saporta F Amsellem D Hozneck A Colombel M Patard JJ Chopin D Abbou CC 《Urology》1999,53(5):908-912
OBJECTIVES: The most frequent urologic complications after renal transplantation involve the ureterovesical anastomosis (ie, leakage, stenosis, and reflux), with a frequency of 1% to 30% in different series. We present the results of pyeloureterostomy using the recipient's ureter. METHODS: From 1988 to 1996, 570 cadaveric renal grafts were performed at our institution. A Lich Gregoir ureterovesical anastomosis was used in every case. Complications involving the anastomosis occurred in 19 cases (3.3%), with 10 stenoses (1.7%), 6 cases of leakage (1.1%), and 3 of reflux (0.5%). The mean donor age was 36.2 years, and the mean duration of cold ischemia was 29.4 hours. The mean recipient age was 41.3 years. Corrective surgery was performed 0.09 years (range 0.01 to 0.22) after transplantation for leakage, 1.13 years (range 0.14 to 5.11) for stenosis, and 5.55 years (range 0.51 to 9.71) for reflux. The recipient's ureter was stented with a ureteral catheter before median laparotomy, except in 3 cases of early leakage (less than 3 days). The recipient's ureter was cut, without the need for ipsilateral nephrectomy, and sutured to the graft pelvis. A nephroureterostomia stent (Gil Vernet stent) (12 cases) or a double J ureteral stent (7 cases) was used for urinary drainage. RESULTS: One graft was lost on day 1 through renal vein thrombosis. Percutaneous nephrostomy was performed on day 2 to clear an obstruction of the double J ureteral stent in one case, and a double J ureteral stent was inserted on day 2 because the nephrouretrostomia stent was incorrectly positioned in another case. Pyelographic controls on day 15 were normal in every case. The mean follow-up was 2.25 years (range 0.24 to 6.1) (2.9 years for leakage, 2.08 years for stenosis, and 1.44 years for reflux). One patient died with a functional graft 3 years after surgery. One graft was lost 4 years after surgery through chronic rejection. There were no complications affecting the ipsilateral kidney. No further ureteral complications occurred after surgery. The mean creatinine level 3 years after surgery was 1.59 mg/dL. CONCLUSIONS: Pyeloureterostomy is a safe and permanent treatment for complications of ureterovesical anastomosis and gives excellent results. The technique requires stenting of the recipient's ureter and graft drainage with a nephroureterostomia stent or a double J ureteral stent. 相似文献
47.
Adenovirus types associated with severe respiratory diseases: A retrospective 4‐year study in Kuwait 下载免费PDF全文
Wassim Chehadeh Anfal Al‐Adwani Sonia Elezebeth John Shaikhah Al‐Dhufairi Hessa Al‐Dousari Maha Alkhaledi Widad Al‐Nakib 《Journal of medical virology》2018,90(6):1033-1039
48.
49.
M A Charles D Simon C Abbou D Mathieu J Bellot J Hazard 《Annales d'endocrinologie》1989,50(6):503-507
Incidental adrenal tumors are more and more often discovered with development of the new radiological techniques (CT scan, sonography). In such an occurrence, the largest panel of adrenal hormones measurements is needed. In the absence of hormonal abnormality, no exam can help for the clinical decision-making. According to epidemiological findings, we propose to operate upon tumors larger than 6 cm and to repeat CT scans at 2, 6 and 18 months for tumors smaller than 6 cm which should be operated upon if an enlargement of the adrenal tumor is demonstrated by a control exam. This attitude relies upon the quite higher frequency of adrenal adenomas (more than 99% of non-functioning adrenal tumors) and the more important risk of malignant adrenal carcinoma in front of a huge tumor. It appears to be the right choice in a cost-effectiveness perspective. 相似文献
50.
Rassweiler J Godin K Goezen AS Kusche D Chlosta P Gaboardi F Abbou CC van Velthoven R 《Der Urologe. Ausg. A》2012,51(5):671-678
Although the technical feasibility of laparoscopic radical cystectomy (LRC) has been proven and the procedure has been accepted in the EAU guidelines 2011 as a valid alternative, its actual position has to be determined. On the one hand the advantages of LRC (less blood loss, lower transfusion rates, shorter analgesia time) have been proven in retrospective studies; however, the technical difficulties of purely laparoscopic urinary diversion result in very long operating times and in cases of a laparoscopic-assisted creation of a neobladder, the question of the advantage of this approach remains doubtful. Despite case reports of port metastases and peritoneal carcinosis following laparoscopic and robot-assisted radical cystectomy, there is no difference in terms of oncological long-term data (up to 10 years) between laparoscopy and open surgery performed at centres of excellence. Evidently, the curative options for the patients do not depend on the type of surgery (open versus minimally invasive) but on the efficacy of adjuvant treatment strategies (polychemotherapy). Currently it is believed that LRC should be considered for patients with low risk of progression (pT1-2). The final position of laparoscopic radical cystectomy can only be evaluated in a multicentric randomized controlled trial. 相似文献