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Berlin Brandenburg

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  • 1
    Article
    Article
    Language: English
    In: The Journal of Urology, January 2013, Vol.189(1), pp.S18-S18
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.juro.2012.08.261 Byline: Bradford J. Wood Author Affiliation: Center for Interventional Oncology, Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland Article Note: (footnote) NIH has intellectual property in the field. This work was supported by the Center for Interventional Oncology and the Intramural Research Program of the NIH Clinical Center. NIH and Philips Healthcare have a cooperative research and development agreement. The opinions expressed herein do not necessarily represent the opinions of the U.S. Government or the NIH.
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 2
    Article
    Article
    Language: English
    In: Urology, June 2013, Vol.81(6), pp.1244-1244
    Keywords: Medicine
    ISSN: 0090-4295
    E-ISSN: 1527-9995
    Source: ScienceDirect Journals (Elsevier)
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  • 3
    Article
    Article
    Language: English
    In: The Journal of Urology, 2010, Vol.183(3), pp.969-969
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 4
    Language: English
    In: Urology, September 2011, Vol.78(3), pp.592-594
    Description: To determine the reliability of the RENAL nephrometry scoring system by studying its reproducibility among different observers. We reviewed computed tomography or magnetic resonance imaging scans from 51 patients who underwent partial nephrectomy at our cancer center. Digitized axial and coronal images were available for all patients. Three surgeons independently scored the renal tumors using the RENAL nephrometry system. The scoring system had 5 components: R (tumor diameter), E (exophytic/endophytic), N (nearness to collecting system), A (anterior/posterior), and L (location in relation to polar lines). Interobserver variability was calculated for each of the 5 components using a frequency procedure and Kappa statistics. The reliability assessed by frequency procedure showed concordance among 3 observers in 94%, 76%, 66%, 80%, and 54% for the R, E, N, A, and L components, respectively. The corresponding kappa values for each of these 5 components were 0.95, 0.86, 0.76, 0.84, and 0.73, respectively. The RENAL nephrometry scoring system has good interobserver reliability. Quantifying the tumor location (L) was more challenging and the least reliable of the 5 components. This variation might affect the total nephrometry score and should be considered when using the system to compare different series of patients undergoing partial nephrectomy.
    Keywords: Medicine
    ISSN: 0090-4295
    E-ISSN: 1527-9995
    Source: ScienceDirect Journals (Elsevier)
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  • 5
    Language: English
    In: Urology, 2011, Vol.77(1), pp.217-222
    Description: Patients with genitourinary tumors and inferior vena cava thrombus often have large lesions and significant neovascularity. Early division of the renal vein with the in situ thrombus is desirable; however, concerns have been raised regarding tumor spillage and thrombus migration. We describe a novel technique using a stapling device to secure the renal vein during resection of renal tumors associated with an inferior vena cava thrombus. Since 2005, 38 patients have undergone surgery for genitourinary tumors and inferior vena cava tumor thrombus by a single surgeon. We examined the utility of an endovascular stapler (Endo-GIA) to transect the renal vein and the in situ thrombus. The renal vein containing the tumor thrombus was divided with an endovascular stapler in 14 of 38 patients. The outcomes of this technique were assessed. The stapled group included more level III-IV thrombi than the nonstapled group. The tumors removed in the stapled group were larger (median 11.5 versus 9 cm), and the median intraoperative transfusion requirements were greater (9.5 versus 3 U). One patient developed an intraoperative pulmonary embolus, and another experienced hemodynamic changes suggestive of an embolus. Local recurrence developed in 1 and 2 patients in the stapled and conventional groups, respectively, during a median follow-up period of 3 months. The Endo-GIA stapler is a safe and effective instrument for division of the in situ renal vein component of the tumor thrombus, allowing the surgeon to complete the nephrectomy, achieve hemostasis, and, subsequently, concentrate on the vena cava and tumor thrombus aspects of the procedure.
    Keywords: Medicine
    ISSN: 0090-4295
    E-ISSN: 1527-9995
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  • 6
    Language: English
    In: The Journal of Urology, August 2018, Vol.200(2), pp.457-458
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
    Source: ScienceDirect Journals (Elsevier)
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  • 7
    Language: English
    In: Urology, November 2016, Vol.97, pp.e15-e16
    Description: Bochdalek hernia is a congenital defect in the diaphragm posterolaterally that allows abdominal contents to enter the thorax. Herniation and development of an intrathoracic kidney associated with this condition are uncommon, with an incidence less than 0.25%. Intrathoracic kidney is also the rarest form of renal ectopia, consisting of less than 5% of cases. We present a series of images from a case of a 55-year-old female with a right renal mass suspicious for malignancy in a solitary right intrathoracic kidney within Bochdalek hernia, who underwent an open right partial nephrectomy for definitive diagnosis and treatment.
    Keywords: Medicine
    ISSN: 0090-4295
    E-ISSN: 1527-9995
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  • 8
    Language: English
    In: The Journal of Urology, September 2012, Vol.188(3), pp.729-735
    Description: We evaluated the ability of renal tumor complexity, as assessed by the R.E.N.A.L. (radius, exophytic, nearness to collecting system, anterior/posterior and location) nephrometry scoring system, to predict the functional efficacy of nephron sparing surgery. We evaluated 42 patients who presented with an anatomically (32) or a functionally (10) solitary kidney and underwent partial nephrectomy. Each renal unit was assigned a R.E.N.A.L. nephrometry score using preoperative imaging. The CKD-EPI equation was applied to calculate the estimated glomerular filtration rate. The difference between the estimated glomerular filtration rate at baseline and at postoperative time points served as a measurement of the renal functional loss attributable to partial nephrectomy. In the 42 patients who underwent partial nephrectomy the mean preoperative estimated glomerular filtration rate was 61.5 ml/minute/1.73 m . The median total nephrometry score was 8 (range 4 to 10). In the immediate postoperative period the cohort mean estimated glomerular filtration rate of 48.6 ml/minute/1.73 m was significantly less than the preoperative value (p 〈0.0001). At 6-month followup the mean estimated glomerular filtration rate had recovered at 54.1 ml/minute/1.73 m but it remained significantly less than the preoperative value (p = 0.0002). We noted no relationship between the postoperative decrease in the estimated glomerular filtration rate and the assigned total nephrometry score or in any individual component of the R.E.N.A.L. scoring system related to the targeted lesion. Neither the individual components of the R.E.N.A.L. nephrometry scoring system nor the total nephrometry score predicted the realized functional loss, as assessed by the estimated glomerular filtration rate in patients with a solitary kidney treated with nephron sparing surgery. However, nephron sparing surgery was quite efficacious for preserving renal function since only a durable 11.6% decrease was noted in the estimated glomerular filtration rate.
    Keywords: Kidney ; Nephrectomy ; Glomerular Filtration Rate ; Kidney Function Tests ; Prognosis ; Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 9
    In: BJU International, December 2012, Vol.110(11b), pp.E470-E474
    Keywords: Renal Cell Carcinoma ; Ivc Thrombus ; Body Mass Index ; Overall Survival ; Prognostic Factors
    ISSN: 1464-4096
    E-ISSN: 1464-410X
    Source: John Wiley & Sons, Inc.
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  • 10
    Language: English
    In: The Journal of Urology, April 2012, Vol.187(4), pp.e582-e582
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
    Source: ScienceDirect Journals (Elsevier)
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