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1. Étude de la qualité de vie des patients ayant un cancer de prostate localisé traité par HIFU

Author

Luc Cormier, Philippe Mangin, Benoit Feuillu, G. Boudrant, and D. Peiffert

Subjects
Gynecology, medicine.medical_specialty, Prostate cancer, Ultrasonic therapy, business.industry, Urology, medicine, Urination disorder, Cancer, Prostate disease, medicine.disease, business
Abstract

Resume But Le traitement du cancer de la prostate par ultrasons focalises de haute intensite (HIFU) est un traitement dit mini-invasif qui a en principe une faible morbidite. L’objectif de cette etude etait d’evaluer la qualite de vie des patients traites par HIFU. Patients et methode Cinquante patients consecutifs traites de premiere intention par HIFU pour cancer localise de la prostate entre 2003 et 2005 ont recu le questionnaire de qualite de vie « UCLA/RAND PCI » en preoperatoire et un an apres traitement. Les scores de qualite de vie postoperatoires ont ete compares aux scores preoperatoires et a une population test sans cancer de prostate. Resultats Quatre-vingt pour cent des patients ont repondu aux deux questionnaires. 72,5 % des patients etaient « satisfaits » ou « tres satisfaits », 2,5 % etaient « tres mecontents » et 25 % etaient sans opinion. Les scores de qualite de vie generale (SF-36) n’ont pas mis en evidence de differences significatives avant et apres traitement. Une alteration de la fonction et de la gene ressentie etait statistiquement significative sur le plan sexuel et urinaire. Pour la fonction digestive, il n’y avait pas de difference avant et apres traitement ; en revanche, il y avait une degradation statistiquement significative de la gene ressentie. Conclusion Le traitement HIFU du cancer de prostate est bien accepte par le patient, la qualite de vie est preservee a un an. Il y a une degradation significative de la fonction sexuelle et plus moderee de la fonction urinaire.

Published
2009

2. Evaluation du taux de PSA sérique des sujets en état de mort encéphalique de plus de 50 ans avant prélèvement d’organes : risque de transmission du cancer de prostate et don d’organes. Enquête des Comités de Transplantation et de Cancérologie de l’Association Française d’Urologie

Author

Laurent Salomon, Jacques Petit, Benoit Feuillu, Eric Lechevallier, Frederico Sallusto, and Pascal Eschwege

Subjects
Gynecology, Transplantation, medicine.medical_specialty, business.industry, Urology, medicine, Prostate disease, Organ donation, business
Abstract

Resume Un cancer chez un sujet en etat de mort encephalique est une contre-indication au prelevement d’organe. Il n’existe aucune donnee sur l’evaluation prostatique des sujets en etat de mort encephalique avant prelevement d’organes. L’objectif de travail a ete d’evaluer le depistage du cancer de prostate par dosage du taux de PSA serique chez les donneurs d’organe de plus de 50 ans. Methodes De fevrier a mai 2006, des dosages du taux de PSA serique ont ete realises chez tous les donneurs de sexe masculin dans 5 centres de prelevement differents. Ont ete egalement releves l’âge du donneur et la duree de sondage vesical. Resultats Sur les 85 prelevements realises, 30 (35,3%) concernaient des hommes âges de plus de 50 ans (moyeune : 60,4 ans, extremes 50-82 ans). La duree de sondage etait en moyenne de 3,l jours (extremes 0,522 jours). Le taux de PSA moyen etait de 8,7 nglml (extremes : 0,03 - 52,7) avec un rapport PSA libre/total de 31% (extremes 14-47). Douze donneurs avaient un taux de PSA superieur a 4 ng/ml (de 4,7 a 52 ngrlml), deux autres avaient un taux de PSA superieur a 2,s ngrlml (respectivement 2,77 et 3,3 a 72 et 57 ans). Il n’y avait pas de correlation entre l’âge des donneurs, leur taux de PSA et la duree de sondage. Conclusion L’âge des donneurs en etat de mort encephalique augmente et atteint les seuils d’âge ou l’Association Francaise d’urologie recommande le depistage du cancer de prostate par le toucher rectal et le dosage du taux de PSA. Si le risque de transmission d’un cancer de prostate apres transplantation est actuellement inconnu, il ce stade ou la majorite des cancers de prostate est decouverte devant une augmentation du taux de PSA avec un toucher rectal normal, le risque de transmission d’un cancer de prostate du donneur au receveur est minime voire inexistant. Il existe une grande variabilite des taux de PSA chez les donneurs en etat de mort encephalique de plus de 50 ans, ce qui ne permet pas d’identifier les donneurs a risque de cancer de prostate. Plus que le taux de PSA, ce sont les donnees du toucher rectal qui peuvent contre-indiquer un prelevement d’organe.

Published
2007

3. Laparoscopic computer-assisted pyeloplasty: the results of experimental surgery in pigs

Author

Philippe Mangin, J.P. Villemot, Jacques Hubert, Benoit Feuillu, Adrian Lobontiu, and M. Artis

Subjects
Laparoscopic surgery, medicine.medical_specialty, Pyeloplasty, Transperitoneal approach, medicine.diagnostic_test, business.industry, Urology, Open surgery, medicine.medical_treatment, Computer aid, Surgery, Endoscopy, Medicine, business, Experimental surgery, Laparoscopy
Abstract

OBJECTIVE To evaluate the experimental feasibility of laparoscopic computer-assisted pyeloplasty for pelvi-ureteric junction obstruction. MATERIALS AND METHODS Fourteen pyeloplasties were undertaken in pigs using a laparoscopic transperitoneal approach and the robotic surgical system (da Vinci, Intuitive Surgical Inc., Sunnyvale, CA, USA). RESULTS The robotic surgical system provides real-time three-dimensional stereoscopic vision. Manipulating the intracorporeal endo-wristed instruments from a remote console allows laparoscopic manoeuvres that are as easy as those during open surgery. Surgeons with no particular experience in laparoscopic surgery could learn complex surgery easily and quickly. CONCLUSION This technique provides faster training and the possibility of undertaking complex laparoscopic procedures, especially reconstructive, with less fatigue for the surgeon.

Published
2003

4. Renal cell carcinoma (RCC) in patients with end-stage renal disease exhibits many favourable clinical, pathologic, and outcome features compared with RCC in the general population

Author

Laurent Salomon, Lionel Badet, Georges Karam, Jacques Tostain, Pierre Bigot, Nathalie Rioux-Leclercq, Sébastien Barbet, Jean-Etienne Terrier, Bernard Escudier, Michel Soulié, Hicham Elkentaoui, Abdel-Rahmène Azzouzi, Fabrice Dugardin, Yann Neuzillet, Jean-Christophe Bernhard, Jacques Hubert, Aurélien Descazeaux, Karim Fehri, Nicolas Brichart, Philippe Paparel, J.M. Boutin, Laurent Guy, Baptiste Tisserand, Arnaud Mejean, Ismaël Galliot, Marc-Olivier Timsit, Laurence Bastien, Jérôme Rigaud, Antoine Valeri, Jacques Petit, Laurent Zini, Benoit Barrou, Christian Pfister, Xavier Tillou, Franck Bruyère, Fabien Saint, Herve Lang, Jean-Jacques Patard, Marie-Dominique Azemar, Denis Chautard, Julien Branchereau, Hervé Wallerand, Pascal Rischmann, Laura Poissonnier, Charles Deruelle, Lucille Martin, Laurence Albiges, Jacques Irani, Arnauld Villers, Thierry Lebret, Hervé Baumert, François Kleinclauss, Nicolas Terrier, Jean-Alexandre Long, Pierre-Etienne Theveniaud, M. Gigante, Frédéric Staerman, Jean-Marie Ferriere, Romain Mathieu, Morgan Rouprêt, F. Sallusto, Benoit Feuillu, Service d'urologie, Hôpital Foch [Suresnes], CHU Amiens-Picardie, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Grenoble-Hôpital Michallon, Service d'urologie-andrologie, CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] ( UJM ) -Hôpital nord, Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Hôpital Saint-Joseph, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy ( IGR ), CHU Strasbourg, Service d'anatomie et cytologie pathologiques [Rennes], Université d'Angers ( UA ) -CHU Angers, Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Institut Mondor de recherche biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Service d'urologie [Tours], Hôpital Bretonneau-CHRU Tours, Hôtel-Dieu, Service d'Urologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Hôpital Huriez-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service de Chirurgie urologique et andrologie [CHU Limoges], CHU Limoges, Service d'urologie et transplantation rénales [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Service de Néphrologie et Urologie, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Service d'urologie [Rouen], CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Université de Reims Champagne-Ardenne ( URCA ), Centre hospitalier universitaire de Poitiers ( CHU Poitiers ) -Hôpital La Milétrie, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -CHU Necker - Enfants Malades [AP-HP], Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], CHU Clermont-Ferrand-Hôpital Gabriel Montpied, Université de Brest ( UBO ) -Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, members of the Comité de Transplantation de l'Association Française d'Urologie, the Comité de Cancérologie de l'Association Française d'Urologie, Service d'urologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM)-Hôpital nord, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Institut Gustave Roussy (IGR), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Institut Mondor de recherche biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Bretonneau-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital Huriez-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'urologie et transplantation rénales [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Université de Reims Champagne-Ardenne (URCA), Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Hôpital La Milétrie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'anatomie et cytologie pathologiques [Rennes] = Anatomy and Cytopathology [Rennes], CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Service d'Urologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, De Villemeur, Hervé, CHU Saint-Etienne-Université Jean Monnet - Saint-Étienne (UJM)-Hôpital nord, Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)

Subjects
Male, [ SDV.MHEP.UN ] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Chi-Square Distribution, Time Factors, MESH : Retrospective Studies, 030232 urology & nephrology, MESH : Aged, Kaplan-Meier Estimate, MESH: Risk Assessment, urologic and male genital diseases, Gastroenterology, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Proportional Hazards Models, MESH : Carcinoma, Renal Cell, 0302 clinical medicine, Renal cell carcinoma, MESH: Risk Factors, Risk Factors, MESH : Female, MESH : Neoplasm Staging, MESH : Risk Assessment, MESH: Treatment Outcome, MESH: Aged, education.field_of_study, Univariate analysis, MESH: Middle Aged, MESH: Carcinoma, Renal Cell, MESH: Neoplasm Staging, Middle Aged, MESH : Adult, MESH : Survival Rate, MESH : Risk Factors, Kidney Neoplasms, 3. Good health, Survival Rate, Treatment Outcome, MESH: Kidney Failure, Chronic, 030220 oncology & carcinogenesis, Female, France, MESH : Time Factors, Adult, medicine.medical_specialty, MESH: Survival Rate, Urology, MESH : Male, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, Risk Assessment, MESH : Kidney Failure, Chronic, End stage renal disease, MESH : Kaplan-Meier Estimate, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, medicine, Humans, MESH : Middle Aged, education, MESH : France, Survival rate, Carcinoma, Renal Cell, MESH: Kaplan-Meier Estimate, Aged, Neoplasm Staging, Proportional Hazards Models, Retrospective Studies, MESH: Humans, Chi-Square Distribution, MESH : Chi-Square Distribution, business.industry, MESH: Time Factors, MESH : Humans, MESH: Adult, MESH: Retrospective Studies, medicine.disease, MESH : Proportional Hazards Models, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Male, MESH : Kidney Neoplasms, Surgery, Transplantation, MESH: France, Kidney Failure, Chronic, MESH: Kidney Neoplasms, business, Kidney cancer, MESH: Female, Kidney disease
Abstract

International audience; BACKGROUND: Patients with end-stage renal disease (ESRD) are at risk of developing renal tumours. OBJECTIVE: Compare clinical, pathologic, and outcome features of renal cell carcinomas (RCCs) in ESRD patients and in patients from the general population. DESIGN, SETTING, AND PARTICIPANTS: Twenty-four French university departments of urology participated in this retrospective study. INTERVENTION: All patients were treated according to current European Association of Urology guidelines. MEASUREMENTS: Age, sex, symptoms, tumour staging and grading, histologic subtype, and outcome were recorded in a unique database. Categoric and continuous variables were compared by using chi-square and student statistical analyses. Cancer-specific survival (CSS) was assessed by Kaplan-Meier and Cox methods. RESULTS AND LIMITATIONS: The study included 1250 RCC patients: 303 with ESRD and 947 from the general population. In the ESRD patients, age at diagnosis was younger (55 ± 12 yr vs 62 ± 12 yr); mean tumour size was smaller (3.7 ± 2.6 cm vs 7.3 ± 3.8 cm); asymptomatic (87% vs 44%), low-grade (68% vs 42%), and papillary tumours were more frequent (37% vs 7%); and poor performance status (PS; 24% vs 37%) and advanced T categories (≥ 3) were more rare (10% vs 42%). Consistently, nodal invasion (3% vs 12%) and distant metastases (2% vs 15%) occurred less frequently in ESRD patients. After a median follow-up of 33 mo (range: 1-299 mo), 13 ESRD patients (4.3%), and 261 general population patients (27.6%) had died from cancer. In univariate analysis, histologic subtype, symptoms at diagnosis, poor PS, advanced TNM stage, high Fuhrman grade, large tumour size, and non-ESRD diagnosis context were adverse predictors for survival. However, only PS, TNM stage, and Fuhrman grade remained independent CSS predictors in multivariate analysis. The limitation of this study is related to the retrospective design. CONCLUSIONS: RCC arising in native kidneys of ESRD patients seems to exhibit many favourable clinical, pathologic, and outcome features compared with those diagnosed in patients from the general population.

Published
2011

5. 2064 RENAL CELL CARCINOMAS ARISING IN NATIVE KIDNEYS OF DIALYZED AND TRANSPLANT PATIENTS: ARE THEY DIFFERENT ENTITIES?

Author

Nicolas Brichart, Laurent Guy, Yann Neuzillet, Baptiste Tisserand, Jean-Alexandre Long, M. Gigante, Hicham Elkentaoui, Georges Karam, Pierre-Etienne Theveniaud, Jacques Petit, Laurent Zini, Abdel-Rahmène Azzouzi, Arnaud Mejean, Aurélien Descazeaux, Jean-Marie Ferriere, Antoine Valeri, Hervé Lang, Laurence Bastien, Fabien Saint, Denis Chautard, Julien Branchereau, Bernard Escudier, Hervé Baumert, Thierry Lebret, Benoit Barrou, Morgan Rouprêt, Jacques Hubert, Jean-Michel Boutin, Pascal Rischmann, Nathalie Rioux-Leclercq, Lucille Martin, Romain Mathieu, Sébastien Barbet, Jérôme Rigaud, Jean-Michel Correas, Jean-Etienne Terrier, Benoit Feuillu, Christian Pfister, Xavier Tillou, Federico Sallusto, Jean-Jacques Patard, Hervé Wallerand, Fabrice Dugardin, Philippe Paparel, Karim Fehri, François Kleinclauss, Nicolas Terrier, Charles Deruelle, Jacques Irani, Arnauld Villers, Jacques Tostain, Franck Bruyère, Marc-Olivier Timsit, Ismaël Galliot, Michel Soulié, Frédéric Staerman, Laurent Salomon, Lionel Badet, Pierre Bigot, Marie-Dominique Azemar, and Laura Poissonnier

Subjects
Pathology, medicine.medical_specialty, medicine.anatomical_structure, business.industry, Urology, Cell, Medicine, Transplant patient, business
Published
2010

6. 505 CLINICO-PATHOLOGICAL AND OUTCOME FEATURES OF RENAL CELL CARCINOMAS IN PATIENTS WITH END STAGE RENAL DISEASE

Author

Bernard Escudier, Arnaud Mejean, Nicolas Brichart, Jean-Michel Boutin, Yann Neuzillet, Pierre-Etienne Theveniaud, Nathalie Rioux-Leclercq, Georges Karam, Marc-Olivier Timsit, Sébastien Barbet, Jean-Alexandre Long, Jean-Etienne Terrier, Jean-Michel Correas, Fabrice Dugardin, Philippe Paparel, Lucille Martin, M. Gigante, Hervé Baumert, Laurence Bastien, Benoit Feuillu, Laurent Guy, Federico Sallusto, Aurélien Descazeaux, Morgan Rouprêt, Christian Pfister, Xavier Tillou, Hervé Wallerand, Thierry Lebret, Jean-Jacques Patard, Benoit Barrou, Jacques Tostain, François Kleinclauss, Nicolas Terrier, Michel Soulié, Pascal Rischmann, Abdel-Rahmène Azzouzi, Jérôme Rigaud, Hicham Elkentaoui, Jean-Marie Ferriere, Antoine Valeri, Frédéric Staerman, Karim Fehri, Baptiste Tisserand, Jacques Petit, Laurent Zini, Charles Deruelle, Jacques Irani, Hervé Lang, Arnauld Villers, Denis Chautard, Julien Branchereau, Romain Mathieu, Jacques Hubert, Ismaël Galliot, Franck Bruyère, Marie-Dominique Azemar, Laura Poissonnier, Fabien Saint, Laurent Salomon, Lionel Badet, and Pierre Bigot

Subjects
medicine.medical_specialty, medicine.anatomical_structure, business.industry, Urology, Internal medicine, Cell, medicine, Clinico pathological, In patient, business, Gastroenterology, End stage renal disease
Published
2010

7. 2164 DE NOVO KIDNEY GRAFT TUMORS: RESULTS FROM A MULTICENTRIC RETROSPECTIVE NATIONAL STUDY

Author

Laurent Guy, Jean Michel Boutin, Bertrand Doré, Christophe Legendre, Xavier Tillou, Francois Kleinclaus, Maxime Audet, Thomas Perez, Jean Jacques Patard, Laurent Salomon, Georges Karam, Lionel Badet, Thierry Lebret, Benoit Barrou, Benoit Feuillu, Federico Sallusto, Julien Deturmeny, Jean Marie Ferriere, Ricardo Codas, Jean Philippe Rerolle, Pierre Bigot, Henri Bensadoun, Rodolphe Thuret, Marian Devonec, Jacques Dantal, Bernard Gattegno, Eric Lechevallier, Jacques Petit, Yann Neuzillet, Arnaud Doerfler, Damien Chambade, Nicolas Terrier, M. Gigante, Cédric Sénéchal, Gregory Verhoest, A. Erauso, Christiane Mousson, Emilie Berthoux, Fabrice Dugardin, and Ivan Bouzguenda

Subjects
Kidney, medicine.medical_specialty, business.industry, Urology, medicine.medical_treatment, Incidence (epidemiology), medicine.disease, Nephrectomy, Surgery, Transplantation, medicine.anatomical_structure, Cohort, medicine, Stage (cooking), business, Kidney transplantation, Dialysis
Abstract

De novo tumors in renal allografts are rare and their prevalence is underestimated. We therefore analyzed renal cell carcinomas arising in renal allografts through a retrospective French renal transplant cohort. We performed a retrospective, multicentric survey by sending questionnaires to all French kidney transplantation centers. All graft tumors diagnosed after transplantation were considered as de novo tumors. Thirty-two centers participated in this study. Seventy-nine tumors were identified among 41 806 recipients (Incidence 0.19%). Patients were 54 men and 25 women with a mean age of 47 years old at the time of diagnosis. Mean tumor size was 27.8 mm. Seventy-four (93.6%), 53 (67%) and 44 tumors (55.6%) were organ confined (T1-2), low grade (G1-2) and papillary carcinomas, respectively. Four patients died of renal cell carcinomas (5%). The mean time lapse between transplantation and RCC diagnosis was 131.7 months. Thirty-five patients underwent conservative surgery by partial nephrectomy (n = 35, 44.3%) or radiofrequency (n = 5; 6.3%). The estimated 5 years cancer specific survival rate was 94%. Most of these tumors were small and incidental. Most tumors were papillary carcinoma, low stage and low grade carcinomas. Conservative treatment has been preferred each time it was feasible in order to avoid a return to dialysis.

Published
2010

8. Initial experience with successful totally robotic laparoscopic cystoprostatectomy and ileal conduit construction in tetraplegic patients: report of two cases

Author

Benoit Feuillu, J.-M. Beis, Jacques Hubert, Mario F. Chammas, J.-M. André, Alain Coissard, Fan Cheng, and Stephane Larre

Subjects
Adult, Male, medicine.medical_specialty, Urology, medicine.medical_treatment, Urinary Diversion, Cystectomy, Quadriplegia, Severity of Illness Index, Cystoprostatectomy, medicine, Humans, Urinary Bladder, Neurogenic, Laparoscopy, Tetraplegia, Prostatectomy, Urinary bladder, medicine.diagnostic_test, business.industry, Urinary diversion, Follow up studies, Robotics, medicine.disease, Surgery, Endoscopy, surgical procedures, operative, medicine.anatomical_structure, Feasibility Studies, business, human activities, Follow-Up Studies
Abstract

To evaluate the feasibility and safety of totally robotic laparoscopic cystoprostatectomy for neurogenic bladder, with intracorporeal ileal-conduit urinary diversion in tetraplegic patients with severe neurogenic bladder complications.Two men, 41 and 38 years old, with complete post-traumatic C7-C8 quadriplegia and poor lower urinary-tract condition underwent totally transperitoneally performed cystoprostatectomy and ileal-conduit urinary diversion with robotic assistance (Da Vinci).The procedures were completed without open conversion. The total surgical time was 9.25 and 6.75 hours, respectively. There were no intraoperative complications. In the postoperative period, both patients had mild complications (pulmonary and urinary infections) that were treated successfully medically. The postoperative hospital stay was 13 days in both cases.Our results demonstrate the safety and feasibility of robot-assisted laparoscopic cystoprostatectomy with ileal-conduit urinary diversion in two tetraplegic patients.

Published
2006

9. Robot-assisted laparoscopic and open live-donor nephrectomy: a comparison of donor morbidity and early renal allograft outcomes

Author

Eric Mourey, Jacques Hubert, Michèle Kessler, Nicolas Billaut, Marc Ladrière, Benoit Feuillu, and E. Renoult

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Renal function, Nephrectomy, Postoperative Complications, medicine, Living Donors, Humans, Adverse effect, Intraoperative Complications, Retrospective Studies, Transplantation, Kidney, business.industry, Robotics, medicine.disease, Kidney Transplantation, Surgery, Venous thrombosis, medicine.anatomical_structure, Treatment Outcome, Nephrology, Tissue and Organ Harvesting, Female, Laparoscopy, Hemodialysis, business, Kidney disease
Abstract

Background. Robot-assisted laparoscopic donor (RALD) nephrectomy, a new procedure for the removal of a kidney from a living donor, was performed on 13 subjects at our centre. Methods. The immediate post-operative courses for these donors, and their respective recipients, were compared with those of 13 previous open live-donor nephrectomies (OPEN), performed in our facility. Results. We found no significant differences between these two donor groups with respect to age, gender, body mass index or renal vasculature. The average operative times and the warm ischaemia times were greater in the RALD group, 185.5 00 vs 113.4 00 (P ¼ 0.0001) and 7 0 15 00 vs 1 0 41 00 (P ¼ 0.0001), respectively. There was no conversion to the open procedure in the RALD group. The estimated blood loss was slight in both groups. Following nephrectomy, deep venous thrombosis occurred in one RALD patient and acute pyelonephritis in one OPEN patient. The average duration of hospitalization was shorter after the RALD procedure (5.84±1.8 days vs 9.69± 2.2 days, P ¼ 0.0001). The estimated creatinine clearance rate (eClcreat) was equivalent for all donors, at 5 days and 1 month after nephrectomy. All kidneys started functioning immediately after the transplantation. The mean recipient eClcreat (ml/min) was 58.16±26.7 for OPEN group kidneys and 62.23±17.59 for RALD group kidneys (P ¼ 0.65), 5 days after transplantation. Conclusions. RALD nephrectomies were associated with very low morbidity among donors, in which both the operative and warm ischaemia times were of longer duration, but had no observable adverse effects upon short-term graft function.

Published
2005

10. Focused ultrasound surgery on the kidney

Author

Jacques Schlosser, Francois Lacoste, Benoit Feuillu, Joelle Andre-Bougaran, and Guy Vallancien

Subjects
Pathology, medicine.medical_specialty, Kidney, Necrosis, business.industry, medicine.medical_treatment, Urinary system, Ultrasound, Histology, Extracorporeal, High-intensity focused ultrasound, medicine.anatomical_structure, medicine, medicine.symptom, business, Nuclear medicine, Preclinical imaging
Abstract

Introduction: High Intensity Focused Ultrasound (HIFU) is a minimally invasive therapy which can produce tissues necrosis in depth by a local thermal effect. Objectives: Evaluate the effect of extracorporeal HIFU with electronic scanning in the treatment of pig kidney. Material and method: The kidney of 12 pigs were treated in vivo under general anaesthesia by extracorporeal HIFU. The HIFU machine was a Pyrotech (Edap-Technomed ; France) modified with a fast electronic scanning of the focal point. Each ultrasonic pulse thus scans a square area of adjustable dimensions from 3x3 mm to 5x5 mm. An ultrasound probe inserted in the treatment head, allowed the localization of the target into the kidney. The volume treated in the kidney was 1.4 to 2.6 cm 3 . The delay between the ultrasound pulses were 40 to 60 s. The treatments duration varied between 9 to 16 min. The kidneys were removed 3 days after the HIFU treatment and analyzed in histology. Results: 7 kidneys had homogeneous necrotic lesions. The volume of the lesions corresponded to the treated volume. 3 kidneys had partial necrotic lesions, with non treated inclusions. In 2 kidneys, no lesions were found. Skin burns were observed on 2 pigs. Conclusion: Extracorporeal HIFU with electronic scanning can produce tissue necrosis into pig's kidneys. This treatment could be used in human as a non invasive therapy of small kidney's tumors less than 30 cm 3 of volume.

Published
1998

11. 415 COMPARISON OF RENAL CELL CARCINOMAS IN END STAGE RENAL DISEASE AND GENERAL POPULATION PATIENTS

Author

Franck Bruyère, Benoit Barrou, Abdel-Rahmène Azzouzi, Jean-Etienne Terrier, Jacques Petit, Laurent Zini, Yann Neuzillet, Denis Chautard, Pascal Rischmann, Julien Branchereau, Marc-Olivier Timsit, Pierre-Etienne Theveniaud, Romain Mathieu, Nicolas Brichart, Aurélien Descazeaux, S. Saint, Charles Deruelle, Jacques Irani, François Kleinclauss, Morgan Rouprêt, Nicolas Terrier, Jacques Hubert, Laurence Bastien, Fabrice Dugardin, Lucille Martin, Philippe Paparel, Michel Soulié, Hicham Elkentaoui, Arnauld Villers, J.M. Boutin, Christian Pfister, Xavier Tillou, Ismaël Galliot, Georges Karam, Jacques Tostain, Jean-Jacques Patard, J.M. Fernere, Marie-Dominique Azemar, Nathalie Rioux-Leclercq, Antoine Valeri, Sébastien Barbet, Bernard Escudier, Jean-Alexandre Long, Frédéric Staerman, Hervé Baumert, Hervé Wallerand, Thierry Lebret, Laura Poissonnier, M. Gigante, Arnaud Mejean, Laurent Salomon, Lionel Badet, Jean-Michel Correas, Pierre Bigot, Karim Fehri, Herve Lang, Benoit Feuillu, F. Sallusto, Laurent Guy, Baptiste Tisserand, and Jérôme Rigaud

Subjects
medicine.medical_specialty, education.field_of_study, medicine.anatomical_structure, business.industry, Urology, Population, Cell, medicine, business, education, End stage renal disease
Published
2010

17. V19 Robotic assisted laparoscopic dismembered pyeloplasty

Author

Clément-Claude Abbou, Jacques Hubert, Benoit Feuillu, Adrian Lobontiu, and Andras Hoznek

Subjects
medicine.medical_specialty, Pyeloplasty, business.industry, Robotic assisted, Urology, medicine.medical_treatment, medicine, business, Surgery
Published
2004

20. V12 Laparoscopic robotic-assisted (Da Vinci®) live-donor nephrectomy

Author

Philippe Mangin, L. Prevot, Benoit Feuillu, N. Billaut, Luc Frimat, M. Kesler, Jacques Hubert, Luc Cormier, and D. Hestin

Subjects
medicine.medical_specialty, Robotic assisted, business.industry, Urology, Medicine, Live donor nephrectomy, business, Surgery
Published
2004

21. Laparoscopic robotic-assisted ileal conduit urinary diversion in a quadriplegic woman

Author

Alain Coissard, Jacques Hubert, Philippe Mangin, J.-M. André, Benoit Feuillu, and J.-M. Beis

Subjects
medicine.medical_specialty, business.industry, Robotic assisted, Urology, medicine.medical_treatment, Urinary system, Urinary diversion, Less invasive, Robotics, Middle Aged, Urinary Diversion, Quadriplegia, Ileal conduit urinary diversion, Surgery, Cervical Vertebrae, medicine, Humans, Female, Laparoscopy, Robotic surgery, Urinary Bladder, Neurogenic, Technical skills, business, Spinal Cord Injuries, Invasive Procedure
Abstract

Urinary diversion is a therapeutic option in quadriplegic patients with poor lower urinary tract conditions, but it is an invasive procedure. Laparoscopic techniques are less invasive, but are technically demanding, and only a few surgical teams are able to complete such a complex procedure endoscopically. Robotics bring an unprecedented control of surgical instruments, shorten the learning curve, and allow open surgeons to apply more easily their technical skill to the laparoscopic approach. This complex case of laparoscopic ileal conduit in a quadriplegic woman was completed by our team with the Da Vinci system after 6 months of clinical experience in robotic surgery.

Published
2003

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