4 results on '"Koch, Michael"'
Search Results
2. Robot-Assisted Radical Prostatectomy in Patients with a History of Holmium Laser Enucleation of the Prostate: The Indiana University Experience.
- Author
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Abedali ZA, Calaway AC, Large T, Koch MO, Lingeman JE, and Boris RS
- Subjects
- Academic Medical Centers, Aged, Erectile Dysfunction, Holmium, Humans, Indiana, Lasers, Solid-State, Male, Margins of Excision, Middle Aged, Perioperative Period, Postoperative Period, Recovery of Function, Treatment Outcome, Universities, Urinary Bladder surgery, Laser Therapy, Prostatectomy methods, Prostatic Neoplasms surgery, Robotic Surgical Procedures
- Abstract
Introduction: We sought to update our experience of oncologic and functional outcomes of robot-assisted radical prostatectomy (RARP) for prostate cancer in patients with history of holmium laser enucleation of the prostate (HoLEP). Patients and Methods: Twenty-seven patients with previous HoLEP who underwent RARP were matched 1:1 with RARP patients with no history of transurethral surgery. Demographic, operative, oncologic, continence, and erectile function outcomes were analyzed. Results: Median time between HoLEP and RARP was 31 months with a mean prostate-specific antigen doubling time of 4.28 ng/mL/year. Operative times were significantly longer with higher bladder neck reconstruction rates and similarly low complication rates. Biochemical recurrence was relatively low (7%) in the HoLEP group, identical to the comparative group. Continence at last follow-up was not statistically significant between groups, although time to continence favored the non-HoLEP cohort. Erectile function recovery was generally poor in the post-HoLEP cohort (11%), although bilateral nerve sparing was rarely performed (11%). Compared with our initial experience, there were significant improvements in time to continence (16 vs 36 weeks). No T2 post-HoLEP RARP since 2010 has had a positive surgical margin. Conclusions: Post-HoLEP prostatectomy remains feasible with similar perioperative and oncologic outcomes compared with matched cohorts. Functional recovery remains slowed yet may continue to improve with technical familiarity.
- Published
- 2020
- Full Text
- View/download PDF
3. Nephrectomy for metastatic renal cell carcinoma: Indiana University experience.
- Author
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Mosharafa A, Koch M, Shalhav A, Gardner T, Logan T, Bihrle R, and Foster R
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma, Renal Cell surgery, Carcinoma, Renal Cell therapy, Cohort Studies, Combined Modality Therapy, Female, Follow-Up Studies, Hospitals, University statistics & numerical data, Humans, Immunotherapy, Indiana, Kidney Neoplasms therapy, Laparoscopy statistics & numerical data, Lung Neoplasms secondary, Lymph Node Excision, Male, Middle Aged, Neoplasm Invasiveness, Postoperative Complications, Retrospective Studies, Severity of Illness Index, Treatment Outcome, Carcinoma, Renal Cell secondary, Kidney Neoplasms surgery, Nephrectomy statistics & numerical data
- Abstract
Objectives: To report on the short-term morbidity of radical nephrectomy in 32 patients with poorer performance status and more advanced primary renal cell carcinoma (RCC). Nephrectomy followed by immunotherapy has been shown to improve survival in selected, good performance status patients with metastatic RCC., Methods: We report on 32 patients who underwent radical nephrectomy (20 open procedures and 12 laparoscopic) in the setting of metastatic RCC at Indiana University between 1999 and 2002. The study group included patients with advanced primary tumors (inferior vena cava involvement, large size, and involvement of adjacent structures). The patients' performance status score ranged from 0 to 2., Results: The average hospital stay was 5.1 days. No significant intraoperative complications were encountered, and postoperative complications occurred in 6 patients, including one perioperative death. At 4 weeks postoperatively, 21 (72.4%) of 29 assessable patients had a performance status equal to, or better than, their preoperative status, including 4 patients who converted from a preoperative performance status of 2 to 0 or 1 postoperatively. Eleven patients (34.4%) went on to receive postoperative immunotherapy., Conclusions: The results of our study demonstrated that radical nephrectomy in the setting of metastatic RCC has a low morbidity and acceptable recovery in these patients with advanced primary tumors and poorer performance status.
- Published
- 2003
- Full Text
- View/download PDF
4. Major complications in 213 laparoscopic nephrectomy cases: the Indianapolis experience.
- Author
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Siqueira TM Jr, Kuo RL, Gardner TA, Paterson RF, Stevens LH, Lingeman JE, Koch MO, and Shalhav AL
- Subjects
- Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Emergencies epidemiology, Female, Hospital Mortality, Hospitals, University statistics & numerical data, Humans, Indiana epidemiology, Intraoperative Complications etiology, Living Donors statistics & numerical data, Male, Middle Aged, Postoperative Complications etiology, Retrospective Studies, Risk Assessment, Intraoperative Complications epidemiology, Laparoscopy statistics & numerical data, Nephrectomy statistics & numerical data, Postoperative Complications epidemiology, Ureter surgery
- Abstract
Purpose: We assessed the incidence of and analyzed factors that may help prevent major complications and open conversion during laparoscopic nephrectomy at our institutions., Materials and Methods: We retrospectively analyzed all laparoscopic nephrectomies performed between August 1, 1999 and July 31, 2001. Data were stratified for nephrectomy type, intraoperative and postoperative complications. Conversion to open surgery was stratified for emergency versus elective procedures., Results: Of the 292 laparoscopic procedures performed at our institutions in 2 years 213 (73%) involved laparoscopic nephrectomy, including 84 live donor nephrectomies, 61 radical nephrectomies, 55 simple nephrectomies and 13 nephroureterectomies. A total of 16 major complications (7.5%) occurred, including access related, intraoperative and postoperative complications in 3, 9 and 4 cases, respectively. The conversion rate was 6.1% (13 patients), the transfusion rate was 1.9% and the mortality rate was 0.5% (1 death). Only 1 complication was related to simple laparoscopic nephrectomy, although this group showed the highest rate of elective conversion (7 of 8 elective conversions). Laparoscopic live donor nephrectomy showed the highest rate for emergency conversion (3 of 5 emergency conversions)., Conclusions: Our results reinforce the importance of thorough preoperative imaging, careful patient selection, surgeon experience and skill maintenance in laparoscopy as well as a low threshold for conversion to open surgery. This series provides additional evidence to support the evolution of laparoscopic nephrectomy into a standard of care.
- Published
- 2002
- Full Text
- View/download PDF
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