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906 results on '"O. Traxer"'

1. Ureteroscopic laser treatment of upper tract transitional cell carcinoma

Author

A. Sierra, M. Corrales, and O. Traxer

Subjects
UTUC, KST, fURS, TFL, TCC, Surgery, RD1-811, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Objective: The improvement of flexible ureteroscopy, thanks to devices’ miniaturization and new armamentarium, has contribute to the development of endoscopic treatment for upper tract urothelial carcinoma (UTUC). UTUC laser treatment can also be offered to a subgroup of patients currently considered high risk. This video offers tips on how to perform kidney-sparing treatment (KST) at this group. Patients and surgical procedure: 79-year-old man with history of UTUC. Prior left nephroureterectomy for a 3cm inferior ureteral tumor in 2007 (AP T1AG). Annual recurrence of non-invasive bladder carcinoma during the follow-up. In 2019 a 1 cm low-grade UTUC was diagnosed, treated endoscopically. Referred to our hospital for a 3 cm recurrence in less than one year without metastasis and negative cytology. Results: The patient underwent conservative treatment for UTUC. The flex-XC1 (Karl Storz, Tuttlingen, Germany) and Thulium fiber laser (TFL) (Fiber Dust, Quanta System Samarate, Lombardia, Italy) with a 200µm fiber were used. Energy pulse and frequency pulse were 1J and 10 Hz, respectively. Total energy used was 12 KJ. There were no intraoperative complications with complete tumor resection, after 45 min. 24 hours hospital stay. A second look was planned 4 weeks later. After 3- and 6-months follow-up a diagnostic flexible ureteroscopy (fURS) was performed without any lesion. Conclusion: In low-grade patients with non-invasive UTUC, KST with TFL appears to be the best option without compromising the oncological results nor the kidney function. In select patients with an imperative indication, KST can be considered, however a stringent follow-up after the intervention is the key element to success.

Published
2022
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37. Ureteral Wall Injury with Ureteral Access Sheaths: A Randomized Prospective Trial

Author

Manoj Monga, Vishnuvardhan Ganesan, O. Traxer, Christopher J. Loftus, Sri Sivalingam, Mark Noble, Nicolas Muruve, and Jesse D. Schold

Subjects
Male, Urologic Diseases, medicine.medical_specialty, Urology, 030232 urology & nephrology, urologic and male genital diseases, Collection system, law.invention, Kidney Calculi, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Ureteral injury, Ureteroscopy, Humans, Medicine, Prospective Studies, urogenital system, business.industry, Ureteral wall, female genital diseases and pregnancy complications, Surgery, surgical procedures, operative, Prospective trial, 030220 oncology & carcinogenesis, Ureter, business
Abstract

Objective: To compare two commercially available ureteral access sheaths in their ability to access the renal collecting system and assess ureteral wall trauma using a prospective, randomized trial...

Published
2020

41. Role of pre-operative ureteral stent on outcomes of retrograde intra-renal surgery (RIRS): systematic review and meta-analysis of 3831 patients and comparison of Asian and non-Asian cohorts

Author

Y X T, Law, J Y C, Teoh, D, Castellani, E J, Lim, E O T, Chan, M, Wroclawski, G M, Pirola, C, Giulioni, E, Rubilotta, M, Gubbioti, S, Scarcella, B H, Chew, O, Traxer, B K, Somani, and V, Gauhar

Subjects
Kidney Calculi, Treatment Outcome, Humans, Stents, Prospective Studies, Ureter, Retrospective Studies
Abstract

To evaluate the outcomes of pre-stented (PS) versus non-pre-stented (NPS) patients who have undergone retrograde intrarenal surgery (RIRS) for renal calculi with subgroup analysis of Asian and non-Asian cohorts.Protocol is registered in PROSPERO, CRD42021261123. Eligible studies identified from four electronic databases. Meta-analysis was done to enumerate the outcomes of RIRS in between PS and NPS. Secondary sub-analysis was done to look for differences in outcomes in Asian and non-Asian cohorts.Fourteen studies involving 3831 patients (4 prospective, 10 retrospective studies) were included. PS patients experienced higher success rates of ureteral access sheath (UAS) insertion than NPS (RR 1.09, 95% CI 1.05-1.13, p 0.00001). PS patients had lower risk of ureteral injuries from UAS placement (RR 0.69, 95% CI 0.50-0.96, p = 0.03). No significant differences in intra- and postoperative complications between two groups were found. Stone-free rate (SFR) outcomes for residual fragment (RF) cut-off of 1 mm and 4 mm favoured the PS patients (RR 1.10, 95% CI 1.04-1.17, p = 0.002 for 4 mm, RR1.10, 95% CI 1.02-1.19, p = 0.02 for 1 mm). In the subgroup analysis, PS Asian patients had similar SFR as NPS patients for SFR( 4 mm) but non-Asian population showed better outcomes in the PS patients for SFR( 4 mm) (RR 1.31, 95% CI 1.13-1.52, p = 0.0005).This meta-analysis suggests that pre-stenting results in a higher success for UAS placement, minimising intraoperative ureteric injury, with higher overall SFR for any RF cut-off in PS cohorts. In non-Asian cohort, significant differences occurred at SFR 4 mm but not for SFR 1 mm. No difference was seen in our Asian cohort for any SFR cut-off in both PS and NPS patients.

Published
2021

42. [Guidelines from the cancer (CC-AFU) and infection disease (CI-AFU) committees of the French Association of Urology for the management of adverse events and complications of BCG]

Author

F, Audenet, A, Sotto, M, Roumiguié, Y, Allory, C, Andrejak, P, Leon, Y, Loriot, A, Masson-Lecomte, B, Pradère, T, Seisen, O, Traxer, E, Xylinas, F, Bruyère, M, Roupret, F, Saint, and Y, Neuzillet

Subjects
Administration, Intravesical, Adjuvants, Immunologic, Urinary Bladder Neoplasms, Urology, BCG Vaccine, Humans
Abstract

Intravesical instillations of BCG are recommended for the treatment of high-risk non-muscle-invasive bladder cancer. However, their prolonged use remains limited by the associated potentially serious adverse effects or complications. The purpose of this article was to provide updated recommendations for the diagnosis and management of adverse events (AEs) or complications of intravesical BCG instillations.Review of the literature in Medline (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using the following MeSH keywords or a combination of these keywords: "bladder," "BCG," "complication," "toxicity," "adverse events," "prevention," and "treatment".AEs or complications of BCG included genitourinary and systemic symptoms. The most common complications (cystitis, moderate fever) should be treated symptomatically and may require adjustment to allow patients to have the most complete BCG treatment possible. Serious complications are rare but must be identified promptly because of the life-threatening nature of the disease. Their management is based on the combination of anti-tuberculosis treatments, anti-inflammatory drugs and the definitive discontinuation of BCG.The management of BCG AEs requires early identification, rational and effective treatment if necessary, and discussion of the continuation of treatment for each situation.

Published
2021

43. [Guidelines from the cancer committee of the French Association of Urology (CC-AFU) for adequate intravesical instillations of Mitomycin C, Epirubicin, and BCG for non-muscle invasive bladder cancer]

Author

P, Leon, F, Saint, F, Audenet, M, Roumiguié, Y, Allory, Y, Loriot, A, Masson-Lecomte, B, Pradère, T, Seisen, O, Traxer, E, Xylinas, M, Roupret, and Y, Neuzillet

Subjects
Male, Administration, Intravesical, Antibiotics, Antineoplastic, Urinary Bladder Neoplasms, Mitomycin, Urology, BCG Vaccine, Humans, Female, Neoplasm Invasiveness, Epirubicin
Abstract

Intravesical instillations of mitomycin C, epirubicin and BCG are considered as the standard treatment for most patients diagnosed with non-muscle invasive bladder cancer. These guidelines aim to optimize the adjuvant intravesical treatment in order to increase the efficacy and lower the morbidity associated with its administration.We conducted a daily practice survey, an online search of available national regulation recommendations and of published guidelines. A bibliography search in French and English using Medline® and Embase® with the keywords "BCG"; "mitomycin C"; "epirubicin"; "bladder"; "complication"; "toxicity"; "adverse reaction"; "prevention" and "treatment" was performed November 2021.Patient information should be given by the attending physician before the first intravesical instillation. A medical exam to look for specific contraindications is also mandatory to select adequate candidates. Intravesical instillations should be delivered in health-care centers where urologic endoscopic procedures are routinely performed. Attending urologist or specialized nurse should check for negative pretreatment urine test. Intravesical instillation can only be delivered after bladder catheter has been inserted in the bladder without any injury of the lower urinary tract. The pharmaceutical agent should be kept in the bladder for two hours. Finally, voiding within the 6hours following intravesical instillations should be done in the sitting position and the patient should drink at least 2 liters of water per day for 2 days.The delivery of intravesical instillations of mitomycin C, epirubicin and BCG should follow a standardized procedure for better efficacy and lower morbidity.

Published
2021

44. MP18-12 THE USE OF URETERAL ACCESS SHEATH DOES NOT REDUCE THE RATE OF INFECTIOUS COMPLICATIONS AFTER FLEXIBLE URETEROSCOPY AND Ho:YAG LASER LITHOTRIPSY FOR RENAL STONES

Author

Guido Giusti, Silvia Proietti, Eugenio Ventimiglia, O. Traxer, Costantino Abbate, Alberto Briganti, Luca Villa, Andrea Salonia, and F. Montorsi

Subjects
medicine.medical_specialty, business.industry, Urology, medicine.medical_treatment, medicine, Flexible ureteroscopy, Lithotripsy, business, Ho yag laser
Published
2021

45. Endoscopic stone recognition: Is the diagnostic accuracy rock-solid or rock-bottom?

Author

M.M.E.L. Henderickx, S.J.M. Stoots, D.M. De Bruin, H. Wijkstra, J.E. Freund, A. Ploumidis, A. Skolarikos, B.K. Somani, T.E. Şener, E. Emiliani, L.B. Dragos, O.J. Wiseman, L. Villa, M. Talso, M. Daudon, O. Traxer, S. Doizi, P. Kronenberg, T. Tailly, T. Tefik, H.P. Beerlage, J. Baard, and G.M. Kamphuis

Subjects
Urology
Published
2022

48. Comparison of irrigation flows between different irrigation methods for flexible ureteroscopy: An in vitro study

Author

D. Grinholtz, H. Kamkoum, C. Capretti, O. Traxer, and S. Doizi

Subjects
Urology, Ureteroscopes, Ureteroscopy, Humans, Equipment Design, Therapeutic Irrigation
Abstract

To compare the irrigation flows between different irrigation methods for f-URS.We compared the automatic irrigation system Endoflow II to gravity-based irrigation, and gravity-based irrigation with pressure cuff. Irrigation pressures were set at 40 and 100cmHIrrigations flows remained constant over the time for the Endoflow II and the gravity-based irrigation methods regardless of the irrigation pressure and setting. For the pressure cuff method, the irrigation flow remained constant only when the working channel was occupied either by the nitinol basket or the laser fiber. Irrigation flow with the Endoflow II were constantly higher than gravity-based irrigation methods. Irrigation flow significantly increased with increased irrigation pressure. In the presence of any instruments at any irrigation pressure, the flow decreased as the size of the instrument in the working channel increased.Automatic irrigation system Endoflow II provided higher irrigation flows than gravity-based irrigation methods. The irrigation flow decreased as the size of the instrument in the working channel increased. Further studies conducted in vivo are needed to investigate if the differences found between irrigation methods result in higher intrarenal pressure during procedures.4.

Published
2021

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