CUA 2018: Outcomes of Metastasectomy in Metastatic Renal Cell Carcinoma Patients: The Canadian Kidney Cancer Information System Experience
Halifax, Nova Scotia (UroToday.com) In common urological practices, it has been shown that over 25% of patients are diagnosed with metastasis at the time of renal cell carcinoma (RCC) diagnosis and up to 35% will eventually progress to metastasis after some time. There have been recent indications that state that surgical resection of these metastatic tumors can be integrated into the treatment plan with the possibility of slowed disease progression and increased survival. Sara Nazha, MD of McGill University determined to discover the efficacy of this treatment by conducting a multi-center retrospective study to assess the impact of metastasectomy in patients suffering from metastatic RCC (mRCC).
CUA 2018: Development of a Patient Decision Aid for Complex, Localized Renal Masses
Halifax, Nova Scotia (UroToday.com) One particularly challenging aspect of quality patient care is the allowance of the patient to make their own informed decisions regarding their care. The problem therein lies in the gap in understanding between the patient and physician’s perception of risk stratification. In particular, in regard to kidney cancer, the decision between radical versus partial nephrectomy remains a debated decision in urology for localized renal masses. Therefore, Dr. Kristen McAlpine and her team of urologists at the University of Ottawa attempted to develop a decision aid for patients with localized renal masses deciding on a proper surgical approach.
CUA 2018: Risk Factors for Deviation of Preoperative Planned Neurovascular Bundle Preservation During Robotic Radical Prostatectomy
Halifax, Nova Scotia (UroToday.com) Currently, with more than 85% of radical prostatectomies being performed robotically, robotic-assisted radical prostatectomy (RARP) has largely replaced the open and laparoscopic approaches and has become the standard of care surgical treatment option for localized prostate cancer in the United States. Accomplishing negative surgical margins while preserving functional outcomes of sexual function and continence play a significant role in determining the success of surgical intervention, particularly since the advent of nerve-sparing (NS) robotic prostatectomy.
CUA 2018: The Association Between Baseline Renal Function And Oncologic Outcomes After Radical Cystectomy
Halifax, Nova Scotia (UroToday.com) In recent literature, there has been speculation about the role of renal function in regard to cancer disease progression. According to some, decreased renal function has been identified as a potential risk factor in cancer recurrence and mortality due to malignancy. Though this was previously reviewed, there has not been a published account of whether decreased renal function is responsible for worsening outcomes among patients with urothelial carcinoma (UC). To expand on this issue, Ross Mason, MD, from the Mayo Clinic in Rochester, Minnesota attempted to examine the association between preoperative renal function and oncological outcomes after radical cystectomy (RC).
CUA 2018: Impact of Percutaneous Nephrolithotomy (PCNL) on Renal Function
Halifax, Nova Scotia (UroToday.com) Percutaneous nephrolithotomy (PCNL) remains the gold standard treatment for large kidney stones (>2cm). Patients with large and staghorn stones often experience renal functional deterioration due to chronic obstruction of the collecting system. Infectious stones with chronic pyelonephritis tend to even further decrease renal functional outcomes. When it comes to less invasive management of kidney stones, urologists nowadays have two or three options depending on the stone size and patients characteristics. PCNL is probably most invasive compared to ureteroscopy and shock wave lithotripsy.
CUA 2018: Incorporating Measures of Patient Safety into Technical Skill Assessments in Robotic Assisted Radical Prostatectomy
Halifax, Nova Scotia (UroToday.com) Recently, the emergence of surgical skill assessment has drastically influenced patient care within urological practice. However, common skill assessments have often focused on measuring technical ability alone, as intraoperative error and technical events have not been utilized in these evaluations. Alaina Garbens, MD, of the University of Toronto believed that these particular metrics may have predictive properties when evaluating surgical skills for robot-assisted radical prostatectomy (RARP). In this particular study, Dr. Garbens hoped to elucidate the urologic community on the distribution of errors and events in RARP, the association between performance scores and safety metrics, and the relationship between safety metrics and outcomes.
CUA 2018: Quantifying the “Assistant Effect” in Robotic-Assisted Radical Prostatectomy: Measures of Technical Performance
Halifax, Nova Scotia (UroToday.com) While robotic-assisted surgery provides improvements over open and laparoscopic surgeries and several other advantages, it imparts several technical challenges to the surgeon. Namely, this approach requires an additional assistant to complete the important technical steps of the procedure. Surgeon's learning curve with robotic surgery of the prostate and kidney has been extensively been evaluated and reported. However, the role of the assistant and his technical skills on a surgeon’s performance has never been studied.