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Ambrosini F, Mantica G, Marchi G, Vecchio E, Col B, Gaia Genova L, Trani G, Ferrari A, Terrone C. Impact of Assistant Experience on Perioperative Outcomes of Simple and Radical Laparoscopic Nephrectomy: Does It Really Matter? Medicina (Kaunas) 2023; 60:45. [PMID: 38256306 PMCID: PMC10820043 DOI: 10.3390/medicina60010045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 12/14/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024]
Abstract
Background and Objectives: While systematic reviews highlight the advantages of laparoscopic nephrectomy over traditional open surgery, the impact of an assistant's experience on surgical outcomes remains unclear. This study aims to evaluate whether the level of assistant expertise influences laparoscopic nephrectomy outcomes. Materials and Methods: Retrospective data from our institutional database were analyzed for patients who underwent laparoscopic nephrectomy between January 2018 and December 2022. Procedures were performed by a highly experienced surgeon, including postgraduate year (PGY)-3 to PGY-5 residents as assistants. Senior-level assistants had completed at least 10 procedures. Patient characteristics, surgical outcomes, and postoperative details were collected. Multivariable linear and logistic regression models were performed to test the effect of assistant experience (low vs. high) on estimated blood loss (EBL), length of stay (LOS), operative time (OT), and postoperative complications. Results: 105 patients were included, where 53% had highly experienced assistants and 47% had less experienced ones. Low assistant experience and higher BMI predicted longer operative time (OT), confirmed by multivariable regression (β = 40.5, confidence interval [CI] 18.7-62.3, p < 0.001). Assistant experience did not significantly affect EBL or LOS after adjusting for covariates (β = -14.2, CI -91.8-63.3, p = 0.7 and β = -0.83, CI -2.7-1.02, p = 0.4, respectively). There was no correlation between assistant experience and postoperative complications. Conclusions: Assistant experience does not significantly impact complications, EBL, and LOS in laparoscopic nephrectomy. Surgeries with less experienced assistants had longer OT, but the overall clinical impact seems limited. Trainee involvement remains safe, guided by experienced surgeons.
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Affiliation(s)
- Francesca Ambrosini
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (F.A.); (G.M.); (E.V.); (B.C.); (L.G.G.); (G.T.); (A.F.); (C.T.)
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16131 Genova, Italy
| | - Guglielmo Mantica
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (F.A.); (G.M.); (E.V.); (B.C.); (L.G.G.); (G.T.); (A.F.); (C.T.)
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16131 Genova, Italy
| | - Giovanni Marchi
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (F.A.); (G.M.); (E.V.); (B.C.); (L.G.G.); (G.T.); (A.F.); (C.T.)
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16131 Genova, Italy
| | - Enrico Vecchio
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (F.A.); (G.M.); (E.V.); (B.C.); (L.G.G.); (G.T.); (A.F.); (C.T.)
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16131 Genova, Italy
| | - Benedetta Col
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (F.A.); (G.M.); (E.V.); (B.C.); (L.G.G.); (G.T.); (A.F.); (C.T.)
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16131 Genova, Italy
| | - Luca Gaia Genova
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (F.A.); (G.M.); (E.V.); (B.C.); (L.G.G.); (G.T.); (A.F.); (C.T.)
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16131 Genova, Italy
| | - Giorgia Trani
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (F.A.); (G.M.); (E.V.); (B.C.); (L.G.G.); (G.T.); (A.F.); (C.T.)
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16131 Genova, Italy
| | - Arianna Ferrari
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (F.A.); (G.M.); (E.V.); (B.C.); (L.G.G.); (G.T.); (A.F.); (C.T.)
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16131 Genova, Italy
| | - Carlo Terrone
- IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (F.A.); (G.M.); (E.V.); (B.C.); (L.G.G.); (G.T.); (A.F.); (C.T.)
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16131 Genova, Italy
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Olivero A, Tappero S, Maltzman O, Vecchio E, Granelli G, Secco S, Caviglia A, Bocciardi AM, Galfano A, Dell’Oglio P. Urinary Continence Recovery after Retzius-Sparing Robot Assisted Radical Prostatectomy and Adjuvant Radiation Therapy. Cancers (Basel) 2023; 15:4390. [PMID: 37686666 PMCID: PMC10486940 DOI: 10.3390/cancers15174390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/16/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) allows the preservation of the structures advocated to play a crucial role in the continence mechanism. This study aims to evaluate the association between adjuvant radiation therapy (aRT) and urinary continence (UC) recovery after RS-RARP. For the purpose of the current study, all patients submitted to RS-RARP for prostate cancer (PCa) at a single high-volume European institution between January 2010 and December 2021 were identified. Only patients that harbored pT2 stage with positive surgical margins or pT3/pN1 stage with or without positive surgical margins were included in the analyses. Two groups of patients were identified as follows: patients who had undergone aRT and patients submitted to observation (no-aRT patients). As per definition, aRT was delivered within 1-6 months after surgery. After 1:1 propensity score matching, 124 aRT patients were compared with 124 no-aRT patients who continued standard follow-up protocol after surgery. UC recovery was 81 vs. 84% in aRT vs. no-aRT patients (p = 0.7). In multivariable Cox regression analyses, aRT did not reach the independent predictor status for UC recovery at 12 months. In the subgroup analysis including only aRT patients, only the nerve-sparing technique was independently associated with UC recovery at 12 months. Conversely, the type of aRT (IMRT/VMAT vs. 3D-CRT) did not reach the independent predictor status for UC recovery at 12 months. The current study is the first to address the association between aRT and UC recovery in patients treated with RS-RARP for PCa. Based on our data, aRT is not associated with worse UC recovery. In the cohort of patients treated with aRT, the nerve-sparing technique independently predicted UC recovery.
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Affiliation(s)
- Alberto Olivero
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.O.); (O.M.); (E.V.); (G.G.); (S.S.); (A.C.); (A.M.B.); (A.G.); (P.D.)
| | - Stefano Tappero
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.O.); (O.M.); (E.V.); (G.G.); (S.S.); (A.C.); (A.M.B.); (A.G.); (P.D.)
- IRCCS Ospedale Policlinico San Martino, University of Genova, 16131 Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16131 Genova, Italy
| | - Ofir Maltzman
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.O.); (O.M.); (E.V.); (G.G.); (S.S.); (A.C.); (A.M.B.); (A.G.); (P.D.)
| | - Enrico Vecchio
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.O.); (O.M.); (E.V.); (G.G.); (S.S.); (A.C.); (A.M.B.); (A.G.); (P.D.)
- IRCCS Ospedale Policlinico San Martino, University of Genova, 16131 Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16131 Genova, Italy
| | - Giorgia Granelli
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.O.); (O.M.); (E.V.); (G.G.); (S.S.); (A.C.); (A.M.B.); (A.G.); (P.D.)
- IRCCS Ospedale Policlinico San Martino, University of Genova, 16131 Genova, Italy
- Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, 16131 Genova, Italy
| | - Silvia Secco
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.O.); (O.M.); (E.V.); (G.G.); (S.S.); (A.C.); (A.M.B.); (A.G.); (P.D.)
| | - Alberto Caviglia
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.O.); (O.M.); (E.V.); (G.G.); (S.S.); (A.C.); (A.M.B.); (A.G.); (P.D.)
| | - Aldo Massimo Bocciardi
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.O.); (O.M.); (E.V.); (G.G.); (S.S.); (A.C.); (A.M.B.); (A.G.); (P.D.)
| | - Antonio Galfano
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.O.); (O.M.); (E.V.); (G.G.); (S.S.); (A.C.); (A.M.B.); (A.G.); (P.D.)
| | - Paolo Dell’Oglio
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy; (A.O.); (O.M.); (E.V.); (G.G.); (S.S.); (A.C.); (A.M.B.); (A.G.); (P.D.)
- Department of Urology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
- Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Rapenburg 70, 2311 EZ Leiden, The Netherlands
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Tappero S, Vecchio E, Palagonia E, Longoni M, Martiriggiano M, Granelli G, Olivero A, Secco S, Bocciardi AM, Galfano A, Dell'Oglio P. Retzius-sparing robot-assisted radical prostatectomy after previous trans-urethral resection of the prostate: Assessment of functional and oncological outcomes. Eur J Surg Oncol 2023; 49:1524-1535. [PMID: 37012110 DOI: 10.1016/j.ejso.2023.03.218] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/01/2023] [Accepted: 03/14/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND no data exist concerning functional and oncological outcomes of Retzius-sparing robot-assisted radical prostatectomy (RS-RARP), in patients previously treated with trans-urethral resection of the prostate (p-TURP), for benign prostate obstruction. Our study addressed the impact of p-TURP on immediate and 12-months urinary continence recovery (UCR), as well as peri-operative outcomes and surgical margins, after RS-RARP. METHODS all patients treated with RS-RARP for prostate cancer at a single high-volume European institution, between 2010 and 2021, were identified and stratified according to p-TURP status. Logistic, Poisson and Cox regression models were performed. RESULTS Of 1386 RS-RARP patients, 99 (7%) had history of p-TURP. Between p-TURP and no-TURP patients no differences were detected regarding both intra- and post-operative complications (p values = 0.9). The rates of immediate UCR were 40 vs 67% in p-TURP vs no-TURP patients (p < 0.001). At 12 months from RS-RARP, the rates of UCR were 68 vs 94% in p-TURP vs no-TURP patients (p < 0.001). At multivariable logistic and Cox regression models, p-TURP was independently associated, respectively, with lower immediate (odds ratio [OR]: 0.32, p < 0.001) and 12-months UCR (hazard ratio: 0.54, p < 0.001). At multivariable Poisson analyses, p-TURP predicted longer operative time (rate ratio: 1.08, p < 0.001) but not longer length of stay or time to catheter removal (p values > 0.05). Positive surgical margins rates were 23 vs 17% in p-TURP vs no-TURP patients (p = 0.1), which translated in a non-statistically significant multivariable OR of 1.14 (p = 0.6). CONCLUSIONS p-TURP does not increase surgical morbidity but portends longer operative time and worse urinary continence after RS-RARP.
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Affiliation(s)
- Stefano Tappero
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; Department of Urology, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy; Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy; Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.
| | - Enrico Vecchio
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; Department of Urology, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy; Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Erika Palagonia
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; Department of Urology, Ospedale San Donato, Arezzo, Italy
| | - Mattia Longoni
- Unit of Urology/Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Milan, Italy, Vita-Salute San Raffaele University, Milan, Italy
| | - Marco Martiriggiano
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; Department of Urology, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy; Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Giorgia Granelli
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; Department of Urology, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy; Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Alberto Olivero
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Silvia Secco
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Antonio Galfano
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Paolo Dell'Oglio
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy; Department of Urology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, the Netherlands; Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
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Dell’Oglio P, Tappero S, Vecchio E, Granelli G, Maltzman O, Olivero A, Secco S, Bocciardi A, Galfano A. Association between age at surgery and urinary continence recovery after Retzius-sparing robot-assisted radical prostatectomy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00537-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Anceschi U, Morelli M, Flammia RS, Brassetti A, Dell’Oglio P, Galfano A, Tappero S, Vecchio E, Martiriggiano M, Luciani LG, Sperduti I, Albisinni S, Tuderti G, Prata F, Ferriero MC, Bove AM, Mastroianni R, Spadaro G, Russo A, Mattevi D, Tufano A, Leonardo C, Lombardo R, De Nunzio C, Cai T, Quackels T, Bocciardi AM, Simone G. Predictors of trainees’ proficiency during the learning curve of robot-assisted radical prostatectomy at high-volume institutions: results from a multicentric series. Cent European J Urol 2023; 76:38-43. [PMID: 37064261 PMCID: PMC10091888 DOI: 10.5173/ceju.2023.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction The aim of this series was to evaluate predictors of Proficiency score (PS) achievement on a multicentric series of robot-assisted radical prostatectomies (RARP) performed by trainee surgeons with two different surgical techniques at four tertiary-care centers. Material and methods Four institutional datasets were merged and queried for RARPs performed by surgeons during their learning curve (LC) between 2010 and 2020 using two different approaches (Group A, Retzius-sparing RARP, n = 164; Group B, standard anterograde RARP, n = 79). Logistic regression analysis was performed to identify predictors of PS achievement for the overall trainee cohort. For all analyses, a two-sided p <0.05 was considered significant. Results Group B showed significantly increased median operative time, positive surgical margins (PSM) status, increased number of nerve-sparing procedures, shorter LC time (each p <0.04). PS, continence status, potency, biochemical recurrence and 1-year trifecta rates were comparable between groups (each p >0.3). On multivariable analysis, time from LC starting ≥12 months (OR = 2.79; 95%IC [1.15-6.76]; p = 0.02) and a nerve-sparing intent (OR = 3.18; 95%IC [1.15-8.77]; p = 0.02) were independent predictors of PS score achievement (Table 3). Conclusions Higher PS rates for RARP trainees may be expected after 12 months from LC beginning. Short-term training courses are unlikely to confer proper surgical training, while long-term structured training programs seem to be beneficial on perioperative outcomes.
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Affiliation(s)
- Umberto Anceschi
- IRCCS ‘Regina Elena’ National Cancer Institute, Department of Urology, Rome, Italy
| | - Michele Morelli
- Ospedale Niguarda Ca’ Granda, Department of Urology, Milan, Italy
| | - Rocco Simone Flammia
- Sapienza University of Rome, Urologic Clinic, Department of Maternal, Child and Urologic Sciences, Rome, Italy
| | - Aldo Brassetti
- IRCCS ‘Regina Elena’ National Cancer Institute, Department of Urology, Rome, Italy
| | - Paolo Dell’Oglio
- Ospedale Niguarda Ca’ Granda, Department of Urology, Milan, Italy
| | - Antonio Galfano
- Ospedale Niguarda Ca’ Granda, Department of Urology, Milan, Italy
| | - Stefano Tappero
- Ospedale Niguarda Ca’ Granda, Department of Urology, Milan, Italy
| | - Enrico Vecchio
- Ospedale Niguarda Ca’ Granda, Department of Urology, Milan, Italy
| | | | | | - Isabella Sperduti
- IRCCS Regina Elena National Cancer Institute, Biostatistical Unit, Rome, Italy
| | - Simone Albisinni
- University of Bruxelles, Erasme Hospital, Service de Urologie, Bruxelles, Belgium
| | - Gabriele Tuderti
- IRCCS ‘Regina Elena’ National Cancer Institute, Department of Urology, Rome, Italy
| | - Francesco Prata
- IRCCS ‘Regina Elena’ National Cancer Institute, Department of Urology, Rome, Italy
| | | | - Alfredo Maria Bove
- IRCCS ‘Regina Elena’ National Cancer Institute, Department of Urology, Rome, Italy
| | - Riccardo Mastroianni
- IRCCS ‘Regina Elena’ National Cancer Institute, Department of Urology, Rome, Italy
| | - Giuseppe Spadaro
- IRCCS ‘Regina Elena’ National Cancer Institute, Department of Urology, Rome, Italy
| | - Andrea Russo
- IRCCS Regina Elena National Cancer Institute, Department of Research, Advanced Diagnostics and Technological Innovation, Pathology Unit, Rome, Italy
| | - Daniele Mattevi
- APSS, Santa Chiara Regional Hospital, Department of Urology, Trento, Italy
| | - Antonio Tufano
- Sapienza University of Rome, Urologic Clinic, Department of Maternal, Child and Urologic Sciences, Rome, Italy
| | - Costantino Leonardo
- Sapienza University of Rome, Urologic Clinic, Department of Maternal, Child and Urologic Sciences, Rome, Italy
| | - Riccardo Lombardo
- Sant' Andrea Hospital, ‘Sapienza’ University, Department of Urology, Rome, Italy
| | - Cosimo De Nunzio
- Sant' Andrea Hospital, ‘Sapienza’ University, Department of Urology, Rome, Italy
| | - Tommaso Cai
- APSS, Santa Chiara Regional Hospital, Department of Urology, Trento, Italy
| | - Thierry Quackels
- University of Bruxelles, Erasme Hospital, Service de Urologie, Bruxelles, Belgium
| | | | - Giuseppe Simone
- IRCCS ‘Regina Elena’ National Cancer Institute, Department of Urology, Rome, Italy
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Tappero S, Dell'Oglio P, Longoni M, Buratto C, Palagonia E, Scilipoti P, Vecchio E, Martiriggiano M, Secco S, Olivero A, Barbieri M, Napoli G, Strada E, Petralia G, Di Trapani D, Bocciardi AM, Galfano A. Challenging cases in high-risk prostate cancer patients treated with Retzius-sparing robot-assisted radical prostatectomy. World J Urol 2022; 40:1993-1999. [PMID: 35771257 DOI: 10.1007/s00345-022-04073-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/07/2022] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE To evaluate the relationship between enlarged prostate, bulky median lobe (BML) or prior benign prostatic hyperplasia (BPH) surgery and perioperative functional, and oncological outcomes in high-risk (HR) prostate cancer (PCa) patients treated with Retzius-sparing robot-assisted radical prostatectomy (RS-RARP). METHODS 320 HR-PCa patients treated with RS-RARP between 2011 and 2020 at a single high-volume center. The relationship between prostate volume, BML, prior BPH surgery and perioperative outcomes, Clavien-Dindo (CD) grade ≥ 2 90-day postoperative complications, positive surgical margins (PSMs), and urinary continence (UC) recovery was evaluated respectively in multivariable linear, logistic and Cox regression models. Complications were collected according to the standardized methodology proposed by EAU guidelines. UC recovery was defined as the use of zero or one safety pad. RESULTS Overall, 5.9% and 5.6% had respectively a BML or prior BPH surgery. Median PV was 45 g (range: 14-300). The rate of focal and non-focal PSMs was 8.4% and 17.8%. 53% and 10.9% patients had immediate UC recovery and CD ≥ 2. The 1- and 2-yr UC recovery was 84 and 85%. PV (p = 0.03) and prior BPH surgery (p = 0.02) was associated with longer operative time. BML was independent predictor of time to bladder catheter removal (p = 0.001). PV was independent predictor of PSMs (OR: 1.02; p = 0.009). Prior BPH surgery was associated with lower UC recovery (HR: 0.5; p = 0.03). CONCLUSION HR-PCa patients with enlarged prostate have higher risk of PSMs, while patients with prior BPH surgery have suboptimal UC recovery. These findings should help physicians for accurate preoperative counseling and to improve surgical planning in case of HR-PCa patients with challenging features.
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Affiliation(s)
- Stefano Tappero
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. .,Department of Urology, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy. .,Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy.
| | - Paolo Dell'Oglio
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.,Department of Urology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands.,Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Mattia Longoni
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Carlo Buratto
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Erika Palagonia
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.,Division of Urology, School of Medicine, Department of Clinical, Special and Dental Sciences, University Hospital "Ospedali Riuniti", Marche Polytechnic University, Ancona, Italy
| | - Pietro Scilipoti
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Enrico Vecchio
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.,Department of Urology, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy.,Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Marco Martiriggiano
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.,Department of Urology, IRCCS Ospedale Policlinico San Martino, University of Genova, Genova, Italy.,Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy
| | - Silvia Secco
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Alberto Olivero
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Michele Barbieri
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Giancarlo Napoli
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Elena Strada
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Giovanni Petralia
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Dario Di Trapani
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Antonio Galfano
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
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Vecchio E, Golino G, Albano F, Pisano A, Iaccino E, Mimmi S, Fiume G, Scala G, Quinto I. PO-059 IBTK promotes B cell lymphomagenesis in Eμ-MYC transgenic mice conferring resistance to apoptosis. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Vecchio E, Baltos J, Qin C, Ritchie R, Christopoulos A, White P, May L. Novel Adenosine A2B Receptor Signalling in Cardiac Fibroblasts: Uncovering Context-Specific Biased Agonism. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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9
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Gentile E, Venutelli M, Ricci K, Vecchio E, Montemurno A, Delussi M, Balconi M, de Tommaso M. 90. Hemodynamic and EEG changes in patients with fibromyalgia. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2017.09.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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10
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de Tommaso M, Ricci K, Montemurno A, Vecchio E. Age-related changes in laser-evoked potentials following trigeminal and hand stimulation in healthy subjects. Eur J Pain 2017; 21:1087-1097. [DOI: 10.1002/ejp.1010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2016] [Indexed: 11/08/2022]
Affiliation(s)
- M. de Tommaso
- Department of Basic Medical Science; Neuroscience and Sensory System (SMBNOS); Neurophysiopathology of Pain Unit; University of Bari Aldo Moro; Bari Italy
| | - K. Ricci
- Department of Basic Medical Science; Neuroscience and Sensory System (SMBNOS); Neurophysiopathology of Pain Unit; University of Bari Aldo Moro; Bari Italy
| | - A. Montemurno
- Department of Basic Medical Science; Neuroscience and Sensory System (SMBNOS); Neurophysiopathology of Pain Unit; University of Bari Aldo Moro; Bari Italy
| | - E. Vecchio
- Department of Basic Medical Science; Neuroscience and Sensory System (SMBNOS); Neurophysiopathology of Pain Unit; University of Bari Aldo Moro; Bari Italy
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Vecchio E, Montemurno A, Ricci K, de Tommaso M. 38. Influence of age on laser-evoked potentials in normal subjects. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.10.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Mimmi S, Vecchio E, Iaccino E, Rossi M, Lupia A, Albano F, Chiurazzi F, Fiume G, Pisano A, Ceglia S, Pontoriero M, Golino G, Tassone P, Quinto I, Scala G, Palmieri C. Evidence of shared epitopic reactivity among independent B-cell clones in chronic lymphocytic leukemia patients. Leukemia 2016; 30:2419-2422. [PMID: 27568521 PMCID: PMC5155031 DOI: 10.1038/leu.2016.245] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S Mimmi
- Department of Experimental and Clinical Medicine, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - E Vecchio
- Department of Experimental and Clinical Medicine, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - E Iaccino
- Department of Experimental and Clinical Medicine, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - M Rossi
- Department of Experimental and Clinical Medicine, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - A Lupia
- Department of Experimental and Clinical Medicine, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - F Albano
- Department of Experimental and Clinical Medicine, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - F Chiurazzi
- Department of Clinical Medicine, University 'Federico II' of Naples, Naples, Italy
| | - G Fiume
- Department of Experimental and Clinical Medicine, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - A Pisano
- Department of Experimental and Clinical Medicine, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - S Ceglia
- Department of Experimental and Clinical Medicine, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - M Pontoriero
- Department of Experimental and Clinical Medicine, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - G Golino
- Department of Experimental and Clinical Medicine, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - P Tassone
- Department of Experimental and Clinical Medicine, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - I Quinto
- Department of Experimental and Clinical Medicine, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - G Scala
- Department of Experimental and Clinical Medicine, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
| | - C Palmieri
- Department of Experimental and Clinical Medicine, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy
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Vecchio E, Sciruicchio V, Ricci K, Montemurno A, Gentile F, Foschino Barbaro M, Simeoni M, Goffredo M, de Tommaso M. ID 424 – Laser evoked potentials habituation and central sensitization symptoms in childhood migraine. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Magis D, Baschi R, Sava S, Vecchio E, Schoenen J. EHMTI-0337. Visual evoked potential abnormalities in migraineurs: is there a correlation with alpha power and photic driving on the EEG? J Headache Pain 2014. [PMCID: PMC4182084 DOI: 10.1186/1129-2377-15-s1-e16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Baschi R, Vecchio E, Sava SL, De Pasqua V, Schoenen J, Magis D. EHMTI-0217. Neurophysiological study of tdcs effects in healthy volunteers. J Headache Pain 2014. [PMCID: PMC4182256 DOI: 10.1186/1129-2377-15-s1-e3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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de Tommaso M, Trotta G, Vecchio E, Marinazzo D, Stramaglia S. S59: Migraine with and without aura. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50058-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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17
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Zoccolella S, Vecchio E, Direnzo V, Luciannatelli E, Brancasi B, Bellomo R, Liguori M, Tortorella C. Concomitant myotonic dystrophy type 1, CIDP-like neuropathy and Hashimoto thyroiditis: a causal link? Eur J Neurol 2012; 19:e117-8. [DOI: 10.1111/j.1468-1331.2012.03820.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S. Zoccolella
- Department of Neurosciences and Organs of Sense; University of Bari; Bari Italy
| | - E. Vecchio
- Department of Neurosciences and Organs of Sense; University of Bari; Bari Italy
| | - V. Direnzo
- Department of Neurosciences and Organs of Sense; University of Bari; Bari Italy
| | - E. Luciannatelli
- Department of Neurosciences and Organs of Sense; University of Bari; Bari Italy
| | - B. Brancasi
- Department of Neurosciences and Organs of Sense; University of Bari; Bari Italy
| | - R. Bellomo
- Department of Neurosciences and Organs of Sense; University of Bari; Bari Italy
| | - M. Liguori
- National Research Council; Institute of Neurological Sciences; Mangone Italy
| | - C. Tortorella
- Department of Neurosciences and Organs of Sense; University of Bari; Bari Italy
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de Tommaso M, Vecchio E, Serpino C, Franco G, Farella I. S20.2 Placebo analgesia in migraine: a study by laser evoked potentials. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60156-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Abstract
Fibromyalgia syndrome (FMS) is a chronic pain condition of unknown aetiology characterized by diffuse pain and tenderness at tender points. The aim of the study was to assess the prevalence and clinical features of FMS in the different forms of primary headaches, in a tertiary headache centre. Primary headache patients (n = 217) were selected and submitted to the Total Tenderness Score, anxiety and depression scales, Migraine Disability Assessment, allodynia questionnaire, Short Form 36 Health Survey and the Medical Outcomes Study-Sleep Scale. In patients with FMS, the Multidimensional Assessment of Fatigue, the Pain Visual Analog Scale, the Manual Tender Point Survey and the Fibromyalgia Impact Questionnaire were employed. FMS was present in 36.4% of patients and prevailed significantly in tension-type headache and in patients with higher headache frequency. Headache frequency, pericranial muscle tenderness, anxiety and sleep inadequacy were especially associated with FMS comorbidity. In the FMS patients, fatigue and pain at tender points were significantly correlated with headache frequency. FMS seems increasingly prevalent with increased headache frequency, for the facilitation of central sensitization phenomena favoured by anxiety and sleep disturbances.
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Affiliation(s)
- M de Tommaso
- Neurological and Psychiatric Sciences Department, Neurophysiopathology of Pain Unit, University of Bari, Bari, Italy.
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de Tommaso M, Sardaro M, Vecchio E, Serpino C, Stasi M, Ranieri M. Central Sensitisation Phenomena in Primary Headaches: Overview of a Preventive Therapeutic Approach. CNSNDDT 2008; 7:524-35. [DOI: 10.2174/187152708787122932] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Morcaldi L, Caggiano G, Forte A, Buono G, D'Alvano L, Garofalo V, Mangione A, Ruggiero G, Tepedino G, Vecchio E. [Study on the relationship between adolescents and the media in the Salerno province]. Minerva Pediatr 2001; 53:476-7. [PMID: 11668277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- L Morcaldi
- Associazione Culturale, Pediatri di Base L'Arcobaleno, Palermo, Italy
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