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Azhar RA, Rabah D, Alenizi AM, Alammari A, Alasker A, Alqahtani AA, Alsaikhan BH, Alyami FA, Alzahrani HM, Alothman KI, Moazin MS, Alhgbani M, Baghdadi M, Alotaibi MF. Saudi Urological Association consensus guidelines on the use of robotic surgery in urology. Urol Ann 2022; 14:199-204. [PMID: 36117790 PMCID: PMC9472305 DOI: 10.4103/ua.ua_46_22] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/01/2022] [Indexed: 11/21/2022] Open
Abstract
Over the past three decades, minimally invasive robotic technology has evolved substantially in urological practice, replacing many open procedures and becoming part of routine clinical practice. The Health Sector Transformation Program for the Kingdom's Vision 2030 aims to restructure the health sector and optimize its status and prospects as an effective and integrated ecosystem centered on the patient's health. Therefore, this consensus seeks to endorse the clinical practice guidelines for robotic surgery (RS) in the KSA, highlighting its effectiveness, safety, and favorable outcomes compared to open and laparoscopic surgeries in certain procedures when used by trained surgeons in well-structured RS programs.
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Affiliation(s)
- Raed A. Azhar
- Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia,Address for correspondence: Dr. Raed A. Azhar, Department of Urology, Faculty of Medicine, King Abdul-Aziz University, Jeddah, Saudi Arabia. E-mail:
| | - Danny Rabah
- Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Adel Alammari
- Department of Urology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Ahmed Alasker
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia,Department of Surgery, Division of Urology, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Ali A. Alqahtani
- Department of Urology, Aseer Central Hospital, Abha, Saudi Arabia
| | - Bader H. Alsaikhan
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia,Department of Surgery, Division of Urology, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Fahad A. Alyami
- Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hassan M. Alzahrani
- Department of Urology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Khalid I. Alothman
- Department of Urology, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
| | - Maher S. Moazin
- Department of Surgery, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mofarej Alhgbani
- Department of Surgery, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammed Baghdadi
- Department of Surgery, Division of Urology, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Mohammed F. Alotaibi
- Department of Urology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
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Alzahrani HM, Mahfouz AA, Farag S, Awadalla NJ, Melha AA, Almobarak M, Meri MH, Omair OM, Alqarni AS, Alqahtani FM. Patients' perceptions and preferences for physicians' attire in hospitals in south western Saudi Arabia. J Family Med Prim Care 2020; 9:3119-3123. [PMID: 32984183 PMCID: PMC7491852 DOI: 10.4103/jfmpc.jfmpc_166_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 03/13/2020] [Accepted: 04/06/2020] [Indexed: 11/04/2022] Open
Abstract
Purpose: Data regarding patients’ perception and satisfaction about physicians providing the medical care based on their attires in Southern Region of Saudi Arabia are scarce and even lacking. The aim of this study was to assess the patients’ opinion regarding the suitable attires of physicians. Materials and Methods: A descriptive cross-sectional survey was performed on a random sample of patients from Aseer Central Hospital, Southern Military Hospital and Abha Maternity Hospital. The questionnaire collected data on their perception of physicians’ attire as well as reflection of dress on trust and willingness to discuss personal issues. Results: The study included 248 patients. The majority (81.9%) of the participants agreed on the importance for physicians to wear their medical attires. Also 84.3% of them confirmed that physician's appearance is important source of their confidence. Skirt plus lab coat was the most favored for female physicians (39.3%). As for male physicians, scrub plus lab coat was the most preferred (33.6%) attire. Conclusion: Patients attending hospitals in southwestern Saudi Arabia preferred for their physicians to wear formal attire with white coats, rather than the Saudi national dress. Skirt plus lab coat was the most preferred for female physicians. As for male physicians, scrub plus lab coat was the most preferred attire. Patients approved the importance for physicians to wear their medical attires and confirmed that physician's appearance is important source for their confidence. The study recommends that physicians should adopt formal attire and the institutional dress code policy should be modified to fit these preferences.
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Affiliation(s)
- Hassan M Alzahrani
- Emergency Medicine, King Khalid University Medical City, Abha, Saudi Arabia
| | - Ahmed A Mahfouz
- Department of Family and Community Medicine, King Khalid University, Abha, Saudi Arabia.,High Institute of Public Health, Alexandria University, Alexandria Governorate, Egypt
| | - Shehata Farag
- Department of Family and Community Medicine, King Khalid University, Abha, Saudi Arabia.,High Institute of Public Health, Alexandria University, Alexandria Governorate, Egypt
| | - Nabil J Awadalla
- Department of Family and Community Medicine, King Khalid University, Abha, Saudi Arabia.,Department of Community Medicine, College of Medicine, Mansoura University, Dakahlia Governorate, Egypt
| | | | | | | | - Othman M Omair
- Emergency Medicine, Aseer Central Hospital, Abha, Saudi Arabia
| | - Afnan S Alqarni
- Medical Intern, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Fatma M Alqahtani
- Medical Intern, College of Medicine, King Khalid University, Abha, Saudi Arabia
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Alothman KI, Mehmood S, Alzahrani HM, Alotaibi MF, Alkhudair WK, Eldali AM. Surgical and oncological outcome after laparoscopic versus open nephroureterectomy for non-metastatic, upper-tract urothelial carcinoma. A single-centre experience. Saudi Med J 2020; 41:25-33. [PMID: 31915791 PMCID: PMC7001069 DOI: 10.15537/smj.2020.1.24780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objectives: We determined the surgical and oncological outcomes of laparoscopic nephroureterectomy (LNU) in comparison to open nephroureterectomy (ONU) and factors predicting bladder recurrence after nephroureterectomy. Methods: We retrospectively reviewed and compared the data of patients who underwent ONU or LNU for non-metastatic, upper-tract urothelial carcinoma from 2000 to 2016. The primary endpoint was to determine bladder cancer recurrence-free survival (BCRFS), cancer-specific survival (CSS), and overall survival (OS). The data were analysed using Student’s t-test, Chi-square test, and Kaplan-Meier curve. Results: Total of 50 patients, of which 24 had LNU and 26 had ONU, met the inclusion criteria. Median durations of follow-up were 4.2 and 6.5 years (p=0.1070) in LNU and ONU, respectively. Operative time, blood loss and hospital stay were significantly lower in the LNU group than in the ONU group (p=0.0001, p=0.0001, p=0.0018). Cancer-specific survival rate in the LNU was 75% and ONU was 73.3% (p=0.1902), whereas BCRFS and CSS were not significantly different in both groups (log-rank test; BCRFS: p=0.809 and CSS: p=0.802). Patients who underwent ureteroscopy with biopsy (p=0.001), had multifocality (p=0.001) and previous history of (H/O) bladder cancer (p=0.020) were at significant risk for developing bladder cancer recurrence after nephroureterectomy. Conclusion: Laparoscopic nephroureterectomy can benefit patients because of its minimal invasiveness, and oncologic outcomes are comparable to ONU. Preoperative ureteroscopy with biopsy, multifocality and previous H/O bladder cancer might be risk factors for bladder cancer recurrence.
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Affiliation(s)
- Khalid I Alothman
- Department of Urology, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Seyam RM, Alalawi MM, Alkhudair WK, Alzahrani HM, Azhar RA, Alothman KI, Al-Hussain TO, Alotaibi MF. Operative outcomes of robotic partial nephrectomy. A report of the first 101 cases from a single center in Saudi Arabia. Saudi Med J 2019; 40:33-40. [PMID: 30617378 PMCID: PMC6452606 DOI: 10.15537/smj.2019.1.22782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To report robotic partial nephrectomy (RPN) outcomes from a single tertiary hospital in Saudi Arabia. Methods: We retrospectively reviewed consecutive cases of patients undergoing RPN at King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia, between January 2008 and January 2018. The study reports patient's demographics, tumor characteristics, operative details, and perioperative outcomes, using descriptive statistics of median and range values. Results: One hundred and one patients underwent RPN during the study period. Average tumor size was 3 (1.3-6.4) cm and average radius exophytic nearness anterior/posterior location (RENAL) score was 6 (4-10). Perioperative parameters were blood loss 200 (5-1500) ml and warm ischemia time 17 (8-40) minutes, excluding off-clamp surgery in 12 (11.9%); operative time was 166 (66-381) minutes. Conversion to open partial nephrectomy occurred in 9 (8.9%) patients, major complications in 3 (3%) patients, positive surgical margins in 5 (5%) patients, and the hospital stay was 4 (2-14) days. A total of 73 (73%) patients achieved a trifecta of freedom from any complication, negative surgical margins, and ischemia time ≤25 minutes. Study limitations included the retrospective design and small cohort size. Conclusions: The initial experience of robotic partial nephrectomy was associated with a surgical outcome comparable to that reported by higher-volume centers.
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Affiliation(s)
- Raouf M Seyam
- Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Seyam R, Alzahrani HM, Alkhudair WK, Dababo MA, Al-Otaibi MF. Robotic partial cystectomy for lymphangioma of the urinary bladder in an adult woman. Can Urol Assoc J 2012; 6:E8-E10. [PMID: 22396382 DOI: 10.5489/cuaj.10103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Lymphangioma of the urinary bladder is a very rare tumour in adulthood. Robotic partial cystectomy is evolving for treatment of a limited number of bladder tumours. We describe a case of an adult woman with a bladder dome lymphangioma for which robotic partial cystectomy was carried out.
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Affiliation(s)
- Raouf Seyam
- Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh Saudi Arabia; and Professor of Urology, Faculty of Medicine, Suez Canal University, Ismailia Egypt
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Seyam RM, Bissada NK, Kattan SA, Mokhtar AA, Aslam M, Fahmy WE, Mourad WA, Binmahfouz AA, Alzahrani HM, Hanash KA. Changing trends in presentation, diagnosis and management of renal angiomyolipoma: comparison of sporadic and tuberous sclerosis complex-associated forms. Urology 2008; 72:1077-82. [PMID: 18805573 DOI: 10.1016/j.urology.2008.07.049] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2008] [Revised: 07/10/2008] [Accepted: 07/21/2008] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To evaluate the changing management of sporadic renal angiomyolipoma and renal angiomyolipoma associated with the tuberous sclerosis complex (TSC) during the past 16 years. METHODS We retrospectively reviewed the charts of 60 patients with angiomyolipoma seen at our institutions. RESULTS The median age at presentation was 45 years (range 7-78). The presentation was pain in 30 patients and hematuria in 13; it was incidentally discovered in 17 patients. Of the 60 patients, 43 were females. TSC was present in 14 patients. The median tumor size was 4 cm (range 0.3-40, mean 6.5 +/- 1.1). Of the 60 patients, 31 were followed up expectantly. Surgery or intervention was needed for 29 patients to control hemorrhage or relieve pain or because of the suspicion of malignancy. Of these 29 patients, 12 underwent nephrectomy, 11 partial nephrectomy, and 6 embolization. The patients treated for hemorrhage had a median tumor diameter of 11 cm (range 2-21). Patients were followed up for a mean of 39.3 +/- 5.4 months. The lesions grew an average of 4.7 +/- 3.4 cm for TSC tumors and 0.6 +/- 0.2 cm for sporadic angiomyolipoma tumors. None of the patients developed renal impairment. Patients with TSC presented at a younger age, had larger and bilateral lesions, and were more symptomatic during follow-up. In the past 6 years, a significant trend was seen toward finding tumors in asymptomatic patients and toward the use of conservative or interventional (embolization) treatment. CONCLUSIONS Renal angiomyolipoma has a slow growth rate. The preservation of renal function was noted in all our patients. A recent shift was noted toward finding smaller tumors in asymptomatic patients and the use of conservative and interventional treatment.
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Affiliation(s)
- Raouf M Seyam
- Department of Urology, Suez Canal University Faculty of Medicine, Ismailia, Egypt.
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