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Brun A, Klein C, Capon G, Alezra E, Estrade V, Blanc P, Bernhard JC, Bladou F, Robert G. Switching from the transrectal to the transperineal route: A single center experience. Fr J Urol 2024; 34:102519. [PMID: 37777435 DOI: 10.1016/j.purol.2023.09.006] [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: 03/18/2023] [Revised: 08/14/2023] [Accepted: 09/07/2023] [Indexed: 10/02/2023]
Abstract
INTRODUCTION This study aimed to evaluate the feasibility of switching from transrectal to transperineal prostate biopsy (TPPBx) by urologists with no previous experience with TPPBx. Material A monocentric clinical study with exhaustive and consecutive inclusions was conducted between January and November 2021, including 105 consecutive patients who underwent TPPBx performed by two senior urologists with no previous experience of TPPBx (GR, FB). Biopsies were performed under local anesthesia (LA) without antibioprophylaxis. The main objective was to assess the safety of this procedure. Adverse events were classified according to the Clavien-Dindo score. The secondary objectives were to assess the level of pain experienced during the different steps of the procedure using a numerating rating scale (NRS), the rate of clinically significant prostate cancer (csPCa) detected, and the level of anxiety using the Hospital Anxiety and Depression Scale (HAD). RESULTS No major complications (Clavien-Dindo score≥3) were reported. One patient presented with acute urinary retention (1%) and a urinary tract infection (1%). Other adverse events were hematuria (43%), hemospermia (23%), rectal bleeding (1%), perineal hematoma (3%), persistent perineal pain (5%), and de novo erectile dysfunction (2%). The median level of pain on NRS for the procedure was 2.00 (IQ: 1.00-4.00); it was 3.00 (IQ: 2.00-5.00) during LA and 3.00 (IQ: 2.00-5.00) during punctions. In anxious patients (HAD score>10), the level of pain during the procedure was 2.5 (IQ: 2.00-3.00). Overall, csPCa was detected in 63%. CONCLUSION TPPBx under LA without antibioprophylaxis provides few complications, an acceptable pain threshold, and a satisfactorily rate of csPCa detection, even if performed by urologists with no previous experience of TPPBx. LEVEL OF EVIDENCE: 3
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Affiliation(s)
- A Brun
- Department of Urology, Bordeaux Pellegrin University Hospital, Bordeaux, France; University of Saint-Pierre, La Réunion, France.
| | - C Klein
- Department of Urology, Bordeaux Pellegrin University Hospital, Bordeaux, France; University of Bordeaux, Bordeaux, France.
| | - G Capon
- Department of Urology, Bordeaux Pellegrin University Hospital, Bordeaux, France; University of Bordeaux, Bordeaux, France.
| | - E Alezra
- Department of Urology, Bordeaux Pellegrin University Hospital, Bordeaux, France; University of Bordeaux, Bordeaux, France.
| | - V Estrade
- Department of Urology, Bordeaux Pellegrin University Hospital, Bordeaux, France; University of Bordeaux, Bordeaux, France.
| | - P Blanc
- Department of Urology, Bordeaux Pellegrin University Hospital, Bordeaux, France; University of Bordeaux, Bordeaux, France.
| | - J C Bernhard
- Department of Urology, Bordeaux Pellegrin University Hospital, Bordeaux, France; University of Bordeaux, Bordeaux, France.
| | - F Bladou
- Department of Urology, Bordeaux Pellegrin University Hospital, Bordeaux, France; University of Bordeaux, Bordeaux, France.
| | - G Robert
- Department of Urology, Bordeaux Pellegrin University Hospital, Bordeaux, France; University of Bordeaux, Bordeaux, France.
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Estrade V, Meria P, Almeras C. 2022 Recommendations of the AFU Lithiasis Committee: Combined approach for the management of kidney and ureteral stones (Endoscopic Combined IntraRenal Surgery, ECIRS). Prog Urol 2023; 33:871-874. [PMID: 37918986 DOI: 10.1016/j.purol.2023.08.009] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 11/04/2023]
Abstract
The primary objective of the combined approach is to limit the number of percutaneous access tracts for the treatment of staghorn, or complex kidney stones by simultaneous percutaneous antegrade and retrograde ureteroscopy. The other indication is the simultaneous presence of several kidney and ureteral stones or of an impacted pelvic stone. The combination of the two techniques may increase the stone-free rate and decrease the retreatment rate of complex stones compared with percutaneous nephrolithotomy alone. The patient is usually in the modified supine position. METHODOLOGY: These recommendations were developed using two methods: the Clinical Practice Recommendation (CPR) method and the ADAPTE method, depending on whether the question was considered in the European Association of Urology (EAU) recommendations (https://uroweb.org/guidelines/urolithiasis) [EAU Guidelines on urolithiasis. 2022] and their adaptability to the French context.
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Affiliation(s)
- V Estrade
- Department of Urology, Bordeaux Pellegrin University Hospital, Bordeaux, France
| | - P Meria
- Service d'Urologie, Hôpital Saint-Louis, AP-HP-Centre, Université Paris Cité, Paris, France
| | - C Almeras
- UroSud, Clinique La Croix du Sud, Quint-Fonsegrives, France.
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Oderda M, Amato A, de la Rosette J, Doizi S, Estrade V, Falcone M, Grey B, Knudsen B, Olsburgh J, Pietropaolo A, Rukin N, Sedigh O, Saeed A, Somani BK, Gontero P. The impact of single-use digital flexible cystoscope for double J removal on hospital costs and work organization: A multicentric evaluation. Urologia 2023; 90:670-677. [PMID: 37154464 DOI: 10.1177/03915603231172543] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
BACKGROUND Isiris-α® is a single-use digital flexible cystoscope with an integrated grasper designed for double J (DJ) stent removal. Aim of this study was to conduct a multicentric evaluation of the costs and criticalities of stent removals performed with Isiris®-α in different hospitals and health systems, as compared to other DJ removal procedures. METHODS After gathering 10 institutions worldwide with experience on Isiris-α®, we performed an analysis of the reported costs of DJ removal with Isiris-α®, as compared to the traditional reusable equipment used in each institution. The cost evaluation included instrument purchase, Endoscopic Room (EnR)/ Operatory Room (OR) occupancy, medical staff, instrument disposal, maintenance, repairs, decontamination or sterilization of reusable devices. RESULTS The main factor affecting the costs of the procedure was OR/EnR occupancy. Decontamination and sterilization accounted for a less important part of total costs. Isiris-α® was more profitable in institutions where DJ removal is usually performed in the EnR/OR, allowing to transfer the procedure to outpatient clinic, with a significant cost saving and EnR/OR time saving to be allocated to other activities. In the only institution where DJ removal was already performed in outpatient clinics, there is a slight cost difference in favor of reusable instruments in high-volume institutions, given a sufficient number to guarantee the turnover. CONCLUSION Isiris-α® leads to significant cost benefit in the institutions where DJ removal is routinely performed in EnR/OR, and brings significant improvement in organization, cost impact and turnover.
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Affiliation(s)
- Marco Oderda
- Dept. of Surgical Sciences, Division of Urology, Città della Salute e della Scienza di Torino - Molinette Hospital, University of Torino, Torino, Italy
| | - Antonio Amato
- Dept of Renal Transplantation, Civico Hospital, Palermo, Italy
| | | | - Steve Doizi
- Dept of Urology, Tenon Hospital, Paris, France
| | | | - Marco Falcone
- Dept. of Surgical Sciences, Division of Urology, Città della Salute e della Scienza di Torino - Molinette Hospital, University of Torino, Torino, Italy
| | - Ben Grey
- Dept of Urology, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Bodo Knudsen
- Dept of Urology, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | | | | | - Nick Rukin
- Dept of Urology, Redcliffe Hospital, Redcliffe, QLD, Australia
| | - Omidreza Sedigh
- Dept. of Surgical Sciences, Division of Urology, Città della Salute e della Scienza di Torino - Molinette Hospital, University of Torino, Torino, Italy
| | - Alhamri Saeed
- Dept. of Urology, Dept. of Surgery, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Bhaskar K Somani
- Dept of Urology, University Hospital Southampton, Southampton, UK
| | - Paolo Gontero
- Dept. of Surgical Sciences, Division of Urology, Città della Salute e della Scienza di Torino - Molinette Hospital, University of Torino, Torino, Italy
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Almeras C, Estrade V, Meria P. 2022 Recommendations of the AFU Lithiasis Committee: Endoscopic description of renal papillae and stones. Prog Urol 2023; 33:766-781. [PMID: 37918978 DOI: 10.1016/j.purol.2023.08.012] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 11/04/2023]
Abstract
Endoscopic observation is performed during treatments by flexible ureteroscopy to differentiate in situ between renal papillary abnormalities and stones based on their concordance with Daudon's morphological/composition descriptions adapted to endoscopy. These intraoperative visual analyses are now an integral part of the urinary stone disease diagnostic approach in addition to the morphological/structural and spectrophotometric analysis that remains the reference exam, but that loses information on the stone component representativeness due to the development of in situ laser lithotripsy. These are the first practical recommendations on the endoscopic description of renal papillae and stones. METHODOLOGY: These recommendations were developed using two methods: the Clinical Practice Recommendations (CPR) and the ADAPTE method, depending on whether the question was considered in the European Association of Urology (EAU) recommendations (https://uroweb.org/guidelines/urolithiasis [EAU Guidelines on urolithiasis. 2022]) and their adaptability to the French context.
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Affiliation(s)
- C Almeras
- UroSud, clinique La Croix du Sud, Quint-Fonsegrives, France.
| | - V Estrade
- Department of Urology, Bordeaux Pellegrin University Hospital, Bordeaux, France
| | - P Meria
- Service d'urologie, Hôpital Saint-Louis, AP-HP-Centre université Paris cité, Paris, France
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Daudon M, Haymann JP, Estrade V, Meria P, Almeras C. 2022 Recommendations of the AFU Lithiasis Committee: Epidemiology, stone analysis and composition. Prog Urol 2023; 33:737-765. [PMID: 37918977 DOI: 10.1016/j.purol.2023.08.013] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 11/04/2023]
Abstract
The incidence of urinary lithiasis is rising steadily in industrialized countries, and its prevalence in the general population of France is estimated at 10%. Renal colic accounts for 1-2% of emergency department consultations. At a time when the new LASER stone fragmentation techniques available to urologists will lead to ever finer in situ pulverization of stones, the exact identification of the compounds that form the stone is essential for etiological diagnosis. Constitutional analysis by infrared spectrophotometry or X-ray diffraction is therefore recommended, to be complemented by morphological typing of the calculi. METHODOLOGY: These recommendations have been drawn up using two methods: the Recommendation for Clinical Practice (RPC) method and the ADAPTE method, depending on whether or not the issue was considered in the EAU recommendations (https://uroweb.org/guidelines/urolithiasis) [EAU 2022] and their adaptability to the French context.
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Affiliation(s)
- M Daudon
- CRISTAL Laboratory, Tenon Hospital, SFBC, Paris, France; Inserm, UMRS 1155 UPMC, Tenon Hospital, Paris, France
| | - J-P Haymann
- Inserm, UMRS 1155 UPMC, Tenon Hospital, Paris, France; Service d'Explorations Fonctionnelles Multidisciplinaires, Tenon Hospital, SP, Paris, France
| | - V Estrade
- Department of Urology, CHU Pellegrin, Bordeaux, France
| | - P Meria
- Service d'Urologie, Hôpital Saint-Louis, AP-HP-Centre Université Paris Cité, Paris, France
| | - C Almeras
- UroSud, clinique La Croix du Sud, Quint-Fonsegrives, France.
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Boulenger de Hauteclocque A, Michiels C, Sarrazin J, Faessel M, Sabatier J, Khaddad A, Margue G, Grenier N, Bos F, Estrade V, Bernhard JC. Three Dimensional Printing Technology Used to Create a High-Fidelity Ureteroscopy Simulator: Development and Validity Assessment (Rein-3D-Print-UroCCR-39). Urology 2023; 176:36-41. [PMID: 36907468 DOI: 10.1016/j.urology.2023.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/21/2022] [Revised: 01/29/2023] [Accepted: 02/28/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVE To create and assess the validity of a high-fidelity, three dimensional (3D) printed, flexible ureteroscopy simulator resulting from a real case. METHODS A patient's CT scan was segmented to obtain a 3D model in .stl format, including the urinary bladder, ureter and renal cavities. The file was printed and a kidney stone was introduced into the cavities. The simulated surgery consisted of monobloc stone extraction. Nineteen participants split into 3 groups according to their level (6 medical students, 7 residents and 6 urology fellows) performed the procedure twice at a 1-month interval. They were rated according to a global score and a task-specific score, based on an anonymized, timed video recording. RESULTS Participants demonstrated a significant improvement between the 2 assessments, both on the global score (29.4 vs 21.9 points out of 35; P < .001) and the task-specific score (17.7 vs 14.7 points out of 20; P < .001) as well as procedure time (498.5 vs 700 seconds; P = .001). Medical students showed the greatest progress for the global score (+15.5 points (mean), P = .001) and the task-specific score (+6.5 points (mean), P < .001). 69.2% of participants considered the model as visually quite realistic or highly realistic and all of them judged it quite or extremely interesting for intern training purposes. CONCLUSION Our 3D printed ureteroscopy simulator was able to enhance the progress of medical students who are new to endoscopy, whilst being valid and reasonably priced. It could become part of a training program in urology, in line with the latest recommendations for surgical education.
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Affiliation(s)
| | - Clément Michiels
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Joffrey Sarrazin
- Department of Additive Fabrication Engineering, Bordeaux University Technological Institute, Gradignan, France
| | - Matthieu Faessel
- Department of Additive Fabrication Engineering, Bordeaux University Technological Institute, Gradignan, France
| | - Jocelyn Sabatier
- Department of Additive Fabrication Engineering, Bordeaux University Technological Institute, Gradignan, France
| | | | - Gaëlle Margue
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Nicolas Grenier
- Department of Radiology, Bordeaux University Hospital, Bordeaux, France
| | - Frédéric Bos
- Department of Additive Fabrication Engineering, Bordeaux University Technological Institute, Gradignan, France
| | - Vincent Estrade
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
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Bernhard JC, Robert G, Ricard S, Rogier J, Degryse C, Michiels C, Margue G, Blanc P, Alezra E, Estrade V, Capon G, Bladou F, Ferriere JM. Nurse-led coordinated surgical care pathways for cost optimization of robotic-assisted partial nephrectomy: medico-economic analysis of the UroCCR-25 AMBU-REIN study. World J Urol 2023; 41:325-333. [PMID: 35727334 DOI: 10.1007/s00345-022-04066-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 11/01/2021] [Accepted: 05/30/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE Robot-assisted partial nephrectomy (RAPN) reduces morbidity, enabling development of Enhanced Recovery After Surgery (ERAS) and day-case protocols. Additional financial costs limit its integration into clinical practice. We evaluated the medico-economic impact of RAPN using a nurse-led coordinated pathway of care (NLC-RAPN). METHODS All tumor RAPNs performed in 2017 were prospectively included in nurse-led protocols: NP-RAAC (ERAS) or Ambu-Rein (day case). Clinico-biological and pathological data were prospectively collected within the French Research Network for Kidney Cancer database (NCT03293563). Estimated costs were compared to "average" patients at the national level operated by open partial nephrectomy (OPN) or RAPN, using data from the 2017 French hospital discharge database and the national cost scale. RESULTS The NLC-RAPN cohort (n = 151) included 27 (18%) outpatients and the average hospital length of stay (LOS) was 2.4 days. In the national control cohorts for OPN (n = 2475) and RAPN (n = 3529), the average LOS were 8.0 and 5.2 days, respectively. The mean incomes per group were €7607 for NLC-RAPN, €9813 for OPN, and €8215 for RAPN. The mean daily cost of stay was €659 for NLC-RAPN, €838 for OPN, and €725 for RAPN. The overall cost for NLC-RAPN was €6594, €8733 for OPN, and €8763 for RAPN. The best operational margin was obtained for day-case NLC-RAPN (€1967). CONCLUSION Combining RAPN with nurse-led coordinated pathways of care led to a shorter hospital stay and reduced costs versus OPN. This may facilitate the economic sustainability of robotic assistance for hospitals where the extra cost is not covered by the healthcare system.
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Affiliation(s)
- Jean-Christophe Bernhard
- Department of Urology, Université de Bordeaux, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France.
- UroCCR, French Research Network On Kidney Cancer, Bordeaux, France.
| | - Grégoire Robert
- Department of Urology, Université de Bordeaux, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - Solène Ricard
- Department of Urology, Université de Bordeaux, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
- UroCCR, French Research Network On Kidney Cancer, Bordeaux, France
| | - Julien Rogier
- Department of Anesthesiology, Université de Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - Cécile Degryse
- Department of Anesthesiology, Université de Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - Clément Michiels
- Department of Urology, Université de Bordeaux, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - Gaëlle Margue
- Department of Urology, Université de Bordeaux, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - Peggy Blanc
- Department of Urology, Université de Bordeaux, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - Eric Alezra
- Department of Urology, Université de Bordeaux, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - Vincent Estrade
- Department of Urology, Université de Bordeaux, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - Grégoire Capon
- Department of Urology, Université de Bordeaux, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - Franck Bladou
- Department of Urology, Université de Bordeaux, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - Jean-Marie Ferriere
- Department of Urology, Université de Bordeaux, CHU de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France
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Michiels C, Khene ZE, Prudhomme T, Boulenger de Hauteclocque A, Cornelis FH, Percot M, Simeon H, Dupitout L, Bensadoun H, Capon G, Alezra E, Estrade V, Bladou F, Robert G, Ferriere JM, Grenier N, Doumerc N, Bensalah K, Bernhard JC. 3D-Image guided robotic-assisted partial nephrectomy: a multi-institutional propensity score-matched analysis (UroCCR study 51). World J Urol 2023; 41:303-313. [PMID: 33811291 DOI: 10.1007/s00345-021-03645-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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: 11/13/2020] [Accepted: 02/19/2021] [Indexed: 01/20/2023] Open
Abstract
PURPOSE Robot-assisted partial nephrectomy (RAPN) is a difficult procedure with risk of significant perioperative complications. The objective was to evaluate the impact of preoperative planning and intraoperative guidance with 3D model reconstructions on perioperative outcomes of RAPN. METHODS We conducted a retrospective analysis of all patients who underwent RAPN for kidney tumor by three high-volume expert surgeons from academic centers. Clinical data were collected prospectively after written consent into the French kidney cancer network database UroCCR (CNIL-DR 2013-206; NCT03293563). Our cohort was divided into two groups: 3D-Image guided RAPN group (3D-IGRAPN) and control group. A propensity score according to age, pre-operative renal function and RENAL tumor complexity score was used. Both surgical techniques were compared in terms of perioperative outcomes. RESULTS The initial study cohort included 230 3D-IGRAPN and 415 control RAPN. Before propensity-score matching, patients in the 3D-IGRAPN group had a larger tumor (4.3 cm vs. 3.5 cm, P < 0.001) and higher RENAL complexity score (9 vs. 8, P < 0.001). Following propensity-score matching, there were 157 patients in both groups. The rate of major complications was lower for patients in the 3D-IGRAPN group (3.8% vs. 9.5%, P = 0.04). The median percentage of eGFR variation recorded at first follow-up was lower in the 3D-IGRAPN group (- 5.6% vs. - 10.5%, P = 0.002). The trifecta achievement rate was higher in the 3D-IGRAPN group (55.7% vs. 45.1%; P = 0.005). CONCLUSION Three-dimensional kidney reconstructions use for pre-operative planning and intraoperative surgical guidance lowers the risk of complications and improve perioperative clinical outcomes of RAPN.
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Affiliation(s)
- Clément Michiels
- Department of Urology, Bordeaux University Hospital, Bordeaux, France.
| | | | - Thomas Prudhomme
- Department of Urology, Toulouse University Hospital, Toulouse, France
| | | | - François H Cornelis
- Department of Radiology, Bordeaux University Hospital, Bordeaux, France.,Department of Radiology, Tenon Hospital, APHP, Paris, France
| | - Mélanie Percot
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Hélène Simeon
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Laure Dupitout
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Henri Bensadoun
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Grégoire Capon
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Eric Alezra
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Vincent Estrade
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Franck Bladou
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Grégoire Robert
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | | | - Nicolas Grenier
- Department of Radiology, Bordeaux University Hospital, Bordeaux, France
| | - Nicolas Doumerc
- Department of Urology, Toulouse University Hospital, Toulouse, France
| | - Karim Bensalah
- Department of Urology, Rennes University Hospital, Rennes, France
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Brun A, Klein C, Capon G, Alezra E, Estrade V, Blanc P, Bernhard J, Bladou F, Robert G. Swich to transperineal prostate biopsies: A single-center experience. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00344-5] [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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Allenet C, Klein C, Rouget B, Margue G, Capon G, Alezra E, Blanc P, Estrade V, Bladou F, Robert G, Bernhard JC. Can Pre-Operative Neutrophil-to-Lymphocyte Ratio (NLR) Help Predict Non-Metastatic Renal Carcinoma Recurrence after Nephrectomy? (UroCCR-61 Study). Cancers (Basel) 2022; 14:cancers14225692. [PMID: 36428784 PMCID: PMC9688470 DOI: 10.3390/cancers14225692] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
Recent studies suggested that the neutrophil-to-lymphocyte ratio (NLR) could play a key role in tumor initiation, progression and response to treatments. The main objective was to assess the prognostic value of the pre-operative NLR on recurrence-free survival (RFS) in patients with non-hereditary localized renal cell carcinoma. From the UroCCR database (NCT03293563), factors influencing the disease recurrence of consecutive patients who underwent nephrectomy for cT1-T4 N0M0 were analyzed using multi-variate cox regression and log-rank methods. We included 786 patients, among which 135 (17.2%) experienced a recurrence at a median time of 23.7 [8.5-48.6] months. RFS for patients with a pre-operative NLR of <2.7 was 94% and 88% at 3 and 5 years, respectively, versus 76% and 63% for patients with a NLR of ≥2.7 (p < 0.001, log-rank test). To predict the risk of post-operative recurrence, the NLR was combined with the UCLA integrated staging system (UISS), and we defined four groups of the UroCCR-61 predictive model. The RFS rates at 3 and 5 years were 100% and 97% in the very-low-risk group, 93% and 86% in the low-risk group, 78% and 68% in the intermediate-risk group and 63% and 46% in the high-risk group (p < 0.0001). The pre-operative NLR seems to be an inexpensive and easily accessible prognostic bio-marker for non-metastatic RCCs.
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Affiliation(s)
- Clément Allenet
- Department of Urology, Bordeaux Pellegrin University Hospital,33000 Bordeaux, France
- Department of Health Sciences, University of Bordeaux, 33000 Bordeaux, France
| | - Clément Klein
- Department of Urology, Bordeaux Pellegrin University Hospital,33000 Bordeaux, France
- Department of Health Sciences, University of Bordeaux, 33000 Bordeaux, France
| | - Benjamin Rouget
- Department of Urology, Robert Boulin Hospital, 33500 Libourne, France
| | - Gaëlle Margue
- Department of Urology, Bordeaux Pellegrin University Hospital,33000 Bordeaux, France
- Department of Health Sciences, University of Bordeaux, 33000 Bordeaux, France
| | - Grégoire Capon
- Department of Urology, Bordeaux Pellegrin University Hospital,33000 Bordeaux, France
- Department of Health Sciences, University of Bordeaux, 33000 Bordeaux, France
| | - Eric Alezra
- Department of Urology, Bordeaux Pellegrin University Hospital,33000 Bordeaux, France
- Department of Health Sciences, University of Bordeaux, 33000 Bordeaux, France
| | - Peggy Blanc
- Department of Urology, Bordeaux Pellegrin University Hospital,33000 Bordeaux, France
- Department of Health Sciences, University of Bordeaux, 33000 Bordeaux, France
| | - Vincent Estrade
- Department of Urology, Bordeaux Pellegrin University Hospital,33000 Bordeaux, France
- Department of Health Sciences, University of Bordeaux, 33000 Bordeaux, France
| | - Franck Bladou
- Department of Urology, Bordeaux Pellegrin University Hospital,33000 Bordeaux, France
- Department of Health Sciences, University of Bordeaux, 33000 Bordeaux, France
| | - Grégoire Robert
- Department of Urology, Bordeaux Pellegrin University Hospital,33000 Bordeaux, France
- Department of Health Sciences, University of Bordeaux, 33000 Bordeaux, France
| | - Jean-Christophe Bernhard
- Department of Urology, Bordeaux Pellegrin University Hospital,33000 Bordeaux, France
- Department of Health Sciences, University of Bordeaux, 33000 Bordeaux, France
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Robert G, Bernhard JC, Capon G, Alezra E, Estrade V, Blanc P, Bladou F, Bensadoun H. Consequences of SARS-CoV-2 pandemic on urological surgery in France: a nationwide analysis of the healthcare system database. BMJ Open 2022; 12:e066220. [PMID: 36375970 PMCID: PMC9664026 DOI: 10.1136/bmjopen-2022-066220] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED The SARS-CoV-2 outbreak overwhelmed the healthcare systems worldwide. Saturation of hospitals and the risk of contagion led to a reduction in the care of other diseases. OBJECTIVE To determine the impact of SARS-CoV-2 pandemic on urological surgery in France during the year 2020. DESIGN, SETTING AND PARTICIPANTS An observational descriptive study was conducted on anonymised data collected from the national healthcare database established each year as part of the Program for the Medicalization of Information Systems in Medicine, Surgery, Obstetrics and Odontology. INTERVENTION None. PRIMARY AND SECONDARY OUTCOME MEASURES We gathered the number of urology surgical procedures carried out between 2010 and 2019, and we observed the difference between the forecast and actual number of urological surgeries performed in 2020. RESULTS Urological surgeries decreased by 11.4%, non-oncological surgeries being more affected (-13.1%) than oncological ones (-4.1%). Among the most relevant surgeries, female urinary incontinence (-44.7%) and benign prostatic hyperplasia (-20.8%) were the most impacted ones, followed by kidney cancer (-9%), urolithiasis (-8.7%), radical cystectomy for bladder cancer (-6.1%), prostate cancer (-3.6%) and transurethral resection of bladder tumour (-2%). Public hospitals had a more reduced activity (-17.7%) than private ones (-9.1%). Finally, the distribution of the reduction in urological activities by region did not correspond to the regional burden of SARS-CoV-2. CONCLUSIONS Urological care was severely affected during SARS-CoV-2 pandemic. Even if oncological surgeries were prioritised, the longer it takes to receive appropriate care, the greater the risk on survival impact. TRIAL REGISTRATION The data collection and analysis was authorised by the French Data Protection Authority (CNIL) under the number1 861 282v2.
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Affiliation(s)
- Gregoire Robert
- Department of Urology, CHU de Bordeaux, Bordeaux, France
- Université de Bordeaux, Talence, France
| | | | - Grégoire Capon
- Department of Urology, CHU de Bordeaux, Bordeaux, France
| | - Eric Alezra
- Department of Urology, CHU de Bordeaux, Bordeaux, France
| | | | - Peggy Blanc
- Department of Urology, CHU de Bordeaux, Bordeaux, France
| | - Franck Bladou
- Department of Urology, CHU de Bordeaux, Bordeaux, France
- Université de Bordeaux, Talence, France
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Margue G, Allenet C, Michiels C, Estrade V, Alezra E, Capon G, Bladou F, Robert G, Bernhard JC. Technical tips of 3D Image Guided Robotic Assisted Partial Nephrectomy (3D-IGRAPN) for the management of a hilar tumor. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02234-0] [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: 11/06/2022] Open
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Estrade V, Denis de Senneville B, Facq L, Daudon M. Endoscopic in-situ recognition of urinary stones during LASER-induced stone fragmentation: a modern, effective and essential approach in the diagnostic process in urolithiasis. CR CHIM 2022. [DOI: 10.5802/crchim.162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Van de Perre E, Bazin D, Estrade V, Bouderlique E, Wissing KM, Daudon M, Letavernier E. Randall’s plaque as the origin of idiopathic calcium oxalate stone formation: an update. CR CHIM 2022. [DOI: 10.5802/crchim.102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Estrade V, Daudon M, Richard E, Bernhard JC, Bladou F, Robert G, Facq L, Denis de Senneville B. Deep morphological recognition of kidney stones using intra-operative endoscopic digital videos. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac8592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/29/2022] [Indexed: 11/11/2022]
Abstract
Abstract
Objective. To assess the performance and added value of processing complete digital endoscopic video sequences for the automatic recognition of stone morphological features during a standard-of-care intra-operative session.Approach. A computer-aided video classifier was developed to predict in-situ the morphology of stone using an intra-operative digital endoscopic video acquired in a clinical setting. Using dedicated artificial intelligence (AI) networks, the proposed pipeline selects adequate frames in steady sequences of the video, ensures the presence of (potentially fragmented) stones and predicts the stone morphologies on a frame-by-frame basis. The automatic endoscopic stone recognition (A-ESR) is subsequently carried out by mixing all collected morphological observations.Main results. The proposed technique was evaluated on pure (i.e. include one morphology) and mixed (i.e. include at least two morphologies) stones involving ‘Ia/Calcium Oxalate Monohydrate’ (COM), ‘IIb/Calcium Oxalate Dihydrate’ (COD) and ‘IIIb/Uric Acid’ (UA) morphologies. The gold standard ESR was provided by a trained endo-urologist and confirmed by microscopy and infra-red spectroscopy. For the AI-training, 585 static images were collected (349 and 236 observations of stone surface and section, respectively) and used. Using the proposed video classifier, 71 digital endoscopic videos were analyzed: 50 exhibited only one morphological type and 21 displayed two. Taken together, both pure and mixed stone types yielded a mean diagnostic performances as follows: balanced accuracy = [88 ± 6] (min = 81)%, sensitivity = [80 ± 13] (min = 69)%, specificity = [95 ± 2] (min = 92)%, precision = [78 ± 12] (min = 62)% and F1-score = [78 ± 7] (min = 69)%.Significance. These results demonstrate that AI applied on digital endoscopic video sequences is a promising tool for collecting morphological information during the time-course of the stone fragmentation process without resorting to any human intervention for stone delineation or the selection of adequate steady frames.
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Margue G, Michiels C, Allenet C, Dupitout L, Ricard S, Jambon E, Blanc P, Alezra E, Estrade V, Capon G, Bladou F, Robert G, Grenier N, Bernhard JC. Feasibility of salvage robotic partial nephrectomy after ablative treatment failure (UroCCR-62 study). Minerva Urol Nephrol 2022; 74:209-215. [PMID: 35345389 DOI: 10.23736/s2724-6051.22.04693-6] [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] [Indexed: 11/08/2022]
Abstract
BACKGROUND Ablative therapies (AT) are increasingly being offered to patients with kidney tumors. In cases of failure or local relapse, salvage surgery may be required. Such procedures often require an open approach, are difficult and have received little attention in the literature. We aim to evaluate the feasibility of salvage robot-assisted partial nephrectomy (sRAPN) after AT. METHODS We conducted a monocentric retrospective study of all patients who benefited from sRAPN. Clinical data were collected prospectively after written consent in the French UroCCR database. RESULTS Between 2013 and 2020, 724 RAPN were performed in our center; of these, 11 patients underwent salvage RAPN and four (36.4%) had an imperative indication for a solitary kidney. The median patient age was 54 (49-72) years, median preoperative glomerular filtration rate (GFR) was 65.5 (42.9-88.4) mL/min/1.73 m2, and median tumor diameter was 34 (16-38) mm. Extensive perinephric fibrosis was present in 90.9% of cases. Postoperative complications occurred in 36.4% of patients, including major complications in 18.2%. The median GFR at three months (56.8 [45.9-63.9] mL/min/1.73 m2) and at last follow-up (52.1 [45.85-68.3] mL/min/1.73 m2) were not significantly different to the preoperative GFR (P=0.51 and P=0.65, respectively). During follow-up (median 12 months), three patients (all with Von Hippel Lindau disease) developed a recurrence, but none were on the sRAPN site. CONCLUSIONS Our series of sRAPN following AT failure confirms that such surgery is feasible with good functional and oncological results. However, these surgeries remain difficult, are associated with significant complication rate and should be performed in expert centers.
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Affiliation(s)
- Gaëlle Margue
- Department of Urology, Bordeaux University Hospital, Bordeaux, France -
| | - Clément Michiels
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Clément Allenet
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Laure Dupitout
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Solène Ricard
- French Research Network on Kidney Cancer (UroCCR), Bordeaux, France
| | - Eva Jambon
- Department of Radiology, Bordeaux University Hospital, Bordeaux, France
| | - Peggy Blanc
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Eric Alezra
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Vincent Estrade
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Grégoire Capon
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Franck Bladou
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Grégoire Robert
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Nicolas Grenier
- Department of Radiology, Bordeaux University Hospital, Bordeaux, France
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Klein C, Marquette T, Capon G, Alezra E, Estrade V, Bernhard J, Bladou F, Robert G. Énucléation de la prostate au laser Holmium (HoLEP) : résultats périopératoires et fonctionnels après 8 ans d’expérience. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.047] [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: 11/16/2022]
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Lopez F, Varelo A, Hinojosa O, Mendez M, Trinh DH, ElBeze Y, Hubert J, Estrade V, Gonzalez M, Ochoa G, Daul C. Assessing deep learning methods for the identification of kidney stones in endoscopic images. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:2778-2781. [PMID: 34891825 DOI: 10.1109/embc46164.2021.9630211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Knowing the type (i.e., the biochemical composition) of kidney stones is crucial to prevent relapses with an appropriate treatment. During ureteroscopies, kidney stones are fragmented, extracted from the urinary tract, and their composition is determined using a morpho-constitutional analysis. This procedure is time-consuming (the morpho-constitutional analysis results are only available after several weeks) and tedious (the fragment extraction lasts up to an hour). Identifying the kidney stone type only with the in-vivo endoscopic images would allow for the dusting of the fragments and eneable early treatments, while the morpho-constitutional analysis is ready. Only few contributions dealing with the in vivo identification of kidney stones have been published. This paper discusses and compares five classification methods including deep convolutional neural networks (DCNN)-based approaches and traditional (non DCNN-based) ones. Even if the best method is a DCCN approach with a precision and recall of 98% and 97% over four classes, this contribution shows that an XGBoost classifier exploiting well-chosen feature vectors can closely approach the performances of DCNN classifiers for a medical application with a limited number of annotated data.
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Denis E, Thiboud P, Estrade V. Reconnaissance endoscopique des calculs par intelligence artificielle : résultats préliminaires. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.134] [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: 10/19/2022]
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Margue G, Debard C, Michiels C, Dupitout L, Alezra E, Estrade V, Blanc P, Capon G, Robert G, Bladou F, Bernhard J. Tumorectomies rénales multiples, robot-assistées sans clampage et guidées par modélisation 3D. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.009] [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: 11/29/2022]
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Margue G, Michiels C, Allenet C, Dupitout L, Ricard S, Blanc P, Alerzra E, Estrade V, Capon G, Bladou F, Robert G, Grenier N, Bernhard J. Faisabilité des néphrectomies partielles robot-assistées de rattrapage après échec de traitement ablatif (Étude UROCCR–62). Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.125] [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: 10/19/2022]
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Estrade V, Daudon M, Bladou F, Bernhard J, Robert G, Denis de senneville B. La reconnaissance automatique des calculs urinaires : premiers résultats à partir d’images numériques endoscopiques peropératoires de calculs purs et mixtes. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.133] [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: 11/30/2022]
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Klein C, Michiels C, Allenet C, Capon G, Alezra E, Estrade V, Bladou F, Robert G, Bernhard J. Validation du score spare (simplified padua renal) pour la prédiction des résultats péri-opératoires après néphrectomie partielle robot assistée (NPRA) dans une cohorte multicentrique française. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.123] [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: 10/19/2022]
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Margue G, Percot M, Dupitout L, Michiels C, Blanc P, Alezra E, Estrade V, Capon G, Bladou F, Robert G, Grenier N, Bernhard JC. MP49-05 FEASIBILITY OF SALVAGE ROBOTIC PARTIAL NEPHRECTOMY AFTER ABLATIVE TREATMENT FAILURE (UROCCR- 62 STUDY). J Urol 2021. [DOI: 10.1097/ju.0000000000002075.05] [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: 11/25/2022]
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Allenet C, Klein C, Rouget B, Rigaud J, Ravaud A, Robert G, Bladou F, Capon G, Estrade V, Blanc P, Bernhard JC. MP61-16 PROGNOSTIC IMPACT OF PREOPERATIVE AND POSTOPERATIVE NEUTROPHIL/LYMPHOCYTE RATIOS IN NON-METASTATIC KIDNEY CANCER (UROCCR N°61). J Urol 2021. [DOI: 10.1097/ju.0000000000002101.16] [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: 11/25/2022]
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Almeras C, Pradere B, Estrade V, Meria P, French Urological Association OBOTLCOT. Endoscopic Papillary Abnormalities and Stone Recognition (EPSR) during Flexible Ureteroscopy: A Comprehensive Review. J Clin Med 2021; 10:jcm10132888. [PMID: 34209668 PMCID: PMC8267668 DOI: 10.3390/jcm10132888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/18/2021] [Accepted: 06/26/2021] [Indexed: 12/29/2022] Open
Abstract
Introduction: The increasing efficiency of the different lasers and the improved performance of endoscopic devices have led to smaller stone fragments that impact the accuracy of microscopic evaluation (morphological and infrared). Before the stone destruction, the urologist has the opportunity to analyze the stone and the papillary abnormalities endoscopically (endoscopic papillary recognition (EPR) and endoscopic stone recognition (ESR)). Our objective was to evaluate the value for those endoscopic descriptions. Methods: The MEDLINE and EMBASE databases were searched in February 2021 for studies on endoscopic papillary recognition and endoscopic stone recognition. Results: If the ESR provided information concerning the main crystallization process, EPR provided information concerning the origin of the lithogenesis and its severity. Despite many actual limitations, those complementary descriptions could support the preventive care of the stone formers in improving the diagnosis of the lithogenesis mechanism and in identifying high-risk stone formers. Conclusion: Until the development of an Artificial Intelligence recognition, the endourologist has to learn EPSR to minimize the distortion effect of the new lasers on the stone analysis and to improve care efficiency of the stone formers patients.
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Affiliation(s)
- Christophe Almeras
- Department of Urology, La Croix du Sud Clinic-RGDS, UroSud, 52 bis Chemin de Ribaute, Boite 301, 31130 Quint Fonsegrives, France
- French Urological Association (AFU), La Maison de l’Urologie, 11 rue Viète, 31017 Paris, France; (V.E.); (P.M.);
- Correspondence: ; Tel.: +33-53-202-7202; Fax: +33-53-202-7203
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria;
| | - Vincent Estrade
- French Urological Association (AFU), La Maison de l’Urologie, 11 rue Viète, 31017 Paris, France; (V.E.); (P.M.);
- Department of Urology, CHU Pellegrin, 33300 Bordeaux, France
| | - Paul Meria
- French Urological Association (AFU), La Maison de l’Urologie, 11 rue Viète, 31017 Paris, France; (V.E.); (P.M.);
- Department of Urology, Saint Louis Hospital, Denis Diderot University, 75010 Paris, France
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Estrade V, Daudon M, Richard E, Bernhard JC, Bladou F, Robert G, Denis de Senneville B. Towards automatic recognition of pure and mixed stones using intra-operative endoscopic digital images. BJU Int 2021; 129:234-242. [PMID: 34133814 PMCID: PMC9292712 DOI: 10.1111/bju.15515] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess automatic computer-aided in situ recognition of the morphological features of pure and mixed urinary stones using intra-operative digital endoscopic images acquired in a clinical setting. MATERIALS AND METHODS In this single-centre study, a urologist with 20 years' experience intra-operatively and prospectively examined the surface and section of all kidney stones encountered. Calcium oxalate monohydrate (COM) or Ia, calcium oxalate dihydrate (COD) or IIb, and uric acid (UA) or IIIb morphological criteria were collected and classified to generate annotated datasets. A deep convolutional neural network (CNN) was trained to predict the composition of both pure and mixed stones. To explain the predictions of the deep neural network model, coarse localization heat-maps were plotted to pinpoint key areas identified by the network. RESULTS This study included 347 and 236 observations of stone surface and stone section, respectively; approximately 80% of all stones exhibited only one morphological type and approximately 20% displayed two. A highest sensitivity of 98% was obtained for the type 'pure IIIb/UA' using surface images. The most frequently encountered morphology was that of the type 'pure Ia/COM'; it was correctly predicted in 91% and 94% of cases using surface and section images, respectively. Of the mixed type 'Ia/COM + IIb/COD', Ia/COM was predicted in 84% of cases using surface images, IIb/COD in 70% of cases, and both in 65% of cases. With regard to mixed Ia/COM + IIIb/UA stones, Ia/COM was predicted in 91% of cases using section images, IIIb/UA in 69% of cases, and both in 74% of cases. CONCLUSIONS This preliminary study demonstrates that deep CNNs are a promising method by which to identify kidney stone composition from endoscopic images acquired intra-operatively. Both pure and mixed stone composition could be discriminated. Collected in a clinical setting, surface and section images analysed by a deep CNN provide valuable information about stone morphology for computer-aided diagnosis.
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Affiliation(s)
| | - Michel Daudon
- Department of Multidisciplinary Functional Explorations, AP-HP, Tenon Hospital, INSERM UMRS 1155, Sorbonne University, Paris, France
| | - Emmanuel Richard
- INSERM, BMGIC, U1035, CHU Bordeaux, University of Bordeaux, Bordeaux, France
| | | | - Franck Bladou
- Department of Urology, CHU Pellegrin, Bordeaux, France
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de Hauteclocque A, Michiels C, Sarrazin J, Faessel M, Percot M, Le Paih JP, Guillaume A, Alezra E, Dupitout L, Vuong N, Grenier N, Capon G, Blanc P, Bensadoun H, Robert G, Bladou F, Ferriere J, Bos F, Estrade V, Bernhard JC. Three-dimensional printing technology to create a high-fidelity ureteroscopy simulator: Development and evaluation. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01347-6] [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: 10/20/2022]
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Klein C, Michiels C, Allenet C, Capon G, Alezra E, Estrade V, Bladou F, Robert G, Bernhard J. Simplified PADUA Renal (SPARE) nephrometry system: French multi-institutional retrospective validation and comparison for Robot-Assisted Partial Nephrectomy (RAPN). Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00980-5] [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: 11/16/2022]
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Margue G, Percot M, Dupitout L, Michiels C, Blanc P, Alezra E, Estrade V, Capon G, Bladou F, Robert G, Grenier N, Bernhard J. Feasibility of salvage robotic partial nephrectomy after ablative treatment failure (UroCCR-62 study). Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00944-1] [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: 11/24/2022]
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Gobinet L, Tesi L, Vuong N, Mosillo L, Percot M, Dupitout L, Simeon H, Blanc P, Alezra E, Estrade V, Capon G, Bladou F, Robert G, Gross Goupil M, Bernhard JC. Monocentric experience of Robot-assisted radical nephrectomy with vena cava thrombectomy: Technique and results. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01631-6] [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: 10/20/2022]
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Estrade V, Denis de Senneville B, Meria P, Almeras C, Bladou F, Bernhard JC, Robert G, Traxer O, Daudon M. Toward improved endoscopic examination of urinary stones: a concordance study between endoscopic digital pictures vs microscopy. BJU Int 2020; 128:319-330. [PMID: 33263948 PMCID: PMC8451759 DOI: 10.1111/bju.15312] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective To improve endoscopic recognition of the most frequently encountered urinary stone morphologies for a better aetiological approach in lithiasis by urologists. Materials and Methods An expert urologist intraoperatively and prospectively (between June 2015 and June 2018) examined the surface, the section, and the nucleus of all encountered kidney stones. Fragmented stones were subsequently analysed by a biologist based on both microscopic morphological (i.e. binocular magnifying glass) and infrared (i.e. Fourier transform‐infrared spectroscopy) examinations (microscopists were blinded to the endoscopic data). Morphological criteria were collected and classified for the endoscopic and microscopic studies. The Wilcoxon–Mann–Whitney test was used to detect differences between the endoscopic and microscopic diagnoses. A diagnosis for a given urinary stone was considered ‘confirmed’ for a non‐statistically significant difference. Results A total of 399 urinary stones were included in this study: 51.4% of the stones had only one morphological type, while 48.6% were mixed stones (41% had at least two morphologies and 7.6% had three morphologies). The overall matching rate was 81.6%. Diagnostics were confirmed for the following morphologies: whewellite (Ia or Ib), weddellite (IIa or IIb), uric acid (IIIa or IIIb), carbapatite‐struvite association (IVb), and brushite (IVd). Conclusions Our preliminary study demonstrates the feasibility of using endoscopic morphology for the most frequently encountered urinary stones and didactic boards of confirmed endoscopic images are provided. The present study constitutes the first step toward endoscopic stone recognition, which is essential in lithiasis. We provide didactic boards of confirmed endoscopic images that pave the way for automatic computer‐aided in situ recognition.
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Affiliation(s)
| | | | - Paul Meria
- Department of Urology, Saint-Louis Hospital, Denis Diderot University, Paris, France
| | - Christophe Almeras
- Department of Urology, La Croix du Sud Clinic, Quint Fonsegrives, France
| | - Franck Bladou
- Department of Urology, CHU Pellegrin, Bordeaux, France
| | | | | | - Olivier Traxer
- Department of Urology, Tenon Hospital, Pierre and Marie Curie University, Paris, France
| | - Michel Daudon
- Unit of Functional Explorations, Tenon Hospital, Pierre and Marie Curie University, Paris, France
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Vuong NS, Ferriere JM, Michiels C, Calen L, Tesi L, Capon G, Bensadoun H, Alezra E, Estrade V, Robert G, Bladou F, Bernhard JC. Robot-assisted versus open surgery for radical nephrectomy with level 1-2 vena cava tumor thrombectomy: a French monocenter experience (UroCCR study #73). Minerva Urol Nephrol 2020; 73:498-508. [PMID: 33200900 DOI: 10.23736/s2724-6051.20.04052-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this paper was to assess the feasibility of robot-assisted radical nephrectomy (RN) with inferior vena cava thrombectomy (RRVCT) and compare perioperative and oncological outcomes of this approach to open surgery for renal tumors with level 1-2 inferior vena cava (IVC) thrombus. METHODS We performed a retrospective analysis of patients surgically treated for renal cancer with IVC level 1-2 thrombus in the Urology department of Bordeaux University Hospital between December 2015 and December 2019. Patients were stratified by surgical approach in two groups: open vs. robotic procedures. Pre-, per- and postoperative data were collected within the framework of the UroCCR project (NCT03293563). Univariate and multivariate analysis using regression models were performed. RESULTS A total of 40 patients underwent RN with IVC tumor thrombus. Open and robotic surgery represented respectively 30 and 10 cases. The two groups were comparable regarding pre-operative tumor and patient characteristics. Robotic procedures were associated with lower estimated blood loss (EBL) (500 vs. 1250 mL, P=0.02), shorter Intensive Care Unit stay (2 vs. 4 days, P=0.03) and decrease of global length of stay (LOS) (7 vs. 10 days, P<0.01). Operative Time (OT) was significantly longer in the robotic group (350.5 vs. 208 min, P<0.01). No difference were observed between the two approaches regarding complications and oncological outcomes. CONCLUSIONS Robotic approach induced lower bleeding and shorter LOS but required longer OT. This technique is feasible and safe for selected cases and experimented surgical teams. Complications rate and oncological outcomes are not different compared to standard open procedures.
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Affiliation(s)
- Nam-Son Vuong
- Department of Urology, Bordeaux University Hospital, Bordeaux, France -
| | | | - Clément Michiels
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Laura Calen
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Lorenso Tesi
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Grégoire Capon
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Henri Bensadoun
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Eric Alezra
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Vincent Estrade
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Grégoire Robert
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Franck Bladou
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
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Vuong NS, Ferriere JM, Michiels C, Calen L, Tesi L, Capon G, Bensadoun H, Alezra E, Estrade V, Robert G, Bladou F, Bernhard JC. Robot-assisted versus open surgery for radical nephrectomy with level 1-2 vena cava tumor thrombectomy: a French monocenter experience (UroCCR study #73). Minerva Urol Nephrol 2020. [PMID: 33200900 DOI: 10.23736/s0393-2249.20.04052-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this paper was to assess the feasibility of robot-assisted radical nephrectomy (RN) with inferior vena cava thrombectomy (RRVCT) and compare perioperative and oncological outcomes of this approach to open surgery for renal tumors with level 1-2 inferior vena cava (IVC) thrombus. METHODS We performed a retrospective analysis of patients surgically treated for renal cancer with IVC level 1-2 thrombus in the Urology department of Bordeaux University Hospital between December 2015 and December 2019. Patients were stratified by surgical approach in two groups: open vs. robotic procedures. Pre-, per- and postoperative data were collected within the framework of the UroCCR project (NCT03293563). Univariate and multivariate analysis using regression models were performed. RESULTS A total of 40 patients underwent RN with IVC tumor thrombus. Open and robotic surgery represented respectively 30 and 10 cases. The two groups were comparable regarding pre-operative tumor and patient characteristics. Robotic procedures were associated with lower estimated blood loss (EBL) (500 vs. 1250 mL, P=0.02), shorter Intensive Care Unit stay (2 vs. 4 days, P=0.03) and decrease of global length of stay (LOS) (7 vs. 10 days, P<0.01). Operative Time (OT) was significantly longer in the robotic group (350.5 vs. 208 min, P<0.01). No difference were observed between the two approaches regarding complications and oncological outcomes. CONCLUSIONS Robotic approach induced lower bleeding and shorter LOS but required longer OT. This technique is feasible and safe for selected cases and experimented surgical teams. Complications rate and oncological outcomes are not different compared to standard open procedures.
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Affiliation(s)
- Nam-Son Vuong
- Department of Urology, Bordeaux University Hospital, Bordeaux, France -
| | | | - Clément Michiels
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Laura Calen
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Lorenso Tesi
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Grégoire Capon
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Henri Bensadoun
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Eric Alezra
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Vincent Estrade
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Grégoire Robert
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - Franck Bladou
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
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Mebroukine S, Chauveau B, Boulenger de Hauteclocque A, Percot M, Dupitout L, Blanc P, Alezra E, Estrade V, Bensadoun H, Ravaud A, Bladou F, Robert G, Ferrière J, Yacoub M, Gross-Goupil M, Bernhard J. Néphrectomie partielle robot-assistée après immunothérapie : faisabilité et partage d’expérience. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.007] [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: 10/23/2022]
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36
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De Hauteclocque A, Michiels C, Sarrazin J, Faessel M, Percot M, Vuong N, Guillaume A, Le Paih J, Grenier N, Capon G, Blanc P, Alezra E, Bensadoun H, Robert G, Bladou F, Ferrière J, Bos F, Estrade V, Bernhard J. Utilisation de la technologie d’impression 3D pour créer un simulateur haute-fidélité d’urétéroscopie : développement et évaluation. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.190] [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: 11/24/2022]
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37
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Gobinet L, Tesi L, Vuong N, Mosillo L, Percot M, Dupitout L, Simeon H, Alezra E, Estrade V, Capon G, Bladou F, Robert G, Bensadoun H, Ferrière J, Bernhard J. Expérience monocentrique de la chirurgie robotique des cancers du rein avec thrombus cave : technique et résultats. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.08.012] [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: 10/23/2022]
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38
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Allenet C, Klein C, Dupitout L, Percot M, Simeon H, Blanc P, Alezra E, Estrade V, Capon G, Bensadoun H, Bladou F, Robert G, Ferriere J, Bernhard J. Impact pronostique des rapports neutrophiles/lymphocytes préopératoire et postopératoire dans le cancer du rein de stade localisé (UroCCR no 61). Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.207] [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: 10/23/2022]
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39
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Verzotti G, Alezra E, Bladou F, Capon G, Bensadoun H, Bernhard J, Ferrière J, Robert G, Estrade V. L’urétérorénoscopie selon as low as reasonably achievable (ALARA) : avec quel(s) endoscope(s) et quelles limites ? Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.019] [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: 11/17/2022]
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40
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Martinez A, Trinh DH, El Beze J, Hubert J, Eschwege P, Estrade V, Aguilar L, Daul C, Ochoa G. Towards an automated classification method for ureteroscopic kidney stone images using ensemble learning. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:1936-1939. [PMID: 33018381 DOI: 10.1109/embc44109.2020.9176121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Urolithiasis is a common disease around the world and its incidence has been growing every year. There are various diagnosis techniques based on kidney stone identification aiming to find the formation cause. However, most of them are time consuming, tedious and expensive. The accuracy of the diagnosis is crucial for the prescription of an appropriate treatment that can eliminate the stones and diminish future relapses. This paper presents two effective supervised learning methods to automate and improve the accuracy of the classification of kidney stones; as well as a dataset consisting of kidney stone images captured with ureteroscopes. In the proposed methods, the image features that are visually exploited by urologists to distinguish the type of kidney stones are analyzed and encoded as vectors. Then, the classification is performed on these feature vectors through Random Forest and ensemble K Nearest Neighbor classifiers. The overall classification accuracy obtained was 89%, outperforming previous methods by more than 10%. The details of the classifier implementation, as well as their performance and accuracy, are presented and discussed. Finally, future work and improvements are proposed.
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Almeras C, Denis E, Meria P, Estrade V, Raynal G, Hoznek A, Malval B, Dominique S, Bart S, Gautier JR, Abid N. [Recommendations of the Urolithiasis Committee of the French Urology Association for the management and the treatment of the stone formers patients during the COVID-19 pandemic crisis]. Prog Urol 2020; 30:426-429. [PMID: 32389492 PMCID: PMC7198169 DOI: 10.1016/j.purol.2020.04.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 11/23/2022]
Abstract
Confrontés à une crise d’une ampleur exceptionnelle liée à la pandémie à coronavirus COVID-19 responsable d’une saturation selon les régions des urgences et des places en réanimation, le Comité Lithiase de l’Association Française d’Urologie (CLAFU) a élaboré pour la première fois les recommandations de prise en charge des calculs urinaires durant cette crise sanitaire.
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Affiliation(s)
- C Almeras
- Urologie, Uro. Sud, RGDS Clinique La Croix du Sud, 52 bis, chemin de Ribaute, 31130 Quint Fonsegrives.
| | - E Denis
- Urologie, Centre hospitalier Saint Joseph Saint Luc, Lyon
| | - P Meria
- Urologie, Hôpital Saint Louis, Paris
| | - V Estrade
- Urologie, Centre hospitalier d'Angoulême, France
| | - G Raynal
- Urologie, Clinique médico- chirurgicale Gaston Métivet, Saint-Maur-des-Fossés
| | - A Hoznek
- Urologie, Hôpital Henri Mondor, Créteil
| | - B Malval
- Urologie, Clinique Saint Hilaire, Rouen
| | - S Dominique
- Urologie, Cabinet d'Urologie Paris Opéra, Paris
| | - S Bart
- Urologie, Centre Hospitalier René Dubos, Pontoise
| | - J R Gautier
- Urologie, Uro. Sud, RGDS Clinique La Croix du Sud, 52 bis, chemin de Ribaute, 31130 Quint Fonsegrives
| | - N Abid
- Urologie, Hospices civils de Lyon, Lyon
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Almeras C, Daudon M, Estrade V, Gautier JR, Traxer O, Meria P. Classification of the renal papillary abnormalities by flexible ureteroscopy: evaluation of the 2016 version and update. World J Urol 2020; 39:177-185. [PMID: 32193654 PMCID: PMC7858204 DOI: 10.1007/s00345-020-03149-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 02/26/2020] [Indexed: 11/18/2022] Open
Abstract
Introduction To assess the use of the 2016 proposed classification of the renal papillary abnormalities during flexible ureteroscopy that aims to standardize their description. Patients and methods We performed a prospective monocentric single operator collection of the data using this classification during 88 consecutive flexible ureteroscopies required for renal stones treatment. Outcome measurements and statistical analysis: data of stones analysis (microscopy and infrared spectrophotometry) and of serum and urines biochemical samples have been compared with the results of the classified endoscopic descriptions. Results Mean duration of description was 81.4 s. We reported that 83% of the patients had Randall plaques (RP), as only 4.5% of the patients had no abnormality. Concerning the papillary stones and anchored stones were observed in 30.7% and aspect of intraductal crystallization (Sc) in 15.9%. Erosions were present in 55.7% and extrophic papillae in 8%. Sa1 and Pa2 were significantly correlated to RP, anchored stones (Sa) to papillary erosions and calcium phosphate stones to intraductal crystallization. Hypercalciuria was significantly higher in Sa2 than Sa1 stones. Conclusions The different descriptions in the 2016 classification were confirmed by the results of this study. Papillary abnormalities are consequences of stones development. Their descriptions could also improve the follow-up and the diagnosis of a metabolic lithogenesis. We recommend their systematic description during ureteroscopy. Some improvements are proposed to update this classification.
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Affiliation(s)
- Christophe Almeras
- Department of Urology, La Croix du Sud Clinic, 52 chemin de Ribaute, 31130, Quint Fonsegrives, France.
| | - Michel Daudon
- Unit of Functional Explorations, Tenon Hospital, Pierre and Marie Curie University, Paris, France
| | | | - Jean Romain Gautier
- Department of Urology, La Croix du Sud Clinic, 52 chemin de Ribaute, 31130, Quint Fonsegrives, France
| | - Olivier Traxer
- Department of Urology, Tenon Hospital, Pierre and Marie Curie University, Paris, France
| | - Paul Meria
- Department of Urology, Saint-Louis Hospital, Denis Diderot University, Paris, France
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De Hauteclocque A, Michiels C, Sarrazin J, Faessel M, Mosillo L, Percot M, Blanc P, Bensadoun H, Bladou F, Robert G, Capon G, Estrade V, Ferrière J, Bos F, Gill I, Bernhard J. Intérêt de modèles tridimensionnels virtuels et physiques pour évaluation de la complexité tumorale rénale et la planification opératoire des néphrectomies partielles (étude UroCCR-63 : 3D-planning). Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.238] [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: 10/25/2022]
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Dupitout L, Ferrière J, Bernhard J, Bensadoun H, Bladou F, Capon G, Estrade V, Robert G. Urolift sous anesthésie locale : expérience préliminaire. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.167] [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: 11/30/2022]
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De Hauteclocque A, Michiels C, Sarrazin J, Faessel M, Mosillo L, Percot M, Blanc P, Bensadoun H, Bladou F, Robert G, Capon G, Estrade V, Ferrière J, Bos F, Bernhard J. La modélisation 3D, un support efficace de l’information-patient avant chirurgie rénale. (Étude UroCCR-39 : Rein-3D-Print). Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.240] [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: 10/25/2022]
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46
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Vuong N, Capon G, Estrade V, Bensadoun H, Robert G, Ferriere J, Bernhard J. Amélioration dans le temps des résultats de la néphrectomie partielle robot-assistée (NPRA) : évaluation monocentrique de 370 procédures consécutives sur 6 années. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.203] [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: 10/27/2022]
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47
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Bergot C, Robert G, Guillaume A, Comat V, Lagabrielle S, Vuong N, Estrade V. Base pédagogique de la reconnaissance endoscopique des calculs, étude prospective monocentrique. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.121] [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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Almeras C, Estrade V, Gautier J, Hoznek A, Abid N, Meria P. Évaluation économique comparative des nouveaux dispositifs d’extraction des endoprothèses urétérales sous anesthésie locale. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.219] [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: 11/27/2022]
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Estrade V, De Gouvello A, Meria P. Hospitalisation ambulatoire ou classique pour urétérorénoscopie souple laser : valeur prédictive des comorbidités. Résultats préliminaires de l’étude prospective multicentrique du clAFU. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.103] [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: 10/28/2022]
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Sarreau M, Bon D, Estrade V, Villemonteix P, Fritel X. [Sexual function after transobturator tape procedure for stress urinary incontinence and overall patients' satisfaction]. Prog Urol 2015; 26:24-33. [PMID: 26586638 DOI: 10.1016/j.purol.2015.10.003] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 09/08/2015] [Accepted: 10/06/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the quality of sexual activity after a transobturator tape procedure for urinary incontinence and to examine the global satisfaction reported by patients. MATERIALS AND METHODS This is a bicentric retrospective study, postoperative questionnaires were sent to 247 women operated for urinary incontinence by TOT/TVT-O surgery, after 1 year, prolaps were excluded. Patients' overall improvement was assessed using the French version of Patient Global Impression and Improvement (PGI-I), urinary symptoms were assessed with the use of ICIQ-Fluts and quality of sexual function using Lemack and Zimmern questionnaire and ICIQ-Fluts-Sex. A logistic regression analysis was run to analyse the factors associated with women overall improvement. RESULTS One hundred and sixty-five patients answered the questionnaire (66.8%). Average age was 55 (±11), and the average postoperative period was 39 months (±17.9). After surgery, according to the PGI-I 135 women (81.8%) found an overall improvement, 22 (13.4%) found their condition unchanged and 8 (4.8%) women found it worse. Among the 165 women, 118 were sexually active, 37 (31.4%) reported improvement in intercourse satisfaction whereas 11 (9.3%) complained about sexual function deterioration and 70 (59.3%) felt unchanged. The 37 women who reported sexual improvement described decreased coital incontinence in 54% of the cases. Eleven women who felt sexually worse, reported dyspareunia. Results of the logistic regression analysis suggested that overall improvement after surgery depended not only on the incontinence score (OR 0.83) but also on the quality of the postoperative sexual activity (OR 12.96). CONCLUSION One third of the women reported improvement of their sexuality after transobturator tape procedure. In fact, global satisfaction after surgery was as related to the improvement of urinary symptoms as it was to the quality of the sexual activity. LEVEL OF EVIDENCE 5.
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Affiliation(s)
- M Sarreau
- Service de gynécologie-obstétrique, CHG Angoulême, rond-point de Girac, 16000 Angoulême, France; Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Poitiers, université de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France.
| | - D Bon
- Service d'urologie, CHG Angoulême, rond-point de Girac, 16000 Angoulême, France; Pôle de la femme, Inserm U947 IADI, maternité régionale universitaire de Nancy, université de Lorraine, 54000 Nancy, France
| | - V Estrade
- Service d'urologie, CHG Angoulême, rond-point de Girac, 16000 Angoulême, France; Pôle de la femme, Inserm U947 IADI, maternité régionale universitaire de Nancy, université de Lorraine, 54000 Nancy, France
| | - P Villemonteix
- Service de gynécologie-obstétrique, CHG Nord Deux-Sèvres, 79800 Bressuire, France
| | - X Fritel
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Poitiers, université de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France; Inserm U1018 CESP, équipe 7, genre, santé sexuelle et reproductive, Inserm CIC-P 1402, centre investigation, clinique plurithématique, CHU de Poitiers, 86000 Poitiers, France
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