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Re: Minimally Invasive Percutaneous Treatment of Small Renal Tumors with Irreversible Electroporation: A Single-Center Experience
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Laparoscopy/New Technology Re: A Prospective Randomized Study of Pfannenstiel versus Expanded Port Site Incision for Intact Specimen Extraction in Laparoscopic Radical Nephrectomy S. Binsaleh, K. Madbouly, E. D. Matsumoto and A. Kapoor Division of Urology, Department of Surgery, Faculty of Medicine, King Saud University and Department of Urology, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia, and McMaster Institute of Urology, St. Joseph’s Healthcare, McMaster University, Hamilton, Ontario, Canada J Endourol 2015; 29: 913e918. doi: 10.1089/end.2014.0899
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/25819645 Editorial Comment: In this study the authors randomized 51 laparoscopic transperitoneal radical nephrectomy cases with intact specimen extraction to either Pfannenstiel or expanded port site incision. Pain scores on postoperative day 1 and hospital stay were significantly less for the Pfannenstiel group, although clinically the improvements were modest (less than 1 point on Likert pain scale and half day hospital stay). Extensive cosmesis and operative satisfaction questioning demonstrated no difference between the groups. Surprisingly the “extra” Pfannenstiel incision did not increase operative time or extraction time, which I believe has been the main impediment to widespread use of the Pfannenstiel extraction. I certainly will use this incision more often for specimen retrieval. Jeffrey A. Cadeddu, MD
Re: Minimally Invasive Percutaneous Treatment of Small Renal Tumors with Irreversible Electroporation: A Single-Center Experience C. K. Trimmer, A. Khosla, M. Morgan, S. L. Stephenson, A. Ozayar and J. A. Cadeddu Departments of Radiology and Urology, University of Texas Southwestern Medical Center, Dallas, Texas J Vasc Interv Radiol 2015; 26: 1465e1471. doi: 10.1016/j.jvir.2015.06.028
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/26250855 Editorial Comment: Irreversible electroporation (IRE) is a new ablation method that uses highvoltage pulses to create permanent nanopores in cells, resulting in cell membrane destabilization and death. IRE is commonly used clinically in liver and pancreas tumor ablation. Since it is purported to be nonthermal, this approach may provide advantages over radio frequency ablation and cryoablation, which are susceptible to vascular heat sinks and can thermally injure adjacent structures. This is the first known clinical experience evaluating outcomes in 20 patients with cT1a renal tumors. Imaging outcomes appear to mirror those of cryoablated tumors with ablation site contraction and resorption through time. Oncologically outcomes are immature. Two patients required salvage ablation and 1 underwent partial nephrectomy 1 year after IRE. Jeffrey A. Cadeddu, MD
0022-5347/16/1954-0001/0 THE JOURNAL OF UROLOGY® Ó 2016 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION
AND
RESEARCH, INC.
http://dx.doi.org/10.1016/j.juro.2016.01.022 Vol. 195, 1, April 2016 Printed in U.S.A.
www.jurology.com Dochead: Urological Survey
LIT 5.4.0 DTD JURO13240_proof 20 January 2016 5:16 pm EO:
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Laparoscopy/New Technology Re: A Prospective Randomized Study of Pfannenstiel versus Expanded Port Site Incision for Intact Specimen Extraction in Laparoscopic Radical Nephrectomy S. Binsaleh, K. Madbouly, E. D. Matsumoto and A. Kapoor Division of Urology, Department of Surgery, Faculty of Medicine, King Saud University and Department of Urology, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia, and McMaster Institute of Urology, St. Joseph’s Healthcare, McMaster University, Hamilton, Ontario, Canada J Endourol 2015; 29: 913e918. doi: 10.1089/end.2014.0899
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/25819645 Editorial Comment: In this study the authors randomized 51 laparoscopic transperitoneal radical nephrectomy cases with intact specimen extraction to either Pfannenstiel or expanded port site incision. Pain scores on postoperative day 1 and hospital stay were significantly less for the Pfannenstiel group, although clinically the improvements were modest (less than 1 point on Likert pain scale and half day hospital stay). Extensive cosmesis and operative satisfaction questioning demonstrated no difference between the groups. Surprisingly the “extra” Pfannenstiel incision did not increase operative time or extraction time, which I believe has been the main impediment to widespread use of the Pfannenstiel extraction. I certainly will use this incision more often for specimen retrieval. Jeffrey A. Cadeddu, MD
Re: Minimally Invasive Percutaneous Treatment of Small Renal Tumors with Irreversible Electroporation: A Single-Center Experience C. K. Trimmer, A. Khosla, M. Morgan, S. L. Stephenson, A. Ozayar and J. A. Cadeddu Departments of Radiology and Urology, University of Texas Southwestern Medical Center, Dallas, Texas J Vasc Interv Radiol 2015; 26: 1465e1471. doi: 10.1016/j.jvir.2015.06.028
Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/26250855 Editorial Comment: Irreversible electroporation (IRE) is a new ablation method that uses highvoltage pulses to create permanent nanopores in cells, resulting in cell membrane destabilization and death. IRE is commonly used clinically in liver and pancreas tumor ablation. Since it is purported to be nonthermal, this approach may provide advantages over radio frequency ablation and cryoablation, which are susceptible to vascular heat sinks and can thermally injure adjacent structures. This is the first known clinical experience evaluating outcomes in 20 patients with cT1a renal tumors. Imaging outcomes appear to mirror those of cryoablated tumors with ablation site contraction and resorption through time. Oncologically outcomes are immature. Two patients required salvage ablation and 1 underwent partial nephrectomy 1 year after IRE. Jeffrey A. Cadeddu, MD
0022-5347/16/1954-0001/0 THE JOURNAL OF UROLOGY® Ó 2016 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION
AND
RESEARCH, INC.
http://dx.doi.org/10.1016/j.juro.2016.01.022 Vol. 195, 1, April 2016 Printed in U.S.A.
www.jurology.com Dochead: Urological Survey
LIT 5.4.0 DTD JURO13240_proof 20 January 2016 5:16 pm EO:
j
1