Venkatesh Bhat Cooking Book Free 242
the average followup was 41.6 months (from 1 to 88 months) and no cancer progression was reported during the study period. on multivariable analysis, the only significant factor associated with progression-free survival was the time interval between the first and second ureteroscopy (fursint) (p<0.001, hr 0.984, 95% ci: 0.973-0.993) (see figure). in the lowess analysis, we identified a possibly nonlinear trend for high grade (hr 0.963, 95% ci: 0.928-0.996, p=0.035) and intermediate grade utuc (hr 0.965-0.995, p=0.003), while low grade utuc did not showed a significant trend (hr 0.972-0.998, p=0.032).
results: average time interval between the diagnostic biopsy and the initial ureteroscopy was 31.5 months (from 1 to 84). the average time interval between two consecutive ureteroscopies was 14.1 months (from 1 to 60). there was a general tendency to decrease time interval, with a plateau at 5 years (figure). the overall complication rate after the procedure was 16.9%. in septic patients (12 cases) a ureteral access sheath was used in 75% of the cases. in all septic patients the infected stones were successfully removed. there were no conversions to open surgery. stone free rate in lithiasis cases was 91.4% after one procedure, 94.5% after the second and 96.6% after the third procedure. ureteral access sheath was used in 75% of the nonseptic complications group. septic complications (12.9%) occurred in 2.9% of the cases. severe clavien ii complications occurred in 6.9% of the cases, mostly being septic shock. in 7.7% of the cases septic patients were prestented, 75% of them were operated using ureteral access sheath.
conclusions: in both cases, the robotic approach afforded a tension-free and watertight anastomosis and excellent visualization of periurethral anatomy. robotic pelvic dissection is feasible and safe, with acceptable postoperative outcomes. ues repair is possible in the setting of complex reconstruction after initial diversion and open primary surgery.
summary: in summary, holep is technically feasible, and seems to provide similar long-term outcomes to turp. holep has the distinct advantage of offering stone-free status at the time of surgery. further studies are needed to confirm these results and to evaluate potential quality of life benefits of holep. the results are promising but need to be confirmed by larger randomized studies comparing holep with turp. however, large long term studies are necessary to evaluate this issue more precisely and to better define the role of holep as a first-line alternative to turp for benign prostatic hyperplasia. regarding the results of the mist procedures, we think that mist appears to be a safe and effective treatment with the potential to provide significant benefits in terms of clinical, hemodynamic, and urodynamics outcomes.
conclusions: holep has comparable long-term durability as turp. the results confirm holep as a safe and effective treatment for bph with early stone-free and low complication rates. however, larger prospective studies are necessary to confirm these results.
abstract: holmium laser enucleation of the prostate (holep) is one of the minimally invasive surgical treatments for benign prostatic hyperplasia (bph). holep has the distinct advantage of offering stone-free status at the time of surgery. however, when compared to open prostatectomy, there is limited data on comparative analysis of holep and open prostatectomy.