Journal of endourology
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Journal of endourology · Jul 2014
Observational StudyIncrease in intracranial pressure during carbon dioxide pneumoperitoneum with steep trendelenburg positioning proven by ultrasonographic measurement of optic nerve sheath diameter.
The purpose of this study was to assess the extent of the increased intracranial pressure (ICP) resulting from CO2 pneumoperitoneum and steep Trendelenburg positioning using ultrasonographic measurement of optic nerve sheath diameter (ONSD) in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALRP). ⋯ In patients undergoing RALRP, the increase of 12.5% in ONSD during CO2 pneumoperitoneum with steep Trendelenburg positioning was observed and thus the increase of ICP corresponding to this change of ONSD could be predicted. In 15% of the enrolled patients, ONSD increased by values equivalent to an ICP above 20 mm Hg without a deterioration of rSO2 or any neurologic complications.
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Journal of endourology · Jul 2014
Effect of multiple access tracts during percutaneous nephrolithotomy on renal function: evaluation of risk factors for renal function deterioration.
To assess the impact of multiple access tracts during percutaneous nephrolithotomy (PCNL) on short- and midterm renal function, and to determine risk factors predicting renal function deterioration and/or recoverability. ⋯ PCNL with multiple tracts carries a risk of adversely affecting renal function. Preoperative baseline renal impairment, diabetes, and hypertension are risk factors for significant renal function deterioration after the procedure.
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Journal of endourology · Jul 2014
Morbidity and mortality after benign prostatic hyperplasia surgery: data from the American College of Surgeons national surgical quality improvement program.
With the aging population, it is becoming increasingly important to identify patients at risk for postsurgical complications who might be more suited for conservative treatment. We sought to identify predictors of morbidity after surgical treatment of benign prostatic hyperplasia (BPH) using a large national contemporary population-based cohort. ⋯ All three surgical modalities for BPH management were found to be safe. Advanced age and non-Caucasian race were independent predictors of adverse outcomes after BPH surgery. In patients with these attributes, conservative treatment might be a reasonable alternative. Also, preoperative hematocrit and albumin levels represent reliable predictors of adverse outcomes, suggesting that these markers should be evaluated before BPH surgery.