Journal of endourology
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Journal of endourology · Jan 2014
Randomized Controlled Trial Clinical TrialOpioid-sparing effect of intravenous paracetamol after percutaneous nephrolithotomy: a double-blind randomized controlled trial.
To evaluate meperidine-sparing effect of intravenous (IV) paracetamol in patients undergoing percutaneous nephrolithotomy (PCNL). ⋯ In this study, IV paracetamol significantly reduced total meperidine consumption and pain intensity scores compared with placebo. IV paracetamol can be an effective and safe part of multimodal analgesia regimes for postoperative pain management after PCNL.
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Journal of endourology · Jan 2014
Comparative StudyComparison of outcomes after minimally invasive versus open partial nephrectomy with respect to trainee involvement utilizing the American College of Surgeons National Surgical Quality Improvement Program.
Complication rates of open partial nephrectomies (OPN) and minimally invasive partial nephrectomies (MIPN) have largely been reported by single and multi-institutional tertiary care centers. We sought to identify complication rates of these approaches and how they are influenced by trainee involvement utilizing an independent national surgical database. ⋯ This is the first report utilizing ACS NSQIP to review surgical approaches as well as the impact of trainee involvement on clinical outcomes. The increased complication rates and cost of healthcare might be mitigated by awareness, investment in surgical simulation laboratories, and competency assessment.
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Journal of endourology · Dec 2013
Urinary cystatin C and NGAL as early biomarkers for assessment of renal ischemia-reperfusion injury: a serum marker to replace creatinine?
To assess application of cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) as biomarkers for renal ischemic injury. We also evaluated the use of allopurinol as a renoprotective agent. A second goal was to assess cystatin C as a biomarker in patients undergoing partial nephrectomy. ⋯ Cystatin C and NGAL both appear to be useful biomarkers of renal injury. Studies with larger numbers are needed, however. Also, allopurinol does exhibit renoprotective effects against ischemic injury.
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Journal of endourology · Dec 2013
Multicenter StudyAdmission rates and costs associated with emergency presentation of urolithiasis: analysis of the Nationwide Emergency Department Sample 2006-2009.
We sought to examine a large nationwide (United States) sample of emergency department (ED) visits to determine data related to utilization and costs of care for urolithiasis in this setting. ⋯ Presentation of urolithiasis to the ED is common, and is associated with significant costs to the medical system, which are increasing over time. Costs and rates of admission differ by region, payer type, and hospital type, which may allow us to identify the causes for cost discrepancies and areas to improve efficiency of care delivery.
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Journal of endourology · Dec 2013
Comparative StudySmall-bore catheter drainage of pleural injury after percutaneous nephrolithotomy: feasibility and outcome from a single large institution series.
A well-known complication of percutaneous nephrolithotomy (PCNL) is pleural injury. Pneumothorax and hydrothorax sustained during PCNL may necessitate the placement of a chest tube. Current literature describes placement of standard chest tubes as well as small-bore catheters for management of hydrothorax sustained during PCNL. This study aims to better delineate the clinical utility and outcomes associated with use of small-bore catheters when compared with standard chest tubes for managing pneumothorax and hydrothorax after PCNL. ⋯ The use of small-bore catheters for management of hydrothorax and pneumothorax have reasonable clinical outcomes when compared with standard large-bore chest tubes after PCNL.