Journal of endourology
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Journal of endourology · Sep 2016
The Impact of Perioperative Aspirin on Bleeding Complications Following Robotic Partial Nephrectomy.
Perioperative administration of aspirin for high-risk urologic procedures is controversial. We evaluated whether continuation of perioperative aspirin alters bleeding complications in patients who undergo robotic partial nephrectomy (RPN). ⋯ Continuation of perioperative 81 mg aspirin for patients undergoing RPN was not associated with significantly higher overall bleeding complications. Patients continuing aspirin had increased comorbidities and overall 30-day complications. While our data suggest that continuing perioperative aspirin is safe in select patients, larger studies are needed to confirm these findings.
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Journal of endourology · Jul 2016
Meta Analysis Comparative StudySupine Versus Prone Position in Percutaneous Nephrolithotomy for Kidney Calculi: A Meta-Analysis.
There are several positions in the operation of percutaneous nephrolithotomy (PCNL), such as prone position, supine position, flank position, and modified supine position for PCNL, but the supine and prone positions are the main two choices for several years. However, there is still discrepancy on the optimal position for PCNL. Therefore, we performed this meta-analysis to evaluate safety and efficacy of the supine versus the prone position in PCNL for renal calculi. ⋯ Compared with the prone position, the PCNL in the supine position has a slightly lower rate of stone clearance, albeit shorter mean operative time, and lower incidence of blood transfusions. The meta-analysis suggests that the PCNL in the supine position is a promising alternative.
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Journal of endourology · Jun 2016
Surgical Staff Radiation Protection During Fluoroscopy-Guided Urologic Interventions.
Over the past 20 years, the use of fluoroscopy to guide urologic surgical interventions has been constantly growing. Thus, in their daily practice, urologists and other operating room (OR) staff are exposed to X-radiation increasingly frequently. This raises questions as to the risks they encounter and the actions needed to reduce them. ⋯ In the present study, radiation exposure for urologists was low, but so was knowledge of radiation safety and optimization practices. This absence of training for radiation safety and reduction, teamed with novel techniques involving long fluoroscopy-guided interventions, could result in unnecessarily high exposure for patients and OR personnel.
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Journal of endourology · Jun 2016
Reduced Pain and Anxiety with Music and Noise-Canceling Headphones During Shockwave Lithotripsy.
We assessed the effects of music and noise-canceling headphones (NCHs) on perceived patient pain and anxiety from extracorporeal shockwave lithotripsy (SWL). ⋯ Music therapy during SWL reduced pain and anxiety. Music therapy with NCHs was more effective for pain and anxiety reduction. To reduce pain and anxiety, nonpharmacologic therapies such as music therapy with NCHs during SWL should be investigated further and used routinely.
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Journal of endourology · May 2016
Randomized Controlled Trial Comparative StudyEffects of Continuous Peritubal Local Anesthetic Instillation on Postoperative Pain After Percutaneous Nephrolithotomy: A Prospective, Randomized Three-Arm Study.
We evaluated the effects of continuous instillation of a local anesthetic at the nephrostomy site on postoperative pain following percutaneous nephrolithotomy (PCNL). ⋯ Continuous infiltration of a local anesthetic is effective for both managing pain immediately after surgery and in dealing with pain that occurs late in the recovery period.