Acta clinica Croatica
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Acta clinica Croatica · Jul 2023
ReviewREVIEW ON COMPLICATIONS AND ADVERSE EFFECTS OF METALLIC URINARY STENTS.
Urinary stents, be it urethral or ureteral, polymeric, metallic or biodegradable, are one of the most frequently used tools in urology and they have been used for decades in prophylactic and therapeutic setting. Although relatively low invasive, they are prone to complications and adverse effects so much that complication rates up to 100% have been described. ⋯ To tackle this issue, a working group was set up within ENIUS (European Network of multidisciplinary research to Improve Urinary Stents) tasked with literature search in order to screen for and systematically review published stent complications in urethra (male only) and ureters (polymeric and metallic ureteral stents in both sexes) when used in obstructed systems. In this paper, we review, catalogue and summarize complications published for metallic urethral and ureteral stents.
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Acta clinica Croatica · Jul 2023
Comparative StudyHISTOPATHOLOGIC FEATURES OF KIDNEY TUMORS AND COMPARISON OF PATIENTS TREATED WITH RADICAL AND PARTIAL NEPHRECTOMY AT OSIJEK UNIVERSITY HOSPITAL CENTER FROM 2017 UNTIL THE END OF 2021.
The objective of this study was to present results of kidney tumor treatment at Osijek University Hospital Center over a 5-year period and to compare the outcomes between patients treated with radical nephrectomy (RN) and partial nephrectomy (PN). From November 2016 until the end of 2021, there were 280 consecutive PNs and RNs included in this cross-sectional study. Exclusion criteria were nephrectomies due to non-oncologic reasons and transitional cell carcinoma. ⋯ RN group had greater tumor diameters and higher tumor grade, higher postoperative creatinine levels and complications of higher grade. There was no difference in median hospital stay (6 days) and follow-up (20 months). With regard to oncologic safety, preservation of kidney function and lower overall morbidity, PN should be preferred to RN whenever oncologically safe and technically feasible.
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Acta clinica Croatica · Jul 2023
Comparative StudySHORT-TERM OUTCOMES OF PERCUTANEOUS RADIOFREQUENCY AND MICROWAVE ABLATION IN THE TREATMENT OF SMALL RENAL MASSES.
Although the gold standard in the management of kidney tumors is surgical treatment, thermal ablation methods are a viable therapeutic option for patients with small (<4 cm) renal masses who are poor surgical candidates. The aim of this study was to compare the technical success, primary efficacy and complication rate of percutaneous radiofrequency and microwave ablation in the treatment of small renal masses. A retrospective analysis of consecutive patients with small renal masses treated with radiofrequency or microwave ablation between December 2017 and January 2022 was conducted. ⋯ Ablation-related complications were noted only in the patients treated with microwave ablation (18.5%), all of them being low grade (Clavien-Dindo 1 and 2). Radiofrequency and microwave ablation exhibited comparable efficacy in the treatment of small renal masses. Microwave ablation was associated with a comparatively higher number of complications.
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Acta clinica Croatica · Jul 2023
CHARACTERISTICS AND TREATMENT OUTCOMES OF UROLOGIC PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT, OSIJEK UNIVERSITY HOSPITAL CENTER.
The postoperative care unit at the Department of Urology has significantly improved treatment of patients undergoing surgical procedures and reduced admission of urologic patients to the Intensive Care Unit (ICU). We examined the characteristics of urologic patients, time on mechanical ventilation, most common complications, and mortality in the period from January 2017 to March 2022. A total of 84 admissions to ICU were recorded, accounting for 1.5% of all patients having undergone surgical, therapeutic or diagnostic interventions under general or regional anesthesia at the Department of Urology. ⋯ The overall mortality of urologic patients was lower than in the rest of surgical ICU patients (10.7% vs. 18.99%, p=0.08) but the difference did not reach statistical significance. Independently of the lower mortality, improvements in the outcome of urologic patients admitted to the ICU are feasible. Early identification of patients at risk of infections, postoperative respiratory failure, cardiovascular incidents, and bleeding may further reduce mortality and improve outcomes.
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Acta clinica Croatica · Jul 2023
Case ReportsDIFFERENT APPROACHES TO MANAGING UROLITHIASIS IN KIDNEY TRANSPLANT PATIENTS - A CASE REPORT.
Urolithiasis is a rare urologic complication after kidney transplantation, and its diagnosis and treatment can be challenging for clinicians. In our 52-year-old male patient, graft hydronephrosis was found six months after transplantation. The patient had recurrent urinary tract infections followed by macrohematuria and an increase in creatinine levels. ⋯ By a repeated retrograde approach, laser lithotripsy was performed successfully. The patient has been monitored for six months and has stable graft function without hydronephrosis or stones. As in our patient's case, the diagnosis and treatment of urolithiasis in kidney transplant patients is challenging, and minimally invasive procedures are the treatment of choice.