A Literature Review of Perioperative Outcomes of Robotic Radical Nephrectomy (RRN) Versus Laparoscopic Radical Nephrectomy (LRN) for Renal Cell Carcinoma (RCC) (2023)

Type of publication:Journal article

Author(s):Alzamzami, Muhannad; Geirbely, Alsamoal; *Ahmed, Mohamed B; Osman, Rabab; Gandhi, Rahi; Mohammed, Mahmoud; Elhadi, Mohammed; Kodera, Ahmed

Citation:Cureus. 15(11):e49077, 2023 Nov.

Abstract:Renal cell carcinoma (RCC) is an adenocarcinoma of the renal cortex. Radical nephrectomy remains the standard of care for managing massive renal tumours. Robotic-assisted radical nephrectomy is an increasing alternative technique to laparoscopic radical nephrectomy (LRN). The da Vinci Surgical System allows for improved dexterity, increased visualisation, tremor filtration and an ergonomic setting to enhance surgeon comfort. The aim was to compare the perioperative outcomes pertaining to operative time, intraoperative complications, blood loss and length of hospital stay between the robotic and LRN for RCC. Studies that compared the perioperative findings between robotic radical nephrectomy (RNN) and LRN for RCC were included. The literature review was carried out according to the Cochrane collaboration standards where applicable. Highly sensitive search strategies like MeSH terms and controlled vocabularies were used to identify relevant studies that compare the RNN outcomes to the LRN. Following the literature search, a total of 73 articles were collected, 60 articles were excluded at the stage of reviewing the titles, eight articles were excluded after reading the abstracts, and five articles were included in this paper. Five studies were included in this analysis, with a total sample size of 1770 patients, 735 were in the robotic arm, and 1035 were in the laparoscopic arm. Generally, there were no differences between both arms in terms of demographic data and age of patients. Closer analysis of the perioperative outcomes did not reveal significant differences between the two groups related to the estimated blood loss, length of hospital stay or post-operative complications. The laparoscopic techniques have less operative time than the robotic ones. RRN is an expanding approach for patients with RCC with some potential technical benefits over laparoscopic ones. RRN is similar to LRN in the perioperative outcomes, with few potential drawbacks of RRN, including higher costs. However, a prospective comparison of RRN with LRN in many cases at multiple centres with long-term oncological results best illustrates the status of RRN versus LRN.

Link to full-text [open access - no password required]

Randomised trial of genetic testing and targeted intervention to prevent the development and progression of Paget's disease of bone (2023)

Type of publication:Journal article

Author(s):Phillips, Jonathan; Subedi, Deepak; Lewis, Steff C; Keerie, Catriona; Cronin, Owen; Porteous, Mary; Moore, David; Cetnarskyj, Roseanne; Ranganath, Lakshminarayan; Selby, Peter L; Turgut, Tolga; Hampson, Geeta; Chandra, Rama; *Ho, Shu; Tobias, Jon; Young-Min, Steven; McKenna, Malachi J; Crowley, Rachel K; Fraser, William D; Tang, Jonathan C Y; Gennari, Luigi; Nuti, Rannuccio; Brandi, Maria Luisa; Del Pino-Montes, Javier; Devogelaer, Jean-Pierre; Durnez, Anne; Isaia, Giovanni Carlo; Di Stefano, Marco; Guanabens, Nuria; Blanch Rubio, Josep; Seibel, Markus J; Walsh, John P; Rea, Sarah L; Kotowicz, Mark A; Nicholson, Geoffrey C; Duncan, Emma L; Major, Gabor; Horne, Anne; Gilchrist, Nigel; Ralston, Stuart H.

Citation:Annals of the Rheumatic Diseases. 2023 Dec 20. [epub ahead of print]

Abstract:INTRODUCTION: Paget's disease of bone (PDB) frequently presents at an advanced stage with irreversible skeletal damage. Clinical outcomes might be improved by earlier diagnosis and prophylactic treatment. METHODS: We randomised 222 individuals at increased risk of PDB because of pathogenic SQSTM1 variants to receive 5 mg zoledronic acid (ZA) or placebo. The primary outcome was new bone lesions assessed by radionuclide bone scan. Secondary outcomes included change in existing lesions, biochemical markers of bone turnover and skeletal events related to PDB. RESULTS: The median duration of follow-up was 84 months (range 0-127) and 180 participants (81%) completed the study. At baseline, 9 (8.1%) of the ZA group had PDB lesions vs 12 (10.8%) of the placebo group. Two of the placebo group developed new lesions versus none in the ZA group (OR 0.41, 95% CI 0.00 to 3.43, p=0.25). Eight of the placebo group had a poor outcome (lesions which were new, unchanged or progressing) compared with none of the ZA group (OR 0.08, 95% CI 0.00 to 0.42, p=0.003). At the study end, 1 participant in the ZA group had lesions compared with 11 in the placebo group. Biochemical markers of bone turnover were significantly reduced in the ZA group. One participant allocated to placebo required rescue therapy with ZA because of symptomatic disease. The number and severity of adverse events did not differ between groups. CONCLUSIONS: Genetic testing for pathogenic SQSTM1 variants coupled with intervention with ZA is well tolerated and has favourable effects on the progression of early PDB. TRIAL REGISTRATION NUMBER: ISRCTN11616770.

Link to full-text [open access - no password required]

Five historical innovations that have shaped modern urological surgery (2023)

Type of publication:Journal article

Author(s):*Patel, Ravi; Desai, Chaitya; Acharya, Radhika; Raveshia, Dimit; *Shah, Saumil; *Panesar, Harrypal; Patel, Neil; Singh, Rohit

Citation:Journal of Perioperative Practice. 2023 Dec 27 [epub ahead of print]

Abstract:Throughout history, many innovations have contributed to the development of modern urological surgery, improving patient outcomes and expanding the range of treatment options available to patients. This article explores five key historical innovations that have shaped modern urological surgery: External shockwave lithotripsy, transurethral resection of prostate, cystoscope, perioperative prostate-specific antigen and robotic surgery. The selection of innovations for inclusion in this article was meticulously determined through expert consensus and an extensive literature review. We will review the development, impact and significance of each innovation, highlighting their contributions to the field of urological surgery and their ongoing relevance in contemporary and perioperative practice.

Rationalise stock on Ward 10 - PRH (2023)

Type of publication:Service improvement case study

Author(s):*Yvonne Herbert, *Gary Francis

Citation:SaTH Improvement Hub, October 2023

Abstract:Ensure all stock items are available, easily accessible and appropriate stock levels are agreed by October 2023, complying with IPC and Healthy and Safety regulations, including a reduction of 1% in holding stock by October 2023.

Link to PDF poster

Training Governance Colleagues in Improvement Methodology (2023)

Type of publication:Service improvement case study

Author(s):*Gemma Styles

Citation:SaTH Improvement Hub, September 2023

Abstract:To ensure that all members of the governance teams (and patient safety teams) have been offered the opportunity to engage in the improvement hub training programmes (either fundamentals or Practitioner) by end of August 2023 in preparation for the introduction of PSIRF.

Link to PDF poster

To reduce the use of take away containers in the improvement hub (2023)

Type of publication:Service improvement case study

Author(s):*Gemma Styles

Citation:SaTH Improvement Hub, October 2023

Abstract:To reduce the number of takeaway cups and takeaway food boxes used by the improvement team whilst in the improvement hub by 95% by the end of September 2023.

Link to PDF poster