ABSTRACTS OF THE 21st ANNUAL MEETING OF THE ITALIAN ...

More documents

Recommendations

Info

onus). A decrease of helplessness/ hopelessness has been identified as a very important variable related to quality of life (Andritsch et al., Support Care Cancer 2007) in cancer patients. To conclude, we highlight that social well-being represents an important variable related to a positive adjustment in patients undergoing AS. The Foundation ProAdamo Onlus and Foundation I. Monzino are acknowledged for supporting the project entitled “Per un sentire condiviso: l’uomo e il tumore alla prostata”. 86 ROBOTIC RADICAL PROSTATECTOMY ANASTOMOSIS (RRP) ASSISTED BY V-Loc 180 ABSORBABLE CLOSURE SUTURE DEVICE: PRELIMINARY DATA AND PERSONAL SURGICAL EXPERIENCE Antonio Cisternino, Costanzo Latiano, Antonio Rosati, Fernando Gatta, Michelina Croce, Nicola Sebastio, Matteo Santodirocco and Michele Morcaldi IRCCS-Casa Sollievo Della Sofferenza-Opera Padre Pio, San Giovanni Rotondo, Foggia, Italy Background: Robotic radical prostatectomy (RRP) anastomosis, suture of the lateral prostatic vascular pedicles, anterior retropubic Santorini’s plexus and, when indicated, bladder neck reconstruction are stressed parts of robotic radical prostatectomy surgery. A new suture, namely the V- Lov 180 absorbable closure device, was tested with regard to various features of the RRP procedure. Materials and Methods: The V-Loc 180 consists of a barbed absorbable thread, armed with a surgical needle at one end and a loop end-effector at the other. The barb and loop end-effector design allows for tissue access without the need to tie surgical knots. The V-Loc 180 is completely absorbed in 180 days. This wound closure device is prepared from a copolymer of glycolic acid and trimethylene carbonate and is available in clear or green colors. The device is sterile, inert, noncollagenous and non-antigenic. United States Pharmacopoeia (U.S.P.) designations for diameter are applicable to the V-Loc 180 prior to barbing. After the creation of barbs, the V-Loc 180 is one size smaller than a non-barbed suture. This modification reduces the tensile strength of the suture similar to the effect of knot tying in a non-barbed suture. Therefore, the straight-pull tensile strength of the V-Loc 180 is comparable to the U.S.P. knot pull strength for a non-barbed suture of the equivalent size. The V-Loc 180 meets the requirements established by the U.S.P. and the European Pharmacopoeia for synthetic absorbable sutures for needle attachment only. The V-Loc 180 was tested in 15 Robotic Da Vinci RRP procedures. During the surgical steps, the suture of 1856 ANTICANCER RESEARCH 31: 1807-1956 (2011) the lateral prostatic vascular pedicles and anterior retropubic Santorini’s plexus were carried out using 15-cm V-Loc 180 material. The anastomoses were performed with two 15-cm or one 30-cm in length V-Loc 180. Comparisons between the Emo-loc clips and the V-Loc suture of the lateral prostatic vascular pedicles and between the traditional suture and the V-Loc suture in retropubic Santorini’s plexus and anastomosis were performed. The following features of the RPP procedures were analyzed: safety of surgical steps, time required for anastomosis, surgical skill needed, check for intraoperative dry anastomosis, damage to the tissues by the suturing device, cost of suturing material, stay of the catheter and X-ray images of the anastomosis. Results: From July 2010 to January 2011, 20 V-Loc 180 RRP’s were carried out. Multifactorial analysis was performed for the various features of the RPP procedure. Regarding the timing of the vesicourethral anastomosis, the traditional method required 35 min on average, while the V-Loc averaged 20 min; there was no difference between the single 30-cm and the double 15-cm semicircular suture stitches. Overlocked bleeding control of the lateral prostatic vascular pedicles by the 15-cm V-Loc suture was an easy procedure, requiring a short time compared to the multiple Emo-loc clips. Using the V-Loc, elegant sutures were made in the Santorini’s plexus and, when necessary, in the bladder neck reconstruction before the vesico-urethral anastomosis. Use of the V-Loc reduced hospitalization time because of the dry vesical-urethral anastomosis, as shown on early X-ray images. Conclusion: The V-Loc 180 absorbable wound closure device armed with a surgical needle at one end and a loop end-effector at the other is currently used in RRP procedures. The improved surgical skill, reduced surgical working time, the elegant approach to the different RRP steps and the reduced hospitalization due to the dry anastomosis make the V-Loc a promising device for complex pelvic urological surgical sutures. 89 LEIOMYOMA OF THE FEMALE URETHRA Giacomo Perugia1 , Domenico Di Viccaro1 , Alessandro Chinazzi2 , Francesca Antonini1 , Antonio De Cillis1 , Giuseppe Borgoni1 , Francesco Croce1 and Marcello Liberti1 1Urologia, Dipartimento Di Scienze Ginecologiche- Ostetriche Ed Urologiche, 2Patologia Clinica, Dipartimento Di Biochimiche, Policlinico Umberto I, Roma, Italy Background: Paraurethral leiomyoma is a rare benign hormone-dependent neoplasm of mesenchymal origin affecting women. Clinical evidence is variable but it tends to be asymptomatic or associated with the sensation of a foreign
Abstracts of the 21st Annual Meeting of the Italian Society of Uro-Oncology (SIUrO), 22-24 June, 2011, Naples, Italy body, while urinary symptoms are rarely described. Excision of the mass is the recommended treatment and diagnosis is confirmed by pathological analysis to rule out the presence of a sarcoma. A case of paraurethral leiomyoma associated with dysuria, dyspareunia and obstructive voiding symptoms is reported here. Case Report: A 28-year-old woman, presented with dysuria, dyspareunia and occasional urinary retention, associated with the presence in the vaginal introitus of a palpable, smooth, solid mass located above the urethral orifice just beneath the clitoris. Transvaginal ultrasonography showed a 25×25 mm hypoechoic mass, highly vascularized on colored Doppler imaging. The voiding cystogram did not show communication of the mass with the lower urinary tract but a constriction of the urethra was revealed. Axial T 1- and T 2-weighted MRI scans were performed and a neoplasm with signal similar to that of a uterine fibroid, compressing the urethra, was diagnosed. The patient underwent surgical excision of the mass, which was easily performed by blunt dissection, after 4-cm longitudinal incision of the anterior vaginal wall. The pathological analysis showed the presence of a paraurethral leiomyoma with less than 1 mitotic figure per 10 high-power fields. The patient had no immediate postoperative complications, the urethral catheter was removed two days after surgery and micturition was immediately restored. Urinary flow evaluation performed one month later revealed a normal Qmax nomogram and dyspareunia had disappeared. Discussion: Distinction between urethral, paraurethral, and anterior vaginal wall leiomyoma may be difficult due to their close anatomical proximity. Differential diagnosis of these lesions includes urethral diverticulum, Skene duct abscess, Bartolini gland cyst, Gartner duct cyst, vaginal wall cyst and urethral carcinoma. The literature supports the excision of these lesions to determine the mitotic count, which differentiates leiomyoma from locally recurrent or metastatic leiomyosarcoma, and this can help to predict the possibility of recurrence, which is extremely rare if there are fewer than 5 mitotic figures per 10 high-power fields. The case described here was unusual because of the symptoms (usually, there is paraurethral mass and increased urinary frequency, while voiding dysfunction and urinary retention, as presented here, are very rare) and the young age of the patient (28 years of age while the average age of patients at presentation is 47 years, with a range from 39 to 62 years). 1 Fry M, Wheeler JS Jr., Mata JA et al: Leiomyoma of the female urethra. J Urol 140: 613-614, 1988. 2 Cattolica EV, Klein R and Knigge W: Paraurethral leiomyoma – an imitator. Urology 8: 605-607, 1976. 3 Cornella JL, Larson TR, Lee RA et al: Leiomyoma of the female urethra and bladder: report of twenty-three patients and review of the literature. Am J Obstet Gynecol 176: 1278-1285, 1997. 90 PROSTATE LOW-DOSE RATE BRACHYTHERAPY IN ELDERLY PATIENTS: OUTCOMES AND TOXICITY PROFILE Costanza Chiumento, Alba Fiorentino, Anna Maria Mileo, Rocchina Caivano, Mariella Cozzolino and Piernicola Pedicini IRCCS-CROB, Radioterapia Oncologica, Centro Di Riferimento Oncologico Di Basilicata, Rionero In Vulture, Potenza, Italy Aim: To determine the toxicity and the biochemical diseasefree survival (b-DFS) rate after low-dose rate 125 I permanent prostate brachytherapy implant (LDR-BRT) in elderly patients with prostate cancer. Patients and Methods: A total of 80 patients were treated between June 2003 and December 2008 and were retrospectively evaluated. Among them, 51 had lowrisk (64%) and the remaining 29 had intermediate-risk (36%) prostate cancer. The median age was 75 (range 65- 86) years. All patients received LDR-BRT as monotherapy. The prescribed dose was 145 Gy to the prostate. Patients were divided into recurrence-risk groups according to the criteria of the National Comprehensive Cancer Network. Biochemical failure was defined according to the guidelines of the American Society of Therapeutic Radiology and Oncology. Toxicity was scored according to the RTOG scale. b-DFS was calculated from the implantation date to the date of biochemical recurrence. Results: With a median follow-up of 53 (range, 9-87) months, the global actuarial 5-year b-DFS rate was 91.3%. The 5-year overall survival rate was 95%. Acute genitourinary (GU) toxicity was mild; there was no acute grade G3 GU toxicity. Only four patients (5%) experienced late grade G3 GU toxicity. No patients experienced acute and late grade G3 gastrointestinal toxicity. Discussion and Conclusion: Older men receive potentially curative therapy for prostate cancer less often than younger men because of side effects, leaving the question of survival benefit open for these patients (1, 2). Our data suggest that LDR-BRT is effective and safe as monotherapy in elderly patients with prostate cancer. 1 Geinitz H, Zimmermann FB and Thamn R: 3D conformal radiation therapy for prostate cancer in elderly patients. Radiother Oncol 76: 27-34, 2005. 2 Stangelberger A, Waldert M and Djavan B: Prostate cancer in elderly men. Rev Urol 10(2): 111-119, 2008. 91 PROSTATE LOW-DOSE RATE BRACHYTHERAPY WITH PERMANENT 125 I SEED IMPLANT: A SINGLE-INSTITUTION EXPERIENCE 1857
Page 1 and 2: ANTICANCER RESEARCH 31: 1807-1956 (
Page 3 and 4: ANTICANCER RESEARCH 31: 1807-1956 (
Page 5 and 6: 1Department of Urology, Ospedale Sa
Page 7 and 8: Abstracts of the 21st Annual Meetin
Page 47: Abstracts of the 21st Annual Meetin
Page 99 and 100:
Table II. Median value 3DCRT V40 V5
Page 101 and 102:
Abstracts of the 21st Annual Meetin
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
255 ACCURACY OF ENDORECTAL MRI AND
Page 143 and 144:
Page 145 and 146:
Page 147:
Nucciotti R, 35 Oderda M, 37, 38, 1
show all

ABSTRACTS OF THE 21st ANNUAL MEETING OF THE ITALIAN ...

Create successful ePaper yourself

Delete template?

Save as template?