Minh Do

University of Patras, Patrís, Kentriki Makedonia, Greece

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Publications (67)155.09 Total impact

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    ABSTRACT: We assessed the misdiagnosed prostate cancer in radical prostatectomy (RP) specimens and the associated parameters. A total of 3,821 patients were treated by RP. A meticulous process to identify misdiagnosed PCa in the specimen was followed. This protocol included the review of biopsies, prostatic specimens after TURP and RP surgical specimens. The prostatic specimens were further sectioned. Immunohistochemistry was also performed. The clinical parameters of the cases that were confirmed to be pT0 stage were compared to 1,164 RP patients. The incidence of pT0 was 0.7 % of the cases. Eighteen patients (Group A) were operated after TURP and 10 patients (Groups B) after transrectal ultrasound-guided biopsy of the prostate. Eleven (Group Ac) cases of Group A and seven (Group Bc) cases of Group B were confirmed to be pT0 cases. The re-examination of the slides and specimens revealed the presence of PCa in three cases. The remaining cases were detected by IHC. The comparison of Group Ac to the Group C (representative cohort, 1164 patients) showed that the pre-operative PSA value was significantly higher in the case of the Group C. The pre-operative Gleason, the percentage of biopsy cores for cancer and the length of cores containing cancer were observed to be significantly lower in the case of Group Bc in comparison with Group C. The meticulous search protocol in pT0 cases showed that 35.7 % of the specimens included undiagnosed PCa. This strengthens the need for further careful work-up of any RP specimen of stage pT0.
    World Journal of Urology 11/2014; · 2.89 Impact Factor
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    ABSTRACT: To present the experience with the extraperitoneal approach for robotic-assisted simple prostatectomy (RASP) in a technique replicating the vesicocapsular incision technique of open surgery. RASP was performed on patients with a prostate volume of >80 cm(3) with an indication for open enucleation of the prostate. Preoperatively, all patients were evaluated by uroflowmetry, prostate-specific antigen level, and postvoid residual measurement, as well as by the International Prostate Symptom Score questionnaire. All perioperative data were recorded in a prospective database. Follow-up appointments included the aforementioned measurements and were scheduled at 1 and 6 months postoperatively. Ten RASP procedures were successfully performed by the extraperitoneal approach. Mean patient age and prostate volume were 63.1 years (range, 55-74 years) and 129.4 cm(3) (range, 90-170 cm(3)), respectively. Mean operative time was 122.5 minutes (range, 85-140 minutes) and represented the time from the first incision to the closure of the all incisions. The estimated blood loss was minimal (mean value, 230 mL). Transfusions were not necessary. Mean catheterization period was 7.4 days (range, 6-8 days). The symptomatology, as reported by the International Prostate Symptom Score, was improved at the follow-up appointments in comparison with the baseline values. One case of prolonged fever was noted postoperatively and managed by antibiotics. The extraperitoneal approach for RASP proved to be efficient in the management of large prostates. The results are directly comparable with the current available experience with transperitoneal RASP. The extraperitoneal RASP seems to favorably compare with the open simple prostatectomy, while the results are at least comparable with those of conventional laparoscopic approach. Copyright © 2014 Elsevier Inc. All rights reserved.
    Urology 11/2014; 84(5):1099-105. · 2.42 Impact Factor
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    ABSTRACT: Clinical management of prostate cancer increasingly aims to distinguish aggressive types that require immediate and radical treatment from indolent tumors that are candidates for watchful waiting. This requires reliable and reproducible parameters to effectively control potential cancer progression. Magnetic resonance imaging (MRI) may provide a non-invasive means for this purpose. To assess the value of diffusion-weighted imaging and proton MR spectroscopy for the prediction of prostate cancer (PCa) aggressiveness. In 39 of 64 consecutive patients who underwent endorectal 3-T MRI prior to radical prostatectomy, prostate specimens were analyzed as whole-mount step sections. Apparent diffusion coefficient (ADC), normalized ADC (nADC: tumor/healthy tissue), choline/citrate (CC), and (choline + creatine)/citrate (CCC) ratios were correlated with Gleason scores (GS) from histopathological results. The power to discriminate low (GS ≤ 6) from higher-risk (GS ≥ 7) tumors was assessed with receiver operating characteristics (area under the curve [AUC]). Resulting threshold values were used by a blinded reader to distinguish between aggressive and indolent tumors. Ninety lesions (1 × GS = 5, 41 × GS = 6, 36 × GS = 7, 12 × GS = 8) were considered. nADC (AUC = 0.90) showed a higher discriminatory power than ADC (AUC = 0.79). AUC for CC and CCC were 0.73 and 0.82, respectively. Using either nADC < 0.46 or CCC > 1.3, as well as both criteria for aggressive PCa, the reader correctly identified aggressive and indolent tumors in 31 (79%), 28 (72%), and 33 of 39 patients (85%), respectively. Predictions of tumor aggressiveness from TRUS-guided biopsies were correct in 27 of 36 patients (75%). The combination of a highly sensitive normalized ADC with a highly specific CCC was found to be well suited to prospectively estimate PCa aggressiveness with a similar diagnostic accuracy as biopsy results.
    Acta Radiologica 02/2014; · 1.33 Impact Factor
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    ABSTRACT: Introduction: Ureteral reconstructive surgery requires adequate exposure of the ureteral lesion and results in large abdominal incisions. Robotic-assistance allows the performance of complex ureteral reconstructive surgery through small incisions. The current series includes only cases of Boari flaps performed by robotic-assistance and attempts to describe in detail the technique, review the literature as well as to expand the experience in current literature. Patients and methods: Eight patients underwent ureteral reimplantation by Boari flap technique. The indications for the performance of the procedure included ureteral stricture due to iatrogenic injury in 3 patients, recurrent ureteral stricture after multiple endoscopic stone management procedures in 1 patient, ureteral stricture due to previous malignant disease in the pelvis or abdomen in 3 patients and ureteral stricture due to trauma in 1 patient. Five cases were located in the left side and 3 cases in the right side. A variety of parameters were recorded in a prospective database including the time for robot docking and total operative time as well as catheterization and drainage time. The follow-up of the patients included the performance of renal ultrasound 4 weeks, 3, 6 and 12 months after the procedure. Results: Mean age of the patients was 50.8 (range 39-62) years and mean Body Mass Index of 26.2 (range 23.22-29.29) kg/m2. Operative time ranged 115 and 240 (mean 171.9) min. Mean blood loss was 161.3 (50-250) ml. Conversion to open surgery did not take place in the current series. No intra-operative complications were observed. Post-operative complications included one case of prolonged anastomotic leakage Conclusion: The Robotic-assisted approach is efficient in the performance of ureteral reimplantation with Boari flap. Low blood loss, short catheterization time, low complication rate and excellent reconstructive outcome are associated with the approach. Robotic-assistance seems to be beneficial for ureteral reconstructive surgery.
    Journal of endourology / Endourological Society 01/2014; · 1.75 Impact Factor
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    ABSTRACT: The frequent application of ultrasound and radiological imaging for non-urological indications in recent years has resulted in an increase in the diagnosis of small renal masses. The treatment options for patients with a small renal mass include active surveillance, surgery (both open and minimally invasive) as well as ablative techniques. As there is a risk for metastatic spread even in small renal masses surgical extirpation remains the treatment of choice in most patients. Ablative procedures, such as cryoablation and radiofrequency ablation are appropriate for old and multi-morbid patients who require active treatment of a small renal mass. Active surveillance is an alternative for high-risk patients. Meticulous patient selection by the urologist and patient preference will determine the choice of treatment option in the future.
    Der Urologe 10/2012; 51(10):1459-68. · 0.46 Impact Factor
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    ABSTRACT: Abstract Background and Purpose: Radical prostatectomy is the gold standard surgical treatment for organ-confined prostate cancer. There is no consensus on the impact of previous laparoscopic experience on the learning curve of robot-assisted laparoscopic prostatectomy (RALP). We compared the perioperative complications and early patient outcomes from our initial 100 cases of RALP with laparoscopic prostatectomy (LRP) cases performed well beyond the learning curve. Patients and Methods: Between July 2011 and January 2012, 110 RALP were performed by one of two surgeons, each with previous experience of more than 1000 LRP. The cases were pair matched from among the last 208 patients who had undergone LRP by the same surgeons at the same time. The clinical parameters, operative details, postoperative complications, and short-term outcomes from these patients, collected prospectively, were compared between the two groups. Results: The prostate-specific antigen (PSA) level and age of the two groups was similar. The operative time (128.4 vs 153.9 min; P=0.01) and blood loss (200 vs 254 mL; P=0.01) was significantly less for the LRP group, but the duration of catheterization was similar (5.89 vs 6.2 days). The complication rate was low. No procedures needed conversions, and no patient had a visceral injury or blood transfusion. Twenty-three patients in the LRP group and 33 patients in the RALP group had extraprostatic disease, and the positive margin rate was 14% and 19% for these respective groups. At 3 months, PSA level was undetectable in 94% of LRP and 92% RALP patients, while 56% and 65% (P=0.062) patients in these groups were using 0 to 2 pads per day. Conclusions: The initial results of the outcome of RALP are at least at par with those of LRP and with those of previously published RALP series. This suggests the lack of a steep learning curve for experienced laparoscopic surgeons in performing RALP.
    Journal of endourology / Endourological Society 07/2012; · 1.75 Impact Factor
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    ABSTRACT: Objectives:  Urologists are cautious to offer minimally invasive radical prostatectomy in prostate cancer patients with high prostate-specific antigen (and therefore anticipated to have locally advanced or metastatic disease) because of concerns regarding lack of complete cure after minimally invasive radical prostatectomy and of worsening of continence if adjuvant radiotherapy is used. Methods:  A retrospective review of our institutional database was carried out to identify patients with PSA ≥20 ng/mL who underwent minimally invasive radical prostatectomy between January 2002 and October 2010. Intraoperative, pathological, functional and short-term oncological outcomes were assessed. Results:  Overall, 233 patients met study criteria and were included in the analysis. The median prostate-specific antigen and prostate size were 28.5 ng/mL and 47 mL, respectively. Intraoperative complications were the following: rectal injury (0.86%) and blood transfusion (1.7%). Early postoperative complications included prolonged (>6 days) catheterization (9.4%), hematoma (4.7%), deep venous thrombosis (0.86%) and lymphocele (5.1%). Late postoperative complications included cerebrovascular accident (0.4%) and anastomotic stricture (0.8%). Pathology revealed poorly differentiated cancer in 48.9%, pT3/pT4 disease in 55.8%, positive margins in 28.3% and lymph node disease in 20.2% of the cases. Adverse pathological findings were more frequent in patients with prostate-specific antigen >40 ng/mL and (or) in those with locally advanced disease (pT3/pT4). In 62.2% of the cases, adjuvant radiotherapy was used. At 1-year follow up, 80% of patients did not show evidence of biochemical recurrence and 98.8% of them had good recovery of continence. Conclusion:  Minimally invasive radical prostatectomy might represent a reasonable option in prostate cancer patients with high prostate-specific antigen as a part of a multimodality treatment approach.
    International Journal of Urology 07/2012; 19(10):923-7. · 1.73 Impact Factor
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    ABSTRACT: Organ-confined prostate cancer can be treated with curative intent by different types of radiotherapy or by radical surgery. Regardless of improvements in radiotherapy about 60% of patients with prostate cancer develop biochemical recurrence (BCR) which is defined by the progressive increase in serum prostate-specific antigen (PSA) and necessitates further diagnostic procedures. If non-organ-confined cancer and metastasis are categorically excluded by cross-sectional imaging using computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography CT (PET-CT) and bone scintigraphy, a prostate biopsy should be performed. Biopsy proven detection of recurrent or persisting prostate cancer after irradiation is essential prior to a salvage prostatectomy. The function of the lower urinary tract should be evaluated prior to surgery. Preoperative PSA measurement is the best prognostic indicator prior to surgery. Salvage prostatectomy in irradiated patients is more challenging and requires extensive skill. The most common complications are incontinence, rectal injury and anastomotic strictures. Both functional and oncologic outcome have improved due to better irradiation techniques and surgical skills. Provided post-radiotherapy recurrence of prostate cancer is diagnosed early enough, curing is possible by salvage prostatectomy.
    Der Urologe 06/2012; 51(6):869-78; quiz 879-80. · 0.46 Impact Factor
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    ABSTRACT: To evaluate the influence of the choice of b values on the diagnostic value of the apparent diffusion coefficient (ADC) for detection and grading of prostate cancer (PCa). Forty-one patients with biopsy-proven PCa underwent endorectal 3-T MRI before prostatectomy. Different combinations of b values (0-800 s/mm(2)) were used to calculate four representative ADC maps. Mean ADCs of tumours and non-malignant tissue were determined. Tumour appearance on different ADC maps was rated by three radiologists as good, fair or poor by assigning a visual score (VS) of 2, 1 or 0, respectively. Differences in the ADC values with the choice of b values were analysed using one-way ANOVA. Choice of b values had a highly (P < 0.001) significant influence on the absolute ADC in each tissue. Maps using b = [50, 800] and [0, 800] were rated best (VS= 1.6 ± 0.3) and second best (1.1 ± 0.3, P < 0.001), respectively. For low-grade carcinomas (Gleason score ≤ 6, 13/41 patients), only the former choice received scores better than fair (VS = 1.4 ± 0.3). Mean tumour ADCs showed significant negative correlation (Spearman's ρ -0.38 to -0.46, P < 0.05) with Gleason score. Absolute ADC values strongly depend on the choice of b values and therefore should be used with caution for diagnostic purposes. A minimum b value greater than zero is recommended for ADC calculation to improve the visual assessment of PCa in ADC maps. • Absolute ADC values are highly dependent on the choice of b values. • Absolute ADC thresholds should be used carefully to predict tumour aggressiveness. • Subjective ratings of ADC maps involving b = 0 s/mm ( 2 ) are poor to fair. • Minimum b value greater than 0 s/mm ( 2 ) is recommended for ADC calculation.
    European Radiology 04/2012; 22(8):1820-8. · 4.34 Impact Factor
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    ABSTRACT: Laparoendoscopic single-site surgery (LESS) represents the next step of laparoscopic surgery and a major advancement towards scarless surgery. LESS radical nephrectomy is an evolving technique based on technological advancement of laparoscopic instruments as well as the refinement of existing techniques.The current report describes LESS nephrectomy technique, presents the experience with the technique in a series of 42 patients and reviews current literature in the field of LESS nephrectomy.
    Archivos españoles de urología 04/2012; 65(3):294-302.
  • European Urology Supplements 02/2012; 11(1):e71, e71a. · 3.37 Impact Factor
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    ABSTRACT: Endoscopic extraperitoneal radical prostatectomy (EERPE) is a well-established and standardized technique for treating patients with localized prostate cancer. Nevertheless, the procedure is continuously being refined with the expansion of anatomical knowledge. The development of a nerve-sparing approach and improvements in currently used equipment are expected to yield better results in cosmesis and convalescence without sacrificing the procedure's established benefits in terms of potency, continence and oncological management. In this study, the technique and its evolution are presented in detail, along with an analysis of its clinical efficacy. We also consult the literature to compare EERPE to transperitoneal laparoscopic radical prostatectomy, and we also discuss new technical advancements regarding the use of robotic assistance during EERPE.
    Asian Journal of Andrology 12/2011; 14(2):278-84. · 2.14 Impact Factor
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    ABSTRACT: The laparoscopic approach has been established as a treatment modality for the performance of radical nephrectomy during the recent years, while laparoscopic partial nephrectomy represents an alternative under investigation in several centers of laparoscopic excellence around the world. Significant advantages of laparoscopic surgery when compared to the classical open approach have extensively documented for over 2 decades. Nevertheless, laparoscopy is an evolving surgical field, which is characterized by the rapid adaptation of technical innovations. Laparoscopic renal surgery includes approaches for radical and partial nephrectomy with oncological outcome similar to open surgery and decreased postoperative morbidity and therefore can be considered for the same indications as open surgery. Several issues regarding the technical feasibility and refinement as well as the oncological efficacy of these procedures are presented.
    World Journal of Urology 11/2011; · 2.89 Impact Factor
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    ABSTRACT: PURPOSE: Laparoendoscopic single-site surgery (LESS) has emerged in the recent years as an alternative approach to conventional laparoscopic surgery which is accompanied by additional advantages over laparoscopy. In this work we attempt to review the current literature and to investigate the possible combination of LESS to other currently available approaches such as natural orifice transluminal endoscopic surgery (NOTES), needlescopic and robotic laparoscopic surgery. METHODS: Extensive literature search on the topics of LESS, hybrid and pure NOTES, Needlescopic-assisted LESS and "Robot-assisted LESS" took place. Additionally, the accumulated experience from 118 LESSs performed in our departments is presented in an attempt to provide evidence regarding the mix of technique in LESS in urology. RESULTS: The challenging nature of LESS limits the broader application and acceptance. Expanding experience in single-site surgery has currently provided tools such as transvaginal access, needlescopic instruments and robot assistance that can aid LESS and enhance its efficiency without compromising any of its advantages. A mix of these techniques with LESS could ease the stiff learning curve of the second and benefit not only its performance but also the adaptation of LESS as a standard practice. CONCLUSION: Pure LESS although feasible, remains a technical challenge for the surgeon, preventing the widespread application of the technique. The goal of urologists on LESS surgery should not be the purity of LESS approach, but the superiority against already established techniques. A mix of techniques could be a key for the documentation of the advantages of LESS over conventional laparoscopy.
    World Journal of Urology 10/2011; · 2.89 Impact Factor
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    ABSTRACT: INTRODUCTION: The conventional laparoscopic surgery is now paving way to the new technologies including robotic and laparoscopic single-site surgery (LESS). We present our updated experience on LESS radical nephrectomy (LESS-RN). PATIENTS AND METHODS: The data from patients undergoing LESS-RN in our two institutions were reviewed along with various clinical and pathological parameters. RESULTS: Between 2008 and 2011, 42 LESS-RN were performed (right = 22, left = 20) with mean (range) age and BMI of 63.7 (33-86) years and 25.1 (18-38.6) kg/m(2), respectively. In addition to the instruments in the single port, one extra 3-mm needlescopic instrument was required in 19 patients (right = 17, left = 2). In three patients, two additional 5-mm trocars and instruments were required. None required open conversion. The recorded adverse events include one bowel injury (intraoperative closure without the need for stoma), one postoperative bleeding requiring blood transfusion, one prolonged ileus, and one deep venous thrombosis. The resected specimens revealed pT1a (n = 3), pT1b (n = 33), pT2a (n = 4), and pT3b (n = 2) tumors. The finding of pT3b was incidental rather than planned procedure. None of the patients had positive margins. CONCLUSION: LESS-RN has proven to be feasible and safe. Beyond cosmesis, further advantages of this approach need to be addressed by randomized trials.
    World Journal of Urology 09/2011; · 2.89 Impact Factor
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    ABSTRACT: Several techniques have been introduced to improve early postoperative continence. In this study, we evaluated the impact of bladder neck (vesicourethral anastomosis) suspension on the outcome of extraperitoneal endoscopic radical prostatectomy (EERPE). In this research, a total of 180 patients underwent EERPE. Group 1 included patients who underwent nerve-sparing EERPE (nsEERPE) (n=45), and Group 2 included patients who underwent nsEERPE with bladder neck suspension (BNS, n=45). Groups 3 (n=45) and 4 (n=45) included patients who received EERPE and EERPE with BNS, respectively. Patients were randomly assigned to receive BNS with their nsEERPE or EERPE procedure. Perioperative parameters were recorded, and continence was evaluated by determining the number and weight of absorbent pads (pad weighing test) on the second day after catheter removal and by a questionnaire 3 months postoperatively. Two days after catheter removal, 11.1% of Group 1, 11.1% of Group 2, 4.4% of Group 3 and 8.9% of Group 4 were continent. The average urine loss was 80.4, 70.1, 325.0 and 291.3 g for the each of these groups, respectively. At 3 months, 76.5% of Group 1 and 81.3% of Group 2 were continent. The continence figures for Group 3 and 4 were 48.5% and 43.8%, respectively. Similar overall rates were observed in all groups. In conclusion, although there are controversial reports in the literature, early continence was never observed to be significantly higher in the BNS groups when compared with the non-BNS groups, regardless of the EERPE technique performed.
    Asian Journal of Andrology 09/2011; 13(6):806-11. · 2.14 Impact Factor
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    ABSTRACT: Pelvic lymphadenectomy (PLA) for the time being appears to be the most reliable staging method for localized prostate cancer (PCa), retrieving information concerning lymph node (LN) invasion that is important for the initiation of adjuvant therapy. LN metastasis is associated with poor prognosis and consequently there is a trend to perform PLA in all patients with respectable probability to harbor LN metastasis. The importance of PLA for prostate cancer (PCa) outcome is unclear. Laparoscopic PLA is a surgical operation carried out in an operative field adjacent to many important and vulnerable structures and is associated with an increased risk for surgical complications. Thus, expert surgical skills and a meticulous knowledge of pelvic anatomy are required in order for this challenging procedure to be carried out with effectiveness and reasonable risk to the patient. KeywordsExtended lymphadenectomy-Laparo­scopic-Pelvic lymphadenectomy-Prostate cancer
    06/2011: pages 97-109;
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    ABSTRACT: Recent technical advances and a trend toward laparoscopic single incision surgery have led us to explore the feasibility of laparoendoscopic single-site (LESS) hernia repair. We present our technique and initial experience with LESS extraperitoneal inguinal hernia repair in 10 consecutive men with unilateral inguinal hernias. Age range was 43.7 (28-64) years. Mean body mass index was 28 (range 24-30). Six were left inguinal hernias. There were six indirect and four direct hernias. Three patients had undergone previous open appendectomy. Incarcerated or bilateral hernias were excluded from our initial series. All cases were performed by three surgeons who were experienced in conventional totally extraperitoneal laparoscopic hernia repair as well as experienced in LESS. A literature review of current single-port inguinal hernia repair data is also presented. The mean operative time was 53 minutes (range 45-65  min). The average length of skin incision was 2.8  cm (range 2.3-3.2  cm). No drain was necessary in any of the patients, while no recordable bleeding was observed. There were no intraoperative or immediate postoperative complications. Hospitalization period was 2 days for all patients. After a limited follow-up of 1 month, there have been no recurrences and no complaints of testicular pain. The results of the current series compare favorably with those found in a literature review. LESS extraperitoneal inguinal hernia repair is both feasible and safe, although more technically demanding than its conventional laparoscopic counterpart. Although the cosmetic result with the former approach may prove superior, there are standing questions regarding the complications and long-term outcome. Randomized and if possible blinded trials that compare conventional and single-incision laparoscopic hernia repair may help to distinguish the most advantageous technique.
    Journal of endourology / Endourological Society 06/2011; 25(6):963-8. · 1.75 Impact Factor
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    ABSTRACT: Current management options for low-stage malignant germ-cell testicular tumours after radical orchiectomy include surveillance, chemotherapy, or retroperitoneal lymph node dissection (RPLND). Open RPLND is the surgical gold standard but has a number of limitations. Firstly, approximately two-thirds of patients have either necrosis/fibrosis or pathologically negative nodes. Secondly, the operation results in a large scar and significant perioperative morbidity and convalescence. Laparoscopic retroperitoneal lymph node dissection has developed as a possible alternative to the open procedure. Currently, laparoscopic retroperitoneal lymph node dissection (L-RPLND) is not recommended as a standard therapeutic option in the European Association of Urology (EAU) guidelines. L-RPLND has, however, proved to be an excellent staging tool ,which should be developed as a less invasive alternative to primary open RPLND. As a staging tool, L-RPLND is performed usually without retrocaval or retroaortic dissection and is used to determine pathological status. The therapeutic value of this more limited dissection is not known and currently trials are underway to establish the therapeutic benefits. L-RPLND has been reported as efficacious compared to open RPLND for staging of the retroperitoneum in patients with stage I nonseminomatous germ-cell testis tumours (NSGCT). The rate of tumour control after L-RPLND and the diagnostic accuracy of L-RPLND were equal to the open procedure, and the morbidity was significantly lower [1, 2]. Therefore, L-RPLND for stage I and low-volume retroperitoneal stage II disease may be performed at experienced urology centres as part of ongoing trials [3, 4]. Loss of antegrade ejaculation is the most common long-term problem that the young men who undergo this operation experience. In an attempt to minimise this problem, either a template dissection or nerve-sparing RPLND should be performed. In a right template dissection, the right postganglionic fibres are resected whilst the left side ones are left intact. This applies to the left side also. Complete unilateral resection of the nerves should not result in loss of antegrade ejaculation. Dissection of both sides is only required in bilateral RPLND.
    05/2011: pages 169-185;
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    ABSTRACT: To investigate the outcome of preperitoneal inguinal hernia mesh repairs performed during endoscopic extraperitoneal radical prostatectomy (EERPE). Ninety-three patients underwent inguinal hernia repair during 2125 EERPEs performed between 2002 and 2008. Seventy-seven patients had a unilateral hernia and 16 bilateral inguinal hernias. Patients were treated with EERPE or nerve-sparing EERPE and pelvic lymphadenectomy (if indicated) for localized prostate cancer. The mean age of the patients was 63 years (range 49-75 years). Operative time was 150 minutes (range 85-285 minutes) and estimated mean blood loss was 240 mL (range 30-600 mL). Blood transfusion was never deemed necessary. No conversions to open surgery took place. The mean duration of catheterization was 6.5 days (range 4-25 days). One patient developed a pelvic haematoma, three patients had symptomatic pelvic lymphoceles, and one developed an anastomotic stricture. One patient suffered a rectal injury during the procedure and another developed deep venous thrombosis. The only complication of hernia repair was mild penile bruising and edema. During the follow-up period, we have never observed mesh infection or hernia recurrence. EERPE combined with either a unilateral or bilateral laparoscopic hernia repair appears to be a safe and effective procedure. The incidence of complications related to either EERPE or the hernia repair was not increased. Oncological and functional outcome of EERPE seems not to be influenced by the performance of inguinal hernia repair.
    Journal of endourology / Endourological Society 03/2011; 25(4):625-9. · 1.75 Impact Factor

Publication Stats

1k Citations
155.09 Total Impact Points


  • 2007–2012
    • University of Patras
      • • Department of Urology
      • • School of Medicine
      Patrís, Kentriki Makedonia, Greece
  • 2003–2011
    • University of Leipzig
      • • Institute of Pathology
      • • Klinik und Poliklinik für Urologie
      Leipzig, Saxony, Germany
  • 2008
    • Universität Regensburg
      • Lehrstuhl für Urologie
      Regensburg, Bavaria, Germany