Francesco Porpiglia's research while affiliated with Azienda Ospedaliero Universitaria San Luigi Gonzaga and other places

Publications (653)

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Objective To compare perioperative outcomes following retroperitoneal robot-assisted partial nephrectomy (RPRAPN) and transperitoneal robot-assisted partial nephrectomy (TPRAPN). Methods With this Vattikuti Collective Quality Initiative (VCQI) database, study propensity scores were calculated according to the surgical access (TPRAPN and RPRAPN) fo...
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Purpose To evaluate the role of 3D models on positive surgical margin rate (PSM) rate in patients who underwent robot-assisted radical prostatectomy (RARP) compared to a no-3D control group. Secondarily, we evaluated the postoperative functional and oncological outcomes. Methods Prospective study enrolling patients with localized prostate cancer (...
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Background Nowadays a tool able to predict the risk of lymph-node invasion (LNI) in patients underwent target biopsy (TB) only before radical prostatectomy (RP) is still lacking. Our aim is to develop a model based on mp-MRI and target biopsy (TB) alone able to predict the risk of LNI. Methods We retrospectively extracted data of patients with pre...
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In current precision prostate cancer (PCa) surgery era the identification of the best patients candidate for prostate biopsy still remains an open issue. The aim of this study was to evaluate if the prostate target biopsy (TB) outcomes could be predicted by using artificial intelligence approach based on a set of clinical pre-biopsy. Pre-biopsy cha...
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Objective The aim of the study was to evaluate three-dimensional virtual models (3DVMs) usefulness in the intraoperative assistance of minimally-invasive partial nephrectomy in highly complex renal tumors. Methods At our institution cT1-2N0M0 all renal masses with Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) classification sc...
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Context: Robot-assisted partial nephrectomy (RAPN) has gained increasing popularity as primary minimally invasive surgical treatment for localized renal tumors, and it has preferably been performed with a transperitoneal approach. However, the retroperitoneal approach represents an alternative approach given potential advantages. Objective: To p...
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Purpose: Prediction of complications and surgical outcomes is of outmost importance even in patients with benign renal masses. The aim of our study is to test the PADUA, SPARE and R.E.N.A.L. scores to predict nephron sparing surgery (NSS) outcomes in patients presenting with renal angiomyolipoma (RAML). Methods: We retrospectively analyzed the c...
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Radical cystectomy (RC) often affects patients’ life as this surgery is a traumatic and invasive event for the patients, with drawbacks on their daily, social, working, and sex life. Such changes in the quality of life (QoL) of patients are commonly studied through retrospective clinical evaluations and rarely with longitudinal studies. To date, st...
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Background Some renal tumors have an imperative indication for nephron-sparing surgery (NSS), such as in cases of chronic kidney disease and bilateral complex tumors. Objective To demonstrate the degree to which three-dimensional virtual model (3DVM) assistance can be helpful in planning the surgical strategy for high-complexity renal masses with...
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Purpose Many software for US/MRI guided fusion prostate biopsy (FPB), have been developed in the last years. However, there are few data comparing diagnostic accuracy of different fusion systems. We assessed diagnostic performance of elastic (EF) versus rigid fusion (RF) PB in a propensity score matched (PSM) analysis. Methods A total of 314 FPB w...
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BACKGROUND : Treatment paradigms for management of metastatic Renal Cell Carcinoma (mRCC) are evolving. We examined impact of surgical metastasectomy on survival across in mRCC stratified by risk-group. METHODS : Multicenter retrospective analysis from the REMARCC (REgistry of MetAstatic RCC) database. The cohort was subdivided utilizing Motzer cr...
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Introduction: Augmented reality (AR) applied to surgical procedures refers to the superimposition of preoperative or intra-operative images onto the operative field. Augmented reality has been increasingly used in myriad surgical specialties including Urology. The following study reviews advances in the use of AR for improvements in urologic outco...
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Background Long-term renal function after partial nephrectomy (PN) is difficult to predict as it is influenced by several modifiable and nonmodifiable variables, often intertwined in complex relations. Objective To identify variables influencing long-term renal function after PN and to assess their relative weight. Design, setting, and participan...
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Robot-assisted simple prostatectomy represents a solid treatment option for benign prostatic obstruction in patients with large prostate glands. This procedure offers multiple attractive features that make it a strong competitor against endoscopic enucleation of the prostate.
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Context The development of a tailored, patient-specific medical and surgical approach is becoming object of intense research. In kidney oncologic surgery, where a clear understanding of case-specific surgical anatomy is considered a key point to optimize the perioperative outcomes, such philosophy gained increasing importance. Recently, important a...
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Objectives: Martini et al. developed a nomogram to predict significant (>25%) renal function loss after robot-assisted partial nephrectomy and identified four risk categories. We aimed to externally validate Martini's nomogram on a large, national, multi-institutional data set including open, laparoscopic, and robot-assisted partial nephrectomy....
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Objective In the last years three dimensional virtual models (3DVMs) had a widespread diffusion in the renal surgery field thanks to their more precise representation of anatomical details. Among the different ways to use the 3DVMs, Augmented reality seems one of the most promising thanks to the possibility of its application during both preoperati...
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Introduction: The current study presents a Deep Learning framework to determine, in real-time, position and rotation of a target organ from an endoscopic video. These inferred data are used to overlay the 3D model of patient's organ over its real counterpart. The resulting augmented video flow is streamed back to the surgeon as a support during la...
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Background: Hypertension (HTN) is a global public health issue. There are limited data regarding the effects of HTN in patients undergoing partial nephrectomy (PN) for renal tumors. To address this void, we tested the association between HTN and renal function after minimally invasive PN (MIPN). Methods: Using a multi-institutional database (200...
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Aim: The purpose of the study was to describe our surgical technique of salvage robot-assisted radical prostatectomy (sRARP) in patients who underwent primary high-intensity focused ultrasound (HIFU) and to report the perioperative, functional, and oncological outcomes during the first year follow up. The secondary aim of the study was to review th...
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Background: To propose a trifecta that summarizes endpoints and predicts their maintenance after adrenalectomy (n = 90) for unilateral primary aldosteronism (UPA). Methods: Trifecta was defined as coexistence of: ≥50% antihypertensive therapeutic intensity score reduction (∆TIS), no hypokalemia at 3 months, and no Clavien grade 2-5. Logistic reg...
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Background: To test for differences in cancer specific mortality (CSM) rates between radical nephrectomy (RN) and partial nephrectomy (PN) in pT3a nmRCC patients. Methods: Within the Surveillance, Epidemiology, and End Results database (2005-2016), 13,177 pT3a patients treated with either PN or RN were identified. Before and after 1:2 ratio prop...
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PurposeTo externally validate the Palacios’ equation estimating the new baseline glomerular filtration rate (NB-GFR) after partial or radical-nephrectomy (PN, RN) for Renal cancer carcinoma (RCC).Materials and methodsOur research group recently published two studies that investigated the association between renal function and cancer-specific surviv...
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Objective : Nowadays the development of new technologies in urological field allows to perform surgical approaches tailored on the characteristics of each single case. Three-dimensional virtual models (3DVMs) have been developed in the last years to overcome the “building in mind” process that the surgeon should do to perceive the features of the o...
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Objectives To present our Urethral Sparing Robotic-Assisted Simple Prostatectomy (usRASP) technique for large Benign Prostatic Enlargement (BPE) and to evaluate its efficacy in maintaining antegrade ejaculation. Patients and surgical procedures In this prospective study we enrolled consecutive patients who underwent RASP with urethral-sparing inte...
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Context Therapies based on immune checkpoint inhibitors (ICIs) are transforming the treatment landscape of urologic oncology. Nevertheless, an exhaustive overview of the toxicity spectrum of these novel therapies has yet to be provided. Objective To comprehensively investigate the incidence and profile of ICI therapy-related adverse events (AEs) a...
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BACKGROUND : Augmented reality robot-assisted partial nephrectomy (AR-RAPN) is limited by the need of a constant manual overlapping of the hyper-accuracy 3D (HA3DTM) virtual models to the real anatomy. OBJECTIVE : To present our preliminary experience with automatic 3D virtual model overlapping during AR-RAPN. MATERIALS : To reach a fully automat...
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Objective In 3% of cases renal cell carcinoma (RCC) is diagnosed with synchronous bilateral renal masses. However, until today, the optimal treatment strategies for these patients remain unknown. In clinical practice bilateral partial nephrectomies (PNs) are the treatment of choice because of the functional advantage relative to radical nephrectomy...
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Introduction: The COVID-19 pandemic has caused wide-reaching change to many aspects of life on a worldwide scale. The impact of these changes on peer-reviewed research journals, including those dedicated to urology, is still unknown. Material and methods: The Web of Science database was queried to retrieve all COVID-19 urological articles writte...
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The development of a tailored, patient-specific medical and surgical approach is becoming the object of intense research. In robotic urologic surgery, where a clear understanding of case-specific surgical anatomy is considered a key point to optimizing the perioperative outcomes, such philosophy has gained increasing importance. Recently, significa...
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In the last few years, new technologies have been developed to treat benign prostatic hyperplasia (BPH) in order to offer valid surgical alternatives to transurethral resection of the prostate with lower complications and hospitalization while maintaining satisfactory functional results. Among these new approaches, transurethral implantation of fir...
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Introduction New evidence indicates that minimally invasive surgery (MIS) (laparoscopic or robotic-assisted [LNU, RANU]) reaches oncologic equivalence compared with Open Radical Nephroureterectomy (ORNU) for high-risk upper-tract urothelial carcinoma (UTUC). Recently, European Association of Urology (EAU) Guidelines suggested implementing neoadjuva...
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Objectives To describe our robotic Y intracorporeal neobladder (ICNB) technique and to report its post-operative complications and urodynamics (UD) findings. Subjects and Methods: In this prospective study we enrolled patients affected by MIBC (T1-T4N0–N1M0) from 01/2017 to 06/2021 at our Centers. All the patients underwent robotic radical cystect...
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INTRODUCTION: Colovesical fistulas (CVFs) account for approximately 95% enterovesical fistulas (EVFs). About 2/3 CVF cases are diverticular in origin. It mainly presents with urological signs such as pneumaturia and fecaluria. Diagnostic investigations aim at confirming the presence of a fistula. Although conservative management can be chosen for s...
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Nowadays, the urologic surgery has entered in precision surgery era. The image guided surgery is one of the most promising technology, and in particular the possibility to overlap virtual images enhancing the patient’s anatomy allows to perform augmented reality procedures (AR).
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Background: The aim of the study was to assess the effectiveness of the main classes of drugs used at reducing morbidity related to ureteric stents. Summary: After establishing a priori protocol, a systematic electronic literature search was conducted in July 2019. The randomized clinical trials (RCTs) selection proceeded in accordance with the...
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PurposeTo assess the outcomes of retroperitoneal robot-assisted partial nephrectomy (r-RAPN) in a large cohort of patients with postero-lateral renal masses comparing to those of transperitoneal RAPN (t-RAPN).Methods Patients with posterior (R.E.N.A.L. score grading P) or lateral (grading X) renal mass who underwent RAPN in six high-volume US and E...
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The clinical utility of three-dimensional virtual models has been widely explored for preoperative planning, patient counseling, surgical training, and intraoperative navigation. There is now a need for standardized methodology for construction of these models so that their utility can be realized in routine practice to achieve the goal of individu...
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Background Despite technical and technological innovations, percutaneous puncture still represents the most challenging step when performing percutaneous nephrolithotomy. This maneuver is characterized by the steepest learning curve and a risk of injuring surrounding organs and kidney damage. Objective To evaluate the feasibility of three-dimensio...
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Background: To investigate the impact of COVID-19 outbreak on the diagnosis and treatment of non-muscle invasive bladder cancer (NMIBC). Methods: A retrospective analysis was performed using an Italian multi-institutional database of TURBT patients with high-risk urothelial NMIBC between January 2019 and February 2021, followed by Re-TURBT and/or a...
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PurposeTo provide a systematic analysis of the comparative outcomes of robot-assisted radical prostatectomy (RARP) versus laparoscopic radical prostatectomy (LRP) in the treatment of prostate cancer based on the best currently available evidence.Methods An independent systematic review of the literature was performed up to February 2021, using MEDL...
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In the last years, the widespread use of the prostate-specific antigen (PSA) blood examination to triage patients who will enter the diagnostic/therapeutic path for prostate cancer (PCa) has almost halved PCa-specific mortality. As a counterpart, millions of men with clinically insignificant cancer not destined to cause death are treated, with no b...
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Introduction: Retzius-Sparing Robotic Assisted Radical Prostatectomy (RS-RARP) is a novel surgical approach to radical prostatectomy. Its pioneers have suggested an improved recovery of urinary continence, while maintaining adequate cancer control. Aim of this systematic review is to explore available data on RS-RALP and compare functional, oncolo...
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Prostate cancer (PCa) therapy has been recently revolutionized by the approval of new therapeutic agents in the metastatic setting. However, the optimal therapeutic strategy in such patients should be individualized in the light of prognostic and predictive molecular factors, which have been recently studied: androgen receptor (AR) alterations, PTE...