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Radiation protection management recommends radiation exposures that are as low as reasonably achievable (ALARA), while still maintaining image quality. The aim of the study is to compare radiation exposure during pediatric percutaneous nephrolithotomy (PCNL) before and after implementation of strategy for optimization of fluoroscopic imaging by measuring the Dose Area Product (DAP) and the Fluoroscopy time (FT) and study its effect on surgical outcomes.

We prospectively observed 56 children (group 1) undergoing PCNL for kidney stones in whom a radiation dose reduction strategy was adopted. The strategy included several intraoperative measures, including optimizing position by keeping the fluoroscopy table as far from the X-ray tube as possible and the image intensifier close to the patient, preventing use of fluoroscopy for positioning, use of pulsed mode with last image hold technique, beam collimation and use of a designated fluoroscopy technician. Outcomes were compared to those in 42 children (group 2) before implementing dose reduction strategy.

DAP was decreased by 44% from 2.46 in group 2 to 1.38mGy m2 in group 1 (p<0.04). Total fluoroscopy time was significantly reduced by 55% from 100.8s in group 2-45s in group 1 (p<0.002) after protocol implementation with very little loss of image quality.

Radiation exposure in children undergoing PCNL can be reduced significantly after optimization of fluoroscopy imaging. A reduced radiation protocol did not increase surgical complexity, operative time, or complication rates while reducing radiation exposure in a population vulnerable to its hazardous effects.

Radiation exposure in children undergoing PCNL can be reduced significantly after optimization of fluoroscopy imaging. A reduced radiation protocol did not increase surgical complexity, operative time, or complication rates while reducing radiation exposure in a population vulnerable to its hazardous effects.

Near-infrared fluorescence (NIRF) imaging with indocyanine green (ICG) has been recently adopted in pediatric minimally invasive surgery (MIS) in order to improve intra-operative visualization of anatomic structures and facilitate surgery.

This study aimed to report our preliminary experience using ICG technology in pediatric urology using laparoscopy and robotics.

ICG technology was adopted in 57 laparoscopic or robotic urological procedures performed in our unit over a 24-month period 41 (38 laparoscopic - 3 robotic) left varicocele repairs with intra-operative lymphography and 16 renal procedures (12 laparoscopic - 4 robotic) including 9 partial nephrectomies, 3 nephrectomies and 4 renal cyst deroofings.

The ICG solution was injected intravenously in renal procedures or into the testis body in case of varicocele repair. Regarding the timing of the administration, the ICG injection was performed intra-operatively in all cases and allowed the visualization of the anatomic structures in a matter of 30tle). The most common and useful applications in pediatric urology included varicocele repair, partial nephrectomy ad renal cyst deroofing. The main limitation is the specific equipment needed in laparoscopy, that is not available in all centers whereas the robot is equipped with the Firefly® software for NIRF.

Evaluate the impact of social deprivation on morbidity and mortality in surgery for colorectal cancer.

The COINCIDE prospective cohort included nearly 2,000 consecutive patients operated on for colorectal cancer at the Assistance Publique-Hospitals of Paris (AP-HP) from 2008 to 2010. The data on these patients were crossed with the PMSI administrative database. The European Social Deprivation Index (EDI) was calculated for each patient and classified into five quintiles (quintiles 4 and 5 being the most disadvantaged patients). Thirty-day post-operative morbidity was determined according to the Dindo-Clavien classification, with a Had®Hoc re-analysis of each file. Statistical analysis was performed using the proprietary Q-finder® algorithm.

One thousand two hundred and fifty nine curative colorectal resections were analyzed. Mortality was 2.7% and severe morbidity (Dindo-Clavien≥3) occurred in 16.4%. Mortality was not statistically significantly increased among the most disadvantaged who made up almost s is its use in health policy for the distribution of resources.

Despite ongoing optimisation of surgical techniques, hemostasis continues to be a fundamental challenge in many operations today. This randomised controlled trial compared the efficacy of a new hemostatic agent made of oxidised regenerated cellulose and collagen (ORC-Coll) with that of a conventional carrier-bound fibrin sealant (CBFS).

Hemostasis was investigated representatively in the case of post-thyroidectomy bleeding from the resection surface. To demonstrate that ORC-Coll (mediCipio®A) has at least the same hemostatic efficacy as CBFS (Tachosil®), the volume of drainage fluid at the time of drain removal was used as the primary endpoint in a non-inferiority test with a significance level of 5%. The secondary endpoints included number and size of hemostatic agents required, adhesion of the hemostatic agent to the bleeding surface, intraoperative hemostatic effect, duration of drainage and adverse events during a six-month follow-up period.

A total of 150 patients (ORC-Coll 75; CBFS 75) were included. After operation, total volume of drainage fluid was 68.20±44.56mL in the ORC group and 68.21±40.20mL in the CBFS group. The non-inferiority of ORC-Coll compared to CBFS with regard to hemostatic efficacy was shown at a significance level of 5%. The results demonstrated effectiveness in achieving hemostasis without adverse events.

ORC-Coll is an effective hemostatic agent and barrier sealant without blood components, which ensures reliable prevention of intra- and postoperative bleeding. buy CBR-470-1 With use of the new technique, any risks associated with the use of human blood components are a priori eliminated.

ORC-Coll is an effective hemostatic agent and barrier sealant without blood components, which ensures reliable prevention of intra- and postoperative bleeding. With use of the new technique, any risks associated with the use of human blood components are a priori eliminated.