0000000000185728
AUTHOR
E. Mourey
Photovaporisation prostatique au laser Greenlight® : comparaison des couts (microcosting) et des recettes (t2a)
Objectifs Depuis une vingtaine d’annees, la chirurgie de l’HBP est marquee par le developpement de techniques lasers sans GHS specifique necessitant un dispositif medical couteux ( fibre laser ) non rembourse en sus des GHS. L’objectif a ete d’evaluer le cout d’une telle intervention en hospitalisation complete afin de le comparer aux recettes percues (GHS) et aux couts estimes par l’etude nationale des couts a methodologie commune (ENCC). Methodes C’est une etude prospective, observationnelle et descriptive des couts de prise en charge. Les ressources medicales directes et indirectes ont ete identifiees et valorisees. Chaque sejour a ete decompose en deux periodes. Les couts de la phase pe…
Robot-assisted or pure laparoscopic nerve-sparing radical prostatectomy: What is the optimal procedure for the surgical margins? A single center experience
Objectives: To compare positive surgical margin rates after robot-assisted and pure laparoscopic radical prostatectomy when neurovascular bundles are preserved, and to identify parameters affecting surgical margin status. Methods: From March 2004 to January 2009, 279 consecutive prostatectomies with preservation of neurovascular bundles were carried out by the same surgeon: 175 robot-assisted radical prostatectomies and 104 laparoscopic radical prostatectomies. An intraperitoneal Montsouris's technique was used for all cases. Patient's age, body mass index, prostate weight, prostate-specific antigen level, clinical stage, preoperative and postoperative Gleason score, percentage of positiv…
Visceral fat area as a new independent predictive factor of survival in patients with metastatic renal cell carcinoma treated with antiangiogenic agents.
Abstract Purpose. A better identification of patients who are more likely to benefit from vascular endothelial growth factor–targeted therapy is warranted in metastatic renal cell carcinoma (mRCC). As adipose tissue releases angiogenic factors, we determined whether parameters such as visceral fat area (VFA) were associated with outcome in these patients. Experimental Design. In 113 patients with mRCC who received antiangiogenic agents (bevacizumab, sunitinib, or sorafenib) (n = 64) or cytokines (n = 49) as first-line treatment, we used computed tomography to measure VFA and subcutaneous fat area (SFA). We evaluated associations linking body mass index (BMI), SFA, and VFA to time to progres…
Le robot améliore-t-il la prostatectomie totale laparoscopique dans les cas complexes ?
Resume La prostatectomie totale est le traitement de reference du cancer de prostate de l’homme jeune. Mais dans les cas difficiles, les patients peuvent etre orientes vers une autre option therapeutique. Objectif Evaluation de la qualite de l’anastomose dans les cas complexes de chirurgie comparant la voie laparoscopique PTL a la voie laparoscopique assistee du robot PTLR. Materiel Trois cent quatre-vingt dix-sept patients ont ete operes de mars 2004 a aout 2009, 176 PTL et 221 PTLR de maniere consecutive par un meme chirurgien. Les antecedents pouvant compliquer le geste chirurgical ont ete analyses : volume prostatique superieur a 80 cc, antecedent de cure de hernie inguinale avec prothe…