96. (C) 2013 Elsevier B.V. All rights reserved.”
“Purpose of review
The evolution of percutaneous renal stone surgery has recently seen an increasing number undergoing Copanlisib molecular weight surgery in the supine position rather than just the classical prone technique. Several advantages have been proposed with the supine approach, including benefits for anaesthesia (cardiovascular and airway), the patient (reduced transfer-related injuries), and surgeon (combined retrograde and antegrade surgery, and ergonomics). As the supine technique and variations have now been practised for several years, it is timely to review whether it has been adopted universally and what factors may lead
to preference for one approach over another.
There have been several retrospective reports, but only two prospective randomized trials published in the literature,
comparing the techniques. There have also been recent attempts at establishing national and international databases for percutaneous nephrolithotomy (PCNL) surgery to try and describe the practice patterns for this surgery, and also the factors that influence the decision to adopt a particular position. Although there CH5424802 Protein Tyrosine Kinase inhibitor appear to be no clear overall benefits for one position over another, and practice is likely to remain fairly surgeon-specific, there are some cases in which the supine PCNL may be preferable (e.g. in obese patients).
Along with the development of centres offering this surgical technical variation, endourology training programmes will increasingly offer exposure to supine PCNL, which may then affect the global practice patterns.”
“Objective: To analyse our experience with endovascular stent graft repair of descending aorta dissections that require supraaortic
branch vessel revascularisation. Design: Retrospective study.
Methods: From 2001 to 2009, 22 consecutive patients with the above dissections were retrospectively analysed. Inclusion requirement: aortic landing zone proximal to the left subclavian artery of less than 15 Hybrid, scalloped or fenestrated endovascular stent grafts were selected based on dissection characteristics. Annual follow-up visits (median 27.1 months) included computed tomography angiography. ACY-1215 molecular weight End points include progressive pathology, complications and survival rates.
Results: Surgery was successful in all except for one operative complication. Two patients died within 30 days after surgery, one to cerebral infarction and the other to myocardial infarction. No postoperative complications occurred in the remaining patients. Thrombosis formed in the aortic false lumen of the graft exclusion segment in all patients. The maximum diameter of this segment decreased in 18 patients and was stable in two. In 19 patients, blood flow remained in the false lumen distal to the exclusion area not covered by stent. Patency was seen at mid- and long-term follow-up, without proximal endoleak, graft displacement or deaths.