Despite improving diagnostic possibilities, the incidence of prostate cancer is increasing, but we are not able to reduce the mortality rate. While PSA, 4K score, PCA3 and other urinary markers, ExoDX, SelectMDX, Confirm MDx or MiPS tests are used to identify potential prostate cancer carriers, Decipher, Prolaris or Oncotype DX tests are used to assess the aggressiveness of proven cancer in order to stratify patients for early or delayed treatment. More modern forms of treatment for advanced disease include second-generation antiandrogens and PARP inhibitors. By assessing genetic mutations (e.g. BRCA1, BRCA2 genes, single nucleotide polymorphism) or the presence of splice variants of the androgen receptor (ARV7), we are able to identify patients in whom the planned treatment may be expected to be ineffective and thus choose other treatment modalities. In the present review article, we offer a comprehensive overview of current diagnostic tests that find application in the diagnosis of early and advanced prostate cancer.
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
INTRODUCTION: A kidney transplant is the best method for treating terminal kidney failure. Long-term results of kidney transplants from living donors are significantly better than transplants from dead donors. Living kidney donors are healthy people who undergo a major operation in order to improve the health of another person. Therefore, major emphasis is on safety, low level of invasiveness and a desirable cosmetic effect of the donor nephrectomy. Since 2012, the Department of Urology at the University Hospital in Olomouc has performed 12 kidney harvestings from living donors. The kidney harvesting was conducted using various techniques. CASE REPORT: The first robotic assisted kidney harvesting in the Czech Republic was performed in June 2022. The donor was a 57-year-old man who donated his kidney to his 32-year-old daughter. The left kidney was evaluated as suitable for kidney harvesting. The operation took 174 min. The kidney's warm ischemia was 145 s. Based on the Clavien Dindo classification, no 2nd degree or high post-operative complications were recorded. The donor's pre-operative glomerular filtration was 1.63 mL/s. Six months post-operation, it went down to 1.19 mL/s. This represents a 27% decrease. The kidney recipient did not require early dialysis. Six months post-operation, the recipient's glomerular filtration was 2.03 mL/s. CONCLUSION: In the hands of experienced professionals and transplantation centres, robotic assisted donor nephrectomy is a feasible and safe option for this operation. It not only provides all the advantages of a laparoscopic operation but it also adds other technical improvements and minimizes intraoperative stress on the surgeon. Currently, the global trend is moving towards increasing the ratio of robotic assisted donor nephrectomies.
- MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- nefrektomie * metody MeSH
- odběr tkání a orgánů metody MeSH
- roboticky asistované výkony * metody MeSH
- transplantace ledvin * metody MeSH
- žijící dárci * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Geografické názvy
- Česká republika MeSH
During endoscopic procedures for suspected urothelial tumors of the upper urinary tract, radiographic imaging using an iodinated contrast medium is often required. However, following ureteropyelography, we detected changes in cytology characteristics not correlating with real cytology findings in naive urine. The aim of our study was to assess cytology changes between naive and postcontrast urine according to The Paris System of cytology classification. Methods: We prospectively assessed urine samples from 89 patients (23 patients with histologically proven urothelial cancer and 66 healthy volunteers). The absence of malignancy was demonstrated by CT urography and/or ureteroscopy. The study was single blind (expert cytopathologist) and naïve Paris system for urine cytology assessment was used. Furthermore, additional cytological parameters were analyzed (e.g., specimen cellularity, degree of cytolysis, cytoplasm and nucleus color, chromatin and nucleo-cytoplasmic ratio). Results: Our study showed statistically significant differences when comparing naïve and postcontrast urine in healthy volunteers (only 51 % concordance, p = 0.001) versus malignant urine specimens (82 % concordance). The most important differences were in the shift from The Paris System category 2 (negative) to 1 (non-diagnostic) and from category 2 (negative) to 3 (atypia). Other significant changes were found in the assessment of specimen cellularity (p = 0.0003), degree of cytolysis (p = 0.001), cytoplasm color (p = 0.003), hyperchromasia (p = 0.001), course chromatin (p = 0.002), nucleo-cytoplasmatic ratio (p = 0.001) and nuclear borders' irregularity (p = 0.01). Conclusion: Our unique study found crucial changes in the cytological assessment of naive and postcontrast urine and we confirm that postcontrast urine is more often assessed as abnormal, suspect or non-diagnostic. Therefore, before urine collection for cytology, the clinician should avoid administration of iodinated contrast into the urinary tract.
- Publikační typ
- časopisecké články MeSH
Karcinom ledviny je nejčastějším primárním nádorem ledviny a Česká republika má z celého světa jeho nejvyšší incidenci. V době diagnózy je u 4–10 % pacientů zaznamenán nádorový trombus prorůstající do dolní duté žíly. Přesto je karcinom ledviny ve většině případů klinicky němý nebo se může projevovat atypickými příznaky. V prezentovaném případu dojde k diagnóze karcinomu ledviny s nádorovým trombem prorůstajícím do pravé srdeční síně náhodně až na základě náhle vzniklé dušnosti. Za spolupráce s kardiochirurgy naše pacientka podstoupila pravostrannou radikální nefrektomii s kavotomií a exstirpací nádorového trombu z pravé srdeční síně. Součástí výkonu bylo zavedení mimotělního oběhu s hlubokou hypotermií. I přes pokročilé stadium nádorového trombu operace proběhla úspěšně a pacientova prognóza je srovnatelná s pacienty, u kterých je nádorový trombus omezen pouze na renální žílu.
Renal cell carcinoma is the most common primary kidney tumor. Czech Republic has the highest incidence of this type of tumor in the world. The occurrence of a tumor thrombus in the inferior vena cava is recorded in 4 % up to 10 % of patients at the time of diagnosis. Renal cell carcinoma is in the most cases clinically mute or it may appear by atypical symptoms. In our case, the diagnosis of the renal cell carcinoma with a tumor thrombus extending in the right atrium was incidental, based on the sudden stuffiness. In collaboration with cardiac surgeons, the patient underwent a radical nephrectomy with cavotomy and exstirpation of the tumor thrombus protruding into right atrium through visual control. Despite the advanced stage of the tumor thrombus, the surgery was successful and there is similar prognosis as if the tumor thrombus was restricted to the renal vein.
- MeSH
- karcinom z renálních buněk * komplikace MeSH
- kardiochirurgické výkony metody MeSH
- koronární trombóza diagnostické zobrazování etiologie chirurgie patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nefrektomie MeSH
- prognóza MeSH
- srdeční síně chirurgie patologie MeSH
- stupeň nádoru MeSH
- trombektomie metody přístrojové vybavení MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Karcinom ledviny je nejčastějším primárním nádorem ledviny a Česká republika má z celého světa jeho nejvyšší incidenci. V době diagnózy je u 4–10 % pacientů zaznamenán nádorový trombus prorůstající do dolní duté žíly. Přesto je karcinom ledviny ve většině případů klinicky němý nebo se může projevovat atypickými příznaky. V prezentovaném případu dojde k diagnóze karcinomu ledviny s nádorovým trombem prorůstajícím do pravé srdeční síně náhodně až na základě náhle vzniklé dušnosti. Za spolupráce s kardiochirurgy naše pacientka podstoupila pravostrannou radikální nefrektomii s kavotomií a exstirpací nádorového trombu z pravé srdeční síně. Součástí výkonu bylo zavedení mimotělního oběhu s hlubokou hypotermií. I přes pokročilé stadium nádorového trombu operace proběhla úspěšně a pacientova prognóza je srovnatelná s pacienty, u kterých je nádorový trombus omezen pouze na renální žílu.
Renal cell carcinoma is the most common primary kidney tumor. Czech Republic has the highest incidence of this type of tumorin the world. The occurrence of a tumor thrombus in the inferior vena cava is recorded in 4 % up to 10 % of patients at the timeof diagnosis. Renal cell carcinoma is in the most cases clinically mute or it may appear by atypical symptoms. In our case, thediagnosis of the renal cell carcinoma with a tumor thrombus extending in the right atrium was incidental, based on the suddenstuffiness. In collaboration with cardiac surgeons, the patient underwent a radical nephrectomy with cavotomy and exstirpationof the tumor thrombus protruding into right atrium through visual control. Despite the advanced stage of the tumor thrombus,the surgery was successful and there is similar prognosis as if the tumor thrombus was restricted to the renal vein.
- MeSH
- karcinom z renálních buněk * diagnóza chirurgie komplikace MeSH
- kardiochirurgické výkony * metody MeSH
- koronární trombóza etiologie chirurgie patofyziologie MeSH
- lidé MeSH
- mimotělní oběh metody trendy MeSH
- nádory ledvin diagnóza chirurgie komplikace MeSH
- srdeční síně chirurgie patofyziologie patologie MeSH
- statistika jako téma MeSH
- terapeutická hypotermie metody trendy MeSH
- trombektomie metody MeSH
- trombóza * diagnóza komplikace patofyziologie MeSH
- vena cava inferior patofyziologie patologie MeSH
- žilní trombóza etiologie chirurgie patofyziologie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
