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Article ; Online: Technical challenges of lymphadenectomy in renal carcinoma performed with a 3D laparoscopic approach at a low pressure pneumoperitoneum due to associated pulmonary pathology - case report.

Bujoreanu, Cristina E / Dor, Yarden / Petrut, Bogdan

2022 Volume 95, Issue 3, Page(s) 332–336

Abstract: We report the case of a 63-year-old male patient presenting left renal cell carcinoma (75/70/60 mm) associated with retroperitoneal lymph node masses (peri hilar of 15 mm; lombo-aortic of 50/40/30 mm), known also with chronic obstructive pulmonary ... ...

Abstract	We report the case of a 63-year-old male patient presenting left renal cell carcinoma (75/70/60 mm) associated with retroperitoneal lymph node masses (peri hilar of 15 mm; lombo-aortic of 50/40/30 mm), known also with chronic obstructive pulmonary disease GOLD4, sleep apnea and asthma with oxygen-dependent chronic obstructive respiratory insufficiency, a BMI of 37 with grade III obesity. Surgical treatment was performed using a 3D transperitoneal laparoscopic approach. The surgery lasted 131 minutes, with 400 ml blood loss and grade 1 Clavien-Dindo post operative complications. An optimal pulmonary ventilation of the patient during surgery required a low intra-abdominal pressure (10 mmHg) which raised technical difficulties due to the lymph node mass dissection from the great vessels in a small operative field on an already obese patient with a voluminous renal tumor. The 3D transperitoneal laparoscopic approach was feasible within safe oncologic parameters.
Language	English
Publishing date	2022-07-26
Publishing country	Romania
Document type	Case Reports
ZDB-ID	2974425-8
ISSN	2668-0572 ; 2602-0807
ISSN (online)	2668-0572
ISSN	2602-0807
DOI	10.15386/mpr-2055
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Article: Post-Pandemic Aftermath: A Two-Year Follow-Up of the Effect of COVID-19 on Oncological Outcomes after Radical Prostatectomy for Prostate Cancer.

Borz, Mihnea Bogdan / Schitcu, Vlad Horia / Crisan, Nicolae / Petrut, Bogdan / Buhas, Bogdan Adrian / Borz, Paul Cristian / Valean, Dan / Duquesne, Igor / Coman, Ioan

Archivos espanoles de urologia

2024 Volume 77, Issue 1, Page(s) 43–48

Abstract: Purpose: This study aimed to evaluate the indirect effect of the Coronavirus Disease 2019 (COVID-19) pandemic on the surgical outcomes and oncological results of patients who underwent surgery during the lockdown period.: Methods: We analysed data ... ...

Abstract	Purpose: This study aimed to evaluate the indirect effect of the Coronavirus Disease 2019 (COVID-19) pandemic on the surgical outcomes and oncological results of patients who underwent surgery during the lockdown period. Methods: We analysed data from 423 patients who underwent radical prostatectomy between 2016 and 2022, with a cut-off date of March 16, 2020. Patients were categorised into two groups, namely, pre-lockdown (n = 289) and during lockdown (n = 134). Perioperative variables, histopathological findings and oncological outcomes, including prostate-specific antigen (PSA) levels and biochemical recurrence (BCR), were assessed. Results: The number of radical prostatectomy increased by 24.26% during lockdown. The study included patients with a mean follow-up of 21 months. A nonsignificant trend towards a higher PSA level at presentation was found (14.22 vs. 12.53 ng/dL, Conclusions: The COVID-19 pandemic led to poor postoperative results. Through a 2-year follow-up, this research investigated the effect of the pandemic on the oncological outcomes, particularly BCR, of patients who underwent radical prostatectomy. Further extended investigations and multi-institutional studies should be conducted to quantify the effect of the pandemic on various cancer outcomes and inform crisis management strategies.
MeSH term(s)	Male ; Humans ; Prostate-Specific Antigen ; Pandemics ; Follow-Up Studies ; COVID-19/epidemiology ; Communicable Disease Control ; Prostatic Neoplasms/epidemiology ; Prostatic Neoplasms/surgery ; Prostatic Neoplasms/pathology ; Prostatectomy/methods ; Retrospective Studies ; Neoplasm Recurrence, Local
Chemical Substances	Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2024-02-19
Publishing country	Spain
Document type	Journal Article
ZDB-ID	211673-x
ISSN	0004-0614
ISSN	0004-0614
DOI	10.56434/j.arch.esp.urol.20247701.6
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Article ; Online: Comprehensive Analysis of Perioperative Factors Influencing the Risk of Biochemical Recurrence in Patients with Radical Prostatectomy.

Borz, Mihnea Bogdan / Schitcu, Vlad Horia / Crisan, Nicolae / Petrut, Bogdan / Borz, Oliviu Cristian / Borz, Paul Cristian / Duquesne, Igor / Nasri, Jordan / Coman, Ioan

Urology journal

2024

Abstract: Purpose: To analyze the perioperative factors that influence the risk of biochemical recurrence (BCR) in patients with localized PCa undergoing radical prostatectomy: Materials and methods: A total of 457 patients, operated by 2 surgeons in our high- ... ...

Abstract	Purpose: To analyze the perioperative factors that influence the risk of biochemical recurrence (BCR) in patients with localized PCa undergoing radical prostatectomy Materials and methods: A total of 457 patients, operated by 2 surgeons in our high-volume oncological center were included in the initial database. Patients who underwent RP for clinically localized PCa in our clinic from 2016 to 2021 were included in the study. Perioperative data were retrospectively reviewed for this study. Follow-up data including post-operative PSA and adjuvant treatment was prospectively gathered by contacting the patients or from the follow-up consultation. Final database was composed of 366 patients who underwent open or 3D laparoscopic RP. Statistical analysis was performed to emphasize the most powerful parameters that influence the BCR. Results: Accounting for multivariable analysis, 4 parameters were statistically significant: initial PSA (iPSA), Gleason score, vascular involvement and positive surgical margins. For the group of patients with no positive margins, 3 parameters were statistically significant: iPSA above 10,98 ng/mL (AUC=0,71); lymph node involvement and Gleason score. Multivariable Cox regression showed that positive margins and iPSA had a significant impact on the time to BCR. Patients that received adjuvant therapy were excluded from the study. Out of the whole cohort, 27,3% of patients presented BCR. Result: Accounting for multivariable analysis, 4 parameters were statistically significant: initial PSA (iPSA), Gleason score, vascular involvement and positive surgical margins. For the group of patients with no positive margins, 3 parameters were statistically significant: iPSA above 10,98 ng/mL (AUC=0,71); lymph node involvement and Gleason score. Multivariable Cox regression showed that positive margins and iPSA had a significant impact on the time to BCR. Patients that received adjuvant therapy were excluded from the study. Out of the whole cohort, 27,3% of patients presented BCR. Conclusion: Perioperative factors need to be carefully analyzed and a detailed follow-up needs to be conducted in order to assess the risk of biochemical recurrence, resulting in the optimal time for adjuvant treatment implementation.
Language	English
Publishing date	2024-01-14
Publishing country	Iran
Document type	Journal Article
ZDB-ID	2251940-3
ISSN	1735-546X ; 1735-1308
ISSN (online)	1735-546X
ISSN	1735-1308
DOI	10.22037/uj.v20i.7835
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Article: Protective Effects of Wine Polyphenols on Oxidative Stress and Hepatotoxicity Induced by Acrylamide in Rats.

Banc, Roxana / Popa, Daniela-Saveta / Cozma-Petruţ, Anamaria / Filip, Lorena / Kiss, Béla / Fărcaş, Anca / Nagy, Andras / Miere, Doina / Loghin, Felicia

Antioxidants (Basel, Switzerland)

2022 Volume 11, Issue 7

Abstract: In recent years, it has been increasingly suggested that the consumption of natural polyphenols, in moderate amounts, is beneficial for health. The aim of this study was to investigate the efficacy of a red wine (the administered dose of 7 mL/kg/day ... ...

Abstract	In recent years, it has been increasingly suggested that the consumption of natural polyphenols, in moderate amounts, is beneficial for health. The aim of this study was to investigate the efficacy of a red wine (the administered dose of 7 mL/kg/day being equivalent to ~16.5 mg/kg/day total polyphenols) compared to a white wine (the administered dose of 7 mL/kg/day being equivalent to ~1.7 mg/kg/day total polyphenols), on the prevention of acrylamide-induced subacute hepatic injury and oxidative stress in Wistar rats. Hepatic damage due to acrylamide intoxication (the administered dose being 250 µg/kg body weight, for 28 days, by intragastric gavage) was assessed by employing biochemical parameters (aspartate aminotransferase (AST) and alanine aminotransferase (ALT)) and by histopathological studies. Markers of oxidative damage were measured in terms of plasma malondialdehyde (MDA), hepatic Thiobarbituric Acid Reactive Substances (TBARS) and glutathione (GSH) levels, and liver antioxidant enzyme (superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx)) activities. Regarding hepatic enzyme activities, treatment with red wine significantly decreased the AST values (p < 0.05), while for the ALT values only a normalization tendency was observed. Treatment with red wine and white wine, respectively, significantly prevented the increase in MDA and TBARS levels (p < 0.05), as well as the depletion of GSH (p < 0.05). Red wine treatment normalized the activities of the antioxidant enzymes CAT and SOD in rats intoxicated with acrylamide, while supplementing the diet with white wine did not produce significant differences in the antioxidant enzyme activities. Histopathological findings revealed a moderate protective effect of red wine after four weeks of daily consumption. Our findings provide evidence that red wine, having a higher phenolic content than white wine, has a significant protective effect on oxidative stress and liver injury induced by acrylamide in rats, through its antioxidative activity.
Language	English
Publishing date	2022-07-10
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2704216-9
ISSN	2076-3921
ISSN	2076-3921
DOI	10.3390/antiox11071347
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Article ; Online: Laparoscopic radical cystectomy and nephroureterectomy

Petruţ, Bogdan / Coman, Roxana-Andra / Hârdo, Vlad / Coste, Bogdan / Maghiar, Teodor

Medicine and pharmacy reports

2020 Volume 93, Issue 4, Page(s) 390–395

Abstract: Background and aims: In patients with recurrent high grade or muscle-invasive bladder cancer and concomitant upper urinary tract tumors or non-functional kidney laparoscopic radical cystectomy and nephroureterectomy with lomboaortic and pelvic lymph ... ...

Abstract	Background and aims: In patients with recurrent high grade or muscle-invasive bladder cancer and concomitant upper urinary tract tumors or non-functional kidney laparoscopic radical cystectomy and nephroureterectomy with lomboaortic and pelvic lymph node dissection can be performed. We present our initial experience. Methods: Between 2018 and 2019, 4 patients underwent laparoscopic radical cystectomy and unilateral nephroureterectomy Results: The patients' demographic characteristics and perioperative outcomes were retrospectively collected and evaluated. All surgeries were completed laparoscopically. There was no need for conversion to open surgery. The mean operative time was 286,25 min with minimal blood loss (260 ml). No major complications were reported. The mean follow-up period was 8.75 months. Conclusion: Laparoscopic radical cystectomy and nephroureterectomy
Language	English
Publishing date	2020-10-25
Publishing country	Romania
Document type	Journal Article
ZDB-ID	2974425-8
ISSN	2668-0572 ; 2602-0807
ISSN (online)	2668-0572
ISSN	2602-0807
DOI	10.15386/mpr-1626
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Article: Robotic and 3D laparoscopic radical nephroureterectomy with en bloc specimen excision (kidney, ureter, bladder cuff excision and extended lymphadenectomy) - Case report.

Tataru, Octavian Sabin / Bujoreanu, Eliza Cristina / Coste, Bogdan Ovidiu / Maghiar, Teodor Traian / Petrut, Bogdan

International journal of surgery case reports

2022 Volume 92, Page(s) 106902

Abstract: Introduction and importance: Upper tract urothelial carcinoma (UTUC) is a highly systemic aggressive disease with a tendency of rapid lymph node invasion and metastasis presenting poor oncologic outcomes. Ureteral localization of tumors leads to ... ...

Abstract	Introduction and importance: Upper tract urothelial carcinoma (UTUC) is a highly systemic aggressive disease with a tendency of rapid lymph node invasion and metastasis presenting poor oncologic outcomes. Ureteral localization of tumors leads to hydronephrosis and early invasion of the muscle wall, being categorized as high risk tumors. Case presentation: A 70 years old female was diagnosed with lower left ureteral urothelial tumor associated with hydronephrosis and paraaortic and iliac enlarged lymph nodes. The disease was stratified as high risk upper tract urothelial carcinoma. Treatment consisted in en bloc radical nephroureterectomy, bladder cuff excision and wide lymph node dissection using a combined robotic and 3D laparoscopic approach. Clinical discussion: Surgical challenges are surpassed by the use of minimal invasive approaches that offer precise dissection and tissue manipulation with a fast postoperative recovery and early adjuvant oncologic treatment. Comprehensive and complete lymph node dissection along with precise bladder cuff excision offers improved staging, possibly impacting disease prognosis. Conclusion: En bloc minimal invasive radical nephroureterectomy, bladder cuff excision and wide lymph node dissection offer improved surgery time and lymph node dissection, better management of distal ureteral and bladder cuff excision, watertight cystorrhaphy and optimal disease staging. The experience of the main surgeon with 3D laparoscopy was used in the hereby case to optimize operatory time for the renal step of the surgery. The gentle and precise movements of the Da Vinci robot allowed an accurate en bloc dissection (pN2, N4+/15) with implications in staging and possibly also in oncologic outcomes.
Language	English
Publishing date	2022-03-01
Publishing country	Netherlands
Document type	Journal Article
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2022.106902
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Article ; Online: Local staging of prostate cancer with multiparametric-MRI: accuracy and inter-reader agreement.

Popiţa, Cristian / Popiţa, Anca-Raluca / Andrei, Adina / Rusu, Adriana / Petruţ, Bogdan / Kacso, Gabriel / Bungărdean, Cătălina / Bolog, Nicolae / Coman, Ioan

Medicine and pharmacy reports

2020 Volume 93, Issue 2, Page(s) 150–161

Abstract: Background: The accuracy of prostate cancer local staging at the time of diagnosis directly influences patient prognosis and treatment.: Aim: To evaluate the diagnostic performance and interobserver variability of mp-MRI in local staging of prostate ... ...

Abstract	Background: The accuracy of prostate cancer local staging at the time of diagnosis directly influences patient prognosis and treatment. Aim: To evaluate the diagnostic performance and interobserver variability of mp-MRI in local staging of prostate cancer, using the histopathologic findings at prostatectomy as the reference standard. Methods: Fifty patients (mean age 64.4±7.2) with biopsy confirmed prostate cancer were included in this prospective study. All patients were examined with mp-MRI before radical prostatectomy and images were read by three independent radiologists. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), and accuracy rate were calculated and compared for all three readers. Interobserver agreement was evaluated using Kappa Cohen coefficient of agreement. Results: The overall Se, Sp, PPV, NPV and accuracy rates for detecting extraprostatic tumor extension (EPE) ranged between 76.5-94.1%, 45.5-84.9%, 43.8-76.2%, 83.3-96.6% and 58-88%. For evaluation of seminal vesicle invasion (SVI), the overall Se, Sp, PPV, NPV and accuracy rates ranged between 57.1-85.7%, 86.1-97.7%, 40.0-85.7%, 92.5-97.7% and 82-96%, respectively. The overall Kappa Cohen coefficient of agreement varied between 0.349-0.638 for EPE and between 0.507-0.668 for SVI. Conclusions: Our results showed that 1.5T mp-MRI is a reliable method for local staging of prostate cancer, with good diagnostic performance in detecting EPE and SVI. The overall interobserver agreement rates between readers with the same level of experience in prostate MRI ranged from fair to good in the evaluation of EPE and from moderate to good for the assessment of SVI.
Language	English
Publishing date	2020-04-22
Publishing country	Romania
Document type	Journal Article
ZDB-ID	2974425-8
ISSN	2668-0572 ; 2602-0807
ISSN (online)	2668-0572
ISSN	2602-0807
DOI	10.15386/mpr-1390
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Article ; Online: How Does Surgeons' Autonomic Physiology Vary Intraoperatively?: A Real-time Study of Cardiac Reactivity.

Del Rosario, Kareena / West, Tessa V / Mendes, Wendy Berry / Kunduzi, Basir / Mamode, Nizam / Gogalniceanu, Petrut

Annals of surgery

2023 Volume 279, Issue 2, Page(s) 258–266

Abstract: Objective: To measure the physiological responses of surgical team members under varying levels of intraoperative risk.: Background: Measurement of intraoperative physiological responses provides insight into how operation complexity, phase of ... ...

Abstract	Objective: To measure the physiological responses of surgical team members under varying levels of intraoperative risk. Background: Measurement of intraoperative physiological responses provides insight into how operation complexity, phase of surgery, and surgeon seniority impact stress. Methods: Autonomic nervous system responses (interbeat intervals, IBIs) were measured continuously during different surgical operations of various complexity. The study investigated whether professional role (eg attending surgeon), operative risk (high vs. low), and type of primary operator (attending surgeon vs. resident) impacted IBI reactivity. Physiological synchrony captured the degree of correspondence between individuals' physiological responses at any given time point. Results: A total of 10,005 observations of IBI reactivity were recorded in 26 participants during 16 high-risk (renal transplant and laparoscopic donor nephrectomy) and low-risk (arteriovenous fistula formation) operations. Attending surgeons showed greater IBI reactivity (faster heart rate) than residents and nurses during high-risk operations and while actively operating (Ps<0.001). Residents showed lower reactivity during high-risk (relative to low-risk) operations (P<0.001) and similar reactivity regardless of whether they or the attending surgeon was operating (P=0.10). Nurses responded similarly during low-risk and high-risk operations (P=0.102) but were more reactive when the resident was operating compared to when the attending surgeon was the primary operator (P<0.001). In high-risk operations, attending surgeons had negative physiological covariation with residents and nurses (P<0.001). In low-risk operations, only attending surgeons and nurses were synchronized (P<0.001). Conclusion: Attending surgeons' physiological responses were well-calibrated to operative demands. Residents' and nurses' responses were not callibrated to the same extent. This suggests that risk sensitivity is an adaptive response to stress that surgeons acquire.
MeSH term(s)	Humans ; Time and Motion Studies ; Kidney Transplantation ; Laparoscopy ; Surgeons ; Tissue Donors
Language	English
Publishing date	2023-07-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000006007
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Article ; Online: Surgical leadership in a culture of safety: An inter-professional study of metrics and tools for improving clinical practice.

Gogalniceanu, Petrut / Kunduzi, Basir / Ruckley, Cameron / Kaafarani, Haytham / Sevdalis, Nick / Mamode, Nizam

American journal of surgery

2023 Volume 228, Page(s) 32–42

Abstract: Background: Leadership in a safety culture environment is essential in avoiding patient harm. However, leadership in surgery is not routinely taught or assessed. This study aims to identify a framework, metrics and tools to improve surgical leadership ... ...

Abstract	Background: Leadership in a safety culture environment is essential in avoiding patient harm. However, leadership in surgery is not routinely taught or assessed. This study aims to identify a framework, metrics and tools to improve surgical leadership and safety outcomes. Methods: Qualitative interviews were performed with leadership experts from safety-critical professions. Non-probability-based sampling was undertaken in major international airlines. Data underwent thematic analysis and clinical adaptation by multiple surgeon-analysts using the framework method. Results: 583 codes were synthesised into 10 themes. Leaders were identified as 'threat and error managers' who placed safety first. Their core attribute was humble confidence. This allowed them to set the tone for high standards of practice, whilst empowering individuals to speak up about safety issues. Safety-oriented leaders assumed complete responsibility and applied their authority discerningly to obtain optimal outcomes. Finally, effective leaders rallied support for their mission by instilling confidence, building collaborations and managing conflict. Conclusions: Surgical leadership requires the ability to manage risk, opportunity and people. The study provides an assessment matrix and deliverable tools for improving surgical safety.
MeSH term(s)	Humans ; Leadership ; Safety Management ; Benchmarking
Language	English
Publishing date	2023-09-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2023.09.002
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Article ; Online: he time limit of maintaining the running speed at VO2max (TLIM VO2max). A comparative study between trained and untrained

Cezar HONCERIU / Petruț-Florin TROFIN / Eduard IFRIM

Timisoara Physical Education and Rehabilitation Journal, Vol 7, Iss 13, Pp 95-

2017 Volume 98

Abstract: ... refute the research hypothesis, Group B, that was made up of subjects with a lower VO2max, obtained ...

Abstract	Specialised literature is very rich in means evaluating of VAM or vVO2max and methods of increasing this physical ability, yet poorer in assessing the limit time of maintaining it (tlimVO2max). tlimVO2max is the running time that an athlete can maintain at VAM. This study assumes that it is possible that trained individuals achieve a tlimVO2max greater than untrained individuals. 14 male persons were involved in this study; they were divided into two groups: trained and untrained. VAM evaluation was done by using the VAMEVAL test. The evaluation of tlimVO2max was done by using the VAMEVAL soft. The results of the study refute the research hypothesis, Group B, that was made up of subjects with a lower VO2max, obtained an average tlimVO2max better than group A, group that consists of athletes and better VO2max subjects.
Keywords	VO2max ; tlimVO2max ; trained ; untrained ; General Works ; A ; Sports ; GV557-1198.995 ; Sports medicine ; RC1200-1245
Subject code	796
Language	English
Publishing date	2017-03-01T00:00:00Z
Publisher	Mirton Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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