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Article: Adrenal masses: A urological perspective.

Fergany, Amr F

2016 Volume 14, Issue 4, Page(s) 248–255

Abstract: Adrenal masses have become increasingly common due to widespread use of sectional imaging. Urologists are commonly faced with management decisions in patients with adrenal masses. Systemic review of available literature related to surgical adrenal ... ...

Abstract	Adrenal masses have become increasingly common due to widespread use of sectional imaging. Urologists are commonly faced with management decisions in patients with adrenal masses. Systemic review of available literature related to surgical adrenal disease was performed to summarise the most pertinent information related to adrenal masses, diagnostic evaluation and surgical treatment. Detailed hormonal evaluation of adrenal disease was not included, being part of endocrinological rather than urological practice. Adrenal masses exhibit a wide spectrum of presentation and pathology, and treatment requires different surgical techniques. Full understanding of the pathology and management of such masses should be completely familiar to practicing urologists.
Language	English
Publishing date	2016-10-26
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	2631788-6
ISSN	2090-598X
ISSN	2090-598X
DOI	10.1016/j.aju.2016.09.001
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Editorial comment.

Fergany, Amr F

Urology

2012 Volume 79, Issue 3, Page(s) 576

MeSH term(s)	Carcinoma, Renal Cell/pathology ; Carcinoma, Renal Cell/surgery ; Female ; Humans ; Kidney Neoplasms/pathology ; Kidney Neoplasms/surgery ; Male ; Nephrectomy/methods
Language	English
Publishing date	2012-03
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	192062-5
ISSN	1527-9995 ; 0090-4295
ISSN (online)	1527-9995
ISSN	0090-4295
DOI	10.1016/j.urology.2011.10.068
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Article ; Online: Epidural Abscess Following Prostate Biopsy.

Lundy, Scott D / Gill, Bradley C / Kalfas, Iain H / Fergany, Amr F / Stephenson, Andrew J

Urology

2017 Volume 113, Page(s) 1–5

MeSH term(s)	Aged ; Antibiotic Prophylaxis/methods ; Biopsy/adverse effects ; Biopsy/methods ; Drainage/methods ; Endosonography/methods ; Epidural Abscess/diagnostic imaging ; Epidural Abscess/etiology ; Epidural Abscess/surgery ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Prostatic Hyperplasia/pathology ; Risk Assessment ; Staphylococcal Infections/diagnosis ; Staphylococcal Infections/etiology ; Staphylococcal Infections/therapy
Language	English
Publishing date	2017-11-06
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	192062-5
ISSN	1527-9995 ; 0090-4295
ISSN (online)	1527-9995
ISSN	0090-4295
DOI	10.1016/j.urology.2017.10.024
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Article ; Online: Bilateral pelvicalyceal duplication with contralateral drainage.

Ghoneim, Islam A / Fergany, Amr F

Urology

2010 Volume 76, Issue 4, Page(s) 849–850

Abstract: We report on a peculiar congenital duplication anomaly of the kidney and collecting system. A bifid left renal pelvis receives the ureter draining the lower moiety of a fully duplicated right system. To our knowledge, such an anomaly has not been ... ...

Abstract	We report on a peculiar congenital duplication anomaly of the kidney and collecting system. A bifid left renal pelvis receives the ureter draining the lower moiety of a fully duplicated right system. To our knowledge, such an anomaly has not been previously described.
MeSH term(s)	Abnormalities, Multiple/diagnostic imaging ; Adult ; Cystoscopy ; Humans ; Hydronephrosis/diagnostic imaging ; Hydronephrosis/etiology ; Kidney Pelvis/abnormalities ; Kidney Pelvis/diagnostic imaging ; Male ; Tomography, X-Ray Computed ; Ureter/abnormalities ; Ureter/diagnostic imaging ; Urography
Language	English
Publishing date	2010-10
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	192062-5
ISSN	1527-9995 ; 0090-4295
ISSN (online)	1527-9995
ISSN	0090-4295
DOI	10.1016/j.urology.2009.09.059
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Article ; Online: Minimally invasive surgery for renal cell carcinoma.

Ghoneim, Islam A / Fergany, Amr F

Expert review of anticancer therapy

2009 Volume 9, Issue 7, Page(s) 989–997

Abstract: The oncologic principles of the surgical management of renal cell carcinoma (RCC) have remained essentially the same since first proposed by Robson in 1963. RCC remains a chemo- and radiation-resistant tumor; hence, surgical treatment is still the ... ...

Abstract	The oncologic principles of the surgical management of renal cell carcinoma (RCC) have remained essentially the same since first proposed by Robson in 1963. RCC remains a chemo- and radiation-resistant tumor; hence, surgical treatment is still the mainstay of curative therapy. Extirpative management of RCC via open radical nephrectomy (and later open partial nephrectomy) has been the standard of care for decades. With the advent of laparoscopic surgery and its intense application in urology in the early 1990s, a paradigm shift to minimally invasive renal surgery was initiated and has spurred an array of technologies, methods and procedures. Guidelines on the proper selection of patients and treatment modalities have been developed and established, allowing patients to benefit from better oncologic efficacy and reduced morbidity, and requiring urologic surgeons to master minimally invasive procedures alongside the techniques of open surgery. This review focuses on the minimally invasive management of RCC, discussing the advantages and disadvantages of laparoscopy, partial nephrectomy, probe ablation and newer treatment modalities. In order to provide material for this review, a search of the MEDLINE database was performed through January 2009 using the National Center for Biotechnology Information PubMed internet site to review the world literature regarding the minimally invasive treatment of RCC.
MeSH term(s)	Carcinoma, Renal Cell/surgery ; Catheter Ablation/methods ; Humans ; Kidney Neoplasms/surgery ; Laparoscopy/methods ; Minimally Invasive Surgical Procedures/methods ; Nephrectomy/methods ; Patient Selection ; Practice Guidelines as Topic
Language	English
Publishing date	2009-07
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2112544-2
ISSN	1744-8328 ; 1473-7140
ISSN (online)	1744-8328
ISSN	1473-7140
DOI	10.1586/era.09.59
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Article: Laparoscopic radical cystectomy.

Fergany, Amr F / Gill, Inderbir S

The Urologic clinics of North America

2008 Volume 35, Issue 3, Page(s) 455–66, viii–ix

Abstract: The application of laparoscopic techniques to radical cystectomy has been a recent and natural evolution of successful laparoscopic applications in renal surgery and prostatectomy. The authors' ongoing international registry comprises over 700 cases from ...

Abstract	The application of laparoscopic techniques to radical cystectomy has been a recent and natural evolution of successful laparoscopic applications in renal surgery and prostatectomy. The authors' ongoing international registry comprises over 700 cases from 14 countries. Most laparoscopic radical cystectomy (LRC) operations are performed using standard laparoscopic technique, with a minority of hand-assisted or robotic-assisted procedures. This article attempts to provide an overview of the current status of LRC, with technical details, modifications, and results of various techniques as reported by the authors' group and other groups.
MeSH term(s)	Cystectomy/methods ; Humans ; Laparoscopy/methods
Language	English
Publishing date	2008-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	192293-2
ISSN	1558-318X ; 0094-0143
ISSN (online)	1558-318X
ISSN	0094-0143
DOI	10.1016/j.ucl.2008.05.002
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Article ; Online: Effect of parenchymal volume preservation on kidney function after partial nephrectomy.

Simmons, Matthew N / Fergany, Amr F / Campbell, Steven C

The Journal of urology

2011 Volume 186, Issue 2, Page(s) 405–410

Abstract: Purpose: The percent of functional volume preservation is a primary determinant of functional outcome after partial nephrectomy. We assessed what is to our knowledge a novel method to estimate the percent of functional volume preservation to assess its ... ...

Abstract	Purpose: The percent of functional volume preservation is a primary determinant of functional outcome after partial nephrectomy. We assessed what is to our knowledge a novel method to estimate the percent of functional volume preservation to assess its effect on functional outcomes. Materials and methods: We studied the glomerular filtration rate outcome based on the modification of diet in renal disease 2 in 39 patients with normal preoperative serum creatinine who underwent open or laparoscopic partial nephrectomy from January 2007 to December 2009. A cylindrical volume ratio method was used to estimate the percent of functional volume preservation on computerized tomography images obtained before and after partial nephrectomy. A model to predict the postoperative estimated glomerular filtration rate was based on multiplying the preoperative glomerular filtration rate by the percent of functional volume preservation, followed by adjustment for the functional contribution of the contralateral kidney. Correlation and multiple regression analysis was done to test the model. Results: The median preoperative, nadir and late estimated glomerular filtration rate in the cohort was 104 (range 53 to 234), 75 (range 21 to 189) and 90 ml per minute/1.73 m2 (range 45 to 228), respectively. The nadir and late estimated glomerular filtration rate was measured at a median of 2 (range 0 to 8) and 358 days (range 13 to 827), respectively. The median percent of functional volume preservation was 88% (range 50% to 100%) for the operated kidney and 94% (range 75% to 105%) when adjusted for total bilateral kidney volume. We noted a 96% correlation between the predicted and the observed late estimated glomerular filtration rate. On multivariate analysis the preoperative glomerular filtration rate (p<0.001) and ischemia time (p=0.02) correlated with the nadir glomerular filtration rate, and the preoperative glomerular filtration rate (p<0.001) and the percent of functional volume preservation (p=0.04) correlated with the late glomerular filtration rate. Conclusions: These data support the notion that preoperative nephron endowment and the percent of functional volume preservation are the primary determinants of the long-term functional outcome after partial nephrectomy in patients with normal preoperative kidney function who have ischemia time within acceptable limits.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Glomerular Filtration Rate ; Humans ; Kidney/anatomy & histology ; Kidney/physiology ; Kidney/surgery ; Male ; Middle Aged ; Nephrectomy/methods ; Organ Size ; Retrospective Studies ; Young Adult
Language	English
Publishing date	2011-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	3176-8
ISSN	1527-3792 ; 0022-5347
ISSN (online)	1527-3792
ISSN	0022-5347
DOI	10.1016/j.juro.2011.03.154
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Article ; Online: Surgically induced chronic kidney disease may be associated with a lower risk of progression and mortality than medical chronic kidney disease.

Lane, Brian R / Campbell, Steven C / Demirjian, Sevag / Fergany, Amr F

The Journal of urology

2013 Volume 189, Issue 5, Page(s) 1649–1655

Abstract: Purpose: Chronic kidney disease from medical causes is present in 25% to 30% of patients before surgery for renal cancer. Although chronic kidney disease due to medical causes is typically associated with a 2% to 5% annual renal functional decline and ... ...

Abstract	Purpose: Chronic kidney disease from medical causes is present in 25% to 30% of patients before surgery for renal cancer. Although chronic kidney disease due to medical causes is typically associated with a 2% to 5% annual renal functional decline and decreased overall survival, reduced glomerular filtration rate occurring only after surgery may not have the same negative consequences. Materials and methods: All patients undergoing surgery for suspected renal malignancy were identified in an institutional registry. Median clinical followup was 6.6 years. Results: Of 4,180 patients 28% had a preoperative glomerular filtration rate of less than 60 ml/minute/1.73 m(2) (chronic kidney disease due to medical causes) and in 22% the glomerular filtration rate decreased to less than 60 ml/minute/1.73 m(2) only after surgery (surgically induced chronic kidney disease). Preoperative glomerular filtration rate was a strong predictor of overall survival on univariable and multivariable analysis. The risk of death after renal surgery was 1.8, 3.5 and 4.4-fold higher in patients with preoperative chronic kidney disease stages 3, 4 and 5, respectively, vs normal preoperative glomerular filtration rate. Average overall loss of renal function was 23%, including 13% within 90 days after surgery and 3.5% annually thereafter. Postoperative glomerular filtration rate only predicted survival for patients with preexisting chronic kidney disease due to medical causes. Neither surgically induced chronic kidney disease nor postoperative glomerular filtration rate was a significant predictor of survival in patients without preexisting chronic kidney disease due to medical causes. Annual renal functional decline was 4.7% and 0.7% for patients with chronic kidney disease due to medical causes and surgically induced chronic kidney disease, respectively, with a greater than 50% reduction in glomerular filtration rate in 7.3% and 2.2%, respectively (p <0.0001). Annual renal functional decline greater than 4.0% was associated with a 43% increase in mortality (p <0.0001). Conclusions: Surgically induced chronic kidney disease is associated with a relatively low risk of progressive renal functional decline and impact on survival does not appear to be substantial during intermediate term followup. In contrast, preoperative chronic kidney disease due to medical causes places patients at increased risk, indicating nephron sparing surgery for such patients.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Disease Progression ; Female ; Humans ; Kidney Neoplasms/surgery ; Male ; Middle Aged ; Nephrectomy/adverse effects ; Renal Insufficiency, Chronic/etiology ; Renal Insufficiency, Chronic/mortality ; Retrospective Studies ; Risk Assessment ; Young Adult
Language	English
Publishing date	2013-05
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	3176-8
ISSN	1527-3792 ; 0022-5347
ISSN (online)	1527-3792
ISSN	0022-5347
DOI	10.1016/j.juro.2012.11.121
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Article ; Online: Perioperative epidural analgesia is not associated with increased survival from renal cell cancer, but overall survival may be improved: a retrospective chart review.

Kovac, Evan / Firoozbakhsh, Farhad / Zargar, Homayoun / Fergany, Amr / Elsharkawy, Hesham

Canadian journal of anaesthesia = Journal canadien d'anesthesie

2017 Volume 64, Issue 7, Page(s) 754–762

Abstract: Purpose: We investigated the possible association between perioperative epidural and both cancer-specific survival (CSS) and overall survival (OS) in patients undergoing partial or radical nephrectomy for localized renal cell carcinoma (RCC).: Methods! ...

Title translation	L’analgésie péridurale périopératoire n’est pas associée à une augmentation de la survie après un cancer des cellules rénales, mais la survie globale pourrait être améliorée : une analyse de dossiers rétrospective.
Abstract	Purpose: We investigated the possible association between perioperative epidural and both cancer-specific survival (CSS) and overall survival (OS) in patients undergoing partial or radical nephrectomy for localized renal cell carcinoma (RCC). Methods: A retrospective chart review was performed on patients who underwent complete surgical resection of localized RCC from 1994-2008 at our institution. Baseline demographics and pathological and survival data were collected. Patients with clinically or pathologically positive lymph nodes or metastatic disease at the time of surgery were excluded. Patients with pathologically positive surgical margins were also excluded. Patients were divided into two groups, systemic analgesia and epidural analgesia. Multivariable Cox regression analysis was used to determine CSS and OS, and survival curves were generated using the Kaplan-Meier method. Results: Four hundred thirty-eight patients were included in the analysis. Baseline characteristics of both groups were similar. Median follow-up was 77 months. On multivariable analysis, patient age (hazard ratio [HR], 1.04; 95% confidence interval [CI], 1.02 to 1.07), epidural status (HR, 0.5; 95% CI, 0.4 to 0.8), year of surgery (HR, 0.9; 95% CI, 0.89 to 0.95), and pathologic T-stage (pT-stage) ≥ 2 (pT-stage2: HR, 2.2; 95% CI, 1.2 to 4.1 and pT-stage3: HR, 3.1; 95% CI, 2.0 to 4.7) were independent predictors of OS. Nevertheless, epidural status did not significantly predict CSS (P = 0.73), while T-stage and year of surgery maintained their respective predictive significance. Tumour grade did not significantly affect OS or CSS. Conclusions: Our retrospective analysis suggests that epidural at the time of surgical excision of localized RCC does not significantly impact CSS. Nevertheless, use of epidural was associated with significantly improved OS. Future prospective clinical and laboratory studies are warranted in order to characterize these associations further and determine the underlying mechanisms.
Language	English
Publishing date	2017-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	91002-8
ISSN	1496-8975 ; 0832-610X
ISSN (online)	1496-8975
ISSN	0832-610X
DOI	10.1007/s12630-017-0875-3
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Article ; Online: Should preservable parenchyma, and not tumor size, be the main determinant of the feasibility of partial nephrectomy?

Lane, Brian R / Fergany, Amr F / Linehan, W Marston / Bratslavsky, Gennady

Urology

2010 Volume 76, Issue 3, Page(s) 608–609

MeSH term(s)	Humans ; Kidney Neoplasms/pathology ; Kidney Neoplasms/surgery ; Nephrectomy/methods
Language	English
Publishing date	2010-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	192062-5
ISSN	1527-9995 ; 0090-4295
ISSN (online)	1527-9995
ISSN	0090-4295
DOI	10.1016/j.urology.2010.04.041
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