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Article ; Online: Perioperative and Functional Results for Robot-assisted Radical Cystectomy with Totally Intracorporeal Neobladder in Male Patients via the Vesica Patavina (Ves.Pa.) Technique: IDEAL Stage 2a Report.

Dal Moro, Fabrizio / Zattoni, Fabio / Tonet, Elisa / Morlacco, Alessandro / Betto, Giovanni / Novara, Giacomo

2023 Volume 57, Page(s) 8–15

Abstract: Background: Robot-assisted radical cystectomy (RARC) offers several advantages over open surgery, but intracorporeal neobladder construction (INC) is a challenging procedure. The vesica patavina (Ves.Pa.) refinement is a modification of the original ... ...

Abstract	Background: Robot-assisted radical cystectomy (RARC) offers several advantages over open surgery, but intracorporeal neobladder construction (INC) is a challenging procedure. The vesica patavina (Ves.Pa.) refinement is a modification of the original technique that simplifies the neobladder configuration and reduces the risk of complications. Objective: To present a stage 2a IDEAL (Idea, Development, Exploration, Assessment and Long-term follow-up) report on RARC with INC using the Ves.Pa. technique. Design setting and participants: This was a prospective study of consecutive male patients undergoing RARC and Ves.Pa. INC performed by a single surgeon for muscle-invasive or non-muscle-invasive, bacillus Calmette-Guérin-refractory urothelial bladder cancer in a tertiary referral center. Surgical procedure: RARC with INC using the refined Ves.Pa. technique. Measurements: Complications were classified using the Clavien-Dindo scheme, and functional outcomes were assessed using validated questionnaires. Results and limitations: A total of 20 male patients were treated. The median operative time was 382 min, and the median estimated blood loss was 350 ml. The incidence of high-grade complications was extremely low, with only one patient experiencing a grade IIIa complication. All patients had clear surgical margins. At median follow-up of 12 mo, statistically significant differences in all the functional scores measured were observed. Specifically, 6-mo parameters were all significantly worse than at baseline (all Conclusions: RARC with the refined Ves.Pa. technique for INC is safe, feasible, and replicable. The technique simplifies the procedure and reduces the risk of complications. The study results suggest acceptable oncological and functional outcomes over short-term follow-up. Patient summary: We report our initial experience with robot-assisted removal of the bladder and construction of a new bladder using our modified technique, called Ves.Pa., in patients with bladder cancer. The technique is simple to perform. We observed a low rate of high-grade complications, and patients had surgical margins negative for cancer in all cases and fair functional outcomes at 12-month follow-up.
Language	English
Publishing date	2023-09-22
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	3040546-4
ISSN	2666-1683 ; 2058-4881
ISSN (online)	2666-1683
ISSN	2058-4881
DOI	10.1016/j.euros.2023.09.001
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Article: Neutrophil-to-lymphocyte ratio as a prognostic factor for patients with urothelial carcinoma of the bladder following radical cystectomy.

Zattoni, Fabio / Novara, Giacomo / Iafrate, Massimo / Carletti, Filippo / Reitano, Giuseppe / Randazzo, Gianmarco / Ceccato, Tommaso / Betto, Giovanni / Dal Moro, Fabrizio

Central European journal of urology

2023 Volume 76, Issue 2, Page(s) 90–103

Abstract: Introduction: The pre-treatment neutrophil-to-lymphocyte ratio (NLR) has been associated with adverse pathology or survival in a variety of malignancies, including urothelial carcinoma of the bladder (UCB) treated with radical cystectomy (RC). Whether ... ...

Abstract	Introduction: The pre-treatment neutrophil-to-lymphocyte ratio (NLR) has been associated with adverse pathology or survival in a variety of malignancies, including urothelial carcinoma of the bladder (UCB) treated with radical cystectomy (RC). Whether the prognostic value of NLR is retained, or even increased, when measured postoperatively remains to be studied. In this study, we evaluated the association of preoperative and postoperative NLR with oncological outcomes following RC. Material and methods: The NLR was recorded in 132 consecutive patients with UCB treated with open RC: before surgery (NLR1), postoperatively within 2 days (NRL2), between 7 and 15 days after RC before discharge (NLR3), and a few days before recurrence or last available follow-up (NLR4). Results: When assessed by multivariate analysis NLR1 remained independently associated with a significantly increased risk of extravesical disease (pT 3-4) (OR = 1.4, p <0.01) and lymphovascular invasion (LVI) (OR = 1.40, 95% CI 1.09-1.83, p <0.01). NLR4 was independently associated with a significantly increased risk of cancer-specific mortality (CSM) (HR = 1.14, 95%CI 1.03-1.24, p = 0.013). In a postoperative model, NLR3 was found to be an independent predictor of all-cause mortality (ACM) [HR = 1.11, 95% CI 1.02-1.21, p = 0.01]. NLR1 was associated with a significantly increased risk of recurrence in the univariable preoperative model [HR = 1.9, 95%CI 1.00-3.65, p = 0.05], while in the postoperative model NLR4 remained independently associated with a significantly increased risk of recurrence (HR = 1.13, 95%CI 1.04-1.23, p = 0.03). Conclusions: In patients with UCB treated with RC, the NLR is associated with more advanced tumour stage, LVI, lymph node metastasis, and higher CSM. Furthermore, the variation of the NLR after surgery might play a role in predicting higher ACM and recurrence-free survival.
Language	English
Publishing date	2023-05-12
Publishing country	Poland
Document type	Journal Article
ZDB-ID	2672528-9
ISSN	2080-4873 ; 2080-4806
ISSN (online)	2080-4873
ISSN	2080-4806
DOI	10.5173/ceju.2023.039
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Article ; Online: Urology: a trip into metaverse.

Randazzo, Gianmarco / Reitano, Giuseppe / Carletti, Filippo / Iafrate, Massimo / Betto, Giovanni / Novara, Giacomo / Dal Moro, Fabrizio / Zattoni, Fabio

World journal of urology

2023 Volume 41, Issue 10, Page(s) 2647–2657

Abstract: Purpose: Metaverse is becoming an alternative world in which technology and virtual experiences are mixed with real life, and it holds the promise of changing our way of living. Healthcare is already changing thanks to Metaverse and its numerous ... ...

Abstract	Purpose: Metaverse is becoming an alternative world in which technology and virtual experiences are mixed with real life, and it holds the promise of changing our way of living. Healthcare is already changing thanks to Metaverse and its numerous applications. In particular, Urology and urologic patients can benefit in many ways from Metaverse. Methods: A non-systematic literature review identified recently published studies dealing with Metaverse. The database used for this review was PubMed, and the identified studies served as the base for a narrative analysis of the literature that explored the use of Metaverse in Urology. Results: Virtual consultations can enhance access to care and reduce distance and costs, and pain management and rehabilitation can find an incredible support in virtual reality, reducing anxiety and stress and improving adherence to therapy. Metaverse has the biggest potential in urologic surgery, where it can revolutionize both surgery planning, with 3D modeling and virtual surgeries, and intraoperatively, with augmented reality and artificial intelligence. Med Schools can implement Metaverse in anatomy and surgery lectures, providing an immersive environment for learning, and residents can use this platform for learning in a safe space at their own pace. However, there are also potential challenges and ethical concerns associated with the use of the metaverse in healthcare. Conclusions: This paper provides an overview of the concept of the metaverse, its potential applications, challenges, and opportunities, and discusses the implications of its development in Urology.
MeSH term(s)	Humans ; Urology ; Artificial Intelligence ; Anxiety ; Augmented Reality ; Databases, Factual
Language	English
Publishing date	2023-08-08
Publishing country	Germany
Document type	Review ; Journal Article
ZDB-ID	380333-8
ISSN	1433-8726 ; 0724-4983
ISSN (online)	1433-8726
ISSN	0724-4983
DOI	10.1007/s00345-023-04560-3
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Article ; Online: Potential Applications of New Headsets for Virtual and Augmented Reality in Urology.

Zattoni, Fabio / Carletti, Filippo / Randazzo, Gianmarco / Tuminello, Arianna / Betto, Giovanni / Novara, Giacomo / Dal Moro, Fabrizio

European urology focus

2023

Abstract: Virtual and augmented reality (VR/AR) technologies hold great promise in various medical fields. The release of a new generation of headsets for medical enhanced VR/AR (MER) opens new possibilities for applications in medicine, particularly in urology, ... ...

Abstract	Virtual and augmented reality (VR/AR) technologies hold great promise in various medical fields. The release of a new generation of headsets for medical enhanced VR/AR (MER) opens new possibilities for applications in medicine, particularly in urology, to improve accessibility to everyone. These innovative headsets offer deep immersion without requiring a controller, which represents a novel approach to VR/AR engagement. The potential of these headsets applies to all aspects of urology, including surgical training, virtual meetings, communication between health care providers, patient counseling, telemedicine, delivering patient advice, and pain control. MER has the potential to improve operative planning and enhance intraoperative navigation and spatial awareness. The surgeon's visualization and overall experience can be significantly enhanced via improved guidance and visualization, ultimately leading to greater precision and safety. This cutting-edge technology has the potential to reshape urology practice, communication methods, and medical procedures, and ultimately to improve patients' experience of their urological condition. PATIENT SUMMARY: This mini review explores how a new generation of headsets for medical enhanced virtual reality could revolutionize urology by improving surgical planning, assistance during procedures, and medical education. Patients can benefit from better pain management and a deeper understanding of their conditions. However, challenges such as costs, accuracy, and ethical concerns must be addressed. This technology holds promise for transforming urological practice and patient care.
Language	English
Publishing date	2023-12-29
Publishing country	Netherlands
Document type	Journal Article ; Review
ISSN	2405-4569
ISSN (online)	2405-4569
DOI	10.1016/j.euf.2023.12.003
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Article ; Online: Robotic partial nephrectomy for complex kidney cyst in a 4-year old boy: Points of technique.

Barneschi, Andrea Celeste / Betto, Giovanni / Zanovello, Nicola / Rigamonti, Waifro / Bianco, Marta / Morlacco, Alessandro / Dal Moro, Fabrizio

Journal of pediatric urology

2022 Volume 18, Issue 5, Page(s) 710–711

Abstract: Complex kidney cysts are rarely observed in childhood. In adult patients, when radiological studies found a suspicious renal lesion, the gold standard is surgical asportation. The robotic surgery is well known as a secure procedure for treatment these ... ...

Abstract	Complex kidney cysts are rarely observed in childhood. In adult patients, when radiological studies found a suspicious renal lesion, the gold standard is surgical asportation. The robotic surgery is well known as a secure procedure for treatment these patients, and is nowadays a real alternative also for pediatric patients. The challenges in children surgery are linked to anesthesiologic gestion, smaller operative fields, the need of specific instruments and more delicate tissue handling. We present a step-by-step video description of a robotic partial nephrectomy for a renal multicystic mass in a 4 year-old child.
Language	English
Publishing date	2022-09-14
Publishing country	England
Document type	Journal Article
ZDB-ID	2237683-5
ISSN	1873-4898 ; 1477-5131
ISSN (online)	1873-4898
ISSN	1477-5131
DOI	10.1016/j.jpurol.2022.09.009
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Zs.A 6387: Show issues

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Article ; Online: Role of targeted biopsy, perilesional biopsy, and random biopsy in prostate cancer diagnosis by mpMRI/transrectal ultrasonography fusion biopsy.

Novara, Giacomo / Zattoni, Fabio / Zecchini, Giovanni / Aceti, Alberto / Pellizzari, Anna / Ferraioli, Giordana / Carlesso, Maria / La Bombarda, Giulia / Morlacco, Alessandro / Lacognata, Carmelo Salvino / Lauro, Alberto / Gardiman, Marina / Betto, Giovanni / Zanovello, Nicola / Moro, Fabrizio Dal

World journal of urology

2023 Volume 41, Issue 11, Page(s) 3239–3247

Abstract: Purpose: It is still not clear the role of perilesional biopsy (PL) and the extension of the random biopsy (RB) scheme to be adopted during mpMRI-guided ultrasound fusion biopsy (FB). To evaluate the increase in diagnostic accuracy achieved by PL and ... ...

Abstract	Purpose: It is still not clear the role of perilesional biopsy (PL) and the extension of the random biopsy (RB) scheme to be adopted during mpMRI-guided ultrasound fusion biopsy (FB). To evaluate the increase in diagnostic accuracy achieved by PL and different RB schemes over target biopsy (TB). Methods: We collected prospectively 168 biopsy-naïve patients with positive mpMRI receiving FB and concurrent 24-core RB. The diagnostic yields of the different possible biopsy schemes (TB only; TB + 4 PL cores; TB + 12-core RB; TB + 24-core RB) were compared by the McNemar test. Clinically significant (CS) prostate cancer (PCA) was defined according to the definition of the PROMIS trial. Regression analyses were used to identify independent predictors of the presence of any cancer, csPCA. Results: The detection rate of CS cancers increased to 35%, 45%, and 49% by adding 4 PL cores, 12, and 24 RB cores, respectively (all p < 0.02). Notably, the largest scheme including 3 TB and 24 RB cores identified a small but statistically significant 4% increase in detection rate of CS cancer, as compared with the second largest scheme. TB alone identified only 62% of the CS cancers. Such figure increased to 72% by adding 4 PL cores, and to 91% by adding 14 RB cores. Conclusions: We found that PL biopsy increased the detection rate of CS cancers as compared with TB alone. However, the combination of those cores missed about 30% of the CS cancers identified with larger RB cores, notably including a considerable 15% of cases located contralaterally to the index tumor.
MeSH term(s)	Male ; Humans ; Multiparametric Magnetic Resonance Imaging ; Prostatic Neoplasms/diagnostic imaging ; Prostatic Neoplasms/pathology ; Prostate/diagnostic imaging ; Prostate/pathology ; Image-Guided Biopsy ; Ultrasonography ; Magnetic Resonance Imaging ; Ultrasonography, Interventional
Language	English
Publishing date	2023-04-20
Publishing country	Germany
Document type	Journal Article
ZDB-ID	380333-8
ISSN	1433-8726 ; 0724-4983
ISSN (online)	1433-8726
ISSN	0724-4983
DOI	10.1007/s00345-023-04382-3
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Article ; Online: Renal function assessment after embolization of vascular complications following partial nephrectomy.

Novara, Giacomo / Lami, Valeria / Evangelista, Laura / Bartoletti, Paola / De Conti, Giorgio / Carletti, Filippo / Martino, Francesca Katiana / Betto, Giovanni / Zattoni, Fabio / Dal Moro, Fabrizio

BJU international

2023 Volume 133, Issue 1, Page(s) 46–48

MeSH term(s)	Humans ; Nephrectomy/adverse effects ; Embolization, Therapeutic ; Kidney ; Kidney Neoplasms/surgery
Language	English
Publishing date	2023-09-06
Publishing country	England
Document type	Letter
ZDB-ID	1462191-5
ISSN	1464-410X ; 1464-4096 ; 1358-8672
ISSN (online)	1464-410X
ISSN	1464-4096 ; 1358-8672
DOI	10.1111/bju.16164
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Ui VI Zs.107: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Role of targeted biopsy, perilesional biopsy, random biopsy, and their combination in the detection of clinically significant prostate cancer by mpMRI/transrectal ultrasonography fusion biopsy in confirmatory biopsy during active surveillance program.

Novara, Giacomo / Zattoni, Fabio / Zecchini, Giovanni / Aceti, Alberto / Pellizzari, Anna / Ferraioli, Giordana / Cobacchini, Claudia / Taverna, Alessandra / Sattin, Francesca / Carletti, Filippo / La Bombarda, Giulia / Lacognata, Carmelo Salvino / Lauro, Alberto / Gardiman, Marina / Morlacco, Alessandro / Betto, Giovanni / Dal Moro, Fabrizio

Prostate cancer and prostatic diseases

2023 Volume 27, Issue 1, Page(s) 129–135

Abstract: Background: Based on the findings of different trials in biopsy naïve patients, target biopsy (TB) plus random biopsy (RB) during mpMRI-guided transrectal ultrasound fusion biopsy (FB) are often also adopted for the biopsy performed during active ... ...

Abstract	Background: Based on the findings of different trials in biopsy naïve patients, target biopsy (TB) plus random biopsy (RB) during mpMRI-guided transrectal ultrasound fusion biopsy (FB) are often also adopted for the biopsy performed during active surveillance (AS) programs. At the moment, a clear consensus on the extent and modalities of the procedure is lacking. Objective: To evaluate the increase in diagnostic accuracy achieved by perilesional biopsy (PL) and different RB schemes during FB performed in AS protocol. Design, setting, and participants: We collected prospectively the data of 112 consecutive patients with low- or very-low-risk prostate cancer; positive mpMRI underwent biopsy at a single academic institution in the context of an AS protocol. Intervention(s): mpMRI/transrectal US FB with Hitachi RVS system with 3 TB and concurrent transrectal 24-core RB. Outcome measurements and statistical analysis: The diagnostic yield of the different possible biopsy schemes (TB only; TB + 4 perilesional (PL) cores; TB + 12-core RB; TB + 24-core RB) was compared by the McNemar test. Univariable and multivariable regression analyses were adopted to identify predictors of any cancer, Gleason grade group (GGG) ≥2 cancers, and the presence of GGG≥2 cancers in the larger schemes only. Results and limitations: The detection rate of GGG ≥2 cancers increased to 30%, 39%, and 49% by adding 4 PL cores, 14, and 24 RB cores, respectively, to TB cores (all p values <0.01). On the whole, TB alone, 14-core RB, and 24-core-RB identified 38%, 47%, and 56% of all the GGG ≥2 cancers. Such figures increased to 62% by adding to TB 4 PL cores, and to 80% by adding 14 RB cores. Most of the differences were observed in PI-RADS 4 lesions. Conclusions: We found that PL biopsy increased the detection rate of GGG ≥2 cancers as compared with TB alone. However, the combination of those cores missed a large percentage of the CS cancers identified with larger RB cores, including a 20% of CS cancers diagnosed only by the combination of TB plus 24-core RB.
MeSH term(s)	Male ; Humans ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/pathology ; Multiparametric Magnetic Resonance Imaging ; Magnetic Resonance Imaging/methods ; Watchful Waiting ; Image-Guided Biopsy/methods ; Ultrasonography
Language	English
Publishing date	2023-10-12
Publishing country	England
Document type	Journal Article
ZDB-ID	1419277-9
ISSN	1476-5608 ; 1365-7852
ISSN (online)	1476-5608
ISSN	1365-7852
DOI	10.1038/s41391-023-00733-8
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Zs.A 5277: Show issues

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Article: Finding of no tumor (pT0) in patients undergoing radical retropubic prostatectomy for clinically localized prostate cancer.

Prayer-Galetti, Tommaso / Gardiman, Marina / Sacco, Emilio / Fracalanza, Simonetta / Betto, Giovanni / Pinto, Francesco

Analytical and quantitative cytology and histology

2007 Volume 29, Issue 2, Page(s) 79–86

Abstract: Objective: To evaluate features and clinical outcome of patients with clinically localized prostate cancer graded pT0 following radical retropubic prostatectomy (RRP).: Study design: Between 1974 and 2001 we performed 1,135 RRPs for cT1-T2 prostate ... ...

Abstract	Objective: To evaluate features and clinical outcome of patients with clinically localized prostate cancer graded pT0 following radical retropubic prostatectomy (RRP). Study design: Between 1974 and 2001 we performed 1,135 RRPs for cT1-T2 prostate cancer, of which 386 (34%) underwent 3-6 months of neoadjuvant endocrine treatment (NHT) before RRP. Median clinical follow-up was 53.8 months (range 24-251). Estimation of likelihood events for biochemical relapse was calculated according to the Kaplan-Meier method. Statistical differences between curves were calculated using the log-rank test. Results: In 24 cases (2.12%) routine histologic workup failed to detect residual tumor. The pT0 group contained a higher proportion of cTla-b patients and a biopsy Gleason score < or =6. A tendency toward lower pre-operatory PSA levels in the pT0 group compared to the pT2-3 group was shown. PSA progression was observed in 3 pT0 patients, all of whom previously underwent NHT. Conclusion: Patients pT0 at RRP presented with lower preoperative PSA values and low preoperative Gleason score compared to the pT+ group. Absence of tumor at pathology examination has a different clinical meaning when it occurs following NHT or in untreated patients. Patients pT0 after NHT may have a worse clinical outcome than pT0 untreated patients.
MeSH term(s)	Aged ; Hormones/therapeutic use ; Humans ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Staging ; Prostate-Specific Antigen/blood ; Prostatectomy ; Prostatic Neoplasms/blood ; Prostatic Neoplasms/mortality ; Prostatic Neoplasms/surgery ; Prostatic Neoplasms/therapy ; Treatment Outcome
Chemical Substances	Hormones ; Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2007-04
Publishing country	United States
Document type	Clinical Trial ; Journal Article
ZDB-ID	632707-2
ISSN	0884-6812 ; 0190-0471
ISSN	0884-6812 ; 0190-0471
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Article ; Online: Involvement of the tubular ClC-type exchanger ClC-5 in glomeruli of human proteinuric nephropathies.

Ceol, Monica / Tiralongo, Emilia / Baelde, Hans J / Vianello, Daniela / Betto, Giovanni / Marangelli, Annunziata / Bonfante, Luciana / Valente, Marialuisa / Della Barbera, Mila / D'Angelo, Angela / Anglani, Franca / Del Prete, Dorella

PloS one

2012 Volume 7, Issue 9, Page(s) e45605

Abstract: Unlabelled: Glomerular protein handling mechanisms have received much attention in studies of nephrotic syndrome. Histopathological findings in renal biopsies from severely proteinuric patients support the likelihood of protein endocytosis by podocytes. ...

Abstract	Unlabelled: Glomerular protein handling mechanisms have received much attention in studies of nephrotic syndrome. Histopathological findings in renal biopsies from severely proteinuric patients support the likelihood of protein endocytosis by podocytes. ClC-5 is involved in the endocytosis of albumin in the proximal tubule. Aim: To investigate whether ClC-5 is expressed in the glomerular compartment and whether it has a role in proteinuric nephropathies. ClC-5 expression was studied using Real-time PCR in manually- and laser-microdissected biopsies from patients with type 2 diabetes (n 37) and IgA nephropathy (n 10); in biopsies of membranous glomerulopathy (MG) (n 14) immunohistochemistry for ClC-5 (with morphometric analysis) and for WT1 was done. Controls: cortical tissue (n 23) obtained from unaffected parts of tumor-related nephrectomy specimens. Results: ClC-5 was expressed at glomerular level in all biopsies. Glomerular ClC-5 levels were significantly higher in diabetic nephropaty and MG at both mRNA and protein level (p<0.002; p<0.01). ClC-5 and WT1 double-staining analysis in MG showed that ClC-5 was localized in the podocytes. ClC-5 ultrastructural immunolocalization was demonstrated in podocytes foot processes. Our study is the first to demonstrate that ClC-5 is expressed in human podocytes. The ClC-5 overexpression found in biopsies of proteinuric patients suggests that proteinuria may play a part in its expression and that podocytes are likely to have a key role in albumin handling in proteinuric states.
MeSH term(s)	Chloride Channels/genetics ; Chloride Channels/metabolism ; Chloride Channels/physiology ; Humans ; Kidney Diseases/metabolism ; Kidney Glomerulus/metabolism ; Kidney Tubules/metabolism ; Proteinuria/metabolism ; RNA, Messenger/genetics ; Real-Time Polymerase Chain Reaction
Chemical Substances	CLC-5 chloride channel ; Chloride Channels ; RNA, Messenger
Language	English
Publishing date	2012-09-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0045605
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