Objectives The aim of this study was to assess the efficacy of laparoscopic transperitoneal pudendal decompression in the improvement of refractory lower urinary tract symptoms (LUTS) in young males presenting with clinical features of pudendal nerve entrapment with no known comorbidities that could explain their LUTS. Methods This is a prospective pilot study involving patients suffering from LUTS refractory to standard treatment and clinical features of pudendal nerve entrapment on physical examination. They underwent laparoscopic transperitoneal pudendal decompression. International Prostate Symptom Score (IPSS) and maximal flow (Qmax) on uroflowmetry were evaluated before and 3 months after the procedure. Results Five male patients aged 34 ± 4 years were recruited. The median IPSS differed significantly before and 3 months after the procedure (18 vs 8, P = .042); likewise, median Qmax differed significantly before and 3 months after the procedure (12 vs 18 mL/s, P = .042). Conclusion Pudendal nerve entrapment syndrome should be considered as a main differential diagnosis for refractory LUTS in young males with no other comorbidities. When clinical features of pudendal nerve entrapment are present, laparoscopic transperitoneal pudendal decompression relieves LUTS in these young males.

Introduction: The lymphocytic population, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are prognostic tools predictive of adverse outcomes for several solid tumors and oncologic surgeries, one of which is esophageal adenocarcinoma. Furthermore, delayed resumption of oral feeding postoperatively is associated with significant morbidity. Given the controversies regarding post-op nutritional support in these patients, this study investigates the prognostic role of the lymphocytic percentage, the NLR and the PLR in predicting prolonged length of hospital stay (LOHS) and ICU stay (LOICUS) as well as delayed oral feeding following transhiatal esophagectomy (THE) for adenocarcinoma of the esophagogastric junction (AEG). Methods: 40 consecutive patients who underwent transhiatal esophagectomy performed by a single surgeon for Siewert type II and type III adenocarcinoma of the esophagogastric junction at a tertiary referral center was selected. Retrospective data collection was performed from the patients’ medical records and statistical analysis was performed using Pearson correlation and Student’s T-test and Chi-square testing.Results: An increased LOHS was correlated with a lower preoperative lymphocyte percentage (p=0.043), higher NLR (p=0.010) and PLR (p=0.015), and an increased number of packed red blood cell (PRBCs) transfusions perioperatively (p=0.030). An increased LOICUS was correlated with a lower preoperative lymphocyte percentage (p=0.033), higher NLR (p=0.018) and PLR (p=0.044), an increased number of PRBCs transfusions (p=0.001) and patients’ comorbidities (p<0.05). A delay in feeding resumption was correlated with a lower preoperative lymphocyte percentage (p=0.022), higher NLR (p=0.004) and PLR (p=0.001), an increased PRBCs transfusions (p=0.001) and diabetes mellitus (p=0.033). Multivariate analysis with automatic linear modeling showed that only the preoperative PLR was a powerful predictor for the delay of feeding resumption (p<0.01).Conclusion: The lymphocyte percentage, PLR and NLR are found to be associated with prolonged hospitalization and ICU stay, delayed oral feeding following THE for Siewert type II and III AEG. We hope by this series, to have set, at least one preliminary cornerstone, in the creation of a prognostic model, capable of assessing the need for an intraoperative jejunostomy placement, in patients undergoing esophagectomy for distal esophageal carcinoma.

No abstract

No abstract