No abstract

The mean PSVs of a normal ICA distal to CEA patching were higher than normal nonoperated ICAs, therefore, standard duplex velocities criteria should be revised after CEA with patch closure.

What's known on the subject? and What does the study add? Penile cancer is a rare malignancy with limited evidence to support most treatment recommendations. No randomised controlled trials have been published and few recommendations are available for guiding management. However, evidence‐based guidelines are currently available through the European Association of Urology. This review provides the reader with the most up‐to‐date information on diagnosis and management of all stages of squamous cell carcinoma of the penis. It provides a rapid review and study guide for this rare disease. To review the current literature available on squamous cell carcinoma (SCC) of the penis and provide a contemporary management algorithm for treatment based on the best evidence available. A complete review of the current English language literature was performed via PubMed and all available guidelines were reviewed. Large randomised controlled trials are lacking in penile SCC due to the fortunately rare occurrence of the disease. Treatment recommendations for the primary lesion, lymph nodes, and follow‐up in this review are based on the best current available literature. Early diagnosis and aggressive organ‐sparing treatment remains the mainstay of therapy for penile SCC. Variable institutional expertise currently makes treatment decisions difficult and unstandardised. A multidisciplinary approach should be used in attempt to improve outcomes in this mutilating disease.

Objective:The objective was to demonstrate that percutaneous nephrolithotomy (PCNL) can be safely performed with a tubeless or totally tubeless drainage technique.Introduction:Standard PCNL includes nephrostomy tube placement designed to drain the kidney and operative tract at the conclusion of the procedure. Modern technique trend is tubeless PCNL and totally tubeless PCNL, which are performed without standard nephrostomy drainage. We aim to reinforce current literature in demonstrating that PCNL can be safely performed using a tubeless technique. With compounded supportive data, we can help generate a trend toward a more cost-effective procedure with improved pain profiles and patient satisfaction, as previously shown with the tubeless technique.Methods:Retrospective analysis of 165 patients who underwent PCNL treatment was performed. Of this group, 127 patients underwent traditional nephrostomy drainage following PCNL. A tubeless procedure was performed in the remaining 38 patients. Patient's postoperative stone size and burden as well as complication profiles were analyzed. Largest stone size and total stone burden was similar between the groups.Results:Patient characteristics and demographic information were compared and no significant statistical difference was identified between the groups. Complication rates between the groups were compared and no statistical difference was noted. A total of 23 patients had at least one postoperative complication.Conclusion:Tubeless and totally tubeless PCNL demonstrates equivalent outcomes in the properly selected patient group when compared to PCNL performed with a nephrostomy tube. Although this is not the first study to demonstrate this, a large majority of urologists continue standard nephrostomy placement after PCNL. More studies are needed that demonstrate safety of this practice to shift the pendulum of care. Thus, tubeless and totally tubeless PCNL can be performed safely and effectively, which has previously been shown to improve cost, patient pain profiles, and length of hospitalization.