ABSTRACT
Partial nephrectomy is a standard intervention for the treatment of small renal tumors. Our study compares the outcomes of three different partial nephrectomy methods [open, laparoscopic and robotic assisted] in obese [>/=30 Kg/m[2]] patients with renal tumors. Between 2005-2011, 66 obese patients had partial nephrectomy. Patients were divided into three groups according to intervention received: Open [n = 21], laparoscopic [n = 31] and robotic [n = 14]. The outcome variables of blood loss, length of hospital stay, and complications were assessed. Mean blood loss in the laparoscopic group [100 mls] was significantly less than open group [300 mls] and no difference between laparoscopic and robotic groups [150 mls]. We observed a shorter median hospital stay in the laparoscopic group [two days] than open group [four days] and no difference between laparoscopic and robotic groups [three days]. Three patients in the laparoscopic group had complications: Two grade II and one with grade III [based on Clavien-Dindo classification]. Tumor location, pathology, grade, stage, patient gender, age, preoperative creatinine and postoperative creatinine were not different among the groups [P > 0.05]. The mean tumor size in the laparoscopic group [2.70 cms] was significantly smaller than that of the open group [4.22 cm] [P; < 0.05], but not statistically different from that of the robotic group [2.99 cm]. Our study demonstrates that in obese patients, both laparoscopic and robotic partial nephrectomy are associated with less blood loss than open partial nephrectomy. Second, the length of the hospital stay was not related to the type of utilized intervention
ABSTRACT
Objectives: To assess the changes in the level of C-reactive protein [CRP] and tumor necrosis factor-alpha [TNF-alpha] in gingival crevicular fluid [GCF] after treatment of chronic gingivitis in systemically healthy individuals
Methods: This is a clinical trial conducted at Case Western Reserve University, Cleveland, Ohio, United States of America from February to December 2011. A total of 41 systemically healthy subjects were assigned to 2 groups according to the severity of gingival inflammation. Group I consisted of 18 subjects who had mild gingival inflammation; and group II consisted of 23 with more severe gingival inflammation. Periodontal assessment consisted of gingival index [GI], probing depths [PD], and GCF volume. Four to six weeks after prophylaxis and oral hygiene instruction, the same measurements were repeated. The level of CRP and TNF-alpha in the GCF was determined using enzyme-linked immunosorbent assays
Results: A statistically significant reduction in the mean CRP and TNF-alpha levels after the treatment was found in the severe, but not in the mild gingivitis group. Both groups showed a statistically significant reduction in GI, PD, and periotron readings after the treatment
Conclusion: Treatment of severe chronic gingivitis reduces the levels of CRP and TNF-alpha in GCF of otherwise systemically healthy individuals, which could have an impact on preventing or controlling future or existing systemic disease conditions