ABSTRACT
With limitedo guidelines on prostate cancer (PCa) diagnosis and management currently in India, this consensus statement has been developed to evaluate Indian literature and current clinical practices to assist healthcare professionals across India in the diagnosis and management of patients with PCa. A group of leading PCa experts from across India convened at the 2019 CAP summit in Kolkata, India, to vote on 42 consensus statements on PCa diagnosis and management. In the subsequent meeting, an expert panel discussed on the consensus results. On the basis of the voting results and the subsequent expert panel discussion, 5 of 42 statements were deleted and 37 were accepted and retained in the final draft, which is divided into 2 parts. This paper covers part 2, which describes in detail the remaining 21 of 37 statements on locally advanced PCa and metastatic PCa with varying degrees of support from the panel. The consensus statement extrapolated from Indian scientific evidences, regional clinical experiences, and international guidelines will serve as a reference guide for clinicians across India in the diagnosis and management of PCa.
ABSTRACT
Purpose@#To evaluate Indian literature, clinical practice and develop consensus opinion on various aspects of prostate cancer diagnosis and management in order to assist medical practitioners across India in effectively choosing right treatment option for patients with prostate cancer. @*Materials and Methods@#At the CAP summit held in Kolkata on 2019, a group of leading experts from across India voted on 42 consensus statements. Final statements were derived on the basis of voting results and subsequent expert panel meeting. Based on the panellists discussion on various areas of prostate cancer and practicability of recommendation in clinical practice, 5 statements were deleted and a draft was prepared. The draft is divided into 2 parts; part 1 covers 16 statements on prostate cancer diagnosis and early prostate cancer. @*Results@#A total of 37 statements were accepted and finalised by expert panel members based on the voting results. Sixteen statements with varying degrees of support from the panel are described in detail in this article. @*Conclusions@#The statements derived from several Indian scientific evidences, local clinical experience, and international guidelines will serve as a reference guide for clinicians across India in the management of prostate cancer.
ABSTRACT
Purpose@#To evaluate Indian literature, clinical practice and develop consensus opinion on various aspects of prostate cancer diagnosis and management in order to assist medical practitioners across India in effectively choosing right treatment option for patients with prostate cancer. @*Materials and Methods@#At the CAP summit held in Kolkata on 2019, a group of leading experts from across India voted on 42 consensus statements. Final statements were derived on the basis of voting results and subsequent expert panel meeting. Based on the panellists discussion on various areas of prostate cancer and practicability of recommendation in clinical practice, 5 statements were deleted and a draft was prepared. The draft is divided into 2 parts; part 1 covers 16 statements on prostate cancer diagnosis and early prostate cancer. @*Results@#A total of 37 statements were accepted and finalised by expert panel members based on the voting results. Sixteen statements with varying degrees of support from the panel are described in detail in this article. @*Conclusions@#The statements derived from several Indian scientific evidences, local clinical experience, and international guidelines will serve as a reference guide for clinicians across India in the management of prostate cancer.
ABSTRACT
PURPOSE: We report our experience with laparoendoscopic single-site (LESS) urological procedures in children less than 5 years of age. MATERIALS AND METHODS: Ten patients (11 procedures) underwent LESS through the umbilicus. Seven patients underwent nephrectomy and three patients underwent pyeloplasty (one simultaneous bilateral). R-port port (Advanced Surgical Concepts, Ireland) was used in nine cases, in one case, the Gelpoint access port (Applied Medical, Rancho Santa Margarita, CA, USA) was used. The Olympus Endoeye camera with coaxial light cable was used. The hilum was secured in all cases with Hem-o-Lok clips (Teleflex Medical, Research Triangle Park, NC, USA) except in one case in which an Endo GIA stapler (Covidien Surgical, Norwalk, CT, USA) was used. RESULTS: All procedures were technically successful. Accessory port (3 mm) was used in 3 patients. Mean age in nephrectomized patients was 3.14+/-1.7 years, the mean operative room time (ORT) was 97.5+/-12.54 minutes. In the pyeloplasty group, mean ORT was 192+/-47.16 minutes and mean age was 2.43+/-2.3 years. Bilateral pyeloplasty was done in a 4-month-old infant. The ORT in this case was 180 minutes. A follow-up renogram done in the pyeloplasty patients (n=2) showed good drainage. Mean length of stay was 3.6 days (range, 3 to 6 days).The analgesic requirement was 23.86 mg (range, 12.5 to 50 mg) of diclofenac sodium. CONCLUSIONS: LESS is technically feasible in patients as young as 4 months of age. It has the potential to offer better cosmesis. This needs to be proved in further comparative studies. Development of miniature instruments will further the growth of LESS in this age group.