Papers by Bianchi Giampaolo
Asian Journal of Andrology, 2009
Transperineal prostate biopsy is a procedure that can be used to obtain histological samples from... more Transperineal prostate biopsy is a procedure that can be used to obtain histological samples from the prostate. To improve both the quality of the biopsy core samples and prostate cancer detection, we are currently performing a prospective, randomized trial comparing prostate biopsy samples obtained using an 18 G-needle to those obtained using a 16 G needle. The aim of this preliminary study was to evaluate pain and complication rates in both groups in order to assess whether performing a prostate biopsy with a larger calibre needle is a feasible procedure. One hundred and eighty-seven patients undergoing transperineal prostate biopsy were prospectively evaluated and divided into two groups. The first group (94 patients, Group A) received a transperineal prostate biopsy using a 16 G-needle and the second group (93 patients, Group B) underwent transperineal prostate biopsy with an 18 G-needle. Anaesthesia was obtained with a single perineal injection at the prostatic apex in all subjects. A visual analogue scale (VAS) and facial expression scale (FES) were used to assess pain during multiple steps of the procedure in each group. A detailed questionnaire was used to obtain information about drug use because it could potentially influence the pain and complications that patients experienced. Two weeks after the procedure, early and late complications were evaluated. Statistical analysis was carried out using non-parametric tests. Prostate Specific Antigen (PSA) and drug use were similar at baseline between the two groups. Pain during prostate biopsy, which was measured with both the VAS and FES instruments, did not differ significantly between the 18-and 16 G-needle groups, and no significant differences were found in early or late complication rates between the groups. Transperineal prostate biopsy with a 16 G-needle is a feasible procedure in terms of pain and complication rates. Further studies with larger patient populations are required to assess whether or not this procedure can improve prostate cancer detection rates.
The Journal of Urology, 2016
Urologia internationalis, 2016
Perioperative bleeding is a potential complication of robot-assisted laparoscopic radical prostat... more Perioperative bleeding is a potential complication of robot-assisted laparoscopic radical prostatectomy (RALP) that may worsen outcomes. The role of local hemostatic materials in RALP has not been adequately assessed. We evaluated the hemostatic impact of FloSeal (Baxter International Inc., Fremont, Calif., USA) in RALP. A retrospective analysis was performed of 392 consecutive patients with prostate cancer who underwent RALP at our institution between February 2008 and July 2014. The patients were divided into 2 consecutive homogenous groups based on the use of FloSeal. Group A included 200 patients who underwent RALP between February 2008 and May 2011, with hemostasis performed using only traditional techniques. Group B included the remaining 192 patients, who underwent RALP between June 2011 and July 2014 and received FloSeal 5 ml after traditional hemostatic methods. We compared the blood transfusion rate, the differences between immediate postoperative hemoglobin (Hb) and mean ...
Journal of Endourology, 2009
To compare the transperitoneal approach and the retroperitoneal approach in the laparoscopic mana... more To compare the transperitoneal approach and the retroperitoneal approach in the laparoscopic management of ureteral stones, at two different urologic centers during the learning curve period. We prospectively evaluated 35 consecutive laparoscopic ureterolithotomies performed by two different urologists during their learning curve period in laparoscopy. Each surgeon used a different approach: Transperitoneal (group A) and retroperitoneal (group B). Timing for patients' positioning, trocar placement, ureter isolation, stone extraction, and suturing were recorded to compare the transperitoneal with the retroperitoneal method. Intraoperative complications and perioperative morbidity were also reported. Eighteen procedures were performed using the transperitoneal method (group A) and 17 using the retroperitoneal method (group B). Significant differences between group A and B were observed in terms of time for access to the operating field (mean times 14 and 24 min, respectively, P = < 0.001); time for suturing the ureter (mean times 16 and 28 min, respectively, P = < 0.001); and total operative time (mean times 75 and 102 min, respectively, P = 0.002). No statistical differences were observed for any other parameters. Blood loss was minimal in all cases (mean losses 50 and 45 mL, respectively, P = 0.852); and hemotransfusion was not needed by either group. At the 12-month follow-up, no cases of ureteral stricture were recorded. We suggest that urologists in training for laparoscopy perform laparoscopic ureterolithotomy using a transperitoneal route. In expert hands, both transperitoneal and retroperitoneal approaches are feasible, and the choice depends on personal preference.
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Papers by Bianchi Giampaolo