Clinical Research Directory

Risk of Scrotal Hydroceles After Nephrectomy For Kidney Cancer

This population-based study will use provincial health administrative data to examine the risk of hospital admission for hydrocelectomy among males who underwent nephrectomy for kidney cancer, compared with males from the general population with similar baseline health characteristics, who did not undergo nephrectomy. We will use health administrative data from Ontario, Canada, to identify males who underwent nephrectomy for kidney cancer between 1992 and 2024. Four surgical cohorts will be constructed based on procedure type and surgical approach: laparoscopic total nephrectomy, open total nephrectomy, laparoscopic partial nephrectomy, and open partial nephrectomy. A propensity score will be calculated based on sociodemographic characteristics, comorbidities, and health care utilization. For each surgical cohort, patients will be matched to non-nephrectomy male controls (1:4) based on propensity score, age, index date, and modified Charlson Score (excluding cancer). The primary analysis will compare patients undergoing laparoscopic total nephrectomy and laparoscopic partial nephrectomy with matched non-nephrectomy controls from the general population. The primary outcome is hospital admission for hydrocelectomy. Secondary outcomes include diagnosis of hydrocele with receipt of a scrotal ultrasound, and receipt of a scrotal ultrasound. Additional analyses will compare surgical approaches.

Effect of Carbon Dioxide Pressure on Optic Nerve Sheath Diameter in Laparoscopic Transperitoneal Nephrectomy

Nephrectomy is a surgical procedure performed for various indications, and with the development and increasing availability of advanced diagnostic techniques, its incidence has been rising. Today, in appropriate cases, laparoscopic surgery is recommended due to its minimally invasive nature and its surgical success rates being comparable to those of open surgery. In laparoscopic surgery, to achieve optimal visualization, a 45° lateral decubitus position is applied, followed by the creation of a pneumoperitoneum using carbon dioxide gas. While the cardiopulmonary effects of this procedure have been shown to be minimal, studies on its intracranial effects are limited. Cerebral perfusion pressure is defined as the difference between mean arterial pressure and either central venous pressure or intracranial pressure, whichever is higher. Intracranial pressure can be assessed non-invasively using ultrasonographic measurement of the Optic Nerve Sheath Diameter (ONSD). The retrobulbar segment of the optic nerve is surrounded by a distensible subarachnoid space, which expands in response to increased intracranial pressure. The effect of increased intra-abdominal pressure during laparoscopic surgery on intracranial pressure, and its impact on ONSD, will be evaluated non-invasively. In patients scheduled for laparoscopic kidney surgery, the Optic Nerve Sheath Diameter will be measured transorbitally using ultrasonography by the investigator at various stages of the surgery (before anesthesia, after anesthesia, in the lateral decubitus position, during pneumoperitoneum, and at routine intraoperative pressure levels). Additionally, standard monitoring parameters such as pulse rate, blood pressure, oxygen saturation, and End-Tidal CO₂ will be recorded. The Optic Nerve Sheath Diameter, which serves as an indicator of increased intracranial pressure, will be compared with variables such as surgical positioning, BMI, ASA score, and other relevant factors.

Comparison of Erector Spina Plan Block and Trnsversus Abdominis Plan Block in Laparoscopic Nephrectomy: Prospective Randomized Clinical Trial

Nephrectomy pain was higher. erector spina plan block and transversus abdominis plan block had shown to be effective in abdominal surgeries. This study aimed to compare these two bloc analgesic efficacy in laparoscopic nephrectomy patients. The primary aim is postoperative morphine consumption.