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- 저자 : Yuki Maruyama (검색결과 5 건)
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Efficacy of holmium laser enucleation in patients with a small (less than 30 mL) prostate volume
Ichiro Tsuboi,Yuki Maruyama,Takuya Sadahira,Nobuyoshi Ando,Yasuhiro Nishiyama,Motoo Araki,Takushi Kurashige,Takaharu Ichikawa,Ryoji Arata,Noriaki Ono,Toyohiko Watanabe,Syunji Hayata,Hiroaki Shiina,Yas 대한비뇨의학회 2021 Investigative and Clinical Urology Vol.62 No.3
Purpose: To evaluate the efficacy of holmium laser enucleation of the prostate (HoLEP) in patients with a small prostate volume (≤30 mL). Materials and Methods: We retrospectively evaluated 1,135 patients who underwent HoLEP at two institutions between July 2007 and March 2020. Patients who were not evaluated for the International Prostate Symptom Score (IPSS) before or after HoLEP were excluded. We divided patients into two groups according to estimated prostate volume (ePV): ≤30 (n=198) and >30 mL (n=539). The patient characteristics, IPSS, peak urinary flow rate (Qmax), postvoid residual urine volume (PVR), and other data were compared before and after surgery in each group and between the two groups. Multivariate analysis was performed to identify the factors associated with the efficacy of HoLEP in the group with ePV ≤30 mL. Results: A total of 737 patients were included in this retrospective study. ePV (23.4 mL vs. 50 mL; p<0.001) and PVR differed significantly between the two groups. The IPSS, IPSS-quality of life, PVR, and Qmax significantly improved after HoLEP in both groups. Improvements in the IPSS, IPSS-quality of life, Qmax, and PVR were greater in the >30 mL group (p<0.001), whereas operation time and morcellation time were significantly shorter in the ≤30 mL group. In the multivariate analysis, age <70 years was independently associated with improvement by HoLEP. Conclusions: HoLEP is an effective treatment for patients with a small prostate, even though the extent of improvement after HoLEP was greater in those with a larger prostate.
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Impact of Sarcopenia on Erectile Function after Nerve-Sparing Robot-Assisted Radical Prostatectomy
Mitsui Yosuke,Sadahira Takuya,Maruyama Yuki,Sato Ryota,Rodrigo Acosta Gonzalez Herik,Wada Koichiro,Araki Motoo,Watanabe Masami,Watanabe Toyohiko,Nasu Yasutomo 대한남성과학회 2021 The World Journal of Men's Health Vol.39 No.4
Purpose: To determine the impact of sarcopenia on erectile functional outcomes after a nerve-sparing (NS) robot-assisted radical prostatectomy (RARP) using patient-reported validated questionnaires. Materials and Methods: In this retrospective study, RARP was performed on 841 patients at Okayama University Hospital, of which 132 underwent NS RARP. Erectile functional outcomes were assessed using the 5-item version of the International Index of Erectile Function (IIEF-5) and the Expanded Prostate Cancer Index Composite before and 1, 3, 6, and 12 months after surgery. Automated measurement of skeletal muscle at L3 was achieved using volume analyzer software and normalizing for height (cm2/m2) to calculate skeletal muscle index (SMI). Patients who had an IIEF-5≤4 comprised the group with erectile dysfunction (ED), and those with an IIEF-5≤5 made up the non-ED group. Results: This study enrolled 95 patients of median age 65 years with a preoperative IIEF‑5 of 16. There were no significant differences between patients with and without sarcopenia among those with preoperative IIEF‑5. Postoperatively, in the ED group, SMI and preoperative IIEF‑5 were significantly lower than in the non-ED group. Multiple linear regression analysis revealed that (1) both SMI and preoperative IIEF-5 were independent predictors of ED, and (2) sarcopenia and preoperative IIEF-5 were predictors of ED at 12 months after NS RARP. Conclusions: Patients with sarcopenia can have worse erectile functional outcomes after NS RARP. Sarcopenia and a lower preoperative IIEF-5 score may be predictive of postoperative ED.
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Kasumi Yoshinaga,Takuya Sadahira,Yuki Maruyama,Yosuke Mitsui,Takehiro Iwata,Koichiro Wada,Motoo Araki,Toyohiko Watanabe,Yasutomo Nasu 대한비뇨의학회 2021 Investigative and Clinical Urology Vol.62 No.1
Purpose: The aim of this study was to compare the prognostic value of pretreatment inflammation-based scoring systems in terms of overall survival (OS) and progression-free survival (PFS) in patients with germ cell tumors (GCTs) receiving bleomycin, etoposide, and cisplatin (BEP) chemotherapy. Materials and Methods: We evaluated 63 patients with GCTs retrospectively. The Glasgow prognostic score (GPS), neutrophil-to-lymphocyte ratio, prognostic index, platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), systemic immune-inflammation index, and albumin-to-globulin ratio (AGR) were measured in all patients before chemotherapy. To assess the predictive ability of each scoring system, areas under the receiver operating characteristic curve were calculated, and multivariate analysis was performed to identify associations between the predictive scores and OS. Results: Of all the inflammation-based scoring systems, the GPS had the greatest area under the curve (0.847) for predicting OS, followed by the PNI (0.829) and AGR (0.810). Kaplan–Meier analyses revealed that the GPS, PNI, and AGR were significantly associated with OS, whereas the GPS, PLR, and PNI were significantly associated with PFS. In the multivariate analysis, the GPS was an independent predictor of OS and PFS. Conclusions: We demonstrated that the GPS was the most valuable biomarker of OS and PFS in patients with GCTs.
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Inoue Takaki,Maki Satoshi,Furuya Takeo,Okimatsu Sho,Yunde Atsushi,Miura Masataka,Shiratani Yuki,Nagashima Yuki,Maruyama Juntaro,Shiga Yasuhiro,Inage Kazuhide,Orita Sumihisa,Eguchi Yawara,Ohtori Seiji 대한척추외과학회 2023 Asian Spine Journal Vol.17 No.4
Study Design: Retrospective study.Purpose: To compare the radiographic risk factors for decreased cervical lordosis (CL) after laminoplasty, focusing on the difference between cervical spondylotic myelopathy (CSM) and cervical ossification of the posterior longitudinal ligament (C-OPLL).Overview of Literature: A few reports compared the risk factors for decreased CL between CSM and C-OPLL although these two pathologies have their characteristics.Methods: This study included 50 patients with CSM and 39 with C-OPLL who underwent multi-segment laminoplasty. Decreased CL was defined as the difference between preoperative and 2-year postoperative neutral C2–7 Cobb angles. Radiographic parameters included preoperative neutral C2–7 Cobb angles, C2–7 sagittal vertical axis (SVA), T1 slope (T1S), dynamic extension reserve (DER), and range of motion. The radiographic risk factors were investigated for decreased CL in CSM and C-OPLL. Additionally, the Japanese Orthopedic Association (JOA) score was assessed preoperatively and 2 years postoperatively.Results: C2–7 SVA (<i>p</i> =0.018) and DER (<i>p</i> =0.002) were significantly correlated with decreased CL in CSM, while C2–7 Cobb angle (<i>p</i> =0.012) and C2–7 SVA (<i>p</i> =0.028) were correlated with decreased CL in C-OPLL. Multiple linear regression analysis revealed that greater C2–7 SVA (<i>B</i> =0.22, <i>p</i> =0.026) and small DER (<i>B</i> =−0.53, <i>p</i> =0.002) were significantly associated with decreased CL in CSM. By contrast, greater C2–7 SVA (<i>B</i> =0.36, <i>p</i> =0.031) was significantly associated with decreased CL in C-OPLL. The JOA score significantly improved in both CSM and C-OPLL (<i>p</i> <0.001).Conclusions: C2–7 SVA was associated with a postoperative decreased CL in both CSM and C-OPLL, but DER was only associated with decreased CL in CSM. Risk factors for decreased CL slightly differed depending on the etiology of the condition.
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