Blaivas J G, Purohit R S, Benedon M, Mekel G, Stern M, Billah M, Olugbade K, Bendavid R, Iakovlev... more Blaivas J G, Purohit R S, Benedon M, Mekel G, Stern M, Billah M, Olugbade K, Bendavid R, Iakovlev V 1. Weill Cornell Medical College; Institute for Bladder and Prostate Research, 2. Institute for Bladder and Prostate Research, 3. Drexel University College of Medicine, 4. SUNY Downstate College of Medicine, 5. Shouldice Hospital, 6. St. Michael's Hospital; Keenan Research Center; University of Toronto
OBJECTIVE To better characterize recovery after minimally invasive kidney surgery, we present a s... more OBJECTIVE To better characterize recovery after minimally invasive kidney surgery, we present a study describing patient-reported health-related quality of life (HRQOL) following minimally invasive radical nephrectomy (RN) and partial nephrectomy (PN). METHODS Patients who underwent minimally invasive PN or RN for renal cancer were invited to enroll in a prospective, patient-reported HRQOL study using the Convalescence and Recovery Evaluation (CARE) instrument and Short Form-12 (SF-12). Patients completed questionnaires at baseline, 2, 4, 8 and 12 weeks after surgery. Mixed repeated measures model were used to assess time effect on HRQOL scores and predictors of scores within each surgery groups. RESULTS 177 patients were included in the study: 50 had RN and 127 had PN. At 2 weeks, both groups had significant decreases in Overall CARE, as well as the Pain, Gastrointestinal, and Activity domain scores which remained slightly below baseline at 4 weeks. At 4 weeks only 50% of patients in both the RN and PN cohorts returned to baseline overall CARE score. By 12 weeks 82% returned to baseline overall CARE score in the RN group while 76% of patients did so in the PN group. CONCLUSIONS Convalescence after minimally invasive renal surgery can often extend beyond 4 weeks post-treatment in PN and RN subjects. This information may be used to provide more accurate preoperative counseling in an attempt to improve overall patient satisfaction.
To evaluate the impact of salvage therapy (ST) on overall survival (OS) in recurrent primary uret... more To evaluate the impact of salvage therapy (ST) on overall survival (OS) in recurrent primary urethral cancer (PUC). A series of 139 patients (96 men, 43 women; median age = 66, interquartile range: 57-77) were diagnosed with PUC at 10 referral centers between 1993 and 2012. The modality of ST of recurrence (salvage surgery vs. radiotherapy) was recorded. Kaplan-Meier analysis with log-rank was used to estimate the impact of ST on OS (median follow-up = 21, interquartile range: 5-48). The 3-year OS for patients free of any recurrence (I), with solitary or concomitant urethral recurrence (II), and nonurethral recurrence (III) was 86.5%, 74.5%, and 48.2%, respectively (P = 0.002 for I vs. III and II vs. III; P = 0.55 for I vs. II). In the 80 patients with recurrences, the modality of primary treatment of recurrence was salvage surgery in 30 (37.5%), salvage radiotherapy (RT) in 8 (10.0%), and salvage surgery plus RT in 5 (6.3%) whereas 37 patients did not receive ST for recurrence (46....
To investigate whether shortened inpatient length of stay (LOS) after radical cystectomy (RC) is ... more To investigate whether shortened inpatient length of stay (LOS) after radical cystectomy (RC) is associated with increased complication rates after hospital discharge. The analytic cohort was comprised of 484 consecutive patients with 90 day follow-up who underwent RC at our institution from 2005-2012 and with LOS ≤9 days. Patients were categorized according to LOS as short (s-LOS; ≤5 days) or routine (r-LOS; 6-9 days). The primary outcome was major complications (Clavien-Dindo grade 3-5) occurring within 90 days after discharge. A Cox proportional hazards model was used to determine the association between LOS and post-discharge major complications. Hospital readmission was a secondary outcome. Patients in the s-LOS cohort had fewer comorbidities (p<0.01), less frequently received neoadjuvant chemotherapy (p=0.02), and more often underwent robotic RC (p<0.01). Major outpatient complications occurred in 18.1% of s-LOS patients compared to 11.2% of r-LOS patients, and s-LOS was...
Background and Purpose: With the aging population, it is becoming increasingly important to ident... more Background and Purpose: With the aging population, it is becoming increasingly important to identify patients at risk for postsurgical complications who might be more suited for conservative treatment. We sought to identify predictors of morbidity after surgical treatment of benign prostatic hyperplasia (BPH) using a large national contemporary population-based cohort. Methods: Relying on the American College of Surgeons National Surgical-Quality Improvement Program (ACS-NSQIP; 2006–2011) database, we evaluated outcomes after transurethral resection of the prostate (TURP), laser vaporization of the prostate (LVP), and laser enucleation of the prostate (LEP). Outcomes included blood-transfusion rates, length of stay, complications, reintervention rates, and perioperative mortality. Multivariable logistic-regression analysis evaluated the predictors of perioperative morbidity and mortality. Results: Overall, 4794 (65.2%), 2439 (33.1%), and 126 (1.7%) patients underwent TURP, LVP, and ...
Blaivas J G, Purohit R S, Benedon M, Mekel G, Stern M, Billah M, Olugbade K, Bendavid R, Iakovlev... more Blaivas J G, Purohit R S, Benedon M, Mekel G, Stern M, Billah M, Olugbade K, Bendavid R, Iakovlev V 1. Weill Cornell Medical College; Institute for Bladder and Prostate Research, 2. Institute for Bladder and Prostate Research, 3. Drexel University College of Medicine, 4. SUNY Downstate College of Medicine, 5. Shouldice Hospital, 6. St. Michael's Hospital; Keenan Research Center; University of Toronto
OBJECTIVE To better characterize recovery after minimally invasive kidney surgery, we present a s... more OBJECTIVE To better characterize recovery after minimally invasive kidney surgery, we present a study describing patient-reported health-related quality of life (HRQOL) following minimally invasive radical nephrectomy (RN) and partial nephrectomy (PN). METHODS Patients who underwent minimally invasive PN or RN for renal cancer were invited to enroll in a prospective, patient-reported HRQOL study using the Convalescence and Recovery Evaluation (CARE) instrument and Short Form-12 (SF-12). Patients completed questionnaires at baseline, 2, 4, 8 and 12 weeks after surgery. Mixed repeated measures model were used to assess time effect on HRQOL scores and predictors of scores within each surgery groups. RESULTS 177 patients were included in the study: 50 had RN and 127 had PN. At 2 weeks, both groups had significant decreases in Overall CARE, as well as the Pain, Gastrointestinal, and Activity domain scores which remained slightly below baseline at 4 weeks. At 4 weeks only 50% of patients in both the RN and PN cohorts returned to baseline overall CARE score. By 12 weeks 82% returned to baseline overall CARE score in the RN group while 76% of patients did so in the PN group. CONCLUSIONS Convalescence after minimally invasive renal surgery can often extend beyond 4 weeks post-treatment in PN and RN subjects. This information may be used to provide more accurate preoperative counseling in an attempt to improve overall patient satisfaction.
To evaluate the impact of salvage therapy (ST) on overall survival (OS) in recurrent primary uret... more To evaluate the impact of salvage therapy (ST) on overall survival (OS) in recurrent primary urethral cancer (PUC). A series of 139 patients (96 men, 43 women; median age = 66, interquartile range: 57-77) were diagnosed with PUC at 10 referral centers between 1993 and 2012. The modality of ST of recurrence (salvage surgery vs. radiotherapy) was recorded. Kaplan-Meier analysis with log-rank was used to estimate the impact of ST on OS (median follow-up = 21, interquartile range: 5-48). The 3-year OS for patients free of any recurrence (I), with solitary or concomitant urethral recurrence (II), and nonurethral recurrence (III) was 86.5%, 74.5%, and 48.2%, respectively (P = 0.002 for I vs. III and II vs. III; P = 0.55 for I vs. II). In the 80 patients with recurrences, the modality of primary treatment of recurrence was salvage surgery in 30 (37.5%), salvage radiotherapy (RT) in 8 (10.0%), and salvage surgery plus RT in 5 (6.3%) whereas 37 patients did not receive ST for recurrence (46....
To investigate whether shortened inpatient length of stay (LOS) after radical cystectomy (RC) is ... more To investigate whether shortened inpatient length of stay (LOS) after radical cystectomy (RC) is associated with increased complication rates after hospital discharge. The analytic cohort was comprised of 484 consecutive patients with 90 day follow-up who underwent RC at our institution from 2005-2012 and with LOS ≤9 days. Patients were categorized according to LOS as short (s-LOS; ≤5 days) or routine (r-LOS; 6-9 days). The primary outcome was major complications (Clavien-Dindo grade 3-5) occurring within 90 days after discharge. A Cox proportional hazards model was used to determine the association between LOS and post-discharge major complications. Hospital readmission was a secondary outcome. Patients in the s-LOS cohort had fewer comorbidities (p<0.01), less frequently received neoadjuvant chemotherapy (p=0.02), and more often underwent robotic RC (p<0.01). Major outpatient complications occurred in 18.1% of s-LOS patients compared to 11.2% of r-LOS patients, and s-LOS was...
RESULTS: 484 patients had open or laparoscopic UOS, with 200 (41%) classified as high risk for VT... more RESULTS: 484 patients had open or laparoscopic UOS, with 200 (41%) classified as high risk for VTE by CRSs. The rates of VTEs and median times to VTE were 6% and 74 days in Group 1, 13% and 44 days in Group 2, 15% and 40 days in Group 3, and 23% and 11 days in Group 4. Adjusted hazard ratios for VTE are shown in Table 1. Group 1 had no VTE’s or fatal pulmonary embolisms in the first 30 days after UOS. Bleeding and lymphocele rates were 0% and 2% in Group 1, 0% and 4% in Group 2, 3% and 3% in Group 3, 0% and 0% in Group 4. Complications were considered Clavien grades II-IIIa. CONCLUSIONS: VTE risk is lowest in patients who receive clinical protocol prophylaxis with EDP. Risk of VTE remains elevated for at least 90 days following UOS. A clinical VTE prevention protocol using perioperative prophylaxis and EDP is effective and safe in reducing VTE risk in UOS patients.
The study aimed to investigate oncological outcomes of patients with concomitant bladder cancer (... more The study aimed to investigate oncological outcomes of patients with concomitant bladder cancer (BC) and urethral carcinoma. This is a multicenter series of 110 patients (74 men, 36 women) diagnosed with urethral carcinoma at 10 referral centers between 1993 and 2012. Kaplan-Meier analysis was used to investigate the impact of BC on survival, and Cox regression multivariable analysis was performed to identify predictors of recurrence. Synchronous BC was diagnosed in 13 (12%) patients, and the median follow-up was 21 months (interquartile range 4-48). Urethral cancers were of higher grade in patients with synchronous BC compared to patients with non-synchronous BC (p = 0.020). Patients with synchronous BC exhibited significantly inferior 3-year recurrence-free survival (RFS) compared to patients with non-synchronous BC (63.2 vs. 34.4%; p = 0.026). In multivariable analysis, inferior RFS was associated with clinically advanced nodal stage (p < 0.001), proximal tumor location (p <...
Blaivas J G, Purohit R S, Benedon M, Mekel G, Stern M, Billah M, Olugbade K, Bendavid R, Iakovlev... more Blaivas J G, Purohit R S, Benedon M, Mekel G, Stern M, Billah M, Olugbade K, Bendavid R, Iakovlev V 1. Weill Cornell Medical College; Institute for Bladder and Prostate Research, 2. Institute for Bladder and Prostate Research, 3. Drexel University College of Medicine, 4. SUNY Downstate College of Medicine, 5. Shouldice Hospital, 6. St. Michael's Hospital; Keenan Research Center; University of Toronto
OBJECTIVE To better characterize recovery after minimally invasive kidney surgery, we present a s... more OBJECTIVE To better characterize recovery after minimally invasive kidney surgery, we present a study describing patient-reported health-related quality of life (HRQOL) following minimally invasive radical nephrectomy (RN) and partial nephrectomy (PN). METHODS Patients who underwent minimally invasive PN or RN for renal cancer were invited to enroll in a prospective, patient-reported HRQOL study using the Convalescence and Recovery Evaluation (CARE) instrument and Short Form-12 (SF-12). Patients completed questionnaires at baseline, 2, 4, 8 and 12 weeks after surgery. Mixed repeated measures model were used to assess time effect on HRQOL scores and predictors of scores within each surgery groups. RESULTS 177 patients were included in the study: 50 had RN and 127 had PN. At 2 weeks, both groups had significant decreases in Overall CARE, as well as the Pain, Gastrointestinal, and Activity domain scores which remained slightly below baseline at 4 weeks. At 4 weeks only 50% of patients in both the RN and PN cohorts returned to baseline overall CARE score. By 12 weeks 82% returned to baseline overall CARE score in the RN group while 76% of patients did so in the PN group. CONCLUSIONS Convalescence after minimally invasive renal surgery can often extend beyond 4 weeks post-treatment in PN and RN subjects. This information may be used to provide more accurate preoperative counseling in an attempt to improve overall patient satisfaction.
To evaluate the impact of salvage therapy (ST) on overall survival (OS) in recurrent primary uret... more To evaluate the impact of salvage therapy (ST) on overall survival (OS) in recurrent primary urethral cancer (PUC). A series of 139 patients (96 men, 43 women; median age = 66, interquartile range: 57-77) were diagnosed with PUC at 10 referral centers between 1993 and 2012. The modality of ST of recurrence (salvage surgery vs. radiotherapy) was recorded. Kaplan-Meier analysis with log-rank was used to estimate the impact of ST on OS (median follow-up = 21, interquartile range: 5-48). The 3-year OS for patients free of any recurrence (I), with solitary or concomitant urethral recurrence (II), and nonurethral recurrence (III) was 86.5%, 74.5%, and 48.2%, respectively (P = 0.002 for I vs. III and II vs. III; P = 0.55 for I vs. II). In the 80 patients with recurrences, the modality of primary treatment of recurrence was salvage surgery in 30 (37.5%), salvage radiotherapy (RT) in 8 (10.0%), and salvage surgery plus RT in 5 (6.3%) whereas 37 patients did not receive ST for recurrence (46....
To investigate whether shortened inpatient length of stay (LOS) after radical cystectomy (RC) is ... more To investigate whether shortened inpatient length of stay (LOS) after radical cystectomy (RC) is associated with increased complication rates after hospital discharge. The analytic cohort was comprised of 484 consecutive patients with 90 day follow-up who underwent RC at our institution from 2005-2012 and with LOS ≤9 days. Patients were categorized according to LOS as short (s-LOS; ≤5 days) or routine (r-LOS; 6-9 days). The primary outcome was major complications (Clavien-Dindo grade 3-5) occurring within 90 days after discharge. A Cox proportional hazards model was used to determine the association between LOS and post-discharge major complications. Hospital readmission was a secondary outcome. Patients in the s-LOS cohort had fewer comorbidities (p<0.01), less frequently received neoadjuvant chemotherapy (p=0.02), and more often underwent robotic RC (p<0.01). Major outpatient complications occurred in 18.1% of s-LOS patients compared to 11.2% of r-LOS patients, and s-LOS was...
Background and Purpose: With the aging population, it is becoming increasingly important to ident... more Background and Purpose: With the aging population, it is becoming increasingly important to identify patients at risk for postsurgical complications who might be more suited for conservative treatment. We sought to identify predictors of morbidity after surgical treatment of benign prostatic hyperplasia (BPH) using a large national contemporary population-based cohort. Methods: Relying on the American College of Surgeons National Surgical-Quality Improvement Program (ACS-NSQIP; 2006–2011) database, we evaluated outcomes after transurethral resection of the prostate (TURP), laser vaporization of the prostate (LVP), and laser enucleation of the prostate (LEP). Outcomes included blood-transfusion rates, length of stay, complications, reintervention rates, and perioperative mortality. Multivariable logistic-regression analysis evaluated the predictors of perioperative morbidity and mortality. Results: Overall, 4794 (65.2%), 2439 (33.1%), and 126 (1.7%) patients underwent TURP, LVP, and ...
Blaivas J G, Purohit R S, Benedon M, Mekel G, Stern M, Billah M, Olugbade K, Bendavid R, Iakovlev... more Blaivas J G, Purohit R S, Benedon M, Mekel G, Stern M, Billah M, Olugbade K, Bendavid R, Iakovlev V 1. Weill Cornell Medical College; Institute for Bladder and Prostate Research, 2. Institute for Bladder and Prostate Research, 3. Drexel University College of Medicine, 4. SUNY Downstate College of Medicine, 5. Shouldice Hospital, 6. St. Michael's Hospital; Keenan Research Center; University of Toronto
OBJECTIVE To better characterize recovery after minimally invasive kidney surgery, we present a s... more OBJECTIVE To better characterize recovery after minimally invasive kidney surgery, we present a study describing patient-reported health-related quality of life (HRQOL) following minimally invasive radical nephrectomy (RN) and partial nephrectomy (PN). METHODS Patients who underwent minimally invasive PN or RN for renal cancer were invited to enroll in a prospective, patient-reported HRQOL study using the Convalescence and Recovery Evaluation (CARE) instrument and Short Form-12 (SF-12). Patients completed questionnaires at baseline, 2, 4, 8 and 12 weeks after surgery. Mixed repeated measures model were used to assess time effect on HRQOL scores and predictors of scores within each surgery groups. RESULTS 177 patients were included in the study: 50 had RN and 127 had PN. At 2 weeks, both groups had significant decreases in Overall CARE, as well as the Pain, Gastrointestinal, and Activity domain scores which remained slightly below baseline at 4 weeks. At 4 weeks only 50% of patients in both the RN and PN cohorts returned to baseline overall CARE score. By 12 weeks 82% returned to baseline overall CARE score in the RN group while 76% of patients did so in the PN group. CONCLUSIONS Convalescence after minimally invasive renal surgery can often extend beyond 4 weeks post-treatment in PN and RN subjects. This information may be used to provide more accurate preoperative counseling in an attempt to improve overall patient satisfaction.
To evaluate the impact of salvage therapy (ST) on overall survival (OS) in recurrent primary uret... more To evaluate the impact of salvage therapy (ST) on overall survival (OS) in recurrent primary urethral cancer (PUC). A series of 139 patients (96 men, 43 women; median age = 66, interquartile range: 57-77) were diagnosed with PUC at 10 referral centers between 1993 and 2012. The modality of ST of recurrence (salvage surgery vs. radiotherapy) was recorded. Kaplan-Meier analysis with log-rank was used to estimate the impact of ST on OS (median follow-up = 21, interquartile range: 5-48). The 3-year OS for patients free of any recurrence (I), with solitary or concomitant urethral recurrence (II), and nonurethral recurrence (III) was 86.5%, 74.5%, and 48.2%, respectively (P = 0.002 for I vs. III and II vs. III; P = 0.55 for I vs. II). In the 80 patients with recurrences, the modality of primary treatment of recurrence was salvage surgery in 30 (37.5%), salvage radiotherapy (RT) in 8 (10.0%), and salvage surgery plus RT in 5 (6.3%) whereas 37 patients did not receive ST for recurrence (46....
To investigate whether shortened inpatient length of stay (LOS) after radical cystectomy (RC) is ... more To investigate whether shortened inpatient length of stay (LOS) after radical cystectomy (RC) is associated with increased complication rates after hospital discharge. The analytic cohort was comprised of 484 consecutive patients with 90 day follow-up who underwent RC at our institution from 2005-2012 and with LOS ≤9 days. Patients were categorized according to LOS as short (s-LOS; ≤5 days) or routine (r-LOS; 6-9 days). The primary outcome was major complications (Clavien-Dindo grade 3-5) occurring within 90 days after discharge. A Cox proportional hazards model was used to determine the association between LOS and post-discharge major complications. Hospital readmission was a secondary outcome. Patients in the s-LOS cohort had fewer comorbidities (p<0.01), less frequently received neoadjuvant chemotherapy (p=0.02), and more often underwent robotic RC (p<0.01). Major outpatient complications occurred in 18.1% of s-LOS patients compared to 11.2% of r-LOS patients, and s-LOS was...
RESULTS: 484 patients had open or laparoscopic UOS, with 200 (41%) classified as high risk for VT... more RESULTS: 484 patients had open or laparoscopic UOS, with 200 (41%) classified as high risk for VTE by CRSs. The rates of VTEs and median times to VTE were 6% and 74 days in Group 1, 13% and 44 days in Group 2, 15% and 40 days in Group 3, and 23% and 11 days in Group 4. Adjusted hazard ratios for VTE are shown in Table 1. Group 1 had no VTE’s or fatal pulmonary embolisms in the first 30 days after UOS. Bleeding and lymphocele rates were 0% and 2% in Group 1, 0% and 4% in Group 2, 3% and 3% in Group 3, 0% and 0% in Group 4. Complications were considered Clavien grades II-IIIa. CONCLUSIONS: VTE risk is lowest in patients who receive clinical protocol prophylaxis with EDP. Risk of VTE remains elevated for at least 90 days following UOS. A clinical VTE prevention protocol using perioperative prophylaxis and EDP is effective and safe in reducing VTE risk in UOS patients.
The study aimed to investigate oncological outcomes of patients with concomitant bladder cancer (... more The study aimed to investigate oncological outcomes of patients with concomitant bladder cancer (BC) and urethral carcinoma. This is a multicenter series of 110 patients (74 men, 36 women) diagnosed with urethral carcinoma at 10 referral centers between 1993 and 2012. Kaplan-Meier analysis was used to investigate the impact of BC on survival, and Cox regression multivariable analysis was performed to identify predictors of recurrence. Synchronous BC was diagnosed in 13 (12%) patients, and the median follow-up was 21 months (interquartile range 4-48). Urethral cancers were of higher grade in patients with synchronous BC compared to patients with non-synchronous BC (p = 0.020). Patients with synchronous BC exhibited significantly inferior 3-year recurrence-free survival (RFS) compared to patients with non-synchronous BC (63.2 vs. 34.4%; p = 0.026). In multivariable analysis, inferior RFS was associated with clinically advanced nodal stage (p < 0.001), proximal tumor location (p <...
Uploads
Papers by Kola Olugbade