Despite the rising popularity of the minimally invasive laparoscopic option, open nephron-sparing surgery is still seen by many experts as the 'gold standard' for open surgery for kidney tumors and should remain the first choice for many patients. This challenges the idea that less-invasive therapies are always more desirable than open surgery. While laparoscopic nephron-sparing surgery may be a more attractive option for treating small, easily accessible kidney tumors, for large tumors this is not always the case.
Nephron-sparing surgery is a outstanding text that analyses all forms of surgery, open or laparoscopic, as well as providing a backdrop on renal cell carcinoma in general, and the complications and outcomes following surgery that both surgeon and patient will face. Featuring 100 colour photos, the text includes chapters on:
Imaging renal masses: current status
Open nephron-sparing surgery for renal cell carcinoma
Minimally invasive approaches for renal cell carcinoma: an overview
Laparoscopic partial nephrectomy
Controversies in nephron-sparing surgery
Renal cell carcinoma: long-term outcome following nephron-sparing surgery
Dr Sasidharan and Professor Soloway have created a superb text covering all aspects of nephron-sparing surgery that should provide excellent guidance for all those who are just beginning to perform nephron-sparing surgery or act as an aide-memoire for those familiar with nephron-sparing surgery.
Dr.K.Sasidharan, the President of the Urological Society of India, is currently the Professor and Chairman of the Division of Urology at Kasturba Medical College Manipal. Prior to his present assignment he was for varying periods, Associate Professor of Urology at Calicut Medical College, Professor and Head of the Department of Urology at Trivandrum Medical College, and Professor and Head of the Department of Urology and Dean of Sri Venkateswara Institute of Medical Sciences, Tirupati. He had his early college education in St.Xavier’s College Calcutta and Jamiamilia, New Delhi. He obtained MBBS, MS (General Surgery) and MCh (Urology) from Calcutta, Delhi and Madras Universities respectively.
Dr.Sasidharan has been an active member of the Urological Society of India. He was elected to the Council of the Society twice. He was the Editor of the Indian Journal of Urology, the official organ of the Society for eight years. He was conferred many of the Society’s coveted honours such as Teacher Fellowship, Pinamaneni Oratorship and the Society’s President’s Gold Medal for the year 2000 for his contribution to Indian Urology.
He is a member of Boards of Study and Examination for MCh (Urology), Academic Councils and Thesis Adjudicator of many Indian Universities as well as a member of the National Board of Examination of India in Urology. He is an examiner of the Malaysian and Singapore Urological Board Exit examinations.
He has delivered several guest lectures and orations in India including the prestigious Dr.H.S.Bhat Oration, Dr.M.N. Sircar Oration , Dr.E.N.B. Sharma Oration, Dr.Subramanian Oration , Abdul Majeed Endowment Oration and G.S. Ramaiah Oration.
Professor K.Sasidharan has played a strategic role in Asian Urological activities. He is a member of the Executive Council of the Urological Association of Asia and has delivered Plenary Lectures , Master Lectures and conducted Operative Work-shops at its various fora. He delivered its prestigious ACU Lecture at Kualalumpur in the year 2003.
In recent years he has been invited several times as a Guest Speaker at the fora of Urological Association of Malaysia, Indonesia, Singapore, China, Taiwan, Bangladesh , Federation of Asian Urological Association ( FAUA ) and Urology and Transplantation Society of SAARC. He was invited to Japan twise ( 1997, 1998 ) to participate in programmes organized by the Kyoto and Hokaido Universities.
He was invited to chair and coordinate a session in the International Continence Society Meeting at Monte Carlo in the last week of June, 2004.
Dr.Sasidharan is a member of the Steering Committee of the International Consultation of Urological Diseases headquartered in Paris and also a member of International Board of the Asian School of Urology headquartered in Kualalumpur. He is in the Editorial Board of the International Journal of Urology published in Japan. He has also been inducted as a member of the ICUD Committee of Epidemiology of Prostate Disease in Asia.
He is a full member of the British Urological Association and International Society of Urology.
Mark Soloway, M.D. began his academic career at Case Western Reserve University School of Medicine in Cleveland, Ohio in the laboratory of Robert White, M.D., Chief of Neurosurgery at Metropolitan General Hospital. It was under the mentorship of Dr. White and his work with cerebral blood flow that Soloway first recognized how essential translational research, applying laboratory findings in the clinical setting, was to cutting-edge patient care. Throughout his career as a researcher, teacher and clinician, that lesson has been critical in shaping his professional life.
After two years of general surgical training at the University Hospitals in Cleveland, Ohio, Soloway was selected for a two year clinical fellowship in the surgery branch of the National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, Maryland. During this time, Soloway made a commitment to the field of urologic oncology and to academic medicine.
Bladder Cancer: Along with his surgical oncology training, Soloway had the opportunity of working in the laboratory and developed in those two years an animal model for human bladder cancer. Soloway found that Cisplatin, today still the most effective agent for treatment of advanced urolthelial cancers, was highly active in his model. One of the first patients to be treated with this experimental drug was Senator Hubert Humphrey, who had been diagnosed with metastatic bladder cancer. For nearly 15 years following his appointment to the NCI, Soloway maintained an NIH funded laboratory to carry on his work in the animal model. Solowayâ€™s animal model is still in use 25 years after its development, and continues to aid researchers worldwide.
While tenured at the NCI, Soloway helped to identify one of the reasons for bladder tumor recurrence. His work with the animal model once again provided documentation that suggested that the implantation of tumor cells can occur on the urothelial surface after the bladder surface has been altered with endoscopic surgery. This work provided the treatment rationale for intravesical chemotherapeutic drugs to be placed in the bladder shortly after tumor resection. Over the last five years, this procedure has become commonplace throughout the world based on large prospective randomized trials confirming what Solowayâ€™s work suggested 20 years before.
Soloway has also written several articles on the management of patients with superficial tumors and carcinoma in situ of the urinary bladder. His research has emphasized the potential involvement of the prostatic urethra and the need for regular monitoring of this location for cancer. His participation in some of the earliest work with industry supported urine markers along with his collaboration with Dr. Vinata Lokeshwar, associate professor of research in the Department of Urology, on the development of her own novel urine marker, a marker that potentially identifies the development of tumor prior to detection by either the physician or the patient, has helped in the diagnosis and early intervention for bladder cancer.
Prostate Cancer: Solowayâ€™s earliest published work in the area of prostate cancer related to technical aspects of performing a radical retropubic prostatectomy, a curative surgical cancer procedure. Three published articles provide data documenting the results from the bladder neck sparing approach and indicating that preservation of the neck of the bladder is safe in terms of cancer control and, in fact, may reduce the incidence of scarring at the bladder neck and possibly hasten the return of continence in the patient. More recently, he has experimented with eliminating the use of an abdominal drain following the radical surgical procedure in an attempt to increase patient satisfaction and decrease hospital stay.
Soloway has helped to develop the use of the periprostatic nerve block, a xylocaine injection similar to Lidocaine injected by dentists, in order to dramatically lessen the pain and discomfort associated with performing prostate biopsies. After careful examination no increase in the risk of performing prostate biopsies was documented as a result of this approach.
Soloway has collaborated on much of the seminal clinical studies evaluating the use of LHRH antagonists to treat metastatic prostate cancer. Soloway has also written several articles examining the significance of tumor found at the edge of the prostatic specimen following surgical removal. By carefully mapping the prostate, the urologist may have a better idea of the location in the prostate at risk for tumor migration outside the prostate. In addition, Soloway has correlated the likelihood of positive margins with the risk of recurrence and found that simply because the tumor has touched the edge of the prostate at the time of surgery, there is no need to proceed with additional treatment. More than 75 percent of those cancers have not recurred as evidenced by undetectable PSA.
Kidney Cancer: Soloway has worked with Dr. Gaetano Ciancio, professor of surgery and urology, to improve the surgical management and outcome of patients with extensive kidney tumors. These tumors have the relatively unique capacity to grow into the major vessels in the abdomen and even may extend towards the heart. As a team, Soloway and Ciancio have worked to develop surgical techniques to reduce the risks associated with removal of these very large, invasive tumors. Their published articles detailing their approach and their excellent results have been regarded with enthusiasm.
Throughout his career, Soloway has involved himself in the advancement of new technologies to improve the physicianâ€™s capacity to diagnose urologic cancers. His participation in the earliest development of both the flexible cystoscope and the transrectal ultrasound have provided him with the opportunity to convert his research endeavors into clinical practice and affect the quality of patient care.
Soloway is one of a handful of urologists who has received the Gold Cystoscope Award presented by the American Urological Association to individuals who have significantly advanced the practice of urology. Soloway has published over 300 articles in peer-reviewed journals, 49 book chapters, and has been invited as a visiting professor to the majority of major medical centers in the United States. He continues to be a guest speaker at national and international meetings speaking on topics related to prostate, bladder and kidney cancers.
To date, Soloway has performed over 1230 radical prostatectomies, 350 radical cystectomies, and 260 radical nephrectomies since coming to the University of Miami as Chairman of the Department of Urology in January, 1992.
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