PURPOSE: We present our experience of a retroperitoneoscopic nephrectomy for a benign renal disease, and evaluate the clinical efficacy and safety of a retroperitoneoscopic nephrectomy. MATERIALS AND METHODS: The clinical results of 20 retroperitoneoscopic nephrectomies (RN) were compared with 20 open nephrectomies (ON). The surgery time, hospital stay, analgesic requirements, and complications were analysed. RESULTS: The mean operative time was 255.2 +/- 72.5 minutes for the RN patients and 161.1 +/- 22.7 minutes for the ON patients (p< 0.05). The mean hospital stay was 4.2 +/- 1.1 days for the RN patients and 9.0 +/- 1.1 days for the ON patients (p< 0.05). The analgesic dose was 80.0 +/- 23.4mg of piroxicam for RN and 240.0 +/- 26.8mg of piroxicam for the ON patients (p< 0.05). Minor and major complications occurred in 4 (20%) patients who underwent a RN and 12 (60%) patients who underwent an ON (p< 0.05). Of the 23 retoroperitoneoscopic nephrectomies, an open conversion was necessary in 3 (13%) patients. CONCLUSIONS: While operative time is longer in RN patients than ON patients, the postoperative hospital stay, analgesic requirement and complication rate are significantly lower than in ON patients. Retroperitoneoscopic nephrectomy appears to be a safe and effective alternative to a traditional open nephrectomy.
Humans ; Length of Stay ; Nephrectomy* ; Operative Time ; Piroxicam

PURPOSE: We present our experience of a retroperitoneoscopic nephrectomy for a benign renal disease, and evaluate the clinical efficacy and safety of a retroperitoneoscopic nephrectomy. MATERIALS AND METHODS: The clinical results of 20 retroperitoneoscopic nephrectomies (RN) were compared with 20 open nephrectomies (ON). The surgery time, hospital stay, analgesic requirements, and complications were analysed. RESULTS: The mean operative time was 255.2 +/- 72.5 minutes for the RN patients and 161.1 +/- 22.7 minutes for the ON patients (p< 0.05). The mean hospital stay was 4.2 +/- 1.1 days for the RN patients and 9.0 +/- 1.1 days for the ON patients (p< 0.05). The analgesic dose was 80.0 +/- 23.4mg of piroxicam for RN and 240.0 +/- 26.8mg of piroxicam for the ON patients (p< 0.05). Minor and major complications occurred in 4 (20%) patients who underwent a RN and 12 (60%) patients who underwent an ON (p< 0.05). Of the 23 retoroperitoneoscopic nephrectomies, an open conversion was necessary in 3 (13%) patients. CONCLUSIONS: While operative time is longer in RN patients than ON patients, the postoperative hospital stay, analgesic requirement and complication rate are significantly lower than in ON patients. Retroperitoneoscopic nephrectomy appears to be a safe and effective alternative to a traditional open nephrectomy.
Humans ; Length of Stay ; Nephrectomy* ; Operative Time ; Piroxicam

Piroxicam is a new nonsteroidal anti-inflammatory drug(NSAID) and widely used in the management of rheumatoid arthritis and osteaorthritis. We experienced. two cases of photosensitive dermatitis developed while taking piroxicam. Both had pruritic and eczematous skin lesions on sun-exposed areas and showed positive reactions to 0. 1 % piroxicam solution in photopatch test in contrast with control group, which suggest a photoallergy mechanism. To our knowledge, these are the first reported cases in the Korean literature.
Arthritis, Rheumatoid ; Dermatitis ; Dermatitis, Photoallergic* ; Piroxicam ; Skin

BACKGROUND: The lidocaine patch has been effectively used as a first-line therapy to treat neuropathic pain such as postherpetic neuralgia (PHN). OBJECTIVE: To evaluate the safety and efficacy of the topical piroxicam patch as a treatment option for the treatment of PHN. METHODS: Eighteen patients completed a 3-session study, applying three different patches (lidocaine, piroxicam and control) in random order. A maximum of three patches were applied to the most painful area for three consecutive days (12 hours on followed by 12 hours off). Each session was conducted at least seven days apart. The changes in visual analog scale (VAS) scores based pain intensity, quality of sleep and adverse effects were recorded. RESULTS: When compared to the control, both the lidocaine and piroxicam patches significantly reduced the mean VAS scores of pain intensity of all different types. However, the lidocaine patch was better at reducing allodynia, whereas the piroxicam patch was more effective for dull pain. The lidocaine patch worked faster than the piroxicam patch for the response to overall pain relief. CONCLUSION: The results of this study suggest the use of the piroxicam patch for dull pain and in patients where the lidocaine patch is contraindicated.
Humans ; Hyperalgesia ; Lidocaine ; Neuralgia ; Neuralgia, Postherpetic ; Piroxicam

BACKGROUND/AIMS: We wanted to compare the efficacy and safety of a Murupe(R) patch, which is a newly-developed piroxicam patch, with the Trast(R) patch for the treatment of knee osteoarthritis. METHODS: Two hundred ten patients with radiologically confirmed symptomatic osteoarthritis of the knee were included in a randomized, open-labeled controlled trial and they were treated with a 48 mg piroxicam patch once every 48 hours for 4 weeks. The main outcome measures were the pain intensity on movement and the spontaneous pain intensity during rest, and these were measured using the 10 cm Visual Analogue Scale (VAS) categorical pain scores, as measured by the patient and the investigator. RESULTS: One hundred sixty-seven of the 210 enrolled patients completed the 4 week study. The pain intensity on movement was significantly reduced in both the Trast(R) and Murupe(R) groups (p<0.001) after 4 weeks of treatment; the improvement on the VAS was significantly higher in the Murupe(R) group (n=82) than that in the Trast(R) group (n=85) (4.5 cm versus 2.2 cm, respectively, p<0.001). Both treatment groups also showed reductions in all the other parameters of pain intensity, including spontaneous pain intensity during rest, the categorical pain scores and the 15 meter-walking time. There was no difference in adverse events between both groups. CONCLUSIONS: The superior analgesic activity of Murupe(R) patch indicates that the topical route of non-steroidal anti-inflammatory drug (NSAID) administration may be a safe, effective alternative to the oral route for the treatment of knee OA, and that the newly developed NSAID patch with its improved transdermal drug delivery may increase the efficacy of topical NSAIDs.
Humans ; Knee ; Osteoarthritis ; Osteoarthritis, Knee ; Outcome Assessment (Health Care) ; Piroxicam

Total 76 patients with acute painful musculoskeletal problems were treated with piroxicam, newly developed non steroidal-anti-inflammatory drug. Patients were divided into three groups, i.e. 1) acute low back strain or sprain group, 2) acute bursitis group, and 3) acute muscle sprain or strain group. The results were as following. 1. The effect of piroxicam on the various inflammatory changes was noticed promptly with initial 40 mg dose and pain control action was most prominent. 2. The drug was very well tolerated and side effect were generally mild. Three gastrointestinal symptoms and one skin eruption were developed. Over-all results of the piroxicam on the patient were evaluated as excellent in 51.3%, and good in 38.21%.
Acute Pain ; Bursitis ; Humans ; Piroxicam ; Skin ; Sprains and Strains ; Therapeutic Uses

BACKGROUND: This study was designed to evaluate the effect of intravenous piroxicam on pruritus and pain in patients undergoing abdominal surgery after epidural fentanyl was administered. METHODS: Ninety nine patients, ASA physical status 1 - 2, were randomly allocated to receive either piroxicam 20 mg (n = 50) or saline 2 ml (n = 49) intravenously before surgical incision. An epidural catheter was inserted in all patients before induction of anesthesia. All patients received 5 mg/kg of thiopental sodium and 1.5 mg/kg of vecuronium. Anesthesia was maintained by 50% O2 in N2O with 2 vol% enflurane. Epidural fentanyl 50 microgram was administered intraoperatively and 9.5 12.5 microgram/ml of fentanyl mixed in 100 ml of 0.15% bupivacaine was infused continuously by the Baxter two day infusor for 50 hours postoperatively. Postoperative pruritus and pain were measured by a numeric rating scale (0 - 10) in the piroxicam group and control group. RESULTS: Pruritus and pain scores at 1, 4, 8 and 24 hours in the piroxicam group were significantly lower than those in the control group (P < 0.05). The incidence of pruritus after epidural fentanyl varied from 2 to 6% in the piroxicam group and from 57 to 67% in the control group. Mean scores of pruritus were 0.6, 0.3, 0.2 and 0.1 in the piroxicam group and 5.1, 3.5, 2.8 and 1.8 in the control group. Mean scores of pain were 1.7, 1.2, 0.9 and 0.6 in the piroxicam group and 3.2, 2.4, 1.9 and 1.1 in the control group. CONCLUSIONS: This study demonstrates that intravenous piroxicam 20 mg significantly reduces the incidence and severity of postoperative pruritus and pain in patients who received perioperative epidural fentanyl.
Anesthesia ; Bupivacaine ; Catheters ; Enflurane ; Fentanyl* ; Humans ; Incidence ; Infusion Pumps ; Piroxicam* ; Pruritus* ; Thiopental ; Vecuronium Bromide

PURPOSE: We report an initial experience with a retroperitoneal laparoscopic ablation of a peripelvic renal cyst. MATERIALS AND METHODS: Five patients (2 males, 3 females), with a mean age of 47 years (22 to 65) underwent a laparoscopic unroofing of a symptomatic peripelvic cyst. All patients complained of flank pain and an obstruction was observed in 3 patients. A laparoscopic ablation was performed retroperitoneally in all patients. Clinical parameters evaluated included the operative time, hospital stay, analgesic use, oral intake and complication rate. RESULTS: The mean operative time was 179 minutes (160-210 minutes). The mean postoperative hospital stay was 2.8 days (2-3 days). The mean analgesic requirement was 44mg of Piroxicam. Oral intake was started on postoperative day 1.4 (1-2 days). Complications included 1 case of subcutaneous emphysema and 1 case of peritoneal tearing, which were managed conservatively. The mean follow-up was 9.2 months (3-18 months) with no evidence of recurrence. CONCLUSIONS: A retroperitoneal laparoscopic ablation of a peripelvic renal cyst is technically feasible and effective alternative to an open cyst unroofing. However, it should be performed by an experienced urologic laparoscopist because of the location and association of these cysts with vessels of the renal hilum and collecting system.
Flank Pain ; Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Male ; Operative Time ; Piroxicam ; Recurrence ; Subcutaneous Emphysema

PURPOSE: We report an initial experience with a retroperitoneal laparoscopic ablation of a peripelvic renal cyst. MATERIALS AND METHODS: Five patients (2 males, 3 females), with a mean age of 47 years (22 to 65) underwent a laparoscopic unroofing of a symptomatic peripelvic cyst. All patients complained of flank pain and an obstruction was observed in 3 patients. A laparoscopic ablation was performed retroperitoneally in all patients. Clinical parameters evaluated included the operative time, hospital stay, analgesic use, oral intake and complication rate. RESULTS: The mean operative time was 179 minutes (160-210 minutes). The mean postoperative hospital stay was 2.8 days (2-3 days). The mean analgesic requirement was 44mg of Piroxicam. Oral intake was started on postoperative day 1.4 (1-2 days). Complications included 1 case of subcutaneous emphysema and 1 case of peritoneal tearing, which were managed conservatively. The mean follow-up was 9.2 months (3-18 months) with no evidence of recurrence. CONCLUSIONS: A retroperitoneal laparoscopic ablation of a peripelvic renal cyst is technically feasible and effective alternative to an open cyst unroofing. However, it should be performed by an experienced urologic laparoscopist because of the location and association of these cysts with vessels of the renal hilum and collecting system.
Flank Pain ; Follow-Up Studies ; Humans ; Laparoscopy ; Length of Stay ; Male ; Operative Time ; Piroxicam ; Recurrence ; Subcutaneous Emphysema

Study purposes were to evaluate ultrasonographic characteristics of transitional cell carcinoma (TCC) and quantitate bladder tumor size in dogs. Heterogeneous mass, wall involvement, and broad-based attachment were significantly associated with TCC, but not prominently the trigone region. Mass size evaluation revealed a significant correlation between progressive disease (PD) in TCC patients with piroxicam therapy. Largest diameter of target lesion/body weight (cm/kg) ratio showed a high mean value in PD. A value > 0.3 was associated with PD with 83% sensitivity and 66% specificity. The results suggest that ultrasonography can provide evidence for diagnosing and predicting a prognosis for TCC.
Animals ; Carcinoma, Transitional Cell* ; Dogs* ; Humans ; Piroxicam ; Prognosis ; Sensitivity and Specificity ; Ultrasonography ; Urinary Bladder Neoplasms ; Urinary Bladder*