Dr. Raju Thomas
Professor and Chairman, Chief of Endourology, Laparoscopy, & Stone Disease
Biography
Dr. Thomas was named Chair of the Department of Urology at Tulane University Medical Center in New Orleans, Louisiana, effective March 1, 1996. Dr. Thomas served as Interim Chairman from January 1, 1994 to February 29, 1996. He is also a Professor of Urology and the Residency Program Director for the Department of Urology. Dr. Thomas obtained his medical degree from the University of Bombay, India in 1975 and subsequently graduated in 1982 from the Urology residency program at Tulane University School of Medicine. He completed a fellowship program at the Tulane Primate Center co-sponsored by the American Urological Association and the National Kidney Foundation (1979-1980). Dr. Thomas' primary interests are in endourology, laparoscopy, lithotripsy and diseases of the prostate. He is the Medical Director of the Extracorporeal Shock Wave Lithotripsy (ESWL) Training Program at Tulane. He has pioneered several innovative endoscopic and surgical procedures and developed the principles for their use. He also has significant experience in such innovative procedures as ureteroscopic retrograde endopyelotomy and urological laparoscopy, and he has promoted radical perineal prostatectomy in conjunction with laparoscopy as a minimally morbid alternative for management of prostate cancer. His career has been dedicated to finding minimally invasive therapy alternatives to urologic surgery. His experience has earned him a place in advanced continuing medical education programs around the U.S. and the world, and he has won a place in the "Best Doctors in America" listing. He continues to be on the faculty list for postgraduate courses at the annual meeting of the American Urological Association. Dr. Thomas has authored over 100 scientific articles, abstracts, and book chapters. He is a member of several national and international scientific societies and is a peer reviewer of several urologic journals.
Education
American Urological Association and National Kidney Foundation
Tulane University
Seth G.S. Medical College of the University of Bombay
Accomplishments
Inducted into the Royal College of Surgeons
2018
Honorary Member of the Endourological Society
2018
Distinguised Service Award of the American Urological Association
2016
Top Doctors for New Orleans, LA Region
2015
Honorable Mention: Award-Winning Video Session
2015
Articles
Robotic vs. open surgical management of ureteroenteric anastomotic strictures: technical modifications to enhance success
2019
Development of ureteroanastamotic strictures (UAS) after urinary diversion is not uncommon, but is challenging to treat. Poor outcomes are likely with endoscopic and radiologic management, and definitive surgical treatment can cause significant morbidity. The comparative advantages of an operative approach have not yet been fully described in the literature. We retrospectively reviewed the prospectively maintained Tulane University Department of Urology quality assurance database of 12 patients who underwent operative UAS repair between 2012 and 2018. Data were reviewed for operative approach, demographics, baseline disease characteristics, operative variables, and perioperative and pathological outcomes. Of the 12 patients analyzed, 5 underwent open repair (OR) (2 bilateral, 2 right, 1 left) and 7 underwent robotic repair (RR) (3 right, 4 left). One robotic case required conversion to open due to significant intestinal and peri-ureteral adhesions. The median ages were 59 years in OR and 60 years in RR. Two patients in each group had failed previous endoscopic repair. Median time from cystectomy to treatment of enteroanastamotic stricture was 13 months for OR and 10 months for RR (p = 0.25). Median estimated blood loss was 80 mL in both OR and RR (p = 1.0), median operative time was 260 min in OR and 255 min in RR (p = 0.13), and median hospital stay was 8 and 4 days, respectively (p = 0.06). There were two intra-operative and one post-operative complication in the OR group, one of whom required further surgical intervention, and no complications in the robotic cohort. A minimally invasive, robotic approach offers a non-inferior alternative to OR with similar outcomes for appropriately selected patients with UAS. High success rates combined with minimal morbidity may provide definitive therapy at an earlier stage of the stricture state.
Robotic Pyeloplasty
2018
Historically, the gold standard for management of ureteropelvic junction obstruction (UPJO) has been open pyeloplasty. However, continued technological and surgical advances have ultimately led to the robotic approach. Continued advances in minimally invasive surgery have led to shorter hospital stays and hastened recovery. Here we present our step by step guide and video to robotic-assisted laparoscopic pyeloplasty.
Regional Differences in the Treatment of Localized Prostate Cancer: An Analysis of Surgery and Radiation Utilization in the United States
2019
Purpose: Men with localized prostate cancer have various treatment options available in their management. The optimal approach is controversial and can be influenced by multiple factors. This study aimed to investigate the influence of geographic region on the selection of treatment for prostate cancer.
Methods And Materials: Using the National Cancer Database, we identified men diagnosed with localized prostate cancer between 2010 and 2014. The United States was divided into 11 regions per the American Cancer Society Divisions. The first course of treatment was recorded as radiation therapy (RT), radical prostatectomy (RP), or active surveillance (AS). The RT subgroup consisted of patients receiving all forms of RT, including external beam and brachytherapy, or RT plus androgen deprivation therapy. The RP subgroup consisted of patients receiving RP alone or combined with RT or androgen deprivation therapy. A χ test was performed to assess the association between region and frequency of RT and RP.
Results: This study included 462,811 men with localized prostate cancer who were treated in the United States, of whom 63.46% underwent RP, 31.54% underwent RT, and 5.00% underwent AS. Significant regional differences in RP and RT were observed ( ≤ .0001). RP was used most commonly in the Midwest (75.07%) and High Plains (73.37%) regions, whereas RP was least used in the South Atlantic (59.04%) region. Similarly, RT was used most commonly in South Atlantic (40.96%) and New England (38.98%) regions and least commonly in the Midwest (24.93%) region. AS was used most in the New England (7.27%) and Midwest (6.8%) regions and least used in the High Plains (2.57%) and Mid-South (2.84%) regions.
Conclusions: Regional differences exist in the United States with regard to the definitive treatment of localized prostate cancer. The etiology for these regional differences is likely multifactorial.
Media Appearances
Get free prostate screenings and Saints selfies at Tulane Medical Center on Saturday
“Part of our message is that men need to take care of themselves,” said Dr. Raju Thomas, a urologist with Tulane Health System. “Men are reluctant users of health care. Women are up on their doctors, up on their mammograms and pelvic exams. The men, nothing. It’s like they don’t even think about these things.”
