ABSTRACT
Objective To discuss the semilateral supine position for retroperitoneoscopic adrenalectomy. Methods From Jan. 2006 to Dec. 2008, 36 patients (20 males and 16 females with mean age of 43 years) underwent retroperitoneoscopic adrenalectomy in 60° -70° semilateral supine position. There were adrenal cortex adenomas in 18 cases, pheochromocytoma in 6 cases, adrenal cysts in 3 cases, myelolipoma in 2 cases, gangliocytoma in 1 case, lymphangioma in 1 case, metastatic tumor in 1 case and corticohyporplasia in 4 cases. The mean diameter of the tumors was 2.6 cm( 0.5 - 7.7 cm ). The tumors were superior to the renal pole in 5 cases, anteromedial in 10 cases and superomedial in 17 cases. The three ports that were usually used in lateral position and were placed anteriorly to create retroperitoneal place: the first port was placed 2 -4 cm superior to the iliac crest along the anterior axillary line, the other two were placed just below the costal margin along the midaxillary line and at the same level along the midclavicular line, and dissected along the anterior surface of kidney to its superomedial aspect, so as to avoid the hampering of the kidney in the exposing of the diseased adrenal gland. Results The procedure was completed successfully in all of the cases with the operating time of 37 - 145 min ( mean 69 min) and intraoperative blood loss of 30 - 100 ml (mean 48 ml). Six cases had rupture of peritoneum, which were sutured and the procedure was continued to completion. The postoperative hospital stay was 3 -8 d (mean 5 d ). Thirty-five patients were available for follow-up of 3 - 28 months ( mean 14 months). The case of metastatic tumor died of the primary diseases in the 12th month postoperatively. No other complication was found. Conclusion With this alternative position and ports' location, the procedure of retroperitoneoscopic adrenalectomy could be easier and safer than the conventional position.
ABSTRACT
Objective To evaluate the clinical effectiveness of ureteroscopic pneumatic ballistic lithotripsy for the treatment of ureteral stones.Methods A total of 185 patients with ureteral stones(accompanying renal colic in 96 patients) were treated with ureteroscopic pneumatic ballistic lithotripsy from February 2004 to March 2005 in this hospital. Results The procedure failed in 12 patients,including conversions to open surgery in 6 patients and to extracorporeal shock wave lithotripsy 3 days later in 6 patients.The single-session success rate was 93.5%(173/185),and was 75.0%(24/32) in the upper segment,95.8%(46/48) in the middle segment,and 98.1%(103/105) in the lower segment.The success rate in patients with renal colic was 100%(96/96).The rate of intraoperative ureteral injury was 2.9%(5/173),with conversions to open surgery required in 3 patients(1.7%).Postoperative renal colic occurred in 1 patient.Follow-up checkups in all the patients for 6~12 months(mean,10.2 months) showed no recurrence. Conclusions Ureteroscopic pneumatic ballistic lithotripsy is safe and effective,being the first choice for patients with middle or lower ureteral stones,especially accompanying renal colic.
ABSTRACT
50%).RT-PCR results were classified as positive and negative according to the presence or absence of corresponding electrophoretic bands. Results Immunohistochemically,integrin ?2 and ?3 subunits were all expressed strongly in 12 cases of normal bladder tissues (100%).In 53 cases of BTCC tissues,?2 was strongly positive in 10 cases (19%),positive in 22(42%),negative in 21(40%);?3 was strongly positive in 16 (30%),positive in 24 (45%),negative in 13(25%).The expressions of ?2 and ?3 were significantly different between normal and BTCC tissues ( P 0.05).RT-PCR results showed that ?3 expression was positive in all normal tissues (100%) and in 36 (68%) out of the 53 cases of BTCC tissues;the difference was significant ( P 0.05),but ?3 mRNA positive expression was significantly related to clinical stages [T is ～T 1:83%(19/23),T 2～T 4:57%(17/30); P