ABSTRACT
One hundred and fifty patients with impacted upper-ureteral calculi were treated with ureteroscopic lithotripsy (URSL group,n =58),percutaneous nephrolithotomy (PCNL group,n =42) or retroperitoneal laparoscopic ureterolithotomy (RPLU group,n =50) from April 2011 to August 2015.The operative time,length of postoperative hospital stay,stone-free rate and the incidence of postoperative complications were observed and compared among three groups.The stone-free rate of URSL group one month after surgery was 77％,which was significantly lower than PCNL (95％) and RPLU groups (100％) (P ＜ 0.05).But the operative time and length of postoperative hospital stay of URSL group [(37.2 ± 5.6)min,(3.9-±0.8)d] were significantly shorter than PCNL group[(75.2 ±6.7) min,(7.9 ±0.9))d] and RPLU group [(65.3 ± 6.1) min,(8.7 ± 0.9) d] (all P ＜ 0.05).The postoperative complication rates of three groups were 8％,10％ and 10％,respectively.
ABSTRACT
Objective:To evaluate whether urological patients at nutritional risk are at higher risk for complications after radical cystectomy than those not at nutritional risk .Methods:We performed a retro-spective observational study in the consecutive patients undergoing radical cystectomy between 2010 and 2013 .A total of 147 patients were enrolled in this study .The nutritional risk score was assessed preoper-atively by a specialized study nurse .The patients with NRS ( nutritional risk screening ,NRS2002) scores≥3 were considered to have nutritional deficiency .Postoperative complications were defined using the standardized Clavien-Dindo classification .Univariate and multivariate analyses were performed to identify the predictors of complications.Results:The patients aged ≥70 years(50.57%) were more prone to nutritional risk than those aged <70 years (31.67%, P=0.023).Of the 63 patients at nutritional risk, 39 (61.90%) presented with at least 1 complication compared with 29 of the 84 controls (34.52%, P=0 .001 ) .The patients at nutritional risk were at threefold risk for complications on binary Logistic analysis (OR=3.128,95%CI 1.538-6.361,P=0.002).The length of hospital stay of the patients at higher nutritional risk was longer than that of those without nutritional risk [(12.9 ±5.7) d vs.(10.4 ± 4.3) d, P=0.003].Conclusion:The patients aged ≥70 years are at higher nutritional risk than that of those aged <70 years .Patients at nutritional risk are more prone to complications after radical cystectomy .
ABSTRACT
The clinical data of 24 bladder cancer patients reoperated shortly after laparoscopic radical cystectomy were retrospectively analyzed.The reoperative reasons included intestinal injury,wound bleeding,intestinal anastomosis fistula,deep vein thrombosis,ileus and single-J tube slipping.All of them were cured after reoperation.The postoperative complications were infected incisional wound (n =2),urinary leakage (n =1) and pulmonary infection (n =1).All were cured by symptomatic treatments.The keys of reducing the rate of reoperation shortly after laparoscopic radical cystectomy included selecting indications strictly,standardizing operative procedures and adopting special measures.
ABSTRACT
Major histocompatibility complex class Ⅰ chain related gene A(MICA) is located within the MHC class Ⅰ region of chromosome 6,including six exons.The MICA locus encodes membrane-bound polypeptides,similar with the classic class Ⅰ molecules,including three extracellular domains (α1,α2 and α3),a transmembrane domain,and a cytoplasmic tail,but is not associated with β2-microglobulin.MICA gene is expressed on endothelial cells,epithelial cells as well as most epithelial tumor cells surfaces,and are involved in the process of cell differentiation,proliferation and infiltration in a variety of tumor cells.Soluble MICA (sMICA) can be used as the prognosis predicting factor for some tumors.MICA gene plays an important role in the pathogenesis of a variety of malignant tumors,which might bring new ideas in prevention and treatment for malignant tumors.
ABSTRACT
The clinical data of 42 patients with impacted upper-ureteral calculi undergoing retroperitoneal laparoscopicureterolithotomy(RPLU)from January 2008toDecember 2010 were retrospectively analyzed.RPLU was successfully performed in 40 cases,and simultaneous laparoscopic electrocoagulation ablation was also performed in 11 cases complicated with ureteral inflammatory polyps.No massive bleeding occurred during the operations.The stone-free rate 3 d after operation was 100％,and no stone left as reviewed by kidney ureter bladder X-ray (KUB) and B-ultrasonography.During the follow-up of 3 to 24 months (mean 11 months),40 cases showed no stone recurrence and no ureteral stricture in KUB and B-ultrasonography.The hydronephrosis of all RPLU patients relieved.Results indicate that RPLU is a safe and effective minimally invasive operation for treatment of impacted upper-ureteral calculi.