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Background and purpose:Laparoscopic partial nephrectomy has been one of the surgery options for patients with single renal carcinoma of T1 stage. Under the effect of some factors, intraoperative renal blood lfow clamping somtimes exceeds the safe limit of 30 minutes of warm ischemia time (WIT) for renal tissues, that might results in warm ischemia-reperfusion injury to severe extent. However, there still remains controversy about the depth of this warm ischemia-reperfusion injury. So this study aimed to evaluate the effects of longer WIT on ipsilateral residual renal tissues. Methods:Forty-four patients underwent retroperitoneal laparoscopic partial nephrectomy from Jan. 2012 to Jan. 2014. All of them were divided into observe group (WIT>30 min) and control group (WIT≤30 min). The differences of glomerular filtration rate (GFR) of operative kidney Pre- and post-operatively between two groups were analyzed. Results: The pre- and post-operative GFRs of operative kidney in observe group were 29.3-53.0 mL/min[(33.1±5.2) mL/min], 23.1-40.5 mL/min[(27.3±5.9) mL/min] respectively (P=0.054). The pre-and post-operative GFRs of operative kidney in control group were 27.4-49.6 mL/min[(32.3±4.1) mL/min], 23.8-44.4 mL/min[(29.1±5.0) mL/min], respectively (P=0.07). There was no statistically differences of the depth of the decrease of GFRs after surgery between the two groups (P=0.051). Conclusion: WIT of 30-60 min does not result in statistically signiifcant injury for ipsilateral residual renal function. However, it is still necessary to reserve more ipsilateral residual renal function through minimizing WIT under the premise of ensuring the safety of surgery.
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Objective To compare the safety and clinical efficiency between minimally invasive percutaneous nephrolithotomy(MPCNL)in supine position and flexible ureteroscopy(FURS)in management of proximal ureteral calculi.Methods From Oct.2010 to May.2012,76 patients with single proximal ureteral calculus between 10-20 mm failed in SWL or other conservative therapy accepted MPCNL (32 cases)or FURS(44 cases).There was no significant difference between the groups in base-line parameters.Stone sizes were(15.6±2.5)mm and(14.9±2.3)mm,P＞0.05.Procedural time,post-operative hospitalization stay,complication rates(Clavien degree Ⅱ or over)and stone free rates were compared.Results In these two groups,procedural time was(49.3± 11.7)and(67.2± 17.3)min,P＜0.05,postoperative hospitalization stay were(4.2±1.1)and(1.8±0.8)days,P＜0.05,complication rates were 12.5％ and 6.8％,P＞0.05 and stone free rates(residual fragments≤3 mm)were 93.7％ and 84.1％,P＞0.05.Conclusions For patients with surgically indicated proximal ureteral calculi,both minimally invasive percutaneous nephrolithotomy in supine position and flexible ureteroscopy are effective and safe therapeutic modalities.Patients treated with flexible ureteroscopy have faster postoperative recovery.
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ObjectiveTo evaluate the relationship between metabolic syndrome (MS) and benign prostatic hyperplasia ( BPH ) in men over 50 years old.Methods Male participants over 50 years old form a community in Beijing were randomly selected.Age,blood pressure,past history,and the international prostate symptom score (IPSS) were recorded.Plasma glucose,triglyceride,high density lipoprotein,prostate specific antigen (PSA),prostatic volume,and Qmax were measured.The morbidity and severity of BPH were compared with statistical analysis.ResultsFour hundred and forty men were enrolled,and were divided into 2 groups:MS group (n =105) and non-MS group (n =335).Compared to the non-MS,non-obesity,and non-hyperlipidemia group respectively,the morbidity of BPH was higher in MS,obesity and hyperlipidemia group (33.3％ vs.11.9％,P ＜ 0.05 ; 20.4％ vs.11.8％,P ＜ 0.05 ; 25.0％ vs.14.1％,P =0.007).The morbidity of moderate and severe LUTS in MS group was higher than non-MS group (61.9％ vs.31.3％,P ＜ 0.05).Significant differences were found in IPSS,prostate volume and PSA between the MS and non-MS groups ( P ＜ 0.05 ),but not found in Qmax ( P =0.069).Obesity,hyperlipemia and diabetes mellitus were risk factors of BPH (OR 1.75,95％ CI 1.40 -21.82,P =0.041 ; OR 3.36,95％ CI 2.34-48.13,P=0.037; OR 2.08,95％ CI 1.32-13.67,P=0.045). Conclusions There is higher morbidity of BPH in MS patient.MS could increase IPSS and prostate volume,and reduce PSA in BPH patient.Obesity,hyperlipemia and diabetes mellitus are risk factors of BPH.MS should be considered when treating BPH.