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<p><b>OBJECTIVES</b>To increase the diagnosis and treatment of ectopic ACTH syndrome.</p><p><b>METHODS</b>The data of 12 ectopic ACTH syndrome patients treated from 1985 to 1999 were retrospectively analyzed.</p><p><b>RESULTS</b>Twelve patients were diagnosed as having ACTH syndrome by endocrinary test and primary tumors were ascertained by imaging examination. Follow-up from 7 months to 8 years showed 3 out of 5 patients with radical resection of primary tumor died. One patient with bilateral adrenorectomy was still alive. All patients received only chemotherapy except one died.</p><p><b>CONCLUSIONS</b>Patients with Cushing's syndrome should be evaluated by endocrine test and followed up by imaging screen examination. The key points to increase treatment effect include early detection, localization and resection of primary tumors.</p>
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Humans , ACTH Syndrome, Ectopic , Adrenocorticotropic Hormone , Cushing SyndromeABSTRACT
0. 05). Conclusions The post-transcription control for survivin gene may be involved in the mechanism of prostate carcinoma's dependency or refractoriness to androgen.
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Objective To investigate the methods for preventing bladder cancer recurrence after surgical treatment for upper tract urothelial carcinoma.Methods Of the 156 patients who underwent total nephroureterectomy for clinically localized transitional cell carcinoma of the upper urinary trace,139 were followed up and their data were retrospectively analyzed.Of the 139 cases,78 had pyelic carcinoma and 61 had ureteral carcinoma.The tumor cell grading showed G_1 in 19 cases,G_2 in 88 and G_3 in 32.The tumor staging showed T_a-T_1 in 38 cases,T_2 in 80 and T_3-T_4 in 21.The tumor diameter ranged from 0.8 to 6.0 cm.Results Radical nephroureterectomy and resection of partial bladder wall around the ureteral orifice(1.5-2.0 cm) were performed in all the 139 patients;of whom 55(39.6%) experienced subsequent bladder cancer recurrence during a mean follow-up of 52 months(range,1-10 years).The bladder cancer recurrence rate was 18.5%(5/27) in patients whose ureter had been ligated before the kidney was dissociated;and the recurrence rate was 27.5%(14/51) in patients whose ureter had not been firstly ligated.The recurrence rates in those who had prophylactic intravesical instillation immediately after surgery and in those who had the instillation 3 weeks after surgery were 32.3%(10/31) and 34.9%(30/86),respectively.The recurrence rate was 20.0%(4/20) in those who had intravesical instillation on the surgical day and 3 weeks after surgery sequentially,which was significantly lower than that(39.3%,26/66) in those who had the instillation simply 3 weeks after surgery(P
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Objective To assess the clinical value of gasless laparoscopy-assisted radical nephrectomy in the treatment of renal cell carcinoma.Methods The clinical data of 47 patients who underwent gasless laparoscopy-assisted radical nephrectomy from May 2003 to June 2005 were retrospectively analyzed.The surgical technique and its advantages and disadvantages were evaluated.Results The operative time was 75 to 135 min;and the mean blood loss was 120 to 220 ml.Postoperatively,analgesic at the dose of 5 to 35 mg(morphine sulfate equivalents) was given for pain control.The average time of indwelling drain was 2 to 3 d;the time to oral intake was 6 to 18 h;and the average hospitalization time was 5 to 7 d.Follow-up ranged from 1 month to 1 year,and all the 10 patients survived disease-free.Conclusions Gasless laparoscopy-assisted radical nephrectomy is of the advantages of both open surgery and laparoscopic surgery,and may become a good choice for the treatment of renal cell carcinoma.
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ObjectiveTo investigate the cause, treatment and prevention of splenic injury in radical nephrectomy for left renal cell carcinoma.MethodsThe clinical data of 27 cases of splenic injury in 458 cases of radical nephrectomy for renal cell carcinoma were retrospectively analyzed.ResultsThe injured spleen was saved in 21 cases (18 gradeⅠ injury,3 grade Ⅱ).The injured spleen was sewed up and pressed with hemostatic ganze in 7,pressed with medical sponge laid with spurting argon on biological glue in 11 and the same was carried out in 3 grade Ⅱ injury.Spleenectomy was conducted in the other 6 cases (4 grade Ⅱ injury,2 grade Ⅲ).The patients have been followed up for 6 months to 5 years.The outcome has been good in all except 1 patient died of tumor recurrence 1 month after operation.No late bleeding or adverse side effects has been noted.Conclusionssplenic injury may occur in radical nephrectomy for renal cell carcinoma especially the tumor is lasge or adhered to spleen in the upper past of left kidney.The occurrence of splenic injury is also related to the tumor stage.Attention should be called to the mentioned surgical complication.