ABSTRACT
Objective To explore the surgical features of retroperitoneoscopic excision of adrenal myelolipoma with diameter larger than 6 cm. Methods We retrospectively analyzed clinical data of 28 cases of giant adrenal myelolipoma from March 2010 to December 2015.The diameter of tumor was 6.0-13.7 cm (mean, 8.5 cm).There were 10 left-sided cases and 18 right-sided cases. During the retroperitoneoscopic excision of adrenal myelolipoma , four trocars were used .Two silk sutures were twisted as a loop to entangle one side of the tumor and then pulled it .Blood vessel on the surface of tumor was sealed and cut by ultrasonic scalpel . Adrenal gland was totally or partially removed and the tumor was resected completely . Results The operations were successful in all the 28 cases without hemorrhage during or after the surgery , conversion to open surgery , or injury of adjacent organs .The operation time was 52-117 min (mean, 67.5 min) and the blood loss was 45-110 ml during operation (mean, 60.5 ml).Patients took food 1-2 days after operation and ambulated 3-5 days after operation .The indwelling time of retroperitoneal drainage tube was 3-6 d (mean, 4.1 d).The postoperative hospitalization time was 6 -9 d (mean, 7.5 d). Conclusions Giant myelolipoma leads to seriously changed normal anatomy and is hard to be exposed during operation .Only when the important anatomical landmarks , large blood vessels and adrenal glands are focused , can the operation be safe and controllable .
ABSTRACT
Objective@#To review and discuss the experience of diagnosis and treatment of adrenal ganglioneuroma.@*Methods@#Clinical data of 80 cases of adrenal ganglioneuroma undergoing surgery during January 1982 to May 2017 at Peking Union Medical College Hospital were retrospectively analyzed. There were 36 male and 44 female patients. Age ranged from 8 to 69 years old (mean 37.7 years old). The tumor diameter were 1.5 to 18.0 cm (mean 4.3 cm). There were 61 cases of adrenal ganglioneuroma diagnosed by imaging examination. All patients underwent adrenalectomy.@*Results@#All procedures were performed successfully without serious complication. Including 15 open surgery and 64 retroperitoneal laparoscopic surgery. One laparoscopic case conversion to open surgery. The pathological diagnosis was adrenal ganglioneuroma. Fifteen cases were mixed with other tumor components. No recurrence or metastasis was observed during the follow-up of 2 months to 35 years.@*Conclusions@#The diagnostic techniques for adrenal ganglioneuroma are helpful to judge the tumor property before operation. The laparoscopic surgery has become the current method for resecting tumors. It shows advantages of small trauma and speedy recovery. The relationship between tumor and surrounding tissues should be understand clearly before operation. Full preparation must be made before operation if adrenal ganglioneuroma mixed with other tumor components.
ABSTRACT
Objective To compare the efficacy and safety of 1.9 μm thulium laser with transurethral resection of bladder tumor(TURBT) for the treatment of superficial bladder cancer.Methods We reviewed 53 patients with superficial bladder cancer,who were divided into 1.9 μm laser (n =25) and TURBT groups (n =28) from January 2013 to December 2015.The operation time,blood loss volume in operation,catheter indwelling time,hospital stay time,and complications,cumulative recurrence rate were compared between the two groups.Results Compared to TURBT group,1.9 μm laser group showed significantly lower rate of blood loss volume in operation (21.6 ± 4.6) min,catheter indwelling time (22.4 ± 6.4) h,hospital stay time (2.2 ± 0.7) d,less complications (12％)and recurrence(16％) (P ＜ 0.05).Conclusions 1.9 μm thulium laser is safe and effective for the treatment of patients with superficial bladder cancer.The approach has less complications than TURBT.
ABSTRACT
Objective To detect the efficacy of trimodality treatment combining transurethral resection of bladder tumor (TURBT), chemotherapy and radiotherapy for locally muscle-invasive bladder cancer.Methods From November 2007 to June 2013, 107 local muscle-invasive bladder cancer cases were treated by TURBT.Thirty-six cases ( group A) underwent the bladder-sparing trimodality treatment, aged from 42 to 88 years.Seventy -one cases (group B) underwent radical cystectomy,aged from 38 to 77 years.In group A, there were 19 cases of T2 , 13 cases of T3 , and 4 cases of T4a.Among those patients, 11 patients underwent gemcitabine/cisplatin ( GC ) systemic chemotherapy regimen, 15 patients underwent gemcitabine/cisplatin ( GC ) intrailliac artery chemotherapy regimen, and 10 patients underwent taxane/carboplatin ( TC) systemic chemotherapy regimen.In group B, there were 38 cases of T2 , 27 cases of T3 , 6 cases of T4a.The progress-free survival after 2 years was compared with the only radical cystectomy, and the efficacy among the three chemotherapy regimens was also evaluated.Results There is no statistical difference in age and tumor stage between the two groups.In group A, patients were followed up from 3 to 79 months, and 2 years′progress-free survival was 78.9%(15 cases) in T2 , 46.2%(6 cases) in T3 , and 0 in T4a.In group A, organ-sparing 2 years′progress-free survival was 58.3%, and 6 metastasis (16.7%) and 11 local relapse ( 30.6%) were detected during the follow-up period.In group B, patients were followed up from 2 to 65 months, and 2 years′progress-free survival was 76.3%in T2(29 cases), 55.6%(15 cases) in T3, and 16.7% (1 case) in T4a.Of all the patients in group B, 2 years′progress-free survival was 63.4%, and 22 metastasis ( 31.0%) and 16 local relapse ( 22.5%) were found during the follow-up period.There′s no statistical difference on 2 years′progress-free survival between the two groups, and the efficacy among the three chemotherapy regimens.Conclusions Two years′progress-free survival of bladder-preserving trimodality treatment was similar to that of radical cystectomy for local muscle-invasive bladder cancer.In term of treatment efficacy, stage T2 was much better than T3 and T4a .Each kind of chemotherapy regimen in trimodality treatment was equally effective.
ABSTRACT
Objective To investigate the diagnosis and treatment of renal neoplasm with calcification .Methods Retrospectively summarized the clinical data of the 2 patients with calcific renal neoplasm admitted in our hospital from the May to July in 2014, then analyzed and discussed the clinical manifestations , diagnosis and treatment com-bined with the literatures .Results The two cases were both suspected of renal malignant tumor preoperatively .The case 1 was a 32-year-old male , laparoscopic partial resection of the left kidney was performed , and the postoperative pathology was clear cell carcinoma (Fuhrman levelⅠ).The case 2 was a 18-year-old male, partial resection of the right kidney was performed because of the tumor size , and the postoperative pathology was adult nephroblastoma . Conclusions The calcific renal neoplasm is a rare disease , the property determination depends on postoperative pa-thology, and as to the choice of surgical method , the patients'age, the tumor size and the tumor location should be taken into consideration , and intraoperative frozen should be performed when necessary .
ABSTRACT
Objective To detect differentially expressed genes between human normal skin and photoaging skin, and to investigate the molecular and biological mechanisms of human skin photoaging at transcriptional level. Methods Full-thickness skin specimens were obtained during full-face rhytidectomy from sun-exposed (anterior ear skin) and sun-protected (retroauricular skin) sites of 6 patients with facial photoaging from 2007 to 2008. Genomic microarray analysis was conducted to identify differentially expressed genes between the two groups of specimens followed by gene-cluster analysis. Results The normalization of microarray data showed that the number of differentially expressed genes was 2163 between skin samples from sun-exposed and sun-protected sites in one patient, significantly higher than that in the other 5 patients (less than 200);therefore, the data from the patient with 2163 differentially expressed genes were excluded from further analysis.Totally, 172 differentially expressed genes were identified with Beadarray chip, including 99 up-regulated genes and 73 down-regulated genes. Based on Genebank research, 118 functionally classified genes werefound, which were associated with a series of biological processes, including cell adhesion, receptor regulation,signal transduction, metabolism, and so on. Conclusions There are a lot of differentially expressed genes between human photoaging skin and normal skin. Rhytidectomy may be associated with the differential expression of skin photoaging-related genes.
ABSTRACT
Objective To highlight the diagnose and treatment of stationary paraganglioma in retroperitoneum.Methods Ten cases of stationary medullary chromaffinoma of retroperitoneum proven pathologically from 1997 to 2007 were reviewed and sutdied.Hypertension were not observed in all patients,who were admitted to hospital through routine phisical examination.Endocrine secretion examinations,B-US,CT,MRI,131IMIBG,and octreotide were used to dianose the diease.Among all 10 patients,4 cases took ?-receptor blocker for 2～4 weeks preoperatively.3 were operated laparoscopically,7 were operated with lumber incision.Results Hypertension and urinary catecholamine was usually normal or elevated lightly in stationary medullary chromaffinoma of retroperitoneum.131and octreotide have high sensitivity and accuracy in diagosing medullary chromaffinoma.4 were near renal hilum,6 was in para-aorta.They were from 3 cm to 15 cm in size.The results of pathology were paraganglioma in 7 and malignant paraganglioma in 3.Tumor markers were positive,such as cgA,syn,NSE and s-100.There was 1 case metastasis 1 years later.Conclusion Once the correct diagnosis is made,surgical treatment should be carry out on the basis of correct drug preparation.Intimate follow-up is necessary and important.
ABSTRACT
Objective To evaluate the clinical characteristics, diagnosis and treatment procedures for adrenal pheochromocytoma and adrenal ganglioneucoma.Methods Thirty-two cases of adrenal pheochromocytoma and 14 cases of adrenal ganglioneucoma surgical treated between 1999—2005 were analysed, The average of ganglioneucoma was 39 years old (16～63). tumor size ranged from 2.5 cm to 15 cm. The mean age of pheochromocytoma was 42 years old (19～74), tumor size ranged from 2cm to 16 cm. Tumor located in the adrenal area. All cases accepted surgical operation and were confirmed by pathology. Results Most cases of adrenal ganglioneucoma did not have any symptom but were founded incidentally. Differentials were obviously between ganglioneucoma and pheochromocytoma. Conclusion Both adrenal ganglioneucoma and pheochromocytoma are rare diseases.CT、urinary CA and 131I-MIBG are good methods for diagnosis.The final diagnosis depends on the pathology, surgical resection of tumor is a preferred choice.
ABSTRACT
Objective To review the diagnosis and treatment of adrenal myelolipoma(ML).Methods The medical records of 21 patients with adrenal myelolipoma were reviewed.All patients were examined by B-ultrasound,CT and endocrine tests while some were also examined by MRI and 131I-MIBG.Results All patients had undergone resection of adrenal ML.The mean diameter of tumors was 6.7 cm(4.5 cm～12 cm).Pathological examination of all tumors confirmed the diagnosis of adrenal ML.No recurrence was recorded during the follow-up period(1～15years).Conclusion Adrenal ML is a kind of rare,benign tumor and is often incidentally discovered.Its prognosis is generally good.
ABSTRACT
ObjectiveTo investigate and eveluate the significance of serum and urinary L-selectin in patients with transitional cell carcinoma.MethodsSerum and urinary samples were obtained before operation and 6 days after surgery from 46 patients with transitional cell carcinoma of bladder and from 14 patients with benign prostate hyperplasia.The serum and urinary L-selectin levels were measured using ELISA.ResultsThe preoperative serum concentration of L-selectin was significantly higher in patients with invasive bladder cancer [(766.3?135.1)ng/ml] than those with superficial bladder cancer [(563.8?118.2)ng/ml],P