Early Experience of Laparoscopic Partial Nephrectomy for Renal Tumor / 대한비뇨기과학회지

PURPOSE: To evaluate the feasibility of laparoscopic partial nephrectomy for patients with renal tumors from our early experiences. MATERIALS AND METHODS: Between February 2004 and February 2006, 20 patients with renal tumors underwent a laparoscopic partial nephrectomy, and of these, 15 were enrolled in our study. The mean age and body mass index of 6 male and 9 female were 55.2 years and 23.9, respectively. The mean tumor size was 4.2 cm. The operation was performed with a 4 trocar system through a transperitoneal approach. Bleeding from the renal parenchyme was controlled using sutures, argon beam coagulation, fibrin glue and cellulose meshes. RESULTS: The laparoscopic partial nephrectomies were successfully performed in all patients. The mean operative time and transfusion rate were 180.7 minutes and 60%, respectively. In 6 patients, vascular bulldog clamps were used to remove the tumor mass, with a mean warm ischemic time of 32.5 minutes. The initiation of the postoperative oral intake and ambulation were 1.6 and 2.7 days, respectively, with a mean hospital stay of 8.8 days. Complications were detected in 2 patients, one case each of urinary leakage and an incisional hernia. Pathological examinations revealed renal cell carcinomas with negative surgical margins in 9 patients and angiomyolipomas in a further 6. There was no recurrence during the mean follow-up of 11.4 months. CONCLUSIONS: A laparoscopic partial nephrectomy for a renal tumor can be safely performed. Although excellent perioperative outcomes were observed, long-term follow-up is still necessary to confirm theist effect on cancer control.

Surgical Intervention for the Complications of the Sling Operation in Patients with Female Stress Urinary Incontinence / 대한비뇨기과학회지

PURPOSE: Stress urinary incontinence is a quality of life issue for millions of women worldwide. Mid-urethral slings are becoming the treatment of choice for the management of stress urinary incontinence. Although it is a minimally invasive procedure, the widespread use of this procedure has led to an increasing number of severe complications. In our series, there were 6 patients with complications that necessitated surgery. MATERIALS AND METHODS: Six patients underwent the sling procedure and they required surgical intervention for their complications, including permanent urinary retention, de-novo urgency, intravesical polypropylene mesh tape, intravesical suture material, vaginal mucosal erosion, and urethral shortening. RESULTS: For the patients with urinary retension, they underwent resection of periurethral sling transvaginally. The intravesical tapes were resected by the transurethral approach, and this was supported by suprapubic laparoscopic trocar puncture. The intraravesical suture material was removed by same approach. In the case of vaginal erosion, the periurethral part of the tape was resected transvaginally. A patient with urethral shortening was treated with urethroplasty. CONCLUSIONS: Complications from the sling operation that require surgical intervention are rare. Nevertheless, the surgeon must be aware that complications may occur that require surgical intervention with high morbidity.

Recurrent Cavernous Hemangioma of the Spermatic Cord / 대한비뇨기과학회지

Neoplasms of the spermatic cord are rare tumors. Especially, the spermatic cord is an extremely unusual site for cavernous hemangioma. We experienced a recurrent cavernous hemangioma in a 12 year-old boy. His chief complaint was recurrent inguinal mass and he was pathologically diagnosed as having a cavernous hemangioma of the spermatic cord. To the best of our knowledge, this is the first Korean report of a recurrent cavernous hemangioma of the spermatic cord.