ABSTRACT
Objective To explore the application of nephron-sparing surgery in giant renal angiomyolipomas with the maximum diameter greater than 15 cm and its relevant surgical experience.Methods Between July 2014 to January 2017,5 patients with giant renal angiomyolipoma greater than 15 cm was admitted to our hospital for nephron-sparing surgery.The patients were all female ranging in age from 32-50 years (43.0 ± 7.1) years.According to the tumor imaging characteristics,we divided them into 3 different types including diffuse endogenous,exogenous and mixed type.All the tumors meet the criterion of exogenous type,ranging in diameter from 15.0-28.0 cm (20.4 ± 5.8) cm.4 patients harbored one single tumor and the other bilateral tumors.All the giant tumors located on the right side.Open transperitoneal nephron-sparing surgery was performed.Result During the operation,to find the joint site between the tumor and normal kidney is the key procedure in order to reserve more normal renal parenchyma.The operation time ranged from 105-175 min (125.4 ± 28.4) min,warm ischemia time 8-20 min (15.8 ±4.8) min,blood loss 50-400 ml (162.0 ± 141.5) ml.The average postoperative drainage volume ranged from 50-165 ml (99 ± 45) ml,the time of drainage tube removal 1-8 days (4.0 ± 2.6) days.The postoperative serum creatinine had no significant change compared to the value before operation (P =0.808).Postoperative hospital stay was 5-12 days (7.2 ± 2.9) days.Benign renal angiomyolipoma with negative margins was diagnosed as expected.No patient had a recurrence after a 1-32 months follow-up.Conclusion Nephron-sparing surgery could be used selectively in patients with giant renal angiomyolipoma greater than 15cm.For the tumors with the characteristic of exogenous type on imaging assessment before operation,open transperitoneal nephron-sparing surgery was an optional choice and could be implemented safely.
ABSTRACT
Objective To observe the effects of arsenic trioxide (As2O3) on T24 bladder cancer cells growth, Caspase-3 gene expression, as well as the weight and volume changes of transplantation tumor of hairless mouse. Methods The cell proliferation inhibition was measured by MTT colorimetric assay. Morphological changes in the cell nucleus was measured by fluorescein stain. Morphologic cell apoptosis was analyzed by FCM. The espression of Caspase-3 was observed by immunocytochemistry staining. The weight and volume changes of transplantation tumor of hairless mouse were measured before and after As2 O3 was used. Results As2 O3 could significantly inhibit the growth of T24 cells, which depended on the reaction time and concentration of drug. With the extension of the time, the increase in the rate of apoptosis and expression of casepase-3 increased. The tumor size and tumor analysis of As2O3 group decreased than those of the control group(P＜0. 05). Conclusion As2O3 could significantly inhibit the growth of bladder cancer cells and its anti-cancer mechanisms may be related to increased Caspase-3 protein expression.