ABSTRACT
<p><b>BACKGROUND</b>Although many midterm oncologic data have been reported for extraperitoneal laparoscopic radical prostatectomy (ELRP) in western countries, few oncologic data of the extraperitoneal procedure was published in China. The aim of the study was to evaluate the oncologic outcomes of patients treated with ELRP in China.</p><p><b>METHODS</b>From January 2005 to March 2010, a total of 152 consecutive patients diagnosed with clinically localized prostate cancer were included in this study and treated with ELRP. The patients were staged according to the TNM (tumor, nodes, metastases) system. Median and mean postoperative follow-up were 28.1 months and 27.0 months, respectively. The patients were retrospectively analyzed for progression-free survival.</p><p><b>RESULTS</b>One hundred and twelve cases (73.7%) were postoperatively diagnosed as pT2 in, and 40 cases (26.3%) as pT3. Positive lymph nodes were shown in 5 patients (3.3%). Gleason score was < 7 in 49 men (32.2%), 7 in 69 men (45.4%), and > 7 in 34 men (22.4%). Positive surgical margins (PSM) were observed in 15 patients (9.9%), which included 32.0% of all pT3a cases and 46.7% of all pT3b cases, respectively. The overall prostate-specific antigen recurrence-free survival rate was 86% in all patients. The recurrence-free survival rates were 91.8% and 62.2% in pT2N0 patients and pT3N0 patients, respectively. Preoperative prostate-specific antigen, surgical margins, tumor stage, and lymph nodal status were identified as independent predictors of biochemical recurrence-free survival using multivariate Cox proportional hazard model.</p><p><b>CONCLUSIONS</b>ELRP is a precise, safe and effective procedure at this particular Chinese institution. The prognostic power of prostate-specific antigen relapse after ELRP is not identical to that described previously with transperitoneal or open retropubic approaches.</p>
Subject(s)
Aged , Humans , Male , Middle Aged , Laparoscopy , Methods , Prostate , General Surgery , Prostatectomy , Methods , Prostatic Neoplasms , General Surgery , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To study the application of retroperitoneal laparoscopic partial nephrectomy in renal carcinoma patients with intermediate risk PADUA score.</p><p><b>METHODS</b>From April 2005 to June 2011, 79 cases (48 males and 31 females) of intermediate risk PADUA score (range from 8 to 9 score) renal cell carcinoma were retrospectively analyzed. Mean age was (54 ± 9) years, mean tumor size was (2.8 ± 0.8) cm in diameter, with 37 cases on the left side and 42 cases on the right side. Tumor located anteriorly in 35 cases, and 44 cases were located posteriorly. Preoperative imaging examinations showed tumor invasion of the collecting system was dislocated or infiltrated by tumor invasion were in 13 cases, renal sinus were involved in 5 cases, tumor located near the renal hilum were in 10 cases. All of the 79 patients received retroperitoneal laparoscopic partial nephrectomy.</p><p><b>RESULTS</b>The 79 cases were operated successfully without conversion to open surgery, no severe perioperative complications. The mean operation time was (105 ± 24) minutes, and the median of operation time was 115 minutes (range from 80 - 180 minutes), and mean warm ischemia time (WIT) was (20 ± 5) minutes, and mean blood loss was (24 ± 8) ml; mean postoperative hospital stay was (5.2 ± 1.5) days. Postoperative urinary leakage in 3 cases, symptoms disappeared one week after indwelling catheterization and ureteral catheter. Serum creatinine transient increased in 7 cases after surgery, and fell to normal range within 6 weeks. In a mean follow up for (34 ± 12) months (range from 10 to 84 months), estimated glomerular filtration rate (eGFR) 6 months after operation was no statistical significance compared with preoperation in 77 cases, another 2 patients' eGFR decreased by 30% and 35%. Postoperative renal function remained in CKD3 period and CKD2 period were in 2 cases respectively, none of these cases were treated with hemodialysis, and the remaining patients with normal renal function after surgery, no tumor recurrence and metastasis during follow-up in all cases.</p><p><b>CONCLUSIONS</b>Treatment of retroperitoneal laparoscopic partial nephrectomy in renal carcinoma patients with intermediate risk PADUA score is safe and effective, but its long-term effects still need to study with large samples compare and long-term follow-up.</p>
Subject(s)
Female , Humans , Male , Middle Aged , Kidney Neoplasms , Pathology , General Surgery , Laparoscopy , Nephrectomy , Methods , Retrospective Studies , Treatment OutcomeABSTRACT
Objective: To investigate the association of serum leptin level with erectile dysfunction (ED). Methods: A total of 38 out-patients complaining ED were graded by using IIEF-5 questionnaire. The mean IIEF-5 score of the patients was (12.3±2.4)and no one was higher than 21. The patients were divided into 3 groups according to their scores. The fasting serum leptin levels were determined by ELISA in 38 patients (patient group) and 15 healthy controls (control group). Their body weights and heights were measured for body mass index(BMI). Results: Serum leptin levels were significantly correlated with BMI in both groups, regardless of patient ages and history. The mean leptin level in patients was (10.16±8.67) μg/L, which was significantly higher than that in the healthy controls ([4.81± 3.66] μg/L, P<0.05) after adjusting the effect of BMI. The leptin levels in the mild, moderate, and severe ED groups were (6.98±4.99) μg/L, (10.3±9.51) μg/L and (13.1±10.02) μg/L, respectively, with that of the mild group being significantly lower than those of the latter two groups (P<0.05). Conclusion: It is indicated that human serum leptin level may have a potential value in diagnosing ED.
ABSTRACT
<p><b>OBJECTIVE</b>To study the changes of hypothalamus metabolism in patients with psychogenic erectile dysfunction (ED) so as to get some clues to the possible pathogenic factors and pathophysiological mechanism of the problem.</p><p><b>METHODS</b>Six cases of psychogenic ED and 4 normal volunteers were studied by positron emission tomography (PET) for the characteristics of hypothalamus glucose metabolism. Following audiovisual sexual stimulation, the concentration of fluorine-18-fluorodeoxyglucose (18 F-FDG) was determined and the ratio of the left (right) hypothalamus count to the cerebrum count was calculated.</p><p><b>RESULTS</b>Audiovisual sexual stimulation significantly increased 18F-FDG in the volunteers (left: 1.026 +/- 0.115 vs 2.400 +/- 0.210; right: 1.003 +/- 0.187 vs 2.389 +0.196, P < 0.05) as compared with the psychogenic ED patients (left: 2.781 +/- 0.156 vs 2.769 +/- 0.223; right: 2.809 +/- 0.129 vs 2.793 +/- 0.217, P > 0.05).</p><p><b>CONCLUSION</b>Psychogenic ED may not be simply a functional disease; the hypothalamus may be involved in the pathophysiology of the problem.</p>