Laparoscopic nephrectomy, hysterectomy and rectovaginal endometriotic mass removal in a single session.

The authors reported the first case of endometriosis with ureteral involvement causing nonfunctioning kidney, which was managed by laparoscopic nephrectomy, hysterectomy, and endometriotic mass removal in a single session.

Hand-assisted laparoscopic partial nephrectomy for renal cell carcinoma: the first case report in Thailand: case report.

The authors report their first experience on a hand-assisted laparoscopic partial nephrectomy surgical technique and the result after it was performed successfully in a 45-year-old woman who presented with an asymptomatic small renal mass. This is the first successful case report of this operation in Thailand.

Laparoscopic radical cystectomy with ileal conduit diversion: the first case report in Thailand.

OBJECTIVE: To report the authors' first experience on a surgical technique for laparoscopic radical cystectomy with ileal conduit diversion. MATERIAL AND METHOD: A 55 year-old man, weighing 65 Kg with histology proven T 2 transitional cell carcinoma of the urinary bladder underwent laparoscopic radical cystectomy with ileal conduit diversion. The cystoprostatectomy was performed by laparoscopic technique, whereas ileal conduit and stroma were performed through a mini-laparotomy. RESULTS: The procedure was performed successfully without open conversion. The operation time was 350 min. Estimated blood loss was 1,100 ml. Only 6 mg morphine was needed for postoperative pain relief. The surgical margins were free from tumor. The hospital stay was 8 days. The patient returned to his normal activities 3 weeks after surgery. CONCLUSION: Laparoscopic radical cystectomy with ileal conduit diversion was a feasible and safe operation for muscle invasive carcinoma of the urinary bladder. However, the procedure needed a steep learning curve and should be performed in centers having experience in laparoscopic surgery.

Laparoscopic renal surgery: Ramathibodi Hospital experience.

OBJECTIVE: To report the authors' early experience of laparoscopic renal surgery for benign and malignant renal conditions. MATERIAL AND METHOD: Laparoscopic renal surgery was performed on 24 patients with benign and malignant renal conditions between July 2004 and February 2005. The patient characteristics and perioperative data including operative time, blood loss, analgesic requirement, complications, duration of postoperative drain removal, length of hospital stay, and duration to return to normal activity were all recorded. RESULTS: Laparoscopic simple nephrectomy was performed in 15 patients with nonfunctioning benign renal conditions. Three operations of hand-assisted laparoscopic radical nephrectomy and one of partial nephrectomy were performed for large and small renal cell carcinoma, respectively. Transitional cell carcinomas were managed by retroperitoneoscopic nephrectomy or hand-assisted approach in 3 cases. For a case of severe inflammatory renal condition, hand-assisted approach was used for treatment. Laparoscopic renal cyst decortication was performed in one case. In the laparoscopic simple nephrectomy group, the mean operative time was 126 +/- 38.3 minutes. The median (range) estimated blood loss was 100 (50-500) mL, and one patient required conversion to open surgery because of renal vein injury. In three cases of hand-assisted laparoscopic radical nephrectomy, the operation time was 315, 325 and 150 minutes and the operative blood loss was 500, 1000 and 200 ml, respectively. In cases of hand-assisted laparoscopic partial nephrectomy, the operation time and the operative blood loss were 220 minutes and 350 ml, respectively. In three cases of transitional cell carcinoma, the operation time was 120, 140 and 150 minutes and the operative blood loss was 100, 150 and 150 ml. The surgical margins of all resected specimens for malignant tumors were negative and no major complication was recorded Simple renal cyst decortication was successfully performed within 90 minutes of operation time and bleeding 50 ml. In cases of severe inflammatory renal condition performed by hand-assisted approach, the operative time was 250 minutes and the operative blood loss was 250 ml. CONCLUSION: Laparoscopic renal surgery is a safe and efficacious approach for resection of benign nonfunctioning kidneys and malignant renal tumors.

Reliability of a Thai version of King's Health Questionnaire in Thai females with overactive bladder symptoms.

OBJECTIVES: To develop and test the reliability of a Thai version of the King's Health Questionnaire (KHQ). MATERIAL AND METHOD: Three Thai Urologists forward translated the original English KHQ into a Thai version. Back translations were performed by an independent group of physicians. A consensus was reached on a final Thai version after comparing the original KHQ and various translations. Fifty Thai female patients with symptoms of overactive bladder were tested and retested every two weeks using the Thai version (twice) as well as the English version (once) of the KHQ. Test-retest reliability of the Thai questionnaire was measured using the kappa statistic. RESULTS AND CONCLUSION: The Thai version of the KHQ was found to be reasonably reliable for use in Thai female patients with over active bladder symptoms.

Solitary pancreatic metastasis from renal cell carcinoma 14 years after nephrectomy: a case report.

We report a case of solitary pancreatic metastasis from renal cell carcinoma which occurred 12 years after radical nephrectomy. The patient had no symptom. The lesion was unrecognized until 2 years later. Distal pancreatectomy was performed and the patient was still doing well 2 years after that operation. We also review the relevant literatures about prognosis, surveillance and choice of treatments for pancreatic metastasis from renal cell carcinoma.

Comparative study of renal function between standard and modified anatrophic nephrolithotomy by radionuclide renal scans.

OBJECTIVE: To compare the changes in renal function after surgery between standard and modified anatrophic nephrolithotomy using the technetium 99m-DTPA renal scan in patients with complex staghorn calculi. MATERIAL AND METHOD: From July 2001 to March 2002, standard anatrophic nephrolithotomy (sANL) was performed in 7 patients with complex staghorn calculi and modified anatrophic nephrolithotomy (mANL) was performed in another group of 8 patients with the same condition. Preoperative and postoperative renal function were assessed by technetium 99m-DTPA renal scan. RESULTS: Mean patient age was 41 years in the sANL group and 45 years in the mANL group. Male to female ratio was 4:3 in the sANL group and 5:3 in the mANL group. Median operative time was 205 minutes in the sANL group compare with 180 minutes in the mANL group (P = 0.03). Median estimated blood loss was 300 ml. in the sANL group and 275 ml. in the mANL group (P = 0.17). Median percent reduction of GFR on the operated kidney was 9.13 (-30.03 to -3.15) in the sANL group and 27.25 (-41.81 to -1.55) in the mANL group (P = 0.13). Residual small stone was seen in one patient of the sANL group and ESWL was performed for stone fragmentation. There were no serious short-term complications. CONCLUSION: The average operative time of sANL was longer than mANL however, sANL preserved more renal function than mANL. This study suggested that sANL should be the procedure of choice in patients who have compromised renal function.