ABSTRACT
We retrospectively reviewed the clinical data of 7 patients with intraoperative or postoperative hemorrhage, who underwent percutanous nephrolithotomy (PCNL) in Beijing Luhe Hospital between 2010 and 2016.There are 5 males and 2 females with a mean age 50.7 year (30-75 years). There were 4 cases of multiple stones in kidney, 2 cases of mold stones and 1 case of stone in upper ureter.Digital subtraction angiography (DSA) showed 5 cases of false aneurysms after operation: on lower pole arterial branches in 3 cases and on middle pole arterial branches in 2 cases.Two patients with hemorrhage during operation underwent immediate digital subtraction angiography with negative result and the bleeding disappeared 1 week later with conservative therapy.False aneurysms and arteriovenous fistula caused by the procedure may lead to hemorrhage during and after PCNL.Hyperselective renal arteriolar embolization is an effective and safe method to treat delayed hemorrhage after PCNL.
ABSTRACT
The clinical data of 9 patients with huge adrenal tumors (≥6 cm) undergoing retroperitoneal laparoscopic adrenalectomy between February 2015 and September 2016 were retrospectively analyzed.There were 2 males and 7 females aged 29-65 years.The tumors were detected due to investigation of paroxysmal hypertension in 4 cases, and during the health check-up in 5 cases.The lesions were located on the right side in 4 cases, on the left side in 4 cases and bilaterally in 1 case.The operations were all successful, there was no case transferring to open surgery.The average operation time was 70 min (50-100 min),mean bleeding volum was 100 ml(50-200 ml).The postoperative diagnosis: 4 cases of pheochromocytoma, 2 cases of cortical adenoma, 2 cases of neurilemmoma and 1 case of neuroinoma.The average follow-up time was 13.5 months (6-24 months) and no recurrence was found.
ABSTRACT
The clinical and pathological data of 6 patients with urahcal adenocar,cinoma of the bladder admitted in Beijing Luhe Hospital from 1996 to 2016 were analyzed and relevant literature was reviewed.Urachal carcinoma accounted for 0.66% of the bladder cancers admitted at the same period (6/906) and 6/16 of the bladder adenocarcinomas.Painless hematuria was the most common symptom.One patient had extensive metastasis as shown in biopsy and died 6 month after the diagnosis.Two patients underwent partial excision of bladder with no tumor recurrence.One patient underwent partial cystectomy followed by chemotherapy and radiotherapy, recurrence occurred one year later and he then received radical cystectomy.Another 2 patients underwent laparoscopic cystectomy and en bloc resection of umbilical ligament and umbilicus, and no recurrence was found in the follow-up for 6 years and 15 months, respectively.Pathological and immunohistochemistry are essential for the diagnosis of urachal adenocarcinoma.As it is not sensitive to radiotherapy or chemotherapy,surgery is the preferred treatment for patients with early stage diseases.Individual anticancer therapy may be the trend of treatment.
ABSTRACT
Objective To compare the safety and effectiveness of disposable circumcision suture device (DCSD) with conventional circumcision in surgical treatment of phimosis and redundant prepuce . Methods One hundred and sixty one patients with phimosis or redundant prepuce were randomly assigned to be treated by circumcision using disposable circumcision suture device ( DCSD group , n =89 ) or conventional circumcision (CC group,n =72),respectively.Results The operation time was (3.8 ± 0.5)min in DCSD group and (31.6 ±2.7)min in CC group (F=71.21,P=0.000),blood loss was 1.0(0.9, 1.2)ml in DCSD group and 6.2(5.7, 7.0)ml in CC group (Z =-10.90,P=0.000).There were no significant differences in intraoperative pain score (1.4 ±0.6 vs.2.9 ±0.8, F=2.08, P=0.151) and wound healing time [(14.0 ±1.3) vs.(16.8 ±2.1) d, F=0.10, P=0.754] between two groups.There was no need to change the dressing for patients in DSCD group 3 days after the operation , while patients in CC group changed dressing 3 times after the operation .No significant differences in postoperative complication rate [10%(9/89) vs.4%(3/72),χ2 =2.04,P=0.153] and satisfaction rate with the penile appearance [98%(87/89) vs.94%(68/72), χ2 =0.47,P=0.494] were found between two groups .Conclusion DCSD exhibits superiority over CC for shorter operation time and less blood loss in circumcision .