Laparoscopic radical cystectomy with orthotopic ileal neobladder in the treatment of invasive bladder cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the technique and outcomes of laparoscopic radical cystectomy (LRC) and evaluate the efficacy of the urinary reservoir constructed with ileum in patients with invasive bladder cancer.</p><p><b>METHODS</b>From 2005 - 2010, A total of 11 patients with bladder cancer were enrolled in this study. Laparoscopy was performed with 5 trocars. Urodynamic examination was performed, the function of upper urinary tract was tested, and complications were evaluated in all the eleven cases.</p><p><b>RESULTS</b>The mean operation time was 420 minutes (ranged 350 to 490 min) and mean blood loss was 410 ml (ranged 300 to 700 ml). Ten of the 11 patients had complete continence, and one case had incontinence. The average flow rate was 11.5 ml/s. The first pressure of the reservoir was 29 cm H2O, and the maximum pressure was 36 cm H2O. The average capacity was 162 ml and 410 ml, respectively. The outlet pressure was 49 cm H2O. The volume of residual urine was 0 - 35 ml. No evidence of ureteral reflux was noted.</p><p><b>CONCLUSIONS</b>Laparoscopic radical cystectomy is a promising method for the treatment of bladder cancer. Orthotopic ileal neobladder is considered as an ideal form of urinary diversion characterized with low pressure, larger capacity and continence.</p>

Meta-analysis of laparoscopic and open repair of perforated peptic ulcer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To assess the safety and feasibility of laparoscopic and open repair of perforated peptic ulcer.</p><p><b>METHODS</b>Studies on comparison between laparoscopic repair(LR) and open repair(OR) of perforated peptic ulcer were collected. Data of operating time, blood loss, time to first flatus, postoperative hospital stay, postoperative complications and mortality between LR group and OR group were meta-analyzed using fixed effect model and random effect model.</p><p><b>RESULTS</b>Nineteen studies including 1507 patients were selected for this study,including laparoscopic surgery(n=673) and open surgery(n=834). There were significant differences in blood loss, time to first flatus, postoperative hospital stay, wound infection rate and mortality between LR group and OR group. However, no significant differences existed in operative time, postoperative sepsis, pulmonary infection, abdominal abscess, and suture leakage between the two groups.</p><p><b>CONCLUSIONS</b>Laparoscopic repair of perforated peptic ulcer is associated with improved outcomes in terms of less blood loss, quicker recovery, and lower rates of wound infection and mortality. Laparoscopic repair of perforated peptic ulcer is safe and feasible.</p>