ABSTRACT
Background and purpose:Radical nephroureterectomy can be performed in a variety of ways, and each method has its advantages and disadvantages. It still remains controversial for choosing the surgical methods. In this study, we chose six surgical methods and investigated the safety and efficacy of different methods in treating upper urinary tract carcinoma.Methods:We retrospectively analyzed 135 patients with upper urinary tract transitional cell carcinoma who underwent operations in our hospital from Jan. 2002 to Oct. 2013, and compared the data of six different operations in-cluding operating time, volume of bleeding, time of bowel function recovery and incidence of bladder carcinomas.Results:The operations were successfully completed in groups A and B. Five cases in group C were transferred into group A be-cause of failing to pull the nub of the ureter. Two cases in group D were transferred into group A because of failing to pull the nub of the ureter. Three cases in group E were transferred into group D and 1 case was transferred into group A because of adhesion or bleeding. One case in group F was transferred into group A because of bleeding. There was no statistically significant difference in survival rates among six operations.Conclusion:Six operations are all safe and effective for the treatment of upper urinary tract carcinomas. Each method has its advantages and disadvantages. We should choose differ-ent methods according to particular cases.
ABSTRACT
Objective To explore the feasibility,efficent and safety of transuretheral enucleation of prostate combined with extraction of gland pieces from small lower mid-line incision(LMI).Methods One hundred and twelve patients with large benign prostatic hyperplasia were treated by modified transurethral nucleation of prostate,during the operation,the gland was divided into 2-3 parts which were extracted from a small LMI.Results In this method the operation time was 60-120 min with an average time of(70 ± 10)min and blood loss during operation was 60-400 ml with an average of(150 ± 15)ml.There was no severe complication during and after operation.At the 3 month after surgery,the urine flow rate(Qmax)increased from (7.5 ±2.4)ml/s to(16.0 ±2.5)ml/s,and urine residual volume(RUV)decreased from(75 ± 15)ml to (25 ± 10)ml,international prostate symptom score(IPSS)decreased from 25.5±:4.5 to 8.4 ± 1.3,and the quality of life(QOL)decreased from 5.5 ± 0.4 to 1.2 ± 0.3.All these changes were statistically significant (t =28.53,36.19,37.16 and 59.53,Ps ＜ 0.05).At the 6 month,no complications,e.g.,permenant uroclepsia,urethrostenosis or erection disfounction occurred.Conclusion Transurethral enucleation of prostate combined with gland extraction from LMI for large benign prostatic hyperplasia is safe and effective and it is worthy of generalization in clinical practice.