ABSTRACT
Objective To compare clinical efficacy and complications of three operation methods for treating the localized and high risk prostate cancer.Methods From July 2006 to July 2010,102 cases with localized and high risk prostate cancer were included in the study.Among them,51 cases received open radical prostatectomy (Group A).Their characters included aged (63.7±7.9),PSA (31.8±6.6) μg/L,Gleason scores (8.5±0.5).In this group,T2c stage was diagnosed in 38 cases and T3a stage in 13 cases.32 cases received laparoscopic radical prostatectomy(Group B).Their characters included aged (64.4± 8.3),PSA (29.9±5.2) μg/L,Glcason scores (8.7±0.4).In this group,T2c stage was diagnosed in 21 cases and T3a stage in 11 cases.19 cases received 125I implantation (Group C).Their characters included aged (61.4± 7.4),PSA (30.6±.5.7)μg/L,Gleason scores (8.6±0.6).T2v stage was found in 8 cases and T3a stage in 11 cases.Operation time,amount of bleeding,hospitalization time,drainage time,gastrointestinal function recovery time,medical expenses and survival and recurrence rate in 1 year,3 years,5 years were compared within those groups.Results Operation time in three group were (232.6±38.4) min,(186.3±31.4) min,(35.4±14.6) min,respectively.Amount of bleeding in three group were (413.6±132.4) ml,(273.9± 77.4) ml,(19.4±4.4) ml,respectively.Hospitalization time in three group were (20.9±3.7) d,(15.6± 2.2) d,(6.4±2.6) d respectively.Drainage time in three group were (8.3±1.8) d,(7.5±0.9) d,(3.2± 0.8) d,respectively.Gastrointestinal function recovery time in three group were (4.1 ±0.6) d,(3.2± 0.4) d,(0.4±0.1) d,respectively.Medical expenses in three group were (23±4) thousand yuan,(32±3) thousand yuan,(45t3) thousand yuan respectively.All those items exhibited the significantly statistical difference (P＜0.05).The survival and recurrence rates had no significant difference during the follow-up in three groups.Conciusions Compared to the open radical prostectomy and laparoscopic radical prostectomy,particle implantation for prostate cancer had advantages in minimally invasive,less bleeding,short operation time,fast recovery and protection for Intestinal function.
ABSTRACT
Objective To discuss the diagnosis,therapy and prognosis of primary ureter transitional cell carcinoma with low stage and grade.Methods Retrospective review of 18 cases surgery to treat the primary ureter carcinoma of G1-2 Ta-2 was carried out.There were 12 males and 6 females with the mean age of 67 years.Of the 18 cases with the size of tumor were from 0.5 to 1.5 cm.13 cases had the tumors on the left and 5 cases on the right.The tumors were located at middle parts of the ureter in 3 cases,and at the lower part in 15 cases.The course of the disease was from 5 days to 3 months.10 cases had gross hematuria and 8 cases renal hydronephrosis were found incidentally by B-ultrasound.B-ultrasound was performed in all cases.15 cases were indicated pyelic separation from 1.0-1.5 cm and ureteral separation from 0.8-1.0 cm.8 cases were indicated the low-echo space-occupying disease of ureter.IVU indicated mild hydronephrosis in 12 cases of 15 cases,of whom 5 cases were demonstrated a filling defect.CT indicated the mass of ureter in 10 cases of 15 cases.Cystoscope were performed in 18 cases,of whom 5 cases were found the tumor in the ureter-bladder cuff.Retrograde pyelogram showed filling defect of the diseased ureter in 10 of 11 cases(2 cases had failure of intubation).4 cases ureteroscopy with biopsy were used and demonstrated the diagnosis.Results 8 cases were treated surgically of radical nephroureterectomy with a bladder cuff excision.7 cases were performed ureteral segmental resection,of which 2 cases anastomosis and 5 cases ureterocystostomy with bladder cuff excision.3 cases tumors were resected by ureteroscopy postoperative pathological findings confirmed the diagnosis of transitional cell carcinoma.Pathological staging showed Ta(1 case);T1 (8),T2(9),and grading showed G1(8);G2(10).16 cases(88.9％)were followed up form 6-132 months.The overall 5-year survival rate was 87.5％.Of the 25％ patient showed bladder recurrence in post-operation 6-24 months.2 cases died of tumor recurrence and metastasis in post-operation 36-48 months.Conclusions The primary transitional cell carcinoma of ureter was uncommon and has poor prognosis.Ureter carcinoma with lower stage and grade might have better prognosis.Kidney-sparing surgery is a feasible treatment option in patients with lower stage and grade.The long-term follow up is meticulous.
ABSTRACT
Objective To evaluate thedifferential diagnosis of specially cystic masses located at the area of the left adrenal gland,and to improve the understanding of the clinical symptoms and pathological features,diagnosis and treatment of gastric duplicated cyst.Methods A retrospective study,with literature review,of clinical characteristics and imaging findings of pathologically proved gastric duplicated cyst in 2 adults (2 males,28 years and 42 years)was conducted.Two patients presented no clinical manifestation.Abdominal ultrasonography and CT scan revealed a cystic lesion,in the area of the left adrenal gland,with a thickness wall,measuring 5 cm ×6 cm× 7 cm and 8 cm × 12 cm × 13 cm,attached to the greater curvature of the stomach.The lesion had septums,and the walls and septums could not be enhanced.Preoperative diagnosis of patients was misdiagnosed as a cyst of the left adrenal gland,with inflection or bleeding.Results Complete excision was performed by laparoscopic surgery in all cases.The lesion located in the area of left adrenal gland and no communication between the duplicated cyst and the lumen of stomach was detected.Postoperatively,the lesions were pathologically proved to be gastric duplicated cyst.There was no recurrence during the follow-up of 8 months and 2 years.Conclusions Preoperative definite diagnosis of adult gastric duplication cyst is very difficult.Ultrasonography and Computed Tomography are valuable imaging modality for locating the site and determining the nature of adult gastric duplicated cyst.Preoperative definite diagnosis could be made by EUS (endoscopic ultrasonography) and EUS-guided fine needle aspiration biopsy in gastric duplicated cyst.Although adult gastric duplicated cyst is an extremely rare disease entity,but this unusual developmental abnormality should be include in the differential diagnosis of cystic masses located the area of the left adrenal gland.Because of the possibility of malignancy of the cyst,laparoscopic excision is the first choice as the minimally invasive treatment.