RESUMEN
Objective To investigate the surgical technique and clinical effectiveness of retroperitoneal laparoscopic nephroureterectomy with transurethral bladder-cuff excision and open nephroureterectomy in pelvis carcinoma. Methods We retrospectively analysed the records of all 62 patients who underwent retroperitoneal laparoscopic or open nephroureterectomy in Tianjin Dagang Hospital or the Second Affiliated Hospital of Tianjin Medical University from July 2001 to July 2009. Variables analyse were compared including operative time, blood loss, turning to open operation, complications, length of stay, tumor recurrence and metastasis. Groups were compared using Student's t-test, and a probability (P) value of less than 0.05 was taken to indicate statistical significance. Results The respective mean operative duration [(47.34±39.16) vs (118.17±44.65) ml], length of hospital stay [(9.15±2.19) vs (11.64±3.71) d], time to ambulation [(3.58±0.79) vs (5.67±1.24) d]and blood loss [(70.64±27.33) vs (118.17±44.65) ml]in retroperitoneal laparoscopic nephroureterectomy with transurethral bladder-cuff excision group was significantly reduce to open nephroureterectomy group (t = 3.3167, 2.0587, 8.0494, 5.1777, P ＜0.05). There was no significantly difference between two groups in complication of during operation and post operation [4.8 % (2/42) vs 5.0 %(1/20), 0 vs 0, respectively](P ＞0.05). 4 cases were failed and conversed to open surgery in retroperitoneal laparoscopic nephroureterectomy group. During the follow up period range from 8-48 months, there was no significantly difference between two groups in tumor recurrence and metastasis [4.8 % (2/42) vs 5.0 % (1/20),2.4 % (1/42) vs 5.0 % (1/20), respectively](P ＞0.05). Conclusion Retroperitoneal laparoscopy in upper urinary tract transitional carcinoma uses a small incision, incurs less blood loss, and allows for a more rapid recovery, suggesting it is a safe and effective method for treating patients with renal and pelvis cancer.
RESUMEN
<p><b>OBJECTIVE</b>To understand the incidence and relevant affecting factors of infant vitamin K deficiency bleeding (VKDB) in Shandong Province.</p><p><b>METHODS</b>With stratified cluster sampling, 28 156 live newborns from five districts and six counties were surveyed for the condition of bleeding from their birth to 6 months based on standard diagnostic criteria. A 1:2 matched case-control study of VKDB was performed.</p><p><b>RESULTS</b>An overall incidence of VKDB was 3.27 per thousand in Shandong; higher in the rural areas (4.96 per thousand ) than in the urban areas (1.19 per thousand ). Most of the bleeding cases were breast-fed babies (about 95.57%) and incidence of VKDB in pre-term babies (22.52 per thousand ) was higher than that in term ones (2.96 per thousand ). Mothers' drug taking during pregnancy, asphyxia at birth, breast-feeding and illness within two weeks after birth were risk factors for it. Use of vitamin K after birth and bottle-feeding were protective factors for it.</p><p><b>CONCLUSIONS</b>Incidence of VKDB is higher in Shandong Province, as compared to other areas all over the country at the same time period. It is very important to prevent VKDB, focusing on high-risk babies in the rural areas, including those of preterm, breast-fed and suffering illness after birth.</p>