Real-time transrectal ultrasonography in seminal vesiculoscopy / 中华男科学杂志

Objective@#To compare three different pathways for transurethral seminal vesiculoscopy (SVS) and investigate the reliability and efficiency of transrectal ultrasonography (TRUS)-guided SVS (TRUS-SVS).@*METHODS@#We retrospectively analyzed 90 cases of seminal vesiculoscopy conducted directly through the ejaculatory duct or prostatic utricle or under the guide of TRUS. We compared the success rate and complications among the three approaches.@*RESULTS@#Operations were successfully performed in 87 (96.67%) of the 90 cases, 30 through the ejaculatory duct, 37 via the prostatic utricle, and 20 under the guide of TRUS, the operation time ranging from 25 to 75 minutes. Sperm was detected from the seminal vesicle fluid in (92.06%) of the azoospermia patients (58/63) during the surgery and in 77.78% of them (49/63) in semen analysis at 1 week postoperatively. Fifteen hematospermia and 12 spermatocystitis patients were cured. Postoperative follow-up found 20 cases of water-like semen and 3 cases of orchiepididymitis, but no such complications as retrograde ejaculation, incontinence, or rectourethral fistula.@*CONCLUSIONS@#Transejaculatory duct and transprostatic utricle pathways are two common approaches to SVS, while TRUS-SVS may achieve a higher success rate and avoid injury of both the prostate and the rectum.

Survival status of the surgical treatment of hilar cholangiocarcinoma patient / 中国现代普通外科进展

Objective:To investigate the survival status of the surgical treatment of hilar cholangiocarcinoma patient and related factors that influence long-term survival rate of patients.Methods:79 hilar cholangiocarcinoma patients in our hospital from June 2008 to March 2011 were selected and retrospectively analyzed,survival status of patients after 1,3,5 years was observed and recorded,clinic data was given simple factor and COX regression analysis.Results:From 79 hilar cholangiocarcinoma patients,there were 41 cases given surgical resection,38 cases given operative drainage,postoperative survival rate of all patients after 1,3,5 years were 49.37％ 、22.78％ 、7.59％,postoperative survival rate of patients with surgical resection after 1,3,5 years were 70.73％、36.59％ 、14.63％,postoperative survival rate of patients with operative drainage after 1,3,5 years were 26.32％、7.89％、0.00％.The difference of 5-year survival rate of patients with different pathological pattern,TNM stages,differentiated degree,surgical approach,excision method,lymphatic metastasis or not,different incisal edge had statistic significance (P ＜0.05).Mucinous carcinoma,TNM stages 1 ～ IV,operative drainage,palliative surgery,lymphatic metastasis were independent risk factors that influence survival status of hilar cholangiocarcinoma patients (P ＜ 0.05).Conclusion:The prognosis of surgical treatment of hilar cholangiocarcinoma patient is poor,mucinous carcinoma,TNM stages Ⅲ ～ IV,operative drainage,palliative surgery,lymphatic metastasis are independent risk factors that influence survival status of hilar cholangiocarcinoma patients.

Survival status of the surgical treatment of hilar cholangiocarcinoma patient / 中国现代普通外科进展

Objective:To investigate the survival status of the surgical treatment of hilar cholangiocarcinoma patient and related factors that influence long-term survival rate of patients.Methods:79 hilar cholangiocarcinoma patients in our hospital from June 2008 to March 2011 were selected and retrospectively analyzed,survival status of patients after 1,3,5 years was observed and recorded,clinic data was given simple factor and COX regression analysis.Results:From 79 hilar cholangiocarcinoma patients,there were 41 cases given surgical resection,38 cases given operative drainage,postoperative survival rate of all patients after 1,3,5 years were 49.37％ 、22.78％ 、7.59％,postoperative survival rate of patients with surgical resection after 1,3,5 years were 70.73％、36.59％ 、14.63％,postoperative survival rate of patients with operative drainage after 1,3,5 years were 26.32％、7.89％、0.00％.The difference of 5-year survival rate of patients with different pathological pattern,TNM stages,differentiated degree,surgical approach,excision method,lymphatic metastasis or not,different incisal edge had statistic significance (P ＜0.05).Mucinous carcinoma,TNM stages 1 ～ IV,operative drainage,palliative surgery,lymphatic metastasis were independent risk factors that influence survival status of hilar cholangiocarcinoma patients (P ＜ 0.05).Conclusion:The prognosis of surgical treatment of hilar cholangiocarcinoma patient is poor,mucinous carcinoma,TNM stages Ⅲ ～ IV,operative drainage,palliative surgery,lymphatic metastasis are independent risk factors that influence survival status of hilar cholangiocarcinoma patients.