Combined laparoscopic technique for superficial bladder neoplasms involved orifice / 中华泌尿外科杂志

Objective To assess clinical efficacy of the combined laparoscopic technique for superficial bladder neoplasms involved uretetic orifice. Methods A totsl of 12 patients with bladder neoplasms involved ureteric orifice were treated and reviewed.The clinieal tumor stage was Tis in 6,T1 in 6.During the procedure,the transurethral resection of bladder neoplasms was performed firstlythe extent including 0.5-1.0 cm formal bladder tissue around ureteric orifice,deep to superficial muscle of bladder,then ureteroneocystostomy was done with transperitoneal laparoscopic technique.Results The operations were successfully in all 12 cases.The average procedure time was 2.2 h.The average volume of hemorrhage was 25 ml.The double J stents were removed 3 months postoperatively.Six months after surgery intravenous pyelography(IVU)and cystography showed no ureter obstruction in all cases,Ⅰ-Ⅱ degree vesicle-ureteral reflux in 2 cases.One year after surgery custography showed Ⅰ-Ⅱdegree vesicle-ureteral reflux in 4 cases,Ⅱdegree relux in 3 cases.During 324 months' follow-up,B type ultrasound and IVU showed moderate hydronephrosis in 1 case,mild in 5. Conclusion The treatment of combining laparoscopic technique for superficial bladder neoplasms involved ureterie orifice might be an effective and safe method.

Fulguraçäo endocavitária de vias acessórias no tratamento da síndrome de Wolff-Parkinson-White / Endocavitary fulguration of accessory pathways in the treatment of Wolff-Parkinson-White syndrome

Apresentar nossa experiência inicial no tratamento definitivo da síndrome de Wolff-Parkinson-White, através de fulguraçäo endocavitária de vias acessórias. Quatorze sessöes de fulguraçäo endocavitária realizadas em 9 portadores de síndrome de Wolff-Parkinson-White. Cinco eram do sexo masculino e a média de idade foi de 35 anos. Obteve-se completa interrupçäo da conduçäo pela via anômala em 7 pacientes: 4 através de uma e 3 de duas sessöes. Um paciente (1§ da série) foi submetido a três sessöes, näo se conseguindo a interrupçäo definitiva da conduçäo pela via acessória, e encaminhado a cirurgia. O restante, näo responsivo à primeira tentativa, aguarda nova sessäo. Näo foram observadas complicaçöes cardiológicas inerentes ao procedimento. A fulguraçäo endocavitária de vias acessórias mostrou-se método seguro, eficaz e portanto passível de ser cogitado como primeira opçäo quando da indicaçäo de ablaçäo desses feixes anômalos