Lateral retroperitoneoscopic adrenalectomy for complicated adrenal tumor larger than 5 centimeters.

BACKGROUND: The role of lateral retroperitoneoscopic adrenalectomy (LRA) for complicated tumor with large diameter remains controversial, this study aimed to evaluate the effectiveness of this procedure on the management of tumor larger than 5cm in diameter. METHODS: A retrospective comparison was conducted of 67 patients with large complicated adrenal tumor (>5cm). 41 patients received LRA, and 26 received open adrenalectomy (OA) in our hospital between January 2011 and June 2015. Basic characteristics regarding mean age, gender, body mass index (BMI), tumor size, tumor side, previous abdominal surgery, resection method, pathology were preferentially analyzed. Operative indicators regarding operation time, estimated blood loss (EBL), conversion to ICU, complications, post-operative hospitalization, duration of drain, time to first oral intake and ambulation were compared between groups. RESULTS: There were no significant differences between the two groups in the basic characteristics. The mean operation time for LRA was shorter than OA (98.7±32.3 min vs 152.7±72.3 min, P = 0.001). EBL was 31.9±20.0 ml for LRA and 590.0±1181.1 ml for OA (P = 0.03). There was no complication in LRA group and one patient in OA group had complications, but this difference was not significant (P = NS). The post-operative hospitalization in LRA was 7.4±2.8 days, and shorter than 9.8±2.7 days in OA group (P = 0.00). The time to first oral intake and ambulation for LRA was shorter than OA (first oral intake, 1.9±0.8 days vs 3.1±1.3 days, P = 0.00; time to ambulation, 2.6±1.4 days vs 4.2±1.6 days, P = 0.00). While the difference between groups were not significant in terms of ICU conversion (3/41 vs 4/26, P = NS) and duration of drain (3.9±2.2 days vs 4.7±1.9 days, P = NS). CONCLUSION: Our study shows that LRA can be performed safely and effectively for complicated adrenal tumors larger than 5 cm in diameter, but it remains technically demanding.

Elevated level of nerve growth factor in the bladder pain syndrome/interstitial cystitis: a meta-analysis.

OBJECTIVES: To elucidate the association between nerve growth factor (NGF) level and bladder pain syndrome/interstitial cystitis (BPS/IC) by conducting a meta-analysis. METHODS: We conducted a systematic literature search to identify original studies of NGF level in BPS/IC before November 2015. Eligible studies were retrieved via both computer searches and manual review of references. The summary difference estimates between controlled group and BPS/IC group were calculated based on the weighted mean difference (WMD) with its 95 % confidence interval (CI). Sensitivity and publication analyses were performed after the pooled analysis. RESULTS: Meta-analysis of 10 original studies involving 295 cases and 290 normal controls showed an increased level of urinary NGF in BPS/IC patients (z = 3.08, P = 0.002). The combined WMD was 36.39 (95 % CI 13.27-59.51). There was significant difference between controlled group and BPS/IC patients in the term of NGF/Cr level (WMD = 0.96, 95 % CI 0.58-1.35; z = 4.89, P < 0.01). There was no significant publication bias in the included studies (P for Begg's test = 0.73, P for egger's test = 0.13). CONCLUSIONS: Our results demonstrated that there was an increased level of NGF in the BPS/IC patients.

Long term follow-up of surgery management of prostate leiomyosarcoma metastasized to the rib: A case report and literature review.

Prostate sarcoma, particularly the pathological type of leiomyosarcoma, is a rare carcinoma, which originated from the interstitial tissue of the prostate. This sarcoma type has a poor prognosis. This disease accounts for ~0.1% of all prostate cancer and it usually occurrs in patients aged between 40 and 78-years-old. Although prostate leiomyosarcoma has a poor prognosis, early treatment of post-operative recurrence and metastases via a whole-body examination and closer follow-up was possible. These measurements may significantly prolong the survival time and improve the quality of life. The present study reported a successful case of surgical management for prostate leiomyosarcoma in the Zigong No. 4 People's Hospital (Sichuan, China) during 1995 until 2015, with post-operative follow-up for 20 years.