Open Nephron Sparing Surgery for T1a Renal Tumors: Clinical Experience in an Emerging Country.

BACKGROUND: Nephron sparing surgery has become the standard treatment for small renal masses particularly in Western Europe, but in countries like Kosovo, the experience is much more limited. Our aim is to report our initial experience in managing small renal masses with nephron sparing surgery (NSS). MATERIALS AND METHODS: This is a retrospective study of patients who underwent Open Partial Nephrectomy (OPN) at our Clinic of Urology between January 2000 and December 2015. RESULTS: Of 216 patients with renal tumors, 33 underwent OPN. 11 (33%) were female and 22 (67%) were male. The mean kidney tumor size was 3.2 cm (range 3.1-4.0). The patients median age was 46 years (rage 24-61). The indications were elective in 29 cases and relative is 4 cases. There were no intra-operative complications and the post-operative complications were minimal. After a median follow-up of 34 months (range 24-41) there were no local recurrences or late complications. DISCUSSION: Well recognized modern guidelines on the treatment of small renal masses indicate the use of nephron sparing surgery. Our urological community needs to implement these guidelines and our urologists need to be provided with the necessary education and training and emerging treatment strategy. CONCLUSIONS: Patients with small renal masses that are amenable for a technically and oncologically safe partial nephrectomy, even in presence of a normal contralateral kidney, should undergo nephron sparing surgery. This we showed to be feasible to provide excellent tumor control.

Effects of hyaluronic acid and tacrolimus on the prevention of perineural scar formation and on nerve regeneration after sciatic nerve repair in a rabbit model.

PURPOSE: Scar formation after injured peripheral nerve repair is a significant clinical problem because it prevents nerve regeneration. The aim of this study was to investigate and compare the effects of hyaluronic acid (HA) and tacrolimus (FK506) on peripheral nerve regeneration in rabbits after the drugs were topically applied at the site of nerve repair. METHODS: Thirty adult male European rabbits (Oryctolagus cuniculus), ranging in weight from 2.5 to 3 kg, were randomly assigned to three groups: the HA and FK506 groups comprised the experimental groups, while the saline group served as the control. At week 12, macroscopic and microscopic evaluations were performed and analyzed. RESULTS: In general, the macroscopic evaluations (skin and muscle fascia closure and nerve adherence), microscopic evaluations (cellular components, scar tissue formation index, and histomorphological organization), and measurements of nerve diameter and gastrocnemius muscle wet weight demonstrated the positive effects of topical application of these pharmacological agents (HA and FK506); HA and FK506 prevented scar formation and enhanced nerve regeneration. No significant differences in the parameters described above were observed between the HA and FK506 groups (P > 0.05). However, significant differences were observed between both the HA and FK506 groups and the saline group (P < 0.05). CONCLUSION: Based on our findings, topical application of HA and FK506 exhibits equally positive effects, preventing perineural scar formation and enhancing nerve regeneration after peripheral nerve repair.

Helicobacter pylori gastritis updated Sydney classification applied in our material.

(Full text is available at http://www.manu.edu.mk/prilozi). BACKGROUND. Hp inhabits the stomach of more than 50% of humans and is the most frequent cause of chronic gastritis worldwide. The purpose of this research has been to present the importance of combining topographical, morphological and etiological information of diagnostic evaluation on grading gastritis in our material according to the Updated Sydney Classification, as well as to represent the frequency and the evaluation of Hp gastritis after eradication in order to prevent the development of gastric cancer. MATERIALS AND METHODS. 154 cases of gastric mucosa (endoscopic biopsies) which were fixed in buffered neutral formalin and embedded in paraffin were invwstigated. Tissue sections (5microm thick) were cut and stained with H&E, May Grunwald Giemsa and Silver stain. The biopsy cases were analysed in an attempt to assess the major histopathological features of gastritis. The histopathological major variables were graded on a scale of 3 (mild, moderate and severe). RESULTS. There were 36 (23.37%) cases positive for Hp (22.2%, 72.2%, 5.5%). Atrophy was positive in 23 (14.93%) cases with the scale (47.8%; 47.8%; 4.34%). Dysplasia was positive in 13 (8.44%) cases with the scale (84.6%; 7.6%; 7.6%). Intestinal metaplasia was positive in 25 (16.2%) with the scale (76%; 20%, 4%). There were 6 (3.8%) cases of MZL, which were treated appropriately. CONCLUSIONS. Our data indicate the importannce of early eradication of Helicobacter pylori in order to prevent the eventual development of gastric cancer. These findings should influence the treatment of gastric cancers. Key words: Updated Sydney System of Classification, Hp gastritis, morphology.