The safety of endoscopic ligation of gastric and colic full-thickness wall with detachable nylon loops / 中华消化内镜杂志

Objective To evaluate the safety of endoscopic ligation of gastric and colic full-thickness wall with nylon loops.Methods Endoscopic ligation of full gastric and colic wall with detachable nylon loops, assisted by laparotomy, were performed in 4 dogs.Ligation healing was assessed on 3, 7, 10and 17 days after the procedure.Results All animals recovered after the procedure, without any clinical signs of infection or hemorrhage.Postoperative examination did not reveal gastric or colonic perforation, or local abscess.Loop ligature showed ulcer-like lesion.Histopathology revealed muscularis propria disruption, granulation tissue bridging the site of ligation and formation of scar tissue.Regenerative mucosa coyered the surface of the ligature completely 17 days after the operation.Conclusion Endoscopic ligation of gastric and colic full-thickness wall with detachable nylon loops is safe.Its application can be extended to other fields.

Comparing the safety and efficiency of conventional monopolar, plasmakinetic, and holmium laser transurethral resection of primary non-muscle invasive bladder cancer.

PURPOSE: To compare the safety and efficiency of conventional monopolar, plasmakinetic and holmium laser transurethral resection of bladder tumor (CM-TURBT, PK-TURBT and HoL-TURBT) while managing primary non-muscle invasive bladder cancer. PATIENTS AND METHODS: From 2005 to 2009, 173 patients with primary non-muscle invasive bladder cancer underwent endoscopic surgery. Among them, 51 patients underwent CM-TURBT, 58 patients underwent PK-TURBT, and 64 patients underwent HoL-TURBT. All patients were divided into three risk groups (low, intermediate, and high) based on the European Association of Urology guidelines and prognostic factors of recurrence. Clinical data, included preoperative, operative, and postoperative management and follow-up, were recorded. RESULTS: Patient demographics and tumor characteristics in all three groups were compared before surgery. There was no significant difference in operative duration among the three groups. Compared with the CM-TURBT group, both PK-TURBT and HoL-TURBT groups had less intraoperative and postoperative complications, including obturator nerve reflex, bladder perforation, as well as bleeding and postoperative bladder irritation. There were no significant differences among the three groups in the transfusion rate and occurrence of urethral strictures. Patients in the PK-TURBT and HoL-TURBT groups had less catheterization and hospitalization time than those in the CM-TURBT group, and there were no significant differences in each risk subgroup as well as the overall recurrence rate among the CM-TURBT, PK-TURBT and HoL-TURBT groups. CONCLUSIONS: Both PK-TURBT and HoL-TURBT might prove to be preferable alternatives to CM-TURBT management of non-muscle invasive bladder cancer. PK-TURBT and HoL-TURBT, however, did not demonstrate an obvious advantage over CM-TURBT in tumor recurrence rate.

Long-term follow-up of nephron sparing surgery for renal cell carcinoma / 中华泌尿外科杂志

Objective To evaluate the long-term therapeutic results and the safety of nephronsparing surgery(NSS) for the treatment of renal cell carcinoma. Methods Clinical data of 243 NSSfor renal cell carcinoma were retrospectively analysed. Of them, 159 were males and 84 were femaleswith average age of 58 years (range from 24 ?77 years). The average tumor size was 3. 4 cm (rangefrom 1.1 to 6. 7 cm). Three cases were solitary renal cell carcinoma, 11 were bilateral renal cell carcinoma; 237 cases were in stage T_(1a). and 6 cases were in stage T_(1b). No lymph node and distant metastasis, no renal vein cancer tumor embolus and inferior vena cava tumor embolus was found. Postoperative follow-up was carried out by ultrasound, CT and renal function. Cancer specific survival was estimated using Kaplan-Meier method and log-rank test. Results After a mean 31 months (1-147months) follow-up, long-term follow-up data were obtained in 232 cases because the other 11 did notlive in Dalian, 52 were treated with interferon. Four of the 232 patients treated with NSS had died:1died from lung cancer 16 months after lung cancer treatment, the other 3 died from cardiovascular diseases. The total survival rate and cancer specific survival rate were 98. 3% and 100. 0%, respectively.Local tumor recurrences were detected in 5 patients and tumor metastasis was detected in 1 patient.The recurrence rate was 2. 2%, and the metastasis rate was 0. 4%. The complications included temporary renal failure and urine leakage. The complication rate was 5. 6%. Conclusions NSS for renalcell carcinoma is a safe and feasible treatment option. It has the advantages of low local recurrence,good long-term survival rate and low complication rate. NSS can maximally reserve functional nephron, reduce the risk of chronic renal failure, preserve patient's quality of life and increase patient'ssatisfaction.

In situ big dissection of anatrophic nephrolithotomy to remove large renal staghorn calculi:report of 52 cases / 中国医师进修杂志

Objective To discuss the method and effect of large renal staghorn calculi by anatrophic nephrolithotomy (AN).Methods Fifty-two patients with large renal staghom calculi underwent AN.Bilateral renal calculi disease was present in 3 patients,so that a number of 55 procedures were operated.Preoperative evaluation included urinalysis,urine culture,renal function,and ultragound,CT,KUB and IVU.A flank incision was between the 11th and 12th ribs and the kidney was freed.After interrupted renal pedicle in situ hypothermia,the renal parenchyma incision was made along the avascular plane which is outside in the back of the kidney.The collecting system was opened.The calculi were removed.The collecting system was reconstructed.The renal parenchyma was closed and the renal circulation was reestablished.The protected management of renal function was made intraoperative.Postoperative follow-up consisted of urinalysis,renal function,ultrasound,KUB,IVU and ECT.Results The operative time was (117±45) minutes.The renal ischemia time WaS (29±15)minutes.Five cases underwent blood transfusion.Mean amount of blood transfusion was 230 ml.Four cases had remained calculi.The stone-free rate was 92.3%.No recent complication occurred after operation.Postoperative follow-up indicated that renal function was normal.Conclusions AN is the most appropriate method for patients with large renal staghorn calculi because of the highest stone-free rate,the lowest stone-recurred rate and a safe and effective operative procedure with less complication.Renal function damages just little through a series of protected management.Nephrectomy is avoided to part of patients.

Genitourinary invasion by malignant lymphoma (report of 3 cases and review of the literature) / 中华泌尿外科杂志

Objective To investigate the clinical features of genitourinary invasion by malignant lymphoma.Methods Three cases of genitourinary invasion by malignant lymphoma were reported.Case 1,a 68-year-old man,complained of right flank malaise for 1 month.CT showed a soft tissue shadow of 4.0 cm?5.5 cm with homogeneous density at right renal hilus,and diffusely thickened right greater psoas muscle at the level from lower pole of the kidney to internal iliac muscle with low-density soft tissue shadow inside.Case 2,a 72-year-old man,presented with distended left leg for 2 weeks.CT indicated left seminal vesicle mass with soft tissue density of 2.5 cm in diameter,and a soft tissue mass of 6.5 cm?4.5 cm at the left iliac artery furcation.Case 3,a 48-year-old woman,complained of fever for 1 month.CT showed well-defined,solid masses of 8.0 cm?6.0 cm and 7.0 cm?6.5 cm,respectively,in diameter with inhomogeneous density at bilateral adrenal gland areas.The incidence,clinical features,prognosis and surgical treatment of this disease were summarized in combination with review of the literature.Results All 3 cases underwent operations.The primary foci originated from pelvic or retroperitoneal lymph nodes.The kidney,seminal vesicle and adrenal gland were involved in each of the 3 cases.The pathological types were all non-Hodgkin diffusive big B cell lymphoma.One case died 2 months after operation.The other 2 received CHOP chemotherapy after operation,and were followed for 4 months and 2 years,respectively.They were both alive with no recurrence at last time of the follow-up.Conclusions Genitourinary invasion by malignant lymphoma is an uncommon disease with atypical clinical presentations and poor prognosis.Surgical treatment has little effect,while radiotherapy and chemotherapy should be the first choice.Explorative surgery has positive significance for definite diagnosis.