[Diagnosis and treatment of otogenic sigmoid sinus thrombophlebitis].

Objective:To summarize and analyze the clinical data of sigmoid sinus thrombophlebitis and discuss its treatment strategy. Methods:The clinical manifestations, auxiliary examinations, surgical procedures and anticoagulant therapy of patients diagnosed with otosource sigmoid sinus thrombophlebitis in the Department of Otorhinolaryngology, People's Hospital of Xinjiang Uygur Autonomous Region from November 2014 to November 2021 were retrospectively analyzed. Results:Five patients had a history of otorrhea and hearing loss for more than 5 years. They had headache during the acute episode, and 4 patients had drosive fever. They had severe complications, including brain abscess, sepsis, septic shock, intracranial hemorrhage, and hemorrhagic disseminated pneumonia. HRCT of temporal bone showed defects in the sigmoid sinus wall in 4 cases, and gas accumulation around and inside the sigmoid sinus in 3 cases. T1WI showed low signal, isosignal, and high signal in the sigmoid sinus area on MRI, and T2WI showed high signal in the sigmoid sinus area. The transverse sinus, sigmoid sinus and internal jugular vein were not developed in 2 cases, and the transverse sinus and sigmoid sinus were not developed in 1 case, and the internal jugular vein was thin. All 5 cases underwent radical mastoidectomy and resection of sigmoid sinus wall granulation or peritosinusitis abscess. The patients were followed up for 4-12 months and recovered well. Conclusion:For the cases of sigmoid sinus bone wall destruction accompanied by headache and fever by HRCT, it is necessary to be alert to the occurrence of sigmoid sinus thrombophlegitis, early diagnosis and early surgery to prevent the progression of the disease. Radical mastoidectomy combined with anti-infection therapy is the main treatment, and anticoagulation is necessary to achieve a better prognosis.

Porous (K0.5Na0.5)0.94Li0.06NbO3-polydimethylsiloxane piezoelectric composites harvesting mechanical energy for efficient decomposition of dye wastewater.

Piezoelectricity as a physical property has received great attention due to its excellently functional applications, especially in piezoelectric catalysis and mechanical energy harvesting. To take full advantage of the functions of piezoelectric materials, (K0.5Na0.5)0.94Li0.06NbO3 (KNN6L) piezoelectric powders were compounded with polydimethylsiloxane (PDMS) in this work. The developed KNN6L-PDMS porous piezoelectric composites with flexible and recyclable characteristics could achieve âˆ¼ 91% degradation rate of Rhodamine B (RhB) dye wastewater under mechanical vibration, and the outstanding piezocatalytic activity was still maintained after repeated decomposition multiple times. Besides, the relationship between piezoelectric potential and piezocatalysis was validated by COMSOL simulations. The content of piezoelectric powders played a positive effect on the magnitude of piezoelectric potential generated by the KNN6L-PDMS porous composites. Moreover, the catalytic mechanism was found to be originated by generation of various reactive oxygen species (mainly •O2- and •OH) in water environment as a result of strong piezoelectric effect by the porous composites. The porous piezoelectric composites with flexible and recyclable characteristics exhibited excellent performance in piezoelectric catalysis which has promising applications in the field of environmental remediation.

[Relationship between imaging features and intraoperative perilymph gusher in patients with Mondini inner ear malformation].

Objective:To investigate the relationship between imaging characteristics and intraoperative perilymph gusher in patients with Mondini inner ear malformation in cochlear implantation, in order to provide basis and clinical guidance for predicting of intraoperative perilymph gusher before cochlear implantation. Methods:According to Sennaroglu's classification method, children with severe sensorineural hearing loss screened from January 2020 to December 2021 were divided into Mondini group, simple enlarged vestibular aqueduct group and normal inner ear group according to inclusion criteria strictly. The images of temporal bone HRCT and inner ear MRI were post-processed, some relative indicators were measured, including cochlear height and width of vestibular aqueduct, etc., and the gusher situation during cochlear implantation was recorded. The mean value of each indicator among the three groups were compared respectively, and the differences of each indicator between the gusher group and the non-gusher group were analyzed. Results:There were statistically significant differences in cochlear height, length of cochlear bottom turn, width of cochlear aperture, vestibular length and vestibular width among the Mondini group（24 cases）, simple EVA group（15 cases） and normal inner ear group（28 cases）. The incidence of gusher of Mondini group in cochlear implantation was 30.77%（8/26）. The outer diameter of the VA（[3.10±0.74]mm） and the middle width of the VA（[1.90±0.68] mm） in the gusher group were wider than those in the non-gusher group, and the difference was statistically significant. The incidence of intraoperative gusher in patients with EVA was 20.00%（3/15）, and there was statistically significant difference in the length of endolymph sac between gusher group and non-gusher group（P<0.05）. Conclusion:The causes of intraoperative perilymph gusher in patients with Mondini inner ear malformation are complex. The enlarged vestibular aqueduct may be one of the anatomical basis. Whether it can be used to guide the preoperative assessment of the risk of intraoperative perilymph gusher need to be further confirmed by a large sample of clinical research from multiple centers in the future.

Effects of Donor-Recipient Age Difference in Renal Transplantation, an Investigation on Renal Function and Fluid Proteome.

INTRODUCTION: Our previous study revealed that a young internal environment ameliorated kidney aging by virtue of an animal model of heterochronic parabiosis and a model of heterochronic renal transplantation. In this research, we used proteome to investigate the effects of donor-recipient age difference in clinical renal transplantation. METHODS: This study included 10 pairs of renal transplantation donors and recipients with an age difference of greater than 20 years to their corresponding recipients/donors. All recipients have received transplantation more than 3 years ago. Renal function and the serum/urine proteomes of the donors and recipients were analyzed. RESULTS: The renal function was similar between the young recipients and the old donors. In contrast, the renal function of the young donors was significantly superior to that of the old recipients. Furthermore, 497 and 975 proteins were identified in the serum and urine proteomes, respectively. The content of SLC3A2 in the blood was found to be related to aging, while the contents of SERPINA1 and SERPINA3 in the urine were related to immune functions after renal transplantation. CONCLUSION: This study demonstrated that, in the human body, a younger internal environment could ameliorate kidney aging and provided not only clinical evidence for increasing the age limit of kidney transplant donors but also new information for kidney aging research.

High Energy Storage Performance of PMMA Nanocomposites Utilizing Hierarchically Structured Nanowires Based on Interface Engineering.

To overcome the inherent high hysteresis loss of ferroelectric polymer-based nanocomposites, non-ferroelectric linear dielectric poly(methyl methacrylate) (PMMA) is adopted as the polymer matrix for high discharge efficiency. At the same time, slender ferroelectric BaTiO3 nanowires (BT NWs) with a high dielectric constant are selected as the nanofiller for high energy density. To avoid the agglomeration of BT NWs and enhance the strength of interfaces, dopamine is used as organic coatings to tailor the interface. The BT@dopa NWs/PMMA nanocomposites exhibit excellent interface compatibility between the BT NWs and PMMA matrix and a very good microstructure uniformity. Based on this, hierarchically structured BT@SiO2@dopa NWs are designed and prepared to overcome the uneven electric field distribution at the interface, resulting from the dielectric constant mismatch. The discharged energy density (Ue) can be largely enhanced from 3.76 J/cm3 for pure PMMA films to 11.78 J/cm3 for PMMA-based nanocomposites by incorporating 5.0 wt % BT@SiO2@dopa NWs. In addition, a high discharging efficiency (η) of 91% is obtained simultaneously in the nanocomposites. Both experimental and theoretical simulations demonstrate that the double core-shell structure nanowire fillers can effectively alleviate the local field distortion, inhibit leakage current, and suppress remnant electric displacement, leading to the high Ue and η. These findings are significant in facilitating the development of high-performance film dielectric capacitor materials using PMMA-based nanocomposites toward high energy storage density.

Glass-ceramics microstructure formation mechanism for simultaneous solidification of chromium and nickel from disassembled waste battery and chromium slag.

A new method to solidify Cr(VI), Cr(III), and Ni(II) simultaneously by using a glass-ceramics microstructure was used. For a crystallization temperature of 870 °C, base glass (air cooling) with a mass ratio of CaO / SiO2 (R(C/S)) of 6/16, 10/16 precipitated a CaNiSi2O6 crystalline phase that could not solidify Ni(II) stably, and with an increase in R(C/S), the CaNiSi2O6 crystal precipitation tendency increased. When R(C/S) = 6/16, the crystallization temperature was 760 °C and spinel that was enriched in chromium and nickel formed preferentially during the inhibition of CaNiSi2O6 formation, indicating that lowering R(C/S) can inhibit the formation of CaNiSi2O6. Cr and Ni were mostly solidified in spinel, some of them enter augite (Ca (Mg, Fe, Al) (Si, Al)2O6) phases, a few of them were distributed in the glass matrix. The results of toxic leaching showed that the leached concentration of total Cr and Ni2+ in spinel glass-ceramics were 0 ppm and 0.07 ppm respectively, and the spinel glass-ceramics for simultaneous solidification of Cr(VI), Cr(III) and Ni(II) had excellent curing effect.

Rutin ameliorates renal fibrosis and proteinuria in 5/6-nephrectomized rats by anti-oxidation and inhibiting activation of TGFß1-smad signaling.

OBJECTIVES: Rutin, a polyphenolic flavonoid, was reported to have beneficial effect on drug induced nephropathy. The present study aimed to introduce 5/6 nephrectomized rat model to further evaluate its renal protective effect. METHODS: Adult Wistar rats were induced to develop chronic renal failure through 5/6 nephrectomy (5/6 Nx). After that, animals were treated orally with saline, rutin at 15 and 45 mg/kg, and losartan (10 mg/kg) daily for 20 weeks; sham-operated animals were also involved as control. After treatment for 8 and 20 weeks, blood and urine samples were collected for biochemical examination; all the kidney remnants were collected for histological examination. The protein levels of TGF-ß1, smad2 and phosphorylated-smad2 (p-smad2) in kidney were measured. Immunohistochemistry was used to analyze the expression of TGF-ß1, fibronectin and collagen IV in kidney tissues. RESULTS: Results suggested that rutin could reduce the proteinurea, blood urine nitrogen and blood creatinine in 5/6 Nx animals significantly, as well as oxidation stress in the kidney. By histological examination, rutin administration alleviated glomerular sclerosis scores and tubulointerstitial injuries in a dose-dependent manner (P<0.01). Immunohistochemistry also suggested rutin could reduce the expression of TGF-ß1, fibronectin and collagen IV in kidney tissues. By western blot, we found the rutin could reduce the TGF-ß1, p-smad2 expression in the kidney tissues of rats. CONCLUSIONS: This study suggests that the rutin can improve renal function in 5/6 Nx rats effectively. Its effect may be due to its anti-oxidation and inhibiting TGFß1-Smad signaling.

Coexistence of two forms of LTP in ACC provides a synaptic mechanism for the interactions between anxiety and chronic pain.

Chronic pain can lead to anxiety and anxiety can enhance the sensation of pain. Unfortunately, little is known about the synaptic mechanisms that mediate these re-enforcing interactions. Here we characterized two forms of long-term potentiation (LTP) in the anterior cingulate cortex (ACC); a presynaptic form (pre-LTP) that requires kainate receptors and a postsynaptic form (post-LTP) that requires N-methyl-D-aspartate receptors. Pre-LTP also involves adenylyl cyclase and protein kinase A and is expressed via a mechanism involving hyperpolarization-activated cyclic nucleotide-gated (HCN) channels. Interestingly, chronic pain and anxiety both result in selective occlusion of pre-LTP. Significantly, microinjection of the HCN blocker ZD7288 into the ACC in vivo produces both anxiolytic and analgesic effects. Our results provide a mechanism by which two forms of LTP in the ACC may converge to mediate the interaction between anxiety and chronic pain.

Zero ischaemia laparoscopic nephron-sparing surgery by re-suturing.

AIM OF THE STUDY: To report a pre-suture technique in laparoscopic nephron-sparing surgery (LNSS), which could help reduce and even avoid ischaemia for the treatment of renal cell carcinoma. MATERIAL AND METHODS: Between January and June 2013 we treated 14 patients presenting with renal tumours. The mean age was 46 years and average tumour size was 2.4 cm in diameter determined by computed tomography (CT). All the patients were treated with LNSS by pre-suturing the resection. RESULTS: In 13 out of the 14 cases, no clamping was needed during the whole surgery processes, i.e. zero ischaemia was achieved. In the other case, the renal artery was clamped for only 150 seconds due to suture avulsion. The mean operating time was 75 minutes (range 50 to 110 minutes) and mean blood loss was 60 ml (range 30 to 200 ml). After removal of the drain 2-3 days after surgery, the average postoperative hospital stay time was four days. The surgery had only a minor effect on the renal function. No case of urinary leakage or postoperative bleeding occurred. Postoperative pathological reports showed that the tumours were resected completely with negative surgical margins for all cases. There were no signs of recurrence on follow-up CT performed 1-6 months after surgery. CONCLUSIONS: The pre-suture technique in LNSS reported here required zero or minimal ischaemia time and hence avoided renal ischaemia-reperfusion injury. This surgical technique could be a feasible surgical option for treatment of small, exophytic and peripheral renal tutors.

Sjögren's syndrome accompanied with interstitial cystitis: a case report and review of the literature.

We present a case report of a patient with Sjögren's syndrome accompanied with interstitial cystitis. A 64-year-old woman complained of dry mouth for 21 years, recurrent swelling and pain on the right parotid in 2000, and urinary irritation symptoms in the past 2 years. Several courses of different types of antibiotics could not relieve her urinary irritation symptoms. Bladder hydraulic dilatation had only transient effects. Urine sediment contained neither erythrocytes nor leukocytes, and urine cultures yielded no growth. However, increased γ-globulin, positive antinuclear antibodies, and anti-SS-A and anti-SS-B antibodies were detected. Histopathological data of labial salivary glands showed three foci of numerous mononuclear cells. Cystoscopy revealed redness, edema, angiectasis, and extensive ecchymosis of the mucosal surface and several small floating cruor entities in the bladder. Urinary bladder biopsy specimens revealed the absence of urothelium and edematous lamina propria and submucosa, with diffuse or multiple focal chronic inflammatory cell infiltration. Based on these findings, she was diagnosed with Sjögren's syndrome accompanied with interstitial cystitis. Therapy with corticosteroids relieved the symptoms significantly.

[Frequency and linkage disequilibrium of specific HLA-DR and HLA-DQ genes in Chinese Han population].

This study was aimed to investigate the distribution feature of HLA-DR/DQ gene linkage disequilibrium in Chinese Han population and to improve the accuracy of HLA matching results. Genotyping of HLA-DR and HLA-DQ gene locus was performed using PCR-SSP typing in Chinese Han population receiving kidney transplantation. The results showed that there were 29 new linkage combinations in 1799 patients, in which DR13-DQ5, DR11-DQ8 and DR8-DQ8 were discovered for 11, 8 and 7 times respectively while DR9-DQ8, DR12-DQ6 and DR14-DQ4 were both discovered for 6 times. The linkage disequilibrium parameters of these haplotypes were negative, showing that these linkages were uncommon. It is concluded that this study not only enriches the classical HLA-DR/DQ linkage combinations, but also indicates the national relevance of combination distribution, and it has great importance in improving the accuracy of HLA matching experiments and reducing unnecessary repeated work.

[Transurethral partial cystectomy with a 2 micron laser in diagnosis and treatment for bladder submucosal lesions in adults].

OBJECTIVE: To investigate the characteristics of transurethral partial cystectomy with a 2 µm laser in diagnosis and treatment for the bladder submucosal lesions in adults. METHODS: Nine patients with suspected pathological diagnosed bladder submucosal lesions in out-patient department were diagnosed and treated transurethral with a 2 µm laser under sacral block between August 2009 and December 2010. The diameters of tumors were 1.5 - 2.5 cm. A 2 µm laser was used to incise the full-thickness bladder wall around the tumors. The entire bladder wall was peeled between the detrusor muscle layer and outer connective tissues. Tumors with bladder wall at the base were removed together and sent for pathological examination. The surgical procedures, intraoperative hemorrhage, intraoperative and postoperative complications were observed, pathological diagnosis and postoperative follow-up were performed. RESULTS: All operations were successful. Mean operative time was 36.4 minutes (range 25 to 47 minutes), perioperative blood loss was minimal. There was no obturator nerve reflection and no hemorrhage detected after surgery. Postoperative pathological diagnosis included leiomyoma in 3 cases, pheochromocytoma in 3 cases, endometriosis in 1 case and metastatic bladder cancer in 2 cases. CONCLUSIONS: Transurethral partial cystectomy with a 2 µm laser can diagnose and treat bladder submucosal lesions. The procedures are effective and safe. Patients could get accurate pathological diagnosis without further painful and some bladder tumors can be treated by minimally invasive surgery.

[Extraperitoneal robot-assisted laparoscopic radical prostatectomy: report of 20 cases].

OBJECTIVE: To summarize our experience with extraperitoneal robot-assisted laparoscopic radical prostatectomy (RLRP). METHODS: Twenty patients with confirmed prostate cancer by transrectal needle biopsy but no metastasis detected by radiographic examination underwent extraperitoneal RLRP, including 7 with Gleason score of less than 6, 10 with a score of 7, 2 with a score of 8, and 1 with a score of 9. RESULTS: The procedures were performed successfully in all the patients. In 4 cases, a postoperative PSA value of more than 0.2 ng/ml at 4 weeks suggested residual tumor, for which maximal androgen block therapy was administered before elective radiotherapy. Sixteen patients were followed up for 10 to 37 months (mean 15.5 months). In the 20 cases, the operation was completed in a mean of 180 min (range 150-230 min), with the mean installation time of 48.5 min (range 40-60 min) and average blood loss of 298 ml (range 80-800 ml). The mean postoperative eating time was 1.7 days (1 to 3 days), the mean bladder catheter time was 10.7 days (7 to 14 days), and the mean hospital stay was 10.7 days (range 7-14 days). No postoperative complications occurred in these cases. Postoperative pathology showed a Gleason score no higher than 6 in 6 cases, 7 in 5 cases, and no less than 8 in 9 cases. CONCLUSION: The technique of extraperitoneal RLRP can be easily mastered by the surgeons and is especially advantageous for complicated pelvic operations.

Transurethral partial cystectomy with 2 µm thulium continuous wave laser in the treatment of bladder pheochromocytoma.

PURPOSE: To introduce transurethal partial cystectomy with a 2013 nm thulium laser as a treatment for paraganglioma of the urinary bladder in adults. PATIENTS AND METHODS: Three patients with pheochromocytomas were treated transurethrally with a 2013 nm thulium laser under general anesthesia. A 2013 nm thulium laser was used to incise the full-thickness bladder wall around the tumors. The entire bladder wall was peeled between the detrusor muscle layer and outer connective tissues. Tumors with full-thickness detrusor muscle layers at the base were removed together. Intraoperative fluctuation of blood pressure, preoperative values of 24-hour urine catecholamine (CA) and vanillylmandelic acid (VMA), and postoperative complications were observed, and postoperative followtwoups were performed. RESULTS: All operations were successful. Operative time was 25 to 32 minutes. Perioperative blood pressure was stable in two cases while blood pressure fluctuated in the third case. When the entire tumor and the full-thickness bladder wall at the base were freed, blood pressure reverted to stability. All values of 24-hour urine CA and VMA were within normal limits postoperatively. Patients were followed for 7 to 9 months postoperatively with no recurrence. This series included highly selected patients who were treated by a single senior surgeon who is rich in experience in performing 2013 nm thulium laser procedures. CONCLUSIONS: To our knowledge, this is the first report of a 2013 nm thulium laser used to treat bladder pheochromocytoma. It can be applied to precisely vaporize and incise the full-thickness bladder wall and cut down the blood supply of the tumor, then peel it while blood pressure remains stable, thus completing partial cystectomy for bladder pheochromocytoma safely.

Anatomical variation of the posterior lumbar tributaries of the left renal vein in retroperitoneoscopic left living donor nephrectomy.

OBJECTIVES: To increase awareness of the anatomical variation of the posterior lumbar tributaries of the left renal vein in retroperitoneoscopic left living donor nephrectomy. METHODS: A total of 61 cases of retroperitoneoscopic left living donor nephrectomy were carried out from March 2008 to June 2010. The anatomical variations of the posterior lumbar tributaries of the left renal vein in these patients were noted. RESULTS: According to the variation of posterior lumbar tributaries, there were seven types in total, including five main types (accounts for 95.1%, 58/61 cases) and the type of reno-hemi-azygo-lumbar trunk (AZV; accounts for 16.4%, 10/61 cases). According to the number of posterior lumbar tributaries, no lumbar vein covers accounted for 16.4% (10/61 cases), one lumbar vein accounted for 47.5% (29/61 cases), two lumbar veins accounted for 32.8% (20/61 cases) and three lumbar veins accounted 3.3% (2/61 cases). According to the operation time during the process of managing posterior lumbar veins, it was type 4 (AZV) on which the surgeon spent the most time (P<0.05), and type 5 (no lumbar vein) on which the surgeon spent the least time (P<0.05). CONCLUSIONS: This is the first report of the anatomical variation of the posterior lumbar tributaries of the left renal vein in retroperitoneal laparoscopic left living donor nephrectomy. Detailed knowledge of these anatomical variations will undoubtedly help surgeons to avoid the potential risk of vein damage during nephrectomy and to obtain a longer renal artery for the following renal transplantation.

Retroperitoneal laparoscopic live donor nephrectomy: report of 105 cases.

Retroperitoneal laparoscopic live donor nephrectomy offers an intrinsic advantage over conventional transperitoneal laparoscopic nephrectomy because of the potentially lower risk for early and late donor intraperitoneal complications. Herein we presented our experience performing retroperitoneal laparoscopic live donor nephrectomy in 105 donors. All donor nephrectomy was successful. There were no donor deaths and no conversion to open surgery. Mean operation time was 112 min (range, 70-200 min). Intraoperative blood loss was 10-150 mL with an average of 30 mL. Warm ischemia time was 1.3 to 6 min with an average of 3.1 min. Postoperative retroperitoneal hematoma occurred in only one case and there were no other surgical complications. Donors were discharged from the hospital 5 to 10 days postoperation. Average postoperative hospital stay was 6.4 days. One graft was removed due to acute rejection. Delayed graft function occurred in two recipients but renal function returned to normal within four weeks. The other recipients had normal renal function in two weeks except three recipients in four weeks. We believe that retroperitoneal laparoscopic live donor nephrectomy is safe, reliable, and less invasive.

[Analysis of the 1000 Hz tympanometry in normal hearing neonates].

OBJECTIVE: To analysis the clinical characteristics of 1000 Hz probe tone tympanometry obtained from normal neonates who passed the OAE screening. To calculate the normal range of the variances of the tympanometry, which may serve as the guide for newborn hearing screening and detect middle ear function in neonates. METHODS: OAE screening were performed to screen the hearing with GSI-70 Automated OAE. The 1000 Hz probe tone tympanograms were obtained from 650 neonates who passed the TEOAE screening in both ears and were on the normal physiological conditions after birth with GSI Tympstar Version II Middle Ear Analyzer. The means, the standard deviation, the 95% confidence interval were analyzed. RESULTS: The 1000 Hz tympanometric data showed the 1Y1B1G tympanogram in 732 ears (56.3%), the 1Y3B1G tympanogram in 145 ears (11.2%), the 0Y0B0G tympanogram in 269 ears (20.7%), other shapes in 154 ears (11.8%) according to the Vanhuyse model. The 1000 Hz tympanometric datas showed the single-peaked tympanogram in 967 ears, the 95% confidence interval of the tympanometric data were as follows: tympanometric peak pressure (Tpp) was from -55.0 to 180.0 daPa, peak compensated static acoustic admittance (Peak Ytm) was 0.03-1.18 mmHo, tympanometric width (TW) was 70.0-230.0 daPa. CONCLUSIONS: The majority of 1000 Hz tympanograms from this study show the single-peaked in normal neonates. The 95% confidence interval of the tympanometric data may serve as a guide for hearing screening and detecting middle ear function in neonates.

Retroperitoneal Laparoscopic Live Donor Nephrectomy: Report of 105 Cases / 华中科技大学学报（医学）（英德文版）

Retroperitoneal laparoscopic live donor nephrectomy offers an intrinsic advantage over conventional transperitoneal laparoscopic nephrectomy because of the potentially lower risk for early and late donor intraperitoneal complications.Herein we presented our experience performing retroperitoneal laparoscopic live donor nephrectomy in 105 donors.All donor nephrectomy was successful.There were no donor deaths and no conversion to open surgery.Mean operation time was 112 min (range,70—200 min).Intraoperative blood loss was 10—150 mL with an average of 30 mL.Warm ischemia time was 1.3 to 6 min with an average of 3.1 min.Postoperative retroperitoneal hematoma occurred in only one case and there were no other surgical complications.Donors were discharged from the hospital 5 to 10 days postoperation.Average postoperative hospital stay was 6.4 days.One graft was removed due to acute rejection.Delayed graft function occurred in two recipients but renal function returned to normal within four weeks.The other recipients had normal renal function in two weeks except three recipients in four weeks.We believe that retroperitoneal laparoscopic live donor nephrectomy is safe,reliable,and less invasive.

[Retroperitoneal laparoscopic living donor nephrectomy: report of 58 cases].

OBJECTIVE: To review a single-institution experience with retroperitoneal laparoscopic living donor nephrectomy (RLDN). METHODS: Fifty-eight donors underwent RLDN at our institution (including 32 male and 26 female donors aged 20-61 years, mean 42 years). Left nephrectomy was performed in 56 cases. The first 35 patients underwent total RLDN, and the latter 23 received modified RLDN. RESULTS: RLDN was performed successfully in all the patients without conversion to open surgery. The mean surgical time was 93 min (range 70-130 min), and the mean blood loss was 20 ml (range 10-50 ml), with a mean warm ischemia time of 2.8 min (1.3-6 min). Retroperitoneal hematoma occurred postoperatively in one case. The mean hospital stay of the donors was 6.4 days (5-10 days). Two recipients showed delayed graft function, and one graft was lost because of acute rejection. The other recipients had normal renal function in two weeks except for 3 having normal renal function in 4 weeks. CONCLUSION: RLDN is a safe procedure with minimal invasiveness, and the modified RLDN lowers the learning curve of the surgery.