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1.
Transl Androl Urol ; 11(9): 1292-1303, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36217405

RESUMO

Background: Compound aluminum sulfate injection (CASI) originated from a Chinese traditional medicine, "Kuzhiye", and has been used in treating non-muscle invasive bladder cancer (NMIBC). Previous studies suggested that CASI was a potential monotherapeutic drug for NMIBC. However, the efficacy and safety of CASI in the treatment of NMIBC, as well as the long-term recurrence after treatment, need to be further evaluated. Methods: A multicenter retrospective single-arm cohort study was conducted. From 2006 to 2009, 101 patients (74 men and 27 women, aged 58.9±11.9 years) with T1 or benign NMIBC were enrolled. Each patient was directly injected with CASI through catheter needle into the root of NMIBC. Vital signs, electrocardiography, blood count, blood biochemistry, and urine analysis were re-examined on day 2 and day 14 after CASI injection, together with a cystoscopic examination 4 weeks after CASI treatment was performed for all patients to assess the clinical activity and safety of CASI. To study long-term efficacy, patients in center 2 were followed up for recurrence with a median follow-up time of 13.8 years. Results: For the 101 patients enrolled in this study, demographic characteristics in the 3 centers showed no significant differences. After CASI, 2 patients showed administration site-dependent, but not dose-dependent, increase in their aluminum concentration in 24 hours without obvious abnormality in blood biochemistry. The overall effective rate was 97.03%, including complete tumor necrosis in 94 patients. Treatment-related adverse events occurred in 20 patients (19.80%), including 9 drug-related and 11 cystoscopy-related adverse events (AEs). All AEs were endurable and disappeared within 2 weeks without any treatment. The maximum tolerated single dose of CASI was 21 mL. Among the 43 patients at center 2, 3 patients were excluded because they changed to other treatment regimen. As of April 2022, of the 40 patients enrolled, 22 had no recurrence and 7 relapsed. The follow-up time was 2-16.2 years. The other 11 patients were lost to follow up. Conclusions: CASI may be an effective and safe option for the treatment of NMIBC and is expected to be a potential monotherapy regimen for NMIBC.

2.
Front Mol Neurosci ; 15: 859558, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35966011

RESUMO

TLR4 and Cx43 signaling in dorsal spinal cord has been shown to be involved in the development of neuropathic pain. However, it is not clear whether TLR4 signaling is associated with the expression of MCP-1, CXCL1, and Cx43 in LPS (lipopolysaccharide)-treated rat dorsal spinal cord astrocytes under in vitro condition. In the present study, we found that TLR4 antagonist TAK-242 significantly inhibited LPS-induced MCP-1, CXCL1, and Cx43 expression, suggesting the role of TLR4 in response to LPS in cultured dorsal spinal cord astrocytes. Application of TAK-242 significantly blocked LPS-induced NF-κB and AP-1 activity and the expression of MCP-1, CXCL1 and Cx43. Furthermore, NF-κB inhibitor PDTC and AP-1 inhibitor SR11302 significantly blocked LPS-induced MCP-1, CXCL1, and Cx43 expression. DNA-binding activity of NF-κB, its effect on MCP-1 expression was suppressed by PDTC and SR11302. On the other hand, DNA-binding activity of AP-1, its effect on CXCL1 or Cx43 expression was also suppressed by PDTC and SR11302. In addition, PDTC was found to inhibit the nuclear translocation of AP-1 and the expression of c-Jun induced by LPS, which suggested that NF-κBp65 is essential for the AP-1 activity. Similarly, SR11302 significantly blocked LPS-induced the nuclear translocation of NF-κBp65 and the expression of NF-κBp65 induced by LPS. Pretreatment with CBX, Gap26, or Gap19 (Cx43 blockers) significantly inhibited abnormal astrocytic hemichannel opening and chemokines (MCP-1 and CXCL1) release in LPS-stimulated astrocytes. In summary, cell culture experiments revealed that LPS stimulation could evoke TLR4 signaling with the subsequent activation of NF-κB and AP-1, resulting in the expression of MCP-1, CXCL1, and Cx43. TLR4 activation increased Cx43 hemichannel, but not gap-junction activities and induced the release of the MCP-1 and CXCL1 from astrocytes via Cx43 hemichannel. These findings may help us to understand the role of astrocytic signaling in inflammatory response within dorsal spinal cord tissue.

3.
BMC Cancer ; 17(1): 176, 2017 03 07.
Artigo em Inglês | MEDLINE | ID: mdl-28270206

RESUMO

BACKGROUND: Myeloid ecotropic viral integration site 1 (MEIS1) protein plays a synergistic causative role in acute myeloid leukemia (AML). However, MEIS1 has also shown to be a potential tumor suppressor in some other cancers, such as non-small-cell lung cancer (NSCLC) and prostate cancer. Although multiple roles of MEIS1 in cancer development and progression have been identified, there is an urgent demand to discover more functions of this molecule for further therapeutic design. METHODS: MEIS1 was overexpressed via adenovirus vector in clear cell renal cell carcinoma (ccRCC) cells. Western blot and real-time qPCR (quantitative Polymerase Chain Reaction) was performed to examine the protein and mRNA levels of MEIS1. Cell proliferation, survival, in vitro migration and invasion were tested by MTT, colony formation, soft-agar, transwell (in vitro invasion/migration) assays, and tumor in vivo growthwas measured on nude mice model. In addition, flow-cytometry analysis was used to detect cell cycle arrest or non-apoptotic cell death of ccRCC cells induced by MEIS1. RESULTS: MEIS1 exhibits a decreased expression in ccRCC cell lines than that in non-tumor cell lines. MEIS1 overexpression inhibits ccRCC cells proliferation and induces G1/S arrest concomitant with marked reduction of G1/S transition regulators, Cyclin D1 and Cyclin A. Moreover, MEIS1-1 overexpression also induces non-apoptotic cell death of ccRCC cells via decreasing the levels of pro-survival regulators Survivin and BCL-2. Transwell migration assay (TMA) shows that MEIS1 attenuates in vitro invasion and migration of ccRCC cells with down-regulated epithelial-mesenchymal transition (EMT) process. Further, in nude mice model, MEIS1 inhibits the in vivo growth of Caki-1 cells. CONCLUSIONS: By investigating the role of MEIS1 in ccRCC cells' survival, proliferation, anchorage-independent growth, cell cycle progress, apoptosis and metastasis, in the present work, we propose that MEIS1 may play an important role in clear cell renal cell carcinoma (ccRCC) development.


Assuntos
Carcinoma de Células Renais/genética , Proliferação de Células/genética , Proteína Meis1/genética , Invasividade Neoplásica/genética , Animais , Apoptose/genética , Carcinoma de Células Renais/patologia , Linhagem Celular Tumoral , Movimento Celular/genética , Transição Epitelial-Mesenquimal/genética , Regulação Neoplásica da Expressão Gênica , Humanos , Proteínas Inibidoras de Apoptose/genética , Camundongos , Invasividade Neoplásica/patologia , Proteínas Proto-Oncogênicas c-bcl-2/genética , Transdução de Sinais/genética , Survivina
4.
J Cell Mol Med ; 20(7): 1203-13, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-26914637

RESUMO

Three-dimensional (3D) cell culture has been reported to increase the therapeutic potentials of mesenchymal stem cells (MSCs). In this study, we aimed to investigate the therapeutic effects of 3D spheroids of human adipose-derived MSCs for acute kidney injury (AKI). In vitro studies indicated that 3D spheroids of MSCs produced higher levels of extracellular matrix proteins (including collagen I, fibronectin and laminin), and exhibited stronger anti-apoptotic and anti-oxidative capacities than two-dimensional (2D) cultured cells. Furthermore, 3D culture increased the paracrine secretion of cytokines by MSCs, including angiogenic factors (VEGF and basic fibroblast growth factor), anti-apoptotic factors (epidermal growth factor and hepatocyte growth factor), the anti-oxidative factor insulin-like growth factor and the anti-inflammatory protein tumour necrosis factor-alpha stimulated gene/protein 6. Consistent with in vitro experiments, 3D spheroids of MSCs showed enhanced survival and paracrine effects in vivo. More importantly, when injected into the kidney of model rats with ischemia-reperfusion (I/R)-induced AKI, 3D spheroids were more beneficial in protecting the I/R kidney against apoptosis, reducing tissue damage, promoting vascularization and ameliorating renal function compared with 2D cultured cells. Therefore, the 3D culture strategy improved the therapeutic effects of MSCs, and might be promising for AKI treatment.


Assuntos
Técnicas de Cultura de Células/métodos , Isquemia/terapia , Rim/irrigação sanguínea , Rim/patologia , Transplante de Células-Tronco Mesenquimais , Células-Tronco Mesenquimais/citologia , Esferoides Celulares/citologia , Injúria Renal Aguda/patologia , Injúria Renal Aguda/fisiopatologia , Injúria Renal Aguda/terapia , Tecido Adiposo/citologia , Animais , Antioxidantes/metabolismo , Apoptose/efeitos dos fármacos , Separação Celular , Sobrevivência Celular/efeitos dos fármacos , Proteínas da Matriz Extracelular/metabolismo , Humanos , Peróxido de Hidrogênio/farmacologia , Isquemia/patologia , Isquemia/fisiopatologia , Rim/efeitos dos fármacos , Rim/fisiopatologia , Testes de Função Renal , Masculino , Células-Tronco Mesenquimais/efeitos dos fármacos , Neovascularização Fisiológica/efeitos dos fármacos , Comunicação Parácrina/efeitos dos fármacos , Ratos Sprague-Dawley
5.
Oncol Lett ; 10(3): 1402-1408, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26622681

RESUMO

The aim of the present study was to investigate the pathogenesis of metastatic prostate carcinoma, to find the metabolic pathways changed in the disease and to screen out the potential therapeutic drugs. GSE38241 was downloaded from Gene Expression Omnibus; the Geoquery package was applied to preprocessed expression profiling, and the differentially-expressed genes (DEGs) were selected with limma (linear regression model packages). Next, WikiPathways cluster analysis was performed for DEGs on a Gene Set Analysis Toolkit V2 platform, and DEGs with hypergeometric algorithms were calculated through gene set enrichment analysis. A total of 1,126 DEGs were identified between the normal prostate and metastatic prostate carcinoma. In addition, KPNA4, SYT1, PLCB1, SPRED1, MBNL2, RNF165, MEF2C, MBNL1, ZFP36L1 and CELF2, were found to be likely to play significant roles in the process of metastatic prostate carcinoma. The small molecules STOCK1N-35874 and 5182598 could simulate the state of normal cells well, while the small molecules MS-275 and quinostatin could simulate the state of metastatic prostate carcinoma cells. In conclusions, the small molecules STOCK1N-35874 and 5182598 were identified to be good potential therapeutic drugs for the treatment of metastatic prostate carcinoma, while the two small molecules MS-275 and quinostatin could cause metastatic prostate carcinoma.

7.
Mol Med Rep ; 10(6): 3087-91, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25323786

RESUMO

The aim of the present study was to screen candidate genes that are closely associated with bladder cancer and to select the most distinct candidate target genes in order to provide theoretical evidence and direction for improved treatment of bladder cancer. The gene microarray dataset GSE45184 was downloaded from the Gene Expression Omnibus database. There were a total of six expression prolife microarrays from three pairs of freshly frozen bladder cancer tissues and corresponding normal adjacent tissues. Differentially expressed genes (DEGs) were identified using the limma package in R software and then subjected to further biological information analysis, including hierarchical clustering analysis and gene ontology enrichment analysis. Co­expression networks and functional interaction networks were established using the up­ and downregulated genes. Pathway enrichment analysis was then performed for the genes in the functional interaction networks. A total of 522 DEGs were identified, including 223 upregulated and 299 downregulated genes. Functional enrichment analysis of the target genes indicated that downregulated genes were associated with the regulation of biological processes, while the upregulated genes participated in the processes involved in the cell cycle. The functional network of the upregulated genes comprised 1,518 connections and 92 gene nodes that were associated with 10 closely­related functions, while the network of the downregulated genes consisted of 129 connections and 24 gene nodes involving 11 significantly related functions. Pathway enrichment analysis revealed that the downregulated genes were mainly involved in the mitogen­activated protein kinase signaling pathway, while the upregulated genes were closely associated with the cell cycle. These DEGs and the relevant cell cycle pathways have the potential to be used as targets for the treatment of bladder cancer.


Assuntos
Regulação Neoplásica da Expressão Gênica/genética , Redes Reguladoras de Genes/genética , Neoplasias da Bexiga Urinária/genética , Ciclo Celular/genética , Análise por Conglomerados , Biologia Computacional/métodos , Regulação para Baixo/genética , Perfilação da Expressão Gênica/métodos , Humanos , Análise em Microsséries/métodos , Proteínas Quinases Ativadas por Mitógeno/genética , Mapas de Interação de Proteínas/genética , Transdução de Sinais/genética , Software , Regulação para Cima/genética
8.
PLoS One ; 9(6): e99777, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24924420

RESUMO

To report our experience of pure laparoscopic and robot-assisted laparoscopic reconstructive surgery in congenital megaureter, seven patients (one bilateral) with symptomatic congenital megaureter underwent pure laparoscopic or robot-assisted laparoscopic surgery. The megaureter was exposed at the level of the blood vessel and was isolated to the bladder narrow area. Extreme ureter trim and submucosal tunnel encapsulation or papillary implantations and anti-reflux ureter bladder anastomosis were performed intraperitoneally by pure laparoscopic or robot-assisted laparoscopic surgery. The clinical data of seven patients after operation were analyzed, including the operation time, intraoperative complications, intraoperative bleeding volumes, postoperative complications, postoperative hospitalization time and pathological results. All of the patients were followed. The operation was successfully performed in seven patients. The mean operation times for pure laparoscopic surgery and robotic-assistant laparoscopic surgery were 175 (range: 150-220) and 187 (range: 170-205) min, respectively, and the mean operative blood loss volumes were 20 (range: 10-30) and 28.75 (range: 15-20) ml, respectively. There were no intraoperative complications. The postoperative drainage time was 5 (range: 4-6) and 5.75 (range: 5-6) d, respectively, and the indwelling catheter time was 6.33 (range: 4-8) d and 7 (range: 7-7) d, respectively. The postoperative hospitalization time was 7.67 (range: 7-8) d and 8 (range: 7-10) d, respectively. There was no obvious pain, no secondary bleeding and no urine leakage after the operation. Postoperative pathology reports revealed chronic urothelial mucosa inflammation. The follow-up results confirmed that all patients were relieved of their symptoms. Both pure laparoscopic and robot-assisted laparoscopic surgery using different anti-reflux ureter bladder anastomoses are safe and effective approaches in the minimally invasive treatment of congenital megaureter.


Assuntos
Laparoscopia/métodos , Procedimentos de Cirurgia Plástica/métodos , Procedimentos Cirúrgicos Robóticos/métodos , Obstrução Ureteral/congênito , Obstrução Ureteral/cirurgia , Anormalidades Urogenitais/cirurgia , Adulto , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Feminino , Humanos , Laparoscopia/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Masculino , Duração da Cirurgia , Complicações Pós-Operatórias/epidemiologia , Procedimentos de Cirurgia Plástica/estatística & dados numéricos , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/estatística & dados numéricos , Ureter/anormalidades , Ureter/cirurgia , Obstrução Ureteral/epidemiologia , Anormalidades Urogenitais/epidemiologia , Adulto Jovem
9.
PLoS One ; 8(8): e70958, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23940674

RESUMO

OBJECTIVE: Many studies have reported the prognostic predictive value of CD166 as a cancer stem cell marker in cancers of the digestive system; however, its predictive value remains controversial. Here, we investigate the correlation between CD166 positivity in digestive system cancers and clinicopathological features using meta-analysis. METHODS: A comprehensive search in PubMed and ISI Web of Science through March of 2013 was performed. Only articles containing CD166 antigen immunohistochemical staining in cancers of the digestive system were included,including pancreatic cancer, esophageal cancer, gastric cancer and colorectal cancer. Data comparing 3- and 5-year overall survival along with other clinicopathological features were collected. RESULTS: Nine studies with 2553 patients who met the inclusion criteria were included for the analysis. The median rate of CD166 immunohistochemical staining expression was 56% (25.4%-76.3%). In colorectal cancer specifically, the results of a fixed-effects model indicated that CD166-positive expression was an independent marker associated with a smaller tumor burden (T category; RR = 0.93, 95%, CI: 0.88-0.98) but worse spread to nearby lymph nodes (N category; RR = 1.17, 95% CI: 1.05-1.30). The 5-year overall survival rate was showed relationship with cytoplasmic positive staining of CD166 (RR = 1.47 95% 1.21-1.79), but no significant association was found in the pool or any other stratified analysis with 3- or 5- year overall survival rate. CONCLUSION: Based on the published studies, different cellular location of CD166 has distinct prognostic value and cytoplasmic positive expression is associated with worse prognosis outcome. Besides, our results also find CD166 expression indicate advanced T category and N-positive status in colorectal cancer specifically.


Assuntos
Antígenos CD/metabolismo , Moléculas de Adesão Celular Neuronais/metabolismo , Proteínas Fetais/metabolismo , Neoplasias Gastrointestinais/metabolismo , Neoplasias Gastrointestinais/mortalidade , Neoplasias Gastrointestinais/patologia , Humanos , Metástase Linfática , Prognóstico , Análise de Sobrevida , Taxa de Sobrevida , Carga Tumoral
10.
Urology ; 82(4): 925-7, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23726166

RESUMO

Epithelioid hemangioendothelioma is a distinct vascular tumor with low malignant biologic behavior that is very rare in the kidney. Only 3 adult patients have been reported to date in English-language reports. We report the case of a 9-year-old boy who presented with painless gross hematuria. Magnetic resonance imaging and positron emission tomography-computed tomography demonstrated a primary mass in the left kidney. The pathologic diagnosis of the tumor was epithelioid hemangioendothelioma after radical nephrectomy. To the best of our knowledge, this is the first reported case of primary renal epithelioid hemangioendothelioma in the pediatric age group.


Assuntos
Hemangioendotelioma Epitelioide , Neoplasias Renais , Criança , Hemangioendotelioma Epitelioide/diagnóstico , Hemangioendotelioma Epitelioide/cirurgia , Humanos , Neoplasias Renais/diagnóstico , Neoplasias Renais/cirurgia , Masculino
11.
Fam Cancer ; 12(4): 657-67, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23754170

RESUMO

ACTH independent macronodular adrenal hyperplasia (AIMAH) is a rare disorder characterized by bilateral macronodular hyperplasia of the adrenal glands and increased cortisol production with subclinical or overt Cushing's syndrome. Although the family clustering of AIMAH is infrequent, we have tried our best to find such a familial affected pedigree with complete clinical information and successfully collect adrenalectomy tissue samples from two members of this family. Using whole exome sequencing and several variant prioritization strategies based on disease network analysis, we identified Endothelin receptor type A (EDNRA) Ser420Thr mutation as a causative mutation of AIMAH. EDNRA is a member of G protein coupled receptor family and is involved in cardiovascular or polycystic kidney disease. Our findings indicate that the mutation of EDNRA at S420T site should be regard as a potential AIMAH causative variation in familial and sporadic affected patients.


Assuntos
Síndrome de Cushing/genética , Exoma/genética , Mutação/genética , Receptor de Endotelina A/genética , Síndrome de Cushing/patologia , Feminino , Seguimentos , Redes Reguladoras de Genes , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Pessoa de Meia-Idade , Linhagem , Prognóstico
12.
Nan Fang Yi Ke Da Xue Xue Bao ; 32(5): 749-51, 2012 May.
Artigo em Chinês | MEDLINE | ID: mdl-22588941

RESUMO

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.


Assuntos
Laparoscopia/métodos , Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Robótica , Idoso , Humanos , Masculino , Pessoa de Meia-Idade
13.
Zhonghua Wai Ke Za Zhi ; 48(10): 761-3, 2010 May 15.
Artigo em Chinês | MEDLINE | ID: mdl-20646494

RESUMO

OBJECTIVE: To analyze the influence of benign prostatic hyperplasia (BPH) drugs on incidence and pathology grading of prostate cancer in China. METHODS: Retrospectively investigated the history of drug treatment in 1029 cases of BPH in patients from February 1998 to December 2004. According to the history of drug use, the patients were divided into 4 groups: finasteride group, alpha-receptor inhibitor group, finasteride and alpha-receptor inhibitor combination group and control group (untreated group). We gathered pathology sections of patients in all groups, and gave Gleason Score to each. The difference of incidence and pathology grading of prostate cancer were analyzed by Stata 7.0. RESULTS: The incidence of prostate cancer in the population of our study was 13.5%; The incidence in finasteride group, alpha-receptor inhibitor group, combination group and control group was 9.8%, 16.0%, 10.3% and 18.6%, respectively. There was significant difference between the two groups with the use of finasteride and the two groups without it (P < 0.05). In our study, the ratio of middle or high level pathology grading (Gleason ≥ 7) in prostate cancer patients was 58.3%, the ratio of middle or high level pathology grading prostate cancer patients in the four groups was 71.4%, 59.6%, 67.7% and 40.0%, respectively. In the comparison of composition ratio of middle or high level prostate cancer, there was significant difference between the two groups with the use of finasteride and the two groups without it (P < 0.05). CONCLUSIONS: Finasteride can lower the risk of prostate cancer, but increase the pathology grade of the prostate cancer which has occurred in the same time. The alpha-receptor inhibitor does not have the same effect.


Assuntos
Antagonistas Adrenérgicos alfa/uso terapêutico , Finasterida/uso terapêutico , Neoplasias da Próstata/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Hiperplasia Prostática/tratamento farmacológico , Neoplasias da Próstata/patologia , Estudos Retrospectivos
14.
Zhonghua Wai Ke Za Zhi ; 47(16): 1242-4, 2009 Aug 15.
Artigo em Chinês | MEDLINE | ID: mdl-19781173

RESUMO

OBJECTIVE: To present the technique and experience of robotic-assisted laparoscopic radical cystectomy (RARC) by da Vinci surgical system. METHODS: From December 2007 to September 2008, 4 patients underwent RARC and urinary diversion. The age of patients was 44 to 63 years old. The body mass index was 22.8 to 27.7. All their clinical stages were lower than T2N0M0. The technique for RARC involving ureters dissection, posterior dissection, lateral pedicle control, anterior dissection, dorsal vein complex control, neurovascular bundles sparing, lymphadenectomy, ureter-ileal anastomosis, urethra-neobladder anastomosis to either ileal conduit urinary diversion or neobladder reconstruction performed extracorporeally. RESULTS: All the operations were accomplished successfully. The urinary diversion of 2 case was ileal conduit and others was ileal orthophoria neobladder. The operation time was 300 to 450 min. The time of radical cystectomy was 150 to 180 min. The estimated blood loss was 100 to 500 ml. The postoperative hospital stay was 9 to 35 d. The bed rest time was 4 to 9 d. There was 1 patients who had incomplete intestinal obstruction at 8th postoperative day cured by conservative therapy. The patients were followed up for 3 to 12 months, all patients survived without tumor recurrence. The patients have satisfied urinary continence and normal renal functions without hydronephrosis after the operation. CONCLUSIONS: RARC is small incision and safe, the results are definite. It is one of the direction of minimally invasive urologic surgery.


Assuntos
Cistectomia/métodos , Laparoscopia/métodos , Robótica , Derivação Urinária/métodos , Adulto , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
15.
J Endourol ; 22(8): 1705-8, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18620499

RESUMO

PURPOSE: To evaluate a fast method to identify renal vessels during retroperitoneal laparoscopic nephrectomy. METHODS: One hundred fifty retroperitoneal laparoscopic nephrectomies were performed from October 2003 to June 2006. The renal arteries were identified by following five steps: location, pulling, apophysis, pulsation,and fibrin. Then the renal arteries were severed or ligatured with a linear cutter or Hem-o-lok clips. The renal veins were exposed by dissecting toward the abdominal side under the renal arteries. The management for the renal veins was the same with that of the renal arteries. The fast method to identify the renal vessels during retroperitoneal laparoscopic nephrectomy were evaluated. RESULTS: All 150 procedures were successfully completed, and the renal vessels could be identified in short time. The average time to operation was 90 min (range 45-120 min) with average blood loss of 105 mL (range 10-510 mL). The average specimen weight was 494 g (range 140-890 g). Intake of usual diet and walking were allowed within 3 days for all patients. Drains were removed within 2-4 postoperative days. No patient was converted into an open surgery and blood transfusion. Minor complications were found in 12 cases (8%), and no severe complication occurred in any of the 150 cases. The median time to hospitalization was 6.3 days. Following the five steps, the renal vessels could be identified quickly and easily. The duration of the operations, the risk of conversion to the open surgery, and the vessel injury were decreased. CONCLUSIONS: Renal vessels could be identified quickly by the following the five steps during retroperitoneal laparoscopic nephrectomy: location, pulling, apophysis, pulsation, and fibrin. It proved to be a useful method suitable for clinic application.


Assuntos
Laparoscopia/métodos , Nefrectomia/métodos , Artéria Renal/cirurgia , Veias Renais/cirurgia , Espaço Retroperitoneal/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
16.
Zhonghua Yi Xue Za Zhi ; 87(24): 1693-4, 2007 Jun 26.
Artigo em Chinês | MEDLINE | ID: mdl-17825151

RESUMO

OBJECTIVE: To assess the value of acellular dermal matrix allograft (ADMA) in surgical treatment of vesico-vaginal fistula (VVF) and anterior urethral stricture. METHODS: Four patients suffering from vesico-vaginal fistula and 5 cases with long anterior urethral stricture received surgical treatment in which ADMA were applied. In the VVF patients the ADMA inserted between the vagina and the bladder during transabdominal extraperitoneal repair. In the patients with anterior urethral stricture the ADMA was sutured to substitute the urethra after resection of the stenosis segment. RESULTS: No intraoperative or postoperative complications occurred. Immediate stoppage of urine leakage from the vagina was seen in the 4 VVF patients, and no recurrence was found during the follow-up of 4 - 12 months. Satisfactory voiding was achieved immediately after removing the catheter in 3 of the 5 cases of urethral stricture, although 2 of the 5 needed urethral sounding for about 2 months. Three months postoperatively all patients were voiding well and their urine flow rates were all normal. Urethrography revealed excellent caliber of the reconstructed urethra. CONCLUSION: In plastic surgery of lower urinary tract such as for VVF and urethra stricture, the ADMA may serve as an ideal replacement material for autologous tissue. Its usage avoids the need to harvest autologous tissue, thus providing a novel, safe, effective, microinvasive and economic method in urologic plastic surgery.


Assuntos
Derme/transplante , Transplante de Pele/métodos , Estreitamento Uretral/cirurgia , Fístula Vesicovaginal/cirurgia , Adulto , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Transplante Homólogo , Resultado do Tratamento , Procedimentos Cirúrgicos Urológicos/métodos
17.
J Endourol ; 21(12): 1505-8, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18186692

RESUMO

PURPOSE: To present our preliminary experience with laparoscopic ureter reimplantation for distal ureteral stricture without an everted ureteral nipple or submucosal tunneling, and to evaluate its clinical feasibility, safety, and validity. PATIENTS AND METHODS: Six patients with distal ureteral stricture underwent transperitoneal laparoscopic ureteral reimplantation. The ureter was reimplanted into the bladder without everting the ureter or tunneling construction. The seromuscular wall of the ureter was anastomosed circumferentially to the detrusor muscle using continuous absorbable sutures. RESULTS: All patients had no intraoperative complications or need for open conversion. Intravenous urography 3 months later showed normal drainage without obstruction or reflux. In three patients, hydronephrosis was not revealed by ultrasonography 6 months later. CONCLUSIONS: Laparoscopic noneverted ureteral reimplantation is technically simple, reliable, effective, and feasible.


Assuntos
Cistostomia/métodos , Laparoscopia/métodos , Ureter/cirurgia , Obstrução Ureteral/cirurgia , Bexiga Urinária/cirurgia , Adulto , Idoso , Anastomose Cirúrgica/métodos , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Reimplante/métodos , Estudos Retrospectivos , Resultado do Tratamento , Obstrução Ureteral/diagnóstico por imagem , Urografia
18.
Zhonghua Wai Ke Za Zhi ; 41(7): 530-3, 2003 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-12921662

RESUMO

OBJECTIVE: To summarize the experience in the diagnosis and treatment of non-epithelial tissue tumor of urinary bladder. METHODS: >From 1953 to April 2002, a total of 28 patients with non-epithelial tissue tumor in 3 925 bladder tumor cases were analyzed. RESULTS: Painless gross hematuria, pelvic mass, urinary frequency and dysuria are symptoms of non-epithelial bladder tumor. Ultrasonic examination, computed tomography (CT) scan, cystoscopy and biopsy is used for diagnosis of the tumor. Seventeen of 28 patients (61.7%) were malignant neoplasms in 7 kinds of pathologic types, which was small cell carcinoma (5 cases), rhabdomyosarcoma (4 cases), leiomyosarcoma (4 cases), lymphoma (1 case), malignant fibrous histiocytoma (1 case), liposarcoma(1 case), melanoma (1 case) respectively. Eleven of 28 patients (39.3%) were benign tumors with 4 kinds of histologic types including 2 cases of cavernous hemangioma, 1 case of fibroma, 1 case of leiomyoma, 7 cases of pheochromocytoma. All benign tumor patients were treated with partial cystectomy, transurethral bladder tumor resect (TURBT) and fulguration. In 17 malignant neoplasms patients, 7 of them received partial cystectomy, 9 received radical cystectomy, and 1 patient's tumor was unresectable. Those malignant bladder tumor patient are followed up, but 3 years survival rates is only 8/17. CONCLUSIONS: Non-epithelial tissue tumor of the urinary bladder is rare with complicated pathologic types. Malignant neoplasms are more than benign tumors with very poor prognosis, benign tumors' prognosis is good. Diagnosis rate which was confirmed before operation is low. Dip biopsy under cystoscopy may enhance the diagnosis rate. Surgical treatment is the main therapy for non-epithelial tissue tumor of the urinary bladder. Because of the aggressive biologic behavior of malignant tumors, they should be identified promptly and treated appropriately. According to the histologic appearance radiotherapy and chemotherapy is mandatory in some cases.


Assuntos
Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/cirurgia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Cistectomia/métodos , Cistoscopia , Feminino , Seguimentos , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Resultado do Tratamento , Bexiga Urinária/patologia , Bexiga Urinária/cirurgia , Adulto Jovem
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