OBJECTIVE: To identify the factors to transurethral resection of prostate (TURP) perioperative hypotension. METHODS: The study group included 130 patients undergoing TURP. The control group included 50 patients who had suprapubic prostatectomy. Absorption of irrigation fluid was measured by determining the serum gentamycin level. Blood loss of PURP patients was calculated as the product of the irrigation fluid volume and hemoglobin concentration (determined with a photometer) divided by the preopreative blood hemoglobin concentration. Body temperature was recorded using a rectal probe. Serum electrolytes were determined pre-and postop. RESULTS: The blood loss in study group (380.2+/-98.3)ml was significantly less than in the control group (460.1+/-52.5)ml, P<0.05. However, the incidence of hypotension was significantly higher than the control group 28%, 8%), P<0.01. Factors associated with TURP hypotension included volume of irrigation fluid absorption, blood loss, reduction in core temperature, decrease of serum sodium, operating time, prostate weight and volume and history of cardiovascular disease. After Logistic regression analysis, the most significant factors were excessive absorption of irrigation fluid and rapid central cooling. CONCLUSION: In our study TURP hypotension most closely correlated with volume of irrigation fluid absorbed and reduction in core temperature.

OBJECTIVETo evaluate the effect of pretreatment with finasteride in decreasing intraoperative bleeding and irrigating fluid absorption during transurethral resection of prostate (TURP).

METHODSEighty patients with benign prostate hypertrophy undergoing TURP were divided into two groups: 40 patients were pretreated with finasteride for 7 to 14 days before TURP and 40 patients without pretreatment. Absorption of irrigating fluid was quantified by analyzing the serum concentration of gentamycin. Intraoperative blood loss was calculated based on hemoglobin concentrations before and after operation.

RESULTThe whole blood loss, hemoglobin concentration of irrigating fluid used, blood loss per minute, blood loss per gram tissue resected, whole irrigation absorption, irrigation absorption per minute and per gram tissue resected in patients pretreated with finasteride were significantly less than those in patients without pretreatment (P<0.05). The blood transfusion volume, the incidence of hypotension and hyponatremia in patients pretreated with finasteride were significantly less than those in patients without pretreatment (P<0.05).

CONCLUSIONPretreatment with finasteride is of value in reducing intraoperative bleeding, irrigation absorption and perioperative complication during TURP.

Absorption ; Aged ; Blood Loss, Surgical ; prevention & control ; Finasteride ; therapeutic use ; Humans ; Intraoperative Complications ; prevention & control ; Male ; Middle Aged ; Prostatic Hyperplasia ; surgery ; Therapeutic Irrigation ; Transurethral Resection of Prostate

Adolescent ; Adrenalectomy ; adverse effects ; methods ; Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Laparoscopy ; adverse effects ; methods ; Male ; Middle Aged

OBJECTIVETo investigate the transvesical approach to the surgical treatment of seminal vesicle mass.

METHODSTransvesical removal of seminal vesicle mass was performed for 5 patients aged 45-69 (mean 51) years. The clinical symptoms included those involving the lower urinary tract such as frequent micturition and urgency in 3 cases (1 accompanied with dyschezia), hematospermia in 1, and lower abdominal and perineal malaise in the other. Two masses were in the left side and the other 3 in the right, ranging from 3 to 10 cm (mean 5 cm) in size, detected by transrectal ultrasonography, CT, MRI or digital rectal examination. The mean course of disease was 9 (2-18) months.

RESULTSAll the 5 patients were treated successfully and uneventfully, with a mean operation time of 75 minutes, a mean blood loss of 140 ml and a mean hospital stay of 10 days. Pathological examinations revealed 2 cases of seminal vesicle cyst with infection, 1 cystadenoma, 1 phyllode tumor and 1 prostatic hyperplasia. A 3-72 months follow-up showed that all the patients were free of symptoms and had normal sexual function.

CONCLUSIONTransvesical removal of seminal vesicle mass, with small incisal opening, good visual field and easy operation, is an effective surgical procedure for seminal vesicle disease.

Aged ; Follow-Up Studies ; Genital Diseases, Male ; surgery ; Humans ; Male ; Middle Aged ; Seminal Vesicles ; surgery ; Treatment Outcome ; Urinary Bladder ; surgery

OBJECTIVETo seek a safe, efficient, and cost-effective technique for local thermo-ablation of hepatic cancer.

METHODSThe livers from 16 healthy rabbits were thermocoagulated by diode-laser with scanner fiber tip, 6 w for 10 mins. At the same time, the temperatures were measured at 0, 5 and 10 mm from laser tip. The pre-thermocoagulative liver function was compared with that of 7 days post-thermocoagulation. The pathologic changes were also observed 1 month after laser thermocoagulation.

RESULTSAll the rabbits survived and hepatic tissue temperatures at 0, 5, 10 mm from laser tip reached 96.39 degrees C +/- 3.97 degrees C, 60.79 degrees C +/- 6.21 degrees C, 46.10 degrees C +/- 4.58 degrees C respectively after 10 minutes of thermocoagulation. There were no significant differences in liver function parameters between rabbits of pre-laser thermocoagulation and of post-laser thermocoagulation. Thermocoagulated necrosis of liver tissue with surrounding fibrosis in a diameter of 26.0 mm was formed. Light microscopy revealed coagulative necrosis in the center of the coagulated area without surviving hepatic cells.

CONCLUSIONThe hepatic tissue can be coagulated safely and effectively by diode-laser with scanner fibertip, and such a technique may provide a new method for the treatment of hepatic carcinoma.

Animals ; Female ; Laser Coagulation ; methods ; Liver Neoplasms ; pathology ; surgery ; Male ; Rabbits

OBJECTIVESTo discuss the surgical method of benign prostatic hyperplasia (BPH) with inguinal hernia.

METHODSTwenty eight cases of BPH with inguinal hernia were treated with transurethral resection of the prostate (TURP) combined with repair of inguinal hernia by PPM at the same time.

RESULTSAll patients had been followed up for six months to four years, in which recurrence of hernia or other complications were not found. Qmax was more than 15 ml/s after operations, and IPSS were about 0-7 scores for all patients. The mean time of hospitalization was 4.2 days.

CONCLUSIONSTURP combined with repair of inguinal hernia at the same time is a simple and effective method, which can avoid second operation, and it is more significance to the aged especially.

Aged ; Aged, 80 and over ; Follow-Up Studies ; Hernia, Inguinal ; complications ; surgery ; Humans ; Male ; Middle Aged ; Prostatic Hyperplasia ; complications ; surgery ; Treatment Outcome

OBJECTIVETo discuss the effect of Taohong Siwu Decoction (TSD) in regulating functions of endothelial cells and treating arteriosclerosis obliterans (ASO).

METHODSThe ASO model was prepared by using high-fat diet plus intimal injury. They were randomly divided into the model group (n = 10), the normal control group (n = 9), the low dose TSD group (group A, n = 12), the middle dose TSD group (group B, n = 10), and the high dose TSD group (group C, n = 9). Eight weeks after modeling, the limb blood perfusion was observed using laser Doppler flowmetry. The arterial morphology was observed using light microscope and transmission electron microscope. The number of circulating endothelial cells (CECs) was determined using Percoll density gradient centrifugation method. Serum levels of TNF-alpha, IL-1, ET-1, and NO were detected using double antibody sandwich assay of enzyme linked immunosorbent assay (ELISA).

RESULTSThe ASO rat model was successfully established. Blood lipids levels significantly increased, the blood perfusion of left hind limbs significantly decreased, the number of CECs in the peripheral blood significantly increased, the arterial lumen was irregularly narrowed, the ultra-structure of vessel walls was damaged, serum levels of TNF-alpha, IL-1, and ET-1 significantly increased, and the serum level of NO significantly decreased in the model group, showing statistical difference when compared with the normal control group (P < 0.01). Compared with the model group, significant improvement in the aforesaid indices was shown in group B and C (P < 0.05, P < 0.01).

CONCLUSIONSThe injury and abnormal functions of endothelial cells is an important pathological process of ASO. As an effective recipe for treating ASO, TSD could protect vascular endothelial cells and improve the secretion function of vascular endothelial cells.

Animals ; Arteriosclerosis Obliterans ; blood ; drug therapy ; Diet, High-Fat ; adverse effects ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Endothelial Cells ; metabolism ; Endothelin-1 ; blood ; Endothelium, Vascular ; cytology ; Interleukin-1 ; blood ; Male ; Nitric Oxide ; blood ; Rats ; Rats, Wistar ; Tumor Necrosis Factor-alpha ; blood

Objective: To examine the safety and feasibility of gasless submental-transoral combined appoach endoscopic thyroidectomy for papillary thyroid carcinoma (PTC). Methods: A retrospective analysis of the clinical data of 41 patients with PTC who underwent the gasless submental-transoral combined appoach endoscopic thyroidectomy at the Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from November 2020 to April 2021. There were 5 males and 36 females with the age of (35.0±8.7) years (range: 19 to 58 years). A horizontal incision with a length of 2.0 cm is made under the chin as an observation hole, a 10 mm Trocar and a self-developed retractor are inserted, and two 5 mm longitudinal incisions are made on the labial side in the vestibule of the oral cavity as an operation hole, each inserting a 5 mm Trocar, the operation direction is from the cranial side to the caudal side. The sensation of the lower lip and chin was measured on the first day and one month postoperative. The operation time, hospital stay, the number of lymph nodes dissected and postoperative complications were recorded. Results: Surgical procedures in all cases were successfully completed under endoscopic approach without transfering to open surgery. The operation time was (99±34) minutes (range: 50 to 180 minutes) and the postoperative hospital stay was (3.4±2.2) days (range: 2 to 16 days). The maximum diameter of PTC was (7.6±5.8) mm (range: 2 to 30 mm), and the number of lymph nodes of the central compartment dissection was 6(5) (M(IQR)) (range: 1 to 25). The duration of follow-up is 1 month after operation, and the follow-up method is adopted in outpatient clinic. Postoperation complications included 2 cases of transient hypoparathyroidism, One case of recurrent laryngeal nerve injury (continue to follow up to assess whether it is a temporary injury). Postoperative minor chyle leak, seroma, and local redness and swelling in 1 case each were cured after conservative treatment. 1 case of transient minor numbness of the lower lip was observed. No permanent hypoparathyroidism, postoperative bleeding and numbness of the chin was observed. Conclusion: The gasless submental-transoral combined appoach endoscopic thyroidectomy is a feasible approach in selected PTC patients and has clinical application value.
Adult ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Neck Dissection ; Retrospective Studies ; Thyroid Cancer, Papillary/surgery* ; Thyroid Neoplasms/surgery* ; Thyroidectomy ; Young Adult

The standard first-line treatment of castration-resistant prostate cancer (CRPC) is docetaxel-based chemotherapy. However, CRPC may not respond to docetaxel due to drug resistance or other causes. Several new therapeutic agents have been developed, some of which are approved by FDA or on clinical trials. The mechanisms of action of these agents include stabilizing microtubules, inhibiting hormone synthesis, blocking androgen receptor, bone targeting or immune regulation. In this article we review the novel therapeutic options for CPRC after docetaxel failure.
Bone Neoplasms ; drug therapy ; secondary ; Drug Resistance, Neoplasm ; Humans ; Male ; Prostatic Neoplasms, Castration-Resistant ; drug therapy ; pathology ; Taxoids ; therapeutic use

Objective: To examine the feasibility of the modified gasless trans-subclavian approach endoscopic thyroidectomy for lateral neck dissection (LND) in papillary thyroid carcinoma (PTC). Methods: The clinical data of 31 patients with PTC who underwent modified gasless trans-subclavian approach endoscopic LND in the Department of Head and Neck Surgery, Run Run Shaw Hospital, from January to October 2022 were retrospectively analyzed. There were 2 males and 29 females, aged (32.6±8.3) years (range: 17 to 55 years). The maximum diameter of the primary thyroid lesion (M(IQR)) was 1.06 (1.16) cm (range: 0.53 to 2.44 cm), and the maximum diameter of the metastatic lymph node was (1.04±0.37) cm (range: 0.44 to 1.88 cm). Operation time, postoperative hospital stay, number of lymph nodes dissected, and postoperative complications were recorded. Outpatient follow-up was conducted until November 30, 2022. Results: All operations were successfully completed with the endoscopy approach without conversion to open surgery. The operation time was 160 (20) minutes (range: 100 to 215 minutes), and the postoperative hospital stay was 4 (2) days (range: 2 to 14 days). The number of lymph nodes obtained by dissection in the central and lateral compartment of the neck was 11 (12) (range: 0 to 37) and 34.7±14.8 (range: 15 to 69), respectively. Temporary hypoparathyroidism occurred in 4 cases and all recovered within 1 month after the operation. One case suffered from recurrent laryngeal nerve injury (continuing followed up to assess whether it is a temporary injury). The complication of LND included 1 case of chylous leakage that was recovered with conservative treatment, 1 case of Horner syndrome returned to normal 3 months after surgery. During follow-up, there was no residual tumor or recurrence. Conclusion: The modified gasless trans-subclavian approach endoscopic LND for PTC is feasible, with a thorough dissection and concealed incision.