Adult ; Aged ; Carcinoma, Renal Cell ; diagnosis ; surgery ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; diagnosis ; surgery ; Male ; Middle Aged ; Nephrectomy ; methods ; Treatment Outcome

Acupuncture Therapy ; Adult ; Anal Canal ; surgery ; Anus Diseases ; surgery ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Postoperative Complications ; therapy

Objective Observe the results and reality of the peripheral nerve stimulator in the obtu- rator nerve block in TURBt.Methods 18 cases received the peripheral nerve stimulator in obturator nerve block before TURBt.Results In 17cases obturator nerve reflection vanished;lcase had a little symptom of adductor spasm.Conclusion Obturator nerve block with the help of the nerve stimulator can increase the achievement and quality of obturator nerve block and avoid some complications caused by obturator nerve re- flection in TURBt,such as perforation of bladder and injury of nerve and vessel.

Objective To evaluate the security and effect of combination of adjuvant hormonal thera- py and brachytherapy for localized prostate cancer.Methods 22 patients with T1-T2c prostate cancer were treated with transperineal ultrasound-guide 125I seeds prostate implantation and adjuvant hormonal therapy for 4～7 months.The hormonal therapy include 2-4 months before brachytherapy and 1～4 months after brachytherapy.Results The median operation time was ninety minutes,the median number of ~(125)I seeds used was 56.The follow up time was 12～48 months,the cases of PSA

Objective To elucidate the possible role of p53-p21waf1 pathway for centrosome amplification in oral squamous cell carcinoma ( OSCC ) . Methods Formalin-fixed, paraffin-embedded tissues of 8 cases of normal oral epithelium tissues and 27 cases of OSCC tissues were examined for the expression of p21waf1 and mutated p53 proteins by flowcytometry and immunohistochemistry, and centrosome status was investigated by indirect immunofluorescence double staining with antibodies to centrosome protein gamma-tubulin and cytokeratin. The correlation between p21waf1, p53 and centrosome amplification in OSCC was statistically analyzed by SPSS 12.0. Results All normal oral epithelium tissues showed normal centrosomes( 1-2 centrosomes per cell) in epithelium cells, while 21 out of 27 cases(78%) of OSCC showed the evidence of centrosome amplification characterized by supernumerary centrosomes (＞2 centrosomes per cell) in a fraction of tumor cells. The quantity of p21waf1 protein was lower in OSCC with centrosome amplification [(0. 878±0. 081 )] than that in OSCC without centrosome amplification [ (0. 952±0. 018 ) ,t =3.838,P<0.01] , and negative correlations were found between the quantity of p21waf1 protein and the degree of centrosome amplification ( r = - 0.472, P＜0. 05) , as well as the positive staining of p53 ( r =-0.491 ,P＜0. 01). Conclusions p53-p21waf1 pathway might involve in centrosome duplication cycle in OSCC. Down-regulated p21waf1 protein, via p53 transactivation-dependent mechanism, was likely a contributing factor towards centrosome amplification in OSCC.

OBJECTIVETo present one cases of the use of balloon catheter in surgical treatment of renal angiomyolipoma involving the renal vein and vena cava as a tumor thrombus and review literatures.

METHODSAbdominal ultrasound and CT and MRI demonstrated a large right renal mass with tumor thrombus in the inferior vena cava. Right nephrectomy and en-bloc removal of the intra caval tumor thrombus were performed. A balloon catheter was used to block vena cava under the level of liver vena during the operation.

RESULTSThe pathological diagnosis was angiomyolipoma. The length of the tumor thrombus was 6.5 cm. The patient recovered well 1 year after surgery.

CONCLUSIONRenal angiomyolipoma with a tumor thrombus should be paid more attention.

Adult ; Angiomyolipoma ; complications ; surgery ; Balloon Occlusion ; Embolectomy ; methods ; Embolism ; etiology ; surgery ; Female ; Humans ; Kidney Neoplasms ; complications ; surgery ; Liver ; blood supply ; pathology ; surgery ; Nephrectomy ; Vena Cava, Inferior

OBJECTIVETo analyze the clinical characteristics of 2 microm continuous wave laser vaporization resection for the treatment of bladder tumors.

METHODSA total of 56 patients with 68 bladder tumors underwent 2 microm laser vaporization resection via a transurethral cystoscope under caudal anesthesia. In the operation, the wall of the urinary bladder was vaporized and cut, the muscular layers were removed, and then the specimens were sent for pathological inspection separately. The following variables were recorded: operation time, blood loss, complications during and after the operation, pathology staging of the tumors, and follow-up visit time.

RESULTSAll patients endured the operation. The mean surgery time was 8.8 +/- 3.3 minutes (range, 4 to 15 minutes). Blood loss was minimal, no patient experienced an obturator nerve reflection, or a hemorrhage after the operation. The pathology staging of the tumors were as follows: 40 cases (total 47 tumors) were T1 stage; 16 cases (total 21 tumors) were T2 stage. The follow-up periods were between 12 to 17 months, and the mean period was 14.5 months. Tumor recurrences were found in 3 cases, and one patients suffered two recurrences, the total recurrence rate was 5.3%. There was no primary recurrence.

CONCLUSIONSThe 2 microm continuous wave laser is a new, safe and efficacious method for the treatment of bladder tumors. Because the 2 microm laser can vaporize and cut the muscular layers of the bladder finely, it can not only treat superficial bladder tumors efficiently, but also treat some types of invasive tumors of the bladder.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cystoscopy ; Female ; Follow-Up Studies ; Humans ; Laser Therapy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Urinary Bladder ; surgery ; Urinary Bladder Neoplasms ; surgery

OBJECTIVETo summarize and analyze the clinical features of bladder tumor patients who received transurethral partial cystectomy by 2 microm continuous wave laser, in 1 year post operation follow-up visits.

METHODSFrom December 2007 to May 2008, 47 bladder carcinoma patients were treated with 2 microm laser transurethrally under sacral block. Operation characteristics, operation time, intraoperative hemorrhages and postoperative complications, and pathology staging of the tumor were observed and postoperative follow-up visits were performed.

RESULTSAll of the operation procedures were successful. The surgery time was 5 to 15 minutes. Blood loss in the operation was minimal. There was no obturator nerve reflection, and no hemorrhaging was detected after the operation. The pathological stages can be judged correctly with the obtained specimens. There was one case with peritoneum perforation. The patients received 12 to 17 months of postoperative follow-up visits, and there was no recurrence at the resection site. The survival rate was 100%.

CONCLUSIONSTransurethral partial cystectomy in the treatment of bladder tumor by 2 microm continuous wave laser is a safe, efficient and effective method. The tumor and all the basal part of bladder wall could be excised completely and the pathological stages can be judged correctly using these specimens to fulfill partial cystectomy for the treatment of bladder carcinoma.

Adult ; Aged ; Aged, 80 and over ; Cystectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Laser Therapy ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Urinary Bladder Neoplasms ; surgery

OBJECTIVESTo observe the vaporesection efficiency of the 2 micron laser to the prostatic gland in benign prostatic hyperplasia, and investigate the method of estimating the amount of the vaporesected prostatic tissues during transurethral vaporesection of the prostate using the 2 micron laser system in the treatment of benign prostatic hyperplasia.

METHODSTotal 9 fresh prostatic gland specimens were obtained from patients with BPH under open surgical procedures, and vaporesected under a simulated transurethral environment with the 2 micron laser system immediately after weighted. Energies and time consumptions were noted, collections of vaporesected tissue specimens and the remnants of the prostatic glands were weighted after the procedures. The ratios of the vaporized tissues and the collected tissues to the whole vaporesected tissues were calculated respectively. The vaporesection efficiency of the 2 micron laser to the prostatic tissues was also calculated.

RESULTSAmong the total lost tissues, about (65.6 +/- 1.5) percent of which were that of vaporized, and nearly (34.5 +/- 1.5) percent were resected. Linear correlation between the weight of collected prostatic tissue(x) and the weight of prostatic gland specimens(y) could be defined as a formula of [y = 3.245x - 6.475 (t = 15.097, P = 0.000)].

CONCLUSIONThe amounts of the whole prostatic tissues removed by the 2 micron laser could be calculated from the collected resected prostatic specimens under a simulated transurethral surgical procedure.

Humans ; In Vitro Techniques ; Laser Therapy ; methods ; Lasers ; Male ; Prostate ; surgery ; Prostatic Hyperplasia ; surgery ; Transurethral Resection of Prostate ; methods

OBJECTIVETo summarize the 5-year follow-up to 2 micron continuous wave laser vaporesection for the treatment of patients with low urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), and evaluate the safety and clinical effects of the treatment.

METHODSFrom October 2006 to September 2007, 236 cases with low urinary tract symptom secondary to BPH were treated transurethrally under epidural or general anesthesia using the 70 Watt 2 micron laser system. Vaporesection of the prostate was performed with the traditional "U" or the "dividing" method. The 210 cases who met the inclusion criteria in this study were selected for further observation. Baseline and perioperative data were recorded and evaluated in resection time, transfusion rate, catheter-time, improvements in maximal urinary flow rate (Qmax), international prostate symptom scores (IPSS), quality of life (QoL), and post voiding residual volume (PVR).

RESULTSOut of the 210 cases, 179 cases were followed up to 5 years finally. All the surgical procedures were successfully conducted under epidural or general anesthesia. Mean operation time was (80 ± 22) minutes, and mean retrieved prostatic tissue was (24.9 ± 4.2) g. Resected prostatic tissues could be easily flashed out of the bladder. There were no significant differences in serum sodium concentrations and hemoglobin levels before and after the surgery. Mean catheter time and hospital stay was (114 ± 35) hours and (5.7 ± 1.9) days respectively. Only one postoperative secondary hemorrhage was found and treated with blood transfusion. During the 5-year follow-up, Qmax increased from (8.6 ± 3.5) ml/s preoperatively to (23.6 ± 4.2) ml/s by the end of the follow-up (P < 0.01), IPSS and QoL-Score improved from 25.3 ± 5.2 and 4.1 ± 1.3 to 6.1 ± 3.0 and 1.4 ± 0.8 respectively (P < 0.01), and PVR decreased from (248 ± 89) ml to (15 ± 13) ml. The 3 patients developed urinary incontinence and recovered 3 months later through functional exercises with the help of acupuncture. Five patients were found to have urethral stricture 3 months after the surgery and recovered with the treatment of urethral dilatation (3 cases) or internal urethrotomy (2 cases) respectively.

CONCLUSIONSTransurethral vaporesection of prostate using the 2 micron continuous wave laser system is a safe and effective treatment for benign prostatic hyperplasia with obvious improvements in subjective and objective voiding parameters, which were evident at 3 months after the surgery and were sustained throughout the 5-year long-term follow-up.

Aged ; Aged, 80 and over ; Follow-Up Studies ; Humans ; Laser Therapy ; Male ; Middle Aged ; Postoperative Complications ; Prostatic Hyperplasia ; surgery ; Transurethral Resection of Prostate ; methods