Humans ; Kidney Neoplasms/surgery* ; Laparoscopy ; Nephrectomy ; Retroperitoneal Space/surgery*

OBJECTIVETo report our experiences in retroperitoneoscopic renal pedicle lymphatic stripping for chyluria.

METHODSSix cases of filarial chyluria were admitted to our hospital from November 2001 to June 2002. Of these cases, 4 were men and 2 women, with age ranging from 34 to 52 years (mean, 42 years). Diagnosis was made by using urine test for the presence of chyle and fat globule, cystoscopy, excretory urogram and retrograde pyelography. Chyluria was found on the left renal unit in 2 cases and on the right side in 4 cases. The technique of retroperitoneoscopic management of chyluria consisted of nephrolympholysis, hilar vessel stripping and ureterolympholysis.

RESULTSOperative time ranged from 69 to 120 minutes (mean, 95 minutes). Intraoperative blood loss was 50-180 ml (mean, 85 ml). Chyluria disappeared in all patients immediately after operation. Mild hematuria occurred in 4 cases within 12 hours and disappeared at 24 hours. Subcutaneous emphysema around the lesions was found in 2 cases and was spontaneously absorbed 3 days after the treatment. There was no lymphatic leak at the lesions. The patients were discharged from the hospital 5-9 days after the treatment. All patients gained weight and their haemoglobin and serum protein increased by 13.5 g/L and 3.66 g/L respectively. No chyluria recurrence was reported during 1-1.6 years follow-up.

CONCLUSIONSRetroperitoneoscopic renal pedicle lymphatic disconnection for chyluria is a safe, effective and efficient surgical procedure with minimal invasion, less pain, lower morbidity, short hospital stay and rapid recovery.

Adult ; Chyle ; Endoscopy ; Humans ; Lymphatic Diseases ; surgery ; Lymphatic System ; surgery ; Male ; Middle Aged ; Retroperitoneal Space ; Urine

Adult ; Anemia, Hemolytic, Autoimmune ; complications ; Castleman Disease ; diagnosis ; surgery ; Female ; Humans ; Laparoscopy ; Retroperitoneal Space ; pathology ; surgery

The authors describe a case in which a tailgut cyst occurred at an unusual location in a 22-year-old woman referred for abdominal discomfort and urinary frequency. The left abdomen contained a palpable mass, found at imaging studies to be a homogeneous, unilocular and cystic, and anterior to the left kidney. After surgical excision, it was shown to be a tailgut cyst.
Adult ; Case Report ; Female ; Hamartoma/*radiography/surgery ; Human ; Kidney Diseases/*radiography/surgery ; Retroperitoneal Space

Adult ; Humans ; Kidney Neoplasms ; surgery ; Laparoscopy ; methods ; Male ; Nephrectomy ; methods ; Retroperitoneal Space ; surgery

Clinical features of 1 case of retroperitoneal parasitic fetus (PF) were retrospectively analyzed and Chinese literatures were reviewed. PF in China has 4 clinical features: 1) The incidence was extremely low and it was more common in infants and children. 2) The parasitic parts showed centrality. 3) The retroperitoneum and abdominal cavity were the most common parasite locations. 4) There was no gender difference in the incidence. Retroperitoneal PF should be distinguished from various benign and malignant abdominal tumors. Imaging was the optimal option for PF diagnosis and the axis bone system was its typical manifestation. Complete excision was the optimal treatment. Thick and large nutrient vessels may be found at where the placenta was attached, and should be ligated carefully. The outcome of this case was good because PF was completely excised.
Child, Preschool ; Congenital Abnormalities ; surgery ; Fetus ; abnormalities ; Humans ; Male ; Retroperitoneal Space ; surgery

BACKGROUND: The optimal treatment for large impacted proximal ureteral stones remains controversial. The aim of this study was to evaluate the efficacy, safety, and potential complications of mini-percutaneous nephrolithotomy (MPCNL) and retroperitoneal laparoscopic ureterolithotomy (RPLU) in the treatment of impacted proximal ureteral stones with size greater than 15 mm. METHODS: A total of 268 patients with impacted proximal ureteral stones greater than 15 mm who received MPCNL or RPLU procedures were enrolled consecutively between January 2014 and January 2019. Data on surgical outcomes and complications were collected and analyzed. RESULTS: Demographic and ureteral stone characteristics found between these two groups were not significantly different. The surgical success rate (139/142, 97.9% vs. 121/126, 96.0%, P = 0.595) and stone-free rate after 1 month (139/142, 97.9% vs. 119/126, 94.4%, P = 0.245) of RPLU group were marginally higher than that of the MPCNL group, but there was no significant difference. There was no significant difference in the drop of hemoglobin between the two groups (0.8 ± 0.6 vs. 0.4 ± 0. 2 g/dL, P = 0.621). The mean operative time (68.2 ± 12.5 vs. 87.2 ± 16.8 min, P = 0.041), post-operative analgesics usage (2/121, 1.7% vs. 13/139, 9.4%, P = 0.017), length of hospital stay after surgery (2.2 ± 0.6 vs. 4.8 ± 0.9 days, P < 0.001), double J stent time (3.2 ± 0.5 vs. 3.9 ± 0.8 days, P = 0.027), time of catheterization (1.1 ± 0.3 vs. 3.5 ± 0.5 days, P < 0.001), and time of drainage tube (2.3 ± 0.3 vs. 4.6 ± 0.6 days, P < 0.001) of MPCNL group were significantly shorter than that of the RPLU group. The complication rate was similar between the two groups (20/121, 16.5% vs. 31/139, 22.3%, P = 0.242). CONCLUSIONS MPCNL and RPLU have similar surgical success and stone clearance in treating impacted proximal ureteral stones greater than 15 mm, while patients undergoing MPCNL had a lower post-operative pain rate and a faster recovery.
Humans ; Laparoscopy ; Length of Stay ; Nephrolithotomy, Percutaneous/adverse effects* ; Retroperitoneal Space/surgery* ; Treatment Outcome ; Ureteral Calculi/surgery*

Infradiaphragmatic extralobar pulmonary sequestration is an extremely rare congenital malformation. It is more frequently diagnosed in the antenatal period due to routine ultrasonic examination of the fetus or in the first 6 months of life, though on rare occasions it is discovered incidentally in adults. A 32-yr-old man presenting with epigastric discomfort and fever was referred. Computed tomographic scanning showed that a 16-cm, multiseptated, dumbbell-shaped, huge cystic tumor was located beneath the diaphragm. On the next day, 850 mL of thick yellowish pus was drained by sonography-guided fine needle aspiration for the purpose of infection control and diagnosis, but no microscopic organisms were found in repeated culture studies. Surgical removal of the cyst was performed through thoracoabdominal incision and most of these pathologic lesions were removed but we could not find the feeding arteries or any fistulous tract to surrounding structures. Histopathologic study revealed that it was extralobar pulmonary sequestration and culture study showed that many WBC and necrotic materials were found but there were no microorganisms in the cystic contents. We report the first case of an infected infradiaphragmatic retroperitoneal extralobar sequestration which was administered a staged management and achieved an excellent clinical course.
Adult ; Bronchopulmonary Sequestration/complications/*pathology/surgery ; Diaphragm/abnormalities ; Humans ; Infection/complications/pathology ; Male ; Retroperitoneal Space/abnormalities

OBJECTIVETo compare the surgical effect of three-dimensional (3D) versus 2D laparoscopic surgery in ureter lithotomy.

METHODSFrom January 2014 to 2015 May, 45 patients with ureteral calculi were randomly allocated into 2 groups to undergo ureter lithotomy under 3D laparoscopy (25 cases) and 2D laparoscopy (20 cases). The time used for each surgical process (including the exposure, D-J tube discharge, suture and other surgical procedures) was recorded and compared between the two groups.

RESULTSThe operation was completed smoothly in all the 45 patients. In this cohort, the wound drainage tube was removed in a mean of 3.0mnplus;0.8 days after the operation, the catheter was removed after a week, and the double J tube was removed at 1 month. Follow-up intravenous pyelography at 3 months after the operation reveal ureteral stricture in none of the cases. Comparison of the surgical data showed that the time used in each surgical process was significantly shorter in the 3D group than in the 2D group (P<0.05). 3D laparoscopic surgery allowed more precise operation by providing a good sense of depth as in an open surgery to reduce the operation time.

CONCLUSIONSAs a minimally invasive surgical technique, 3D laparoscopic surgery facilitates more precise and easier operation compared with 2D laparoscopy in ureter lithotomy.

Humans ; Imaging, Three-Dimensional ; Kidney Pelvis ; Laparoscopy ; methods ; Operative Time ; Retroperitoneal Space ; Ureter ; Ureteral Calculi ; surgery

Both new insights in the pathophysiology of severe acute pancreatitis (SAP) and upspringing related evidence-based supports prompt the staged step-up approach, which stress emphasis on minimal invasiveness and damage control, to be accepted and advocated by the majority of guidelines. For documented or suspected patients with infected pancreatic necrosis, an imaging-guided percutaneous catheter drainage or an endoscopic transluminal drainage should be initially performed followed by, if necessary, a minimal access retroperitoneal necrosectomy, or a video-assisted retroperitoneal debridement, or an endoscopic transluminal necrosectomy, or an even an open access necrosectomy. The outstanding performance of staged step-up approach in patients with SAP has been justified from both a clinical and a health economic point of view, meanwhile, there are some issues remained to be further elucidated and optimized.
Acute Disease ; Debridement ; Drainage ; Endoscopy ; Humans ; Pancreatitis ; surgery ; Retroperitoneal Space ; Treatment Outcome