PURPOSE: We applied lateral lithotomy position to the severe ureteral stricture cases supposed to fail with only retrograde approach. MATERIAL AND METHODS: From October 1997 to April 1999, 13 patients with severe ureteral stricture (lenghth>2cm or complete obstruction) supposed to fail with only retrograde approach and one patient with study. The causes of ureteral strictures were pelvic malignancy in 5, tuberculosis in 4, trauma in 2 and others in 2. The patient's ipsilateral shoulder was rotated and fixed like lateral position. And ipsilateral pelvis was elevated with sandbag or pad and rotated about 45 degrees, too. The retrograde approach was tried at first, if fail, antegrade approach was combined. RESULTS: We could insert ureteral stent via retrograde approach only in 3 patients and we needed aid of antegrade approach for passage through ureteral stricture in the other 11 patients (79%). Percutaneous antegrade approaches were combined in those 11 patients and we could pass the guide wire and indwell the stent in 10 of 11 patients (91%) using this position. CONCLUSIONS: The lateral lithotomy position was very helpful to the simultaneous retrograde and antegrade approach in severe fibrotic or malignant ureteral strictures.
Constriction, Pathologic ; Humans ; Pelvis ; Shoulder ; Stents ; Tuberculosis ; Ureter*

Inferior vena cava (IVC) thrombi are detected in 4%–10% of patients with renal cell carcinoma (RCC). The 5-year survival rates following radical nephrectomy (RN) with IVC thrombectomy for patients with nonmetastatic RCC range between 50%–65%. Despite robot-assisted RN (RARN) with IVC thrombectomy proving to be feasible and potentially lessening complication rates, it remains technically demanding, with significant associated morbidity and mortality risks. Thus, meticulous patient selection and careful surgical planning are of paramount importance. This review aims to encapsulate the latest advancements and outline the detailed surgical processes involved in RARN with IVC thrombectomy.

Inferior vena cava (IVC) thrombi are detected in 4%–10% of patients with renal cell carcinoma (RCC). The 5-year survival rates following radical nephrectomy (RN) with IVC thrombectomy for patients with nonmetastatic RCC range between 50%–65%. Despite robot-assisted RN (RARN) with IVC thrombectomy proving to be feasible and potentially lessening complication rates, it remains technically demanding, with significant associated morbidity and mortality risks. Thus, meticulous patient selection and careful surgical planning are of paramount importance. This review aims to encapsulate the latest advancements and outline the detailed surgical processes involved in RARN with IVC thrombectomy.

Inferior vena cava (IVC) thrombi are detected in 4%–10% of patients with renal cell carcinoma (RCC). The 5-year survival rates following radical nephrectomy (RN) with IVC thrombectomy for patients with nonmetastatic RCC range between 50%–65%. Despite robot-assisted RN (RARN) with IVC thrombectomy proving to be feasible and potentially lessening complication rates, it remains technically demanding, with significant associated morbidity and mortality risks. Thus, meticulous patient selection and careful surgical planning are of paramount importance. This review aims to encapsulate the latest advancements and outline the detailed surgical processes involved in RARN with IVC thrombectomy.

Inferior vena cava (IVC) thrombi are detected in 4%–10% of patients with renal cell carcinoma (RCC). The 5-year survival rates following radical nephrectomy (RN) with IVC thrombectomy for patients with nonmetastatic RCC range between 50%–65%. Despite robot-assisted RN (RARN) with IVC thrombectomy proving to be feasible and potentially lessening complication rates, it remains technically demanding, with significant associated morbidity and mortality risks. Thus, meticulous patient selection and careful surgical planning are of paramount importance. This review aims to encapsulate the latest advancements and outline the detailed surgical processes involved in RARN with IVC thrombectomy.

PURPOSE: We evaluated the early results and the learning curve of laparoscopic radical prostatectomy in the first 150 patients. MATERIALS AND METHODS: Between July 2001 and March 2007, 150 consecutive patients with clinically organ-confined prostate cancer underwent laparoscopic radical prostatectomy. For evaluation of the learning curve, morbidity, oncologic, and functional results of the first 50(group 1) and last 50(group 3) procedures were compared. RESULTSs: The mean operating time and hospital stay was 289+/-66 minutes and 6.3+/-2.9 days, respectively. The median postoperative period of an indwelling Foley catheter was 5 days(range, 3-46 days). The intraoperative complication rate, including transfusion, was 15.3%. A positive surgical margin rate was 37.3%. After a mean follow-up of 33.5 months, a PSA relapse was observed in 39(33.6%) patients. The continence rate was 77.1, 92.2, and 93.7% at 1, 6, and 12 months. Analysis of the learning curve revealed significant differences in the operating time, hospital stay, intraoperative complication rate, and indwelling Foley catheter days, whereas the postoperative complication rate, mean estimated blood loss, positive surgical margin rate, and continence rate 6 months postoperatively showed no influence. CONCLUSIONS: Although laparoscopic radical prostatectomy requires significant expertise with a learning curve, the morbidity is low and the oncologic continence result was promising. The learning curve for laparoscopic radical prostatectomy depends not only on the technical skills, but also on the self-perceived definition. It is likely that no complete plateau of the learning curve exists for any article. Standardized expectations and reporting of outcomes could help to better define the true learning curve for laparoscopic radical prostatectomy.

PURPOSE: Minimally invasive donor nephrectomy has become a favored procedure for kidney transplantation. To compare the outcomes of kidneys procured using open donor nephrectomy (ODN), laparoscopic donor nephrectomy (LDN) and hand-assisted laparoscopic donor nephrectomy (HALDN). MATERIALS AND METHODS: A total of 243 patients were included in the study. 177 HALDN and 24 LDN patients were compared with 42 ODN patients. The operation times, warm ischemic times, transfusions, times to regular diet, post-operation hospital stays, analgesics use, post-operation serum creatinine, complications, graft functions and survivals were evaluated. RESULTS: The mean operation times were 197+/-43, 213+/-32.7 and 189+/-28.2 minutes for HALDN, LDN and ODN, respectively. The warm ischemic times were 175+/-76.7, 174+/-67.5 and 135+/-25.4 seconds for HALDN, LDN and ODN, respectively. The mean post-operation hospital stays were shorter for the HALDN and LDN than for ODN. There were no significant differences between the three groups in terms of the times to regular diet. The graft survivals were 98, 96 and 97.6% in the HALDN, LDN and ODN, respectively. The postoperative serum creatinine levels of the recipients showed no differences between the three groups. CONCLUSIONS: HALDN and LDN are technically feasible, and appear to be safe and effective for live-donor transplantation. Evaluation of the HALDN and LDN showed less pain, a more rapid recovery and minimal cosmetic disfigurement than the ODN. The recipient graft functions were also similar in the laparoscopic and open surgery groups. Therefore, HALDN and LDN may result in increased acceptance of the donor operation and expand the pool of potential kidney donors.
Analgesics ; Creatinine ; Diet ; Graft Survival ; Hand ; Humans ; Kidney ; Kidney Transplantation ; Laparoscopy ; Length of Stay ; Nephrectomy* ; Tissue Donors* ; Transplants ; Warm Ischemia

PURPOSE: We evaluated the advantages of simultaneous procedure in bilateral percutaneous nephrolithotomy for the management of bilateral renal stones. MATERIALS AND METHODS: The charts of patients with bilateral renal stones from January 1990 to April 1998 were retrospectively reviewed. We compared operative time, hospital stay, decrease in hemoglobin, and complications of simultaneous procedure with those of sequential procedure. RESULTS: Among the 13 patients with bilateral renal stones treated percutaneously, 9 patients were underwent simultaneous procedure and 4 patients were underwent sequential procedure. Mean operative time was 190 minutes in simultaneous group and 335 minutes in sequential group (p<0.05), mean hospital stay was 10.1 and 16.8 days (p<0.05) and mean decrease in hemoglobin was 2.6 and 1.6g/dl (p>0.05), respectively. Complications included blood loss requiring transfusion in 1 case and paralytic ileus in 1 of simultaneous group, and blood loss in 2 and fever in 1 of sequential group. CONCLUSIONS: Simultaneous bilateral percutaneous nephrolithotomy is a well-tolerated, safe, expeditious, and cost-effective approach to patients with bilateral renal stones at centers proficient in percutaneous techniques.
Fever ; Humans ; Intestinal Pseudo-Obstruction ; Length of Stay ; Nephrostomy, Percutaneous* ; Operative Time ; Retrospective Studies

PURPOSE: We evaluated the advantages of simultaneous procedure in bilateral percutaneous nephrolithotomy for the management of bilateral renal stones. MATERIALS AND METHODS: The charts of patients with bilateral renal stones from January 1990 to April 1998 were retrospectively reviewed. We compared operative time, hospital stay, decrease in hemoglobin, and complications of simultaneous procedure with those of sequential procedure. RESULTS: Among the 13 patients with bilateral renal stones treated percutaneously, 9 patients were underwent simultaneous procedure and 4 patients were underwent sequential procedure. Mean operative time was 190 minutes in simultaneous group and 335 minutes in sequential group (p<0.05), mean hospital stay was 10.1 and 16.8 days (p<0.05) and mean decrease in hemoglobin was 2.6 and 1.6g/dl (p>0.05), respectively. Complications included blood loss requiring transfusion in 1 case and paralytic ileus in 1 of simultaneous group, and blood loss in 2 and fever in 1 of sequential group. CONCLUSIONS: Simultaneous bilateral percutaneous nephrolithotomy is a well-tolerated, safe, expeditious, and cost-effective approach to patients with bilateral renal stones at centers proficient in percutaneous techniques.
Fever ; Humans ; Intestinal Pseudo-Obstruction ; Length of Stay ; Nephrostomy, Percutaneous* ; Operative Time ; Retrospective Studies

No abstract available.
Lithotripsy*