No abstract available.
Adrenalectomy*

PURPOSE: A retrospective review of the medical records of 168 patients who were evaluated for renal transplantation was undertaken to determine whether a voiding cystourethrography (VCUG) influenced the surgi cal care of the recipient. MATERIALS AND METHODS: Between June 1989 to May 1998, 168 patients received a transplantation at our center. These patients proceeded to transplantation, with all of them receiving a VCUG as part of their evaluation. We compared incidence of postoperative complications between normal VCUG group and abnormal group during follow up period (mean 31. 6 months). RESULTS: An urologic abnormality was identified by VCUG in 15 (8.9%) of 168 patients and all of them were vesicoureteral reflux (VUR). In 15 patients with VUR, grade of VUR were grade I in 2, grade II in 10, grade III in 2 and grade IV in 1. None of them with VUR required surgical intervention and had postoperative complications related to VUR. CONCLUSIONS: The VCUG is not essential for the preparation of potential recipients for renal transplantation and should be utilized selectively in individuals with a history of urologic disease or when urinary tract abnormalities are identified by physical examination or an abnormal urine analysis.
Follow-Up Studies ; Humans ; Incidence ; Kidney Transplantation* ; Medical Records ; Physical Examination ; Postoperative Complications ; Retrospective Studies ; Urinary Tract ; Urologic Diseases ; Vesico-Ureteral Reflux

No abstract available.
Carcinoma, Transitional Cell* ; Urinary Bladder*

No abstract available.
Carcinoma, Transitional Cell* ; Urinary Bladder*

PURPOSE: We performed nerve-sparing robot-assisted radical cystectomy (nsRARC) and compared the operative outcomes of nsRARC and open radical cystectomy (ORC). MATERIALS AND METHODS: The data of 38 patients that underwent ORC or nsRARC for bladder cancer between July 2009 and April 2014 (23 ORC and 15 RARC) were retrospectively analyzed. Data were collected on patient demographics, pathologic stages, perioperative outcomes, and oncologic outcomes as well as on erectile function. Five-year overall survival and cancer-specific survival were analyzed using the Kaplan-Meier method. Erection function recovery was defined as the ability to achieve penetration ≥50% of the time and to maintain an erection sufficient enough for penetration ≥50% of the time at 12 months after surgery. RESULTS: No significant differences were found between the nsRARC and ORC groups in terms of age, sex, body mass index, American Society of Anesthesiologists physical status, or clinical stage. Mean estimated blood loss was significantly less in the nsRARC group (205.3 mL vs. 394 mL, p=0.011), but mean operative time was significantly greater (520.3 minutes vs. 415.0 minutes, p=0.004). Five-year overall survival and cancer-specific survival were 86.7% and 86.7%, respectively, for nsRARC, and 77.7% and 86.7% for ORC. With respect to erectile function, the overall postoperative potency rate at 12 months was 40.0% in the RARC group and 9.5% in the ORC group, and this difference was significant (p=0.021). CONCLUSIONS: Our clinical experiences indicate nsRARC in selected patients is a feasible procedure in terms of oncologic outcome and that it preserves erectile function relatively effectively.
Body Mass Index ; Cystectomy ; Demography ; Humans ; Methods ; Operative Time ; Recovery of Function ; Retrospective Studies ; Urinary Bladder Neoplasms

This study is based on the clinical analysis of 14 patients with retroperitoneal tumors experienced at the Department of Urology. Kyungpook University Hospital during the period from February 1980 to May 1991. The results were as follows ; l. The patients age ranged from 27 to 73 years and the ratio of male to female was 1.8: 1. 2. The most common chief complaint was abdominal mass (57.2% ) and 9 of 14 patients (64.4%) had presented symptoms for 1 year or less prior to visiting the hospital. 3. The clinical diagnosis was made by the clinical symptoms, physical findings and radiologic evaluations such as intravenous pyelography, ultrasonography. computerized tomography, angiography and so on. Abdominal CF scan provided clinically the most useful information regarding the state of tumors and also their effect on adjacent structures. 4. There were 5 benign and 9 malignant tumors including 4 metastatic tumors and 3 leiomyosarcomas. 5. Complete excision was performed in all 5 benign tumors and 2 malignant tumors (50%), and others were treated with partial excision followed by radiation therapy and/or chemotherapy or biopsy only.
Angiography ; Biopsy ; Diagnosis ; Drug Therapy ; Female ; Gyeongsangbuk-do ; Humans ; Leiomyosarcoma ; Male ; Ultrasonography ; Urography ; Urology

The intramedullary nailing is one of the most available method in the treatment of femoral shaft fracture. Since the development of Küntscher nail in 1940, new designs such as the Grosse-Kempf interlocking femoral nail, Ressell-Taylor Femoral nial, AO/ASIF universal nail, ACE titanium nail became widely used by more applicable level of femoral shaft fracture. But complication of intramedullary nailing was rarely seen. The authors analyzed the clinical and mechanical factors predisposing to failures of intramedullary interlocking nails in 6 cases whom treated the comminuted fracture of the femoral shaft, at the department of orthopaedic surgery, Sun General Hospital from 1991 to 1995 and the following results are obtained. 1. Initial fracture patterns were comminuted in all 6 cases. 2. The implant nails were AO nail in 4 cases, Grosse-Kempf nail in 1 case, Russell-Taylor nail in 1 case(nail diameter was 10mm to 12mm). 3. The failure sites of the interlocking nail were the initial bone fracture site in 2 cases, distal to the proximal screw hole in 1 case, proximal to the distal screw hole in 2 cases, fracture site and distal to the proximal screw hole in 1 case. 4. The average time to failure of implants were 11.5 months. 5. The average times to partical weight bearing were 6.3 weeks. In the analy of above results, by using diameter of nail more than 13mm and delaying weight bearing on the injured limb until there is clear radiographic evidence of early union of the femur fracture, we may reduce the metal failures of intramedullary interlocking nail in comminuted femoral shaft fractures.
Extremities ; Femur ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Comminuted ; Hospitals, General ; Methods ; Solar System ; Titanium ; Weight-Bearing

PURPOSE: Laparoscopic nephroureterectomy (LNUx) has recently been done to treat patients with upper tract transitional cell carcinoma. We retrospectively evaluated the efficacy and safety of LNUx in comparison with open nephroureterectomy (ONUx). MATERIALS AND METHODS: Between May 2001 and March 2006, a total of 51 patients underwent radical nephroureterectomy for upper tract transitional cell carcinoma, including 22 LNUx and 29 ONUx. LNUx was performed transperitoneally and the ureteral end with a bladder cuff was transected through a 5-7cm modified Gibson incision. All the specimens were extracted intact. The patients' characteristics and the perioperative and followup data were analyzed retrospectively. RESULTS: LNUx was successfully performed in all the patients without open conversion. The analgesic requirement was lower, and the average time to oral intake and the length of hospitalization were shorter for LNUx than for ONUx. The average operative time, estimated blood loss and complications were not statistically different between the LNUx and ONUx. The mean follow-up periods of the LNUx and ONUx were 13.7 and 30.0 months, respectively. Both groups were similar in regard to bladder recurrence, local recurrence and distant metastasis. There was no sign of the trocar site or peritoneal seeding after LNUx. CONCLUSIONS: Our results suggest that LNUx is an acceptable alternative to ONUx for treating upper urinary tract transitional cell carcinoma. However, a longer follow-up period and comparative studies to the standard open techniques will be required.
Carcinoma, Transitional Cell* ; Follow-Up Studies ; Hospitalization ; Humans ; Laparoscopy ; Neoplasm Metastasis ; Nephrectomy ; Operative Time ; Recurrence ; Retrospective Studies ; Surgical Instruments ; Ureter ; Urinary Bladder ; Urinary Tract*

PURPOSE: Robot-assisted laparoscopic radical cystectomy (RLRC) is a new option for the treatment of muscle-invasive bladder cancer, and case series for RLRC have been increasing recently. We report our operative technique and initial experiences with RLRC with extracorporeal urinary diversion. MATERIALS AND METHODS: Between October 2008 and November 2009, 17 consecutive patients with muscle-invasive bladder cancer underwent RLRC, pelvic lymph node dissection, and extracorporeal urinary diversion. Urinary diversion included 13 ileal conduits and 4 orthotopic neobladders (Studer method). Data were collected prospectively on patient demographics, intraoperative parameters, pathologic staging, and postoperative outcomes. RESULTS: The mean patient age was 63.7 years. The mean body mass index was 22.6 kg/m2. No patients had a history of previous abdominal surgery. The mean operative time was 379.1 minutes, including 32.6 minutes for pelvic lymph node dissection, 185.2 minutes for RLRC, and 159.4 minutes for urinary diversion. The mean estimated blood loss was 210.5 ml. The mean hospital stay was 20.7 days and the mean time to oral intake and ambulation was 5.0 and 1.3 days, respectively. There were no major perioperative complications. The pathologic reports showed urothelial cell carcinomas in all cases. CONCLUSIONS: Our initial clinical experiences indicate that RLRC with pelvic lymph node dissection and extracorporeal urinary diversion is a safe and feasible procedure with minimal blood loss and rapid recovery. Long-term follow up in a larger patient population is needed to determine the true oncological and functional benefit of this procedure.
Body Mass Index ; Cystectomy ; Demography ; Humans ; Length of Stay ; Lymph Node Excision ; Operative Time ; Prospective Studies ; Robotics ; Urinary Bladder Neoplasms ; Urinary Diversion ; Walking

PURPOSE: Recent advances and wider application of imaging diagnostic techniques, especially ultrasonography(USG) and computed tomography(CT), account for the increasing incidentaloma in adrenal and renal tumors. We have studied these incidentalomas to investigate the incidences, occasions of detection, pathological findings, prognosis and other clinical properties. MATERIALS AND METHODS: The 186 cases of adrenal and renal tumors, treated surgically in Kyoungpook National University Hospital between 1987 and 1997 were reviewed and compared incidentally detected group(59cases) to symptomatically suspected group(127cases). RESULTS: The analysis of 186 cases demonstrated a marked increase in the frequency of incidentaloma from 15.6%(1987?1992) to 43.1%(1993?1997). The proportions of incidentaloma in adrenal and renal tumors were 20.4% in adrenal tumor, 36.4% in renal tumor and 31.7% in total. The chief method of detection was USG(57.6%), followed by CT(33.9%) and IVP(6.8%). The main reasons for examination leading to the diagnosis in incidentaloma were evaluation of unrelated symptoms(44.1%), follow up of other diseases(35.6%), general health check(18.6%) and during other operation(1.7%). In case of adrenal incidentaloma, the mean tumor diameter was larger than in suspected group(4.8+/-3.4cm vs 3.1+/-2.3cm). The main histologic diagnosis of adrenal incidentaloma was adrenal adenoma and hormonally functional tumors were less than suspected group (63.6% vs 88.4%). In case of renal incidentaloma, the mean tumor diameter was smaller than in suspected group(5.3+/-2.1cm vs 8.7+/-2.2cm) and paraneoplastic syndromes were less than in suspected group(20.8% vs 57.1%). The grade and stage of renal incidentaloma were lower and survival rate was higher than suspected group(5 year survival rate, 83.3% vs 64.3%). CONCLUSIONS: These results indicated that abdominal USG or CT should be performed with special attention to adrenal and renal lesions, where at a health examination or evaluation to unrelated disease.
Adenoma ; Carcinoma, Renal Cell ; Diagnosis ; Follow-Up Studies ; Incidence ; Paraneoplastic Syndromes ; Prognosis ; Survival Rate