1.Ex vivo microscopic testicular sperm extraction at the time of radical orchiectomy in men with nonobstructive azoospermia (NOA): a scoping review.
Carlo GIULIONI ; Nguyen Ho Vinh PHUOC ; Selahittin CAYAN
Asian Journal of Andrology 2025;27(3):416-422
Testicular tumor is the most common solid malignancy in males under 40 years of age. This malignancy is known to have a negative impact on male fertility. Therefore, several techniques for sperm retrieval have been proposed, including microdissection testicular sperm extraction (mTESE). The objective of this study was to review the literature on the outcomes of oncological (Onco)-mTESE at the time of radical orchiectomy. We conducted a comprehensive literature search through PubMed, Scopus, and Cochrane Central Controlled Register of Trials. Only studies reporting ex vivo mTESE in patients with testicular tumor were considered. Twelve papers met the inclusion criteria and were included in this review. Tumor size was identified as the sole preoperative factor influencing spermatogenesis. The considered studies demonstrated a satisfactory success rate for Onco-mTESE, associated with a similarly valid percentage of live healthy births through assisted reproductive technology. Currently, no comparison has been made between Onco-mTESE and conventional Onco-TESE, hence further assessment is required. In cases where the tumor completely replaces the cancer-bearing testicle, a contralateral micro-TESE may be a viable alternative. However, the surgeon should evaluate associated risks and benefits preoperatively. In conclusion, Onco-mTESE at the time of radical orchiectomy appears to be a promising therapeutic option for young patients with testicular tumors. Nevertheless, additional studies are necessary to achieve a definitive conclusion.
Humans
;
Male
;
Azoospermia/etiology*
;
Sperm Retrieval
;
Orchiectomy/methods*
;
Testicular Neoplasms/complications*
;
Microdissection/methods*
;
Testis/surgery*
;
Adult
2.Association between maximal urethral length preservation and postoperative continence after robot-assisted radical prostatectomy: a meta-analysis and systematic review.
Tian-Yu XIONG ; Zhan-Liang LIU ; Hao-Yu WU ; Yun-Peng FAN ; Yi-Nong NIU
Asian Journal of Andrology 2025;27(2):225-230
Urinary incontinence is a common complication following robot-assisted radical prostatectomy (RARP). Urethral length has been identified as a factor affecting postoperative continence recovery. In this meta-analysis, we examined the association between use of the maximal urethral length preservation (MULP) technique and postoperative urinary continence in patients undergoing RARP. We conducted a comprehensive search of PubMed, Web of Science, Embase, and the Cochrane Library up to December 31, 2023. The quality of the literature was assessed using the Newcastle-Ottawa Scale. A random-effects meta-analysis was performed to synthesize data and calculate the odds ratio (OR) from eligible studies on continence and MULP. Six studies involving 1869 patients met the eligibility criteria. MULP was positively associated with both early continence (1 month after RARP; Z = 3.62, P = 0.003, OR = 3.10, 95% confidence interval [CI]: 1.68-5.73) and late continence (12 months after RARP; Z = 2.34, P = 0.019, OR = 2.10, 95% CI: 1.13-3.90). Oncological outcomes indicated that MULP did not increase the overall positive surgical margin rate or the positive surgical margin status at the prostate apex (both P > 0.05). In conclusion, the use of the MULP technique in RARP significantly improved both early and late postoperative continence outcomes without compromising oncological outcomes.
Humans
;
Prostatectomy/adverse effects*
;
Robotic Surgical Procedures/methods*
;
Male
;
Urethra/surgery*
;
Urinary Incontinence/prevention & control*
;
Postoperative Complications/etiology*
;
Prostatic Neoplasms/surgery*
;
Organ Sparing Treatments/methods*
3.Microdissection testicular sperm extraction for men with nonobstructive azoospermia who have a testicular tumor in situ at the time of sperm retrieval.
Hao-Cheng LIN ; Wen-Hao TANG ; Yan CHEN ; Yang-Yi FANG ; Kai HONG
Asian Journal of Andrology 2025;27(3):423-427
Oncological microdissection testicular sperm extraction (onco-micro-TESE) represents a significant breakthrough for patients with nonobstructive azoospermia (NOA) and a concomitant in situ testicular tumor, to be managed at the time of sperm retrieval. Onco-micro-TESE addresses the dual objectives of treating both infertility and the testicular tumor simultaneously. The technique is intricate, necessitating a comprehensive understanding of testicular anatomy, physiology, tumor biology, and advanced microsurgical methods. It aims to carefully extract viable spermatozoa while minimizing the risk of tumor dissemination. This review encapsulates the procedural intricacies, evaluates success determinants, including tumor pathology and spermatogenic tissue health, and discusses the implementation of imaging techniques for enhanced surgical precision. Ethical considerations are paramount, as the procedure implicates complex decision-making that weighs the potential oncological risks against the profound desire for fatherhood using the male gametes. The review aims to provide a holistic overview of onco-micro-TESE, detailing methodological advances, clinical outcomes, and the ethical landscape, thus offering an indispensable resource for clinicians navigating this multifaceted clinical scenario.
Humans
;
Male
;
Azoospermia/therapy*
;
Testicular Neoplasms/pathology*
;
Sperm Retrieval
;
Microdissection/methods*
;
Testis/surgery*
4.Expert consensus on the perioperative management of co-ablation system therapy of liver tumors.
Chinese Journal of Internal Medicine 2025;64(2):110-118
This study aims to improve the quality of clinical treatment and nursing care to standardize perioperative management for patients with liver tumors undergoing co-ablation system therapy. The Committee of Ablation Therapy in Oncology, China Anti-Cancer Association; the Expert Committee on Ablation Therapy; Chinese Society of Clinical Oncology (CSCO); and the Committee of Interventional, Perioperative, and Interventional Physician Branch of Chinese Medical Doctors Association organized medical and nursing experts in China. Based on the clinical practice of co-ablation system therapy in China and relevant domestic literature, an expert consensus about perioperative management was developed. The expert consensus included the key points of perioperative management, prevention, and care of complications; discharge guidance; and follow-up management for patients undergoing co-ablation system therapy of liver tumors. The consensus on the perioperative management of co-ablation system therapy for liver tumors has finally been formulated, serving as a reference and application for medical personnel in relevant fields based on hospital and patient conditions in clinical work.
Humans
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Liver Neoplasms/surgery*
;
Perioperative Care
;
Consensus
;
Catheter Ablation
5.Multidisciplinary expert consensus on thermal ablation for benign thyroid diseases, low-risk thyroid carcinoma, and metastatic cervical lymph nodes (2025 edition).
Chinese Journal of Internal Medicine 2025;64(7):614-624
Thermal ablation has proven an effective treatment modality for certain thyroid diseases. However, its indications remain the subject of significant debate both domestically and internationally. Over recent years, several international academic organizations have issued consensus statements, position papers, and guidelines concerning thyroid thermal ablation. In China, the Chinese College of Interventionalists (CCI), in collaboration with other relevant academic organizations, released the "Expert consensus on thermal ablation for thyroid benign nodes, microcarcinoma and metastatic cervical lymph nodes (2018 edition)". This consensus statement received widespread recognition within the field and contributed significantly to the standardization of thyroid thermal ablation therapy in China. With the continuous accumulation of evidence-based medical data, the need for a more stringent and standardized approach to thyroid thermal ablation has become evident. Accordingly, the Interventional Ultrasound Committee of the CCI, in collaboration with multiple academic organizations and experts, conducted extensive discussions and multiple revisions before finalizing the "Multidisciplinary expert consensus on thermal ablation for benign thyroid diseases, low-risk thyroid carcinoma, and metastatic cervical lymph nodes (2025 edition)". This updated consensus builds on the framework of the 2018 edition, refining indications and contraindications, emphasizing standardized treatment, and outlining future directions for research and clinical applications of thyroid thermal ablation technology.
Humans
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Thyroid Neoplasms/surgery*
;
Consensus
;
Lymphatic Metastasis
;
Lymph Nodes/pathology*
;
Thyroid Diseases/surgery*
6.Chinese expert consensus on MRI-guided thermal ablation for liver tumors (2025 edition).
Chinese Journal of Internal Medicine 2025;64(11):1084-1095
Image-guided thermal ablation (IGTA) has been widely used in the treatment of liver tumors. MRI-guided thermal ablation of liver tumors offers several advantages, including the absence of ionizing radiation; excellent soft-tissue contrast; multi-parametric and multiplanar imaging; non-invasive, real-time temperature monitoring of the thermal field during the procedure; and accurate post-procedural assessment of therapeutic efficacy. To standardize and promote MRI-guided thermal ablation for liver tumors in China, advance the technological development of IGTA for tumor treatment, and enhance the efficacy of "precision ablation" for hepatic tumors, this expert consensus (2025 edition) was collaboratively developed by national experts from multiple societies and committees through multidisciplinary discussions. The contributing groups included the Society of Tumor Ablation Therapy of the Chinese Anti-Cancer Association, the Ablation Expert Committee of the Chinese Society of Clinical Oncology (CSCO), the Tumor Ablation Subgroup of the National Health Commission Comprehensive Interventional Therapy Quality Control Center, the Expert Group on Tumor Ablation Therapy of the Chinese Medical Doctors Association, and the Tumor Ablation Committee of the Chinese College of Interventionalists. The main contents of the consensus include: (1) indications, contraindications, and characteristics of MRI-guided thermal ablation for liver tumors; (2) MRI magnets, guidance sequences, and MRI-compatible thermal ablation equipment and instruments; and (3) protocols for MRI-guided thermal ablation of liver tumors, efficacy assessment, and the prevention and management of complications.
Humans
;
Liver Neoplasms/surgery*
;
Magnetic Resonance Imaging
;
Consensus
;
China
;
Catheter Ablation/methods*
;
Ablation Techniques/methods*
;
Surgery, Computer-Assisted
7.Clinical analysis of mandibular tumor resection with free fibula transplantation and implant implantation via the intraoral approach.
Jiancheng LI ; Mingming YAN ; Zhenghao MA ; Ruixue TIAN ; Xuji WANG ; Kai HU ; Lina JIANG
West China Journal of Stomatology 2025;43(2):212-219
OBJECTIVES:
To investigate the clinical application of the digital-assisted reconstruction of the mandible and tumors with free fibula transplantation and immediate implantation via the intraoral approach.
METHODS:
Twelve patients with benign mandibular tumors were collected. Three-dimensional mandibular reconstruction was performed digitally before surgery to simulate mandibular tumor resection, fibula resection and reconstruction, and implant implantation. The intraoperative resection of the mandibular tumor was conducted through the intraoral approach under the guidance of a guide plate, and fibula resection, molding, reconstruction, and oral fixation were immediately performed. Implant implantation was performed during the second phase of implant surgery and denture restoration was performed 1-2 months after surgery.
RESULTS:
The types of mandibular defects were BrownⅠ (one case), Ⅰc (four cases), Ⅱ (one case), Ⅱc(three cases), and Ⅲ (three cases). The length of the fibular bone was 12-22 cm. The number of fibular molding amputations was as follows: two cases in two segments, six cases in three segments, three cases in four segments, and one case in five segments. All of these cases underwent folding fibular reconstruction of mandibular and alveolar bone defects. A total of 44 implants were implanted, and none failed after operation.
CONCLUSIONS
The intraoral approach is a reliable method for the resection of mandibular benign tumors, with few postoperative complications and the ability to position and fix accurately the reconstructed folded fibula under digital design. The immediate implantation of the transplanted fibula does not affect the blood supply and has a high success rate. It is an effective and reliable method for the resection and reconstruction of mandibular benign tumors.
Humans
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Fibula/transplantation*
;
Mandibular Neoplasms/surgery*
;
Mandibular Reconstruction/methods*
;
Bone Transplantation/methods*
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Male
;
Middle Aged
;
Female
;
Mandible/surgery*
;
Adult
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Free Tissue Flaps
;
Surgery, Computer-Assisted
8.Effects of Total Intravenous Anesthesia and Inhalational Anesthesia on Postoperative Recovery in Patients Undergoing Transsphenoidal Pituitary Surgery:A Systematic Review.
Yun-Ying FENG ; Yu-Pei ZHANG ; Yue-Lun ZHANG ; Bing XING ; Wei LIAN ; Xiao-Peng GUO ; Lu-Lu MA ; Yu-Guang HUANG
Acta Academiae Medicinae Sinicae 2025;47(3):434-440
Objective To systematically evaluate the effects of total intravenous anesthesia and inhalational anesthesia on postoperative recovery in patients undergoing transsphenoidal pituitary tumor resection.Methods A comprehensive search was conducted in international biomedical databases including Ovid Medline,Embase,CINAHL(EBSCO),Cochrane Library,and Web of Science,from inception to July 4,2023.Additionally,ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing and completed trials.The randomized controlled trials(RCT)comparing total intravenous anesthesia and inhalational anesthesia in patients undergoing transsphenoidal surgery for pituitary tumors were included.The methodological quality of the included studies was evaluated by the Cochrane Collaboration tool.Relevant data were extracted and synthesized for analysis.Results A total of 327 records were identified,of which eight RCTs met the inclusion criteria.Four studies showed that the patients receiving desflurane or sevoflurane anesthesia experienced faster emergence from anesthesia than those receiving propofol.Two studies indicated that patients in the propofol group had lower levels of emergence agitation and a lower incidence of early postoperative nausea and vomiting.The results on postoperative cognitive function were inconsistent across studies.No differences were found between the groups in terms of postoperative complications or overall recovery quality during hospitalization.Conclusions Inhalational anesthesia appears to provide an advantage in promoting faster emergence following transsphenoidal pituitary surgery,whereas total intravenous anesthesia may contribute to smoother and more stable recovery.Further high-quality studies are needed to clarify the effects of different anesthetic techniques on both short- and long-term postoperative recovery.
Humans
;
Anesthesia, Intravenous
;
Pituitary Neoplasms/surgery*
;
Anesthesia, Inhalation
;
Randomized Controlled Trials as Topic
;
Anesthesia Recovery Period
;
Pituitary Gland/surgery*
;
Postoperative Period
9.Characteristics and outcomes of patients with colorectal cancer who underwent laparoscopic colorectal surgery: Descriptive study.
Kim Recoli S. delos Reyes ; Orlando F. Basilio Jr.
Southern Philippines Medical Center Journal of Health Care Services 2025;11(2):1-6
BACKGROUND
Laparoscopic surgery is a widely accepted treatment modality, but with few disadvantages.
OBJECTIVETo describe the demographic, clinical, tumor, and operative characteristics of patients with colorectal cancer who underwent laparoscopic surgery.
DESIGNDescriptive study.
PARTICIPANTS47 males and 40 females, aged 19 years and older with colorectal cancer who underwent laparoscopic colorectal surgery.
SETTINGSurgery Department - Colorectal Surgery section, Southern Philippines Medical Center, Davao City, August 2014 to August 2018.
MAIN OUTCOME MEASURESDemographic and clinical characteristics, tumor profile, and operative outcomes.
MAIN RESULTSThis study analyzed 87 patients with colorectal cancer who underwent laparoscopic colorectal surgery. The participants had a mean age of 56.55 ± 11.99 years, with a slight male predominance (54.02%). Most patients resided within Davao Province (72.41%) and commonly presented with comorbidities, particularly hypertension (22.99%). Tumors were mostly located in the rectum (62.07%), and the majority of patients had advanced disease, with 59.77% classified as stage IIIB. Advanced tumor invasion was common, with 60.92% of patients presenting with T3 and 32.18% with T4 disease, while lymph node involvement was observed in 75.86% of cases. Distant metastasis was present in 11.49% of patients, most frequently involving the liver. Low anterior resection was the most commonly performed procedure (39.08%). The mean operative time was 278.89 ± 72.76 minutes, with a mean blood loss of 476.73 ± 341.86 mL and a conversion-to-open rate of 23.26%. Postoperative outcomes showed a morbidity rate of 26.44% and a mortality rate of 3.45%, with patients resuming oral intake after a mean of 4.02 ± 2.17 days and a mean hospital stay of 8.35 ± 6.38 days.
CONCLUSIONLaparoscopic colorectal surgery at our institution was performed among middle-aged patients, mostly males. Rectal cancer was the most common diagnosis, with most patients presenting with advanced stage IIIB disease, and low anterior resection was the most frequently performed procedure. The mean operative time was 279 minutes, with a conversion-to-open rate of nearly 25%. The mean intraoperative blood loss was 476 mL. Oral intake was resumed after a mean of 4 days. The mean hospital stay was 8 days, with low mortality despite a moderate morbidity rate.
Human ; Minimally Invasive Surgery ; Minimally Invasive Surgical Procedures ; Tumor ; Neoplasms ; Mortality
10.The supraclavicular artery island flap: A practical approach for reconstruction of extensive cervicofacial defects following giant cavernous hemangioma resection
Heather Grace P. Dulnuan ; Anna Claudine F. Lahoz ; Arsenio Claro A. Cabungcal
Philippine Journal of Otolaryngology Head and Neck Surgery 2025;40(Supplement):45-49
OBJECTIVES
o demonstrate the utility of the supraclavicular artery island flap (SCAIF) as a viable alternative to free tissue transfer for reconstruction of large cervicofacial defects.
METHODSDesign:Case Report
Setting:Tertiary National University Hospital
Patient: One
RESULTSA 43-year-old woman with a giant cavernous hemangioma measuring 21.43 x 9.91 x 20.75cm underwent tumor resection and immediate reconstruction using SCAIF. Following preoperative embolization and complete tumor excision, an 11 x 15cm cervicofacial defect was successfully reconstructed using SCAIF. The patient experienced post-operative complications including multiple wound dehiscences and hypertrophic scar formation but achieved significant functional and aesthetic improvement. At three months follow up, the patient reported cessation of bleeding episodes, improved feeding capacity, and enhanced quality of life despite persistent tracheostomy dependence. Plans for secondary surgery include scar revision, commissuroplasty, and intralesional steroid injections.
CONCLUSIONThe supraclavicular artery island flap presents a practical, cost-effective alternative to free tissue transfer for extensive cervicofacial reconstruction, particularly in resource-limited environments or in patients where free tissue transfer is contraindicated. Advantages include good color match, wide arc of rotation, and ease of harvest. Despite potential complications, it offers excellent functional and aesthetic outcomes with acceptable donor site morbidity.
Human ; Female ; Young Adult: 19-24 Yrs Old ; Aids-related Complex ; Neoplasms ; Costs And Cost Analysis ; General Surgery ; Environment ; Research Report ; Steroids ; Tracheostomy ; Hospitals


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