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Selenized yeast is commonly used as a highly bioavailable source of selenium in dietary supplements and feed additives and is used in research settings in various disciplines due to the large number of selenium-containing metabolites formed during growth. With the selenomethionine being the major form of selenium present in selenized yeasts, its accurate quantitation is essential, however, values are frequently underestimated due to the costly and time-consuming hydrolysis-based sample preparation required to release the selenoamino acid from proteins for analysis. The National Research Council Canada has developed an 82-Se-enriched selenized yeast Certified Reference Material, SEEY-1 (DOI: 10.4224/crm.2023.seey-1) intended to be used as a matrix-matched spike material for isotope dilution analysis of selenized yeasts. The total selenium and selenomethionine contents of SEEY-1 were determined to be 322.1 ± 4.8 mg/kg (k = 2) and 635.6 ± 16.8 mg/kg (k = 2), respectively. Here we present results on the preparation of the 82-Se-enriched yeast, the certification process, and provide an example of the use of SEEY-1 as a matrix-matched spike for the analysis of selenomethionine in a sample of selenized yeast. We demonstrate here that SEEY-1 is able to compensate for the partial digestion of yeast proteins and provide reliable analytical data on Se amino acid content in under an hour instead of the 16 hours required for conventional complete acid hydrolysis.
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Selenio , Selenometionina , Selenometionina/análisis , Selenometionina/química , Selenometionina/metabolismo , Saccharomyces cerevisiae/metabolismo , Selenio/química , Espectrometría de Masas/métodos , Isótopos/metabolismoRESUMEN
AIM: To investigate the use of docetaxel for the treatment of metastatic castration-resistant prostate cancer (mCRPC) in real-world clinical practice in China. METHODS: This single-arm, prospective, observational study was conducted at 32 study centers in China and included male patients aged ≥18 years with histologically confirmed prostate cancer who received ≥1 dose of docetaxel following failure of hormonal therapy (disease progression with serum testosterone <50 ng/dL). The primary aim was to investigate patterns of docetaxel treatment. RESULTS: Overall 403 patients were included between August 2011 and June 2016; patients initiated docetaxel after failure of first- (42.2% [170]), second- (31.0% [125]) and ≥third-line (12.7% [51]) hormonal therapy, estramustine (11.4% [46]) or other (2.7% [11]). The planned cycles of docetaxel therapy were completed by 30.8% of patients, and the mean (SD) number of cycles received was 4.4 (2.86). Median overall survival (mOS) was 22.4 (95% CI, 20.4-25.8) months and the prostate-specific antigen (PSA) response rate in patients with available data was 70.9% (168/237), with no differences in mOS and PSA response rates between treatment settings. Subgroup analysis revealed higher mOS in patients without visceral metastasis versus those with such metastases (22.9 vs. 17.4 months; P = 0.022). No new safety signals were observed and the most common adverse events associated with docetaxel were granulocytopenia (5%) and leukopenia (4.5%). CONCLUSION: Data from this study showed that around three-quarters of Chinese patients with mCRPC treated with docetaxel initiated treatment following first- or second-line hormonal therapy and no new safety signals were observed.
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Adenocarcinoma/tratamiento farmacológico , Antineoplásicos/uso terapéutico , Docetaxel/uso terapéutico , Neoplasias de la Próstata Resistentes a la Castración/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , China , Progresión de la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Antígeno Prostático Específico/sangreRESUMEN
Cases of renal cell carcinoma (RCC) presenting as a simple cyst are extremely rare. We herein report the case of a patient with RCC diagnosed as a simple renal cyst preoperatively. A 39-year-old female patient presented with abdominal pain for 3 months. Ultrasonography and contrast-enhanced computed tomography revealed a simple cyst in the left kidney. The patient underwent laparoscopic decortication of the renal cyst. Biochemical analysis of the cystic fluid revealed unusually low levels of potassium, sodium, calcium and glucose, and the histological examination of the floor of the cyst indicated malignancy. Laparoscopic nephrectomy was performed 20 days later and the pathological examination confirmed the diagnosis of RCC of the clear cell type. At the 2-year follow-up, the patient remained well and recurrence-free on imaging. The aim of the present study was to emphasize the importance of recognizing that RCC may occur in what appears to be a simple renal cyst based on imaging results. Biochemical analysis of the cystic fluid may help identify the presence of malignancy.
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BACKGROUND: The homeobox (HOX) genes have been implicated playing important roles in many human cancers. HOXA13 is a member of HOX genes that encode transcription factors regulating embryonic development and cell fate. In the present study, we aimed to investigate the expression and prognostic significance of HOXA13 in bladder cancer. METHODS: Immunohistochemical staining was initially performed to screen the differentially expressed HOXA13 between bladder cancer tissues and paired adjacent non-cancerous tissues. Subsequent Western blotting analysis validation was conducted using tissue samples from patients with bladder cancer. RESULTS: The expression level of HOXA13 was significantly higher in bladder cancer tissues compared to that in adjacent non-cancerous tissues (P < 0.001). The χ2-test showed that expression of HOXA13 was positively correlated with lymphatic metastasis (P = 0.013), bladder tumor TNM stage (P = 0.002) and pathological grade (P < 0.001). Kaplan-Meier survival analysis revealed that patients with bladder cancer with high expression of HOXA13 had shorter overall survival time (P = 0.001) and disease-free survival time (P = 0.001) compared to patients with low expression of HOXA13. Multivariate analysis indicated that HOXA13 was an independent prognostic factor for overall survival for bladder cancer patients. CONCLUSIONS: The results of our study show that high expression of HOXA13 is associated with the progression of bladder cancer and that HOXA13 might serve as a biomarker for prognosis of bladder cancer.
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Biomarcadores de Tumor/genética , Proteínas de Homeodominio/metabolismo , Neoplasias de la Vejiga Urinaria/metabolismo , Neoplasias de la Vejiga Urinaria/mortalidad , Anciano , Anciano de 80 o más Años , China/epidemiología , Supervivencia sin Enfermedad , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Pronóstico , Factores de Riesgo , Tasa de Supervivencia , Neoplasias de la Vejiga Urinaria/patologíaRESUMEN
OBJECTIVES: We retrospectively reviewed the urethral stricture cases treated in our tertiary center, and assessed the safety and feasibility of the high-pressure balloon dilation (HPBD) technique for anterior urethral stricture. METHODS: From January 2009 to December 2012, a total of 31 patients with anterior urethral strictures underwent HPBD at our center, while another 25 cases were treated by direct vision internal urethrotomy (DVIU). Patient demographics, stricture characteristics, surgical techniques, and operative outcomes were assessed and compared between the two groups. The Kaplan-Meier survival analysis was applied to evaluate the stricture-free rate for the two surgical techniques. RESULTS: The operation time was much shorter for the HPBD procedure than for the DVIU ((13.19±2.68) min vs. (18.44±3.29) min, P<0.01). For the HPBD group, the major postoperative complications as urethral bleeding and urinary tract infection (UTI) were less frequently encountered than those in DVIU (urethral bleeding: 2/31 vs. 8/25, P=0.017; UTI: 1/31 vs. 6/25 P=0.037). The Kaplan-Meier survival analysis showed that there was no significant difference in stricture-free rate at 36 months between the two groups (P=0.21, hazard ratio (HR)=0.65, 95% confidence interval (CI): 0.34 to 1.26). However, there was a significantly higher stricture-free survival in the HPBD group at 12 months (P=0.02, HR=0.35, 95% CI: 0.14 to 0.87), which indicated that the stricture recurrence could be delayed by using the HPBD technique. CONCLUSIONS: HPBD was effective and safe and it could be considered as an alternative treatment modality for anterior urethral stricture disease.
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Dilatación/métodos , Estrechez Uretral/cirugía , Adulto , Anciano , Hemorragia/complicaciones , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Tempo Operativo , Complicaciones Posoperatorias , Presión , Modelos de Riesgos Proporcionales , Recurrencia , Estudios Retrospectivos , Centros de Atención Terciaria , Factores de Tiempo , Resultado del Tratamiento , Uretra/patología , Infecciones Urinarias/complicacionesRESUMEN
To compare percutaneous nephrolithotomy (PCNL) and laparoscopic pyelolithotomy (LP) for surgical management for large (>2â cm) renal stones. We searched MEDLINE, Cochrane, and EMBASE databases until March 11, 2015, using the following search terms: renalpelvic stone, percutaneous nephrolithotomy, laparoscopic pyelolithotomy. Randomized controlled and prospective and retrospective two-armed studies were included. Sensitivity analysis and assessment of the quality of the included studies and publication bias were performed. Nine studies were included in the study with a patient population of 622. The studies were homogeneous with respect to the primary end point of stone-free rate, but were heterogeneous with respect to operation time, length of hospital stay, and blood loss. A higher percentage of patients who received LP remained stone-free following surgery compared with patients who were treated with PCNL (p=0.001). However, the mean operation time was longer for patients with LP than for those treated with PCNL (p=0.002). There was no difference between procedures with regard to length of hospital stay or blood loss (p≥0.071). Sensitivity and quality analysis indicated that the data are reliable and the included studies are of good quality. No publication bias was observed. The study suggests that both procedures are effective and safe for removing large renal stones. However, LP may be more efficacious than PCNL in treating large kidney stones.
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Cálculos Renales/patología , Cálculos Renales/cirugía , Laparoscopía/efectos adversos , Nefrolitotomía Percutánea/efectos adversos , Adulto , Pérdida de Sangre Quirúrgica , Transfusión Sanguínea , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Tempo Operativo , Complicaciones Posoperatorias/etiología , Sesgo de Publicación , Sensibilidad y Especificidad , Resultado del TratamientoRESUMEN
BACKGROUND: It is well known that a significant number of prostate cancers (PCa) showed different extents of radio-resistance and the tumor may recur after treatment. Recent studies demonstrated that Testicular orphan nuclear receptor 4 (TR4) could play a critical role in anti-oxidative stress responses and might modulate the DNA damage repair. The objective of this study is to investigate the role of TR4 in the radiotherapy for PCa. METHODS: The TR4 expression in tissue samples from PCa patients treated with brachytherapy was measured by immunohistochemistry (IHC). Cell survival test and colony formation assay were applied to test the radio-sensitivity of PCa cells with modulated TR4 gene expression upon irradiation. RESULTS: PCa patients with biochemical recurrence (BCR) after brachytherapy tend to have higher TR4 expression (80%, n = 30) as compared to those without BCR (36.67%, n = 30). Survival analysis demonstrated a significant higher BCR occurrence in patients with high level of TR4 expression (HR = 3.474, 95%CI 1.678-7.192, P = 0.0008). Multivariate analysis showed that the TR4 staining score on IHC was the only significant variable for predicting the PCa patients' clinical outcomes after radiotherapy (OR = 9.919, 95% CI 2.516-39.101, P = 0.001). Using cell survival test and colony forming assay, we found that the addition of functional TR4 in PC3 cells lead to elevated radio-resistance. In contrast, knocking-down TR4 in LNCaP cells resulted in increased radio-sensitivity. The γH2AX foci kinetic analysis suggested that knocking down TR4 might delay the PCa cell's DNA damage repair which would enhance the radio-sensitivity. CONCLUSION: TR4 could mediate the PCa cells' radio-sensitivity and might become a prognostic indicator for PCa patients received radiotherapy. This study provides a novel approach to manipulate radio-sensitivity of PCa cells, and may bring a promoted therapeutic outcome of radiotherapy to battle PCa in future.
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Biomarcadores de Tumor/biosíntesis , Proteínas Nucleares/biosíntesis , Neoplasias de la Próstata/metabolismo , Neoplasias de la Próstata/radioterapia , Tolerancia a Radiación/fisiología , Proteínas Represoras/biosíntesis , Anciano , Línea Celular Tumoral , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
The hepatocyte growth factor and its receptor c-Met are correlated with castration-resistance in prostate cancer. Although HGF has been considered as an attractive target for therapeutic antibodies, the lack of cross-reactivity of monoclonal antibodies with human/mouse HGFs is a major obstacle in preclinical developments. We generated a panel of anti-HGF RabMAbs either blocking HGF/c-Met interaction or inhibiting c-Met phosphorylation. We selected one RabMAb with mouse cross-reactivity and demonstrated that it blocked HGF-stimulated downstream activation in PC-3 and DU145 cells. Anti-HGF RabMAb inhibited not only the growth of PC-3 cells but also HGF-dependent proliferation in HUVECs. We further demonstrated the efficacy and potency of the anti-HGF RabMAb in tumor xenograft mice models. Through these in vitro and in vivo experiments, we explored a novel therapeutic antibody for advanced prostate cancer.
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Anticuerpos Monoclonales/farmacología , Anticuerpos Neutralizantes/farmacología , Regulación Neoplásica de la Expresión Génica , Factor de Crecimiento de Hepatocito/antagonistas & inhibidores , Neoplasias de la Próstata/tratamiento farmacológico , Proteínas Proto-Oncogénicas c-met/antagonistas & inhibidores , Animales , Anticuerpos Monoclonales/biosíntesis , Anticuerpos Monoclonales/aislamiento & purificación , Anticuerpos Neutralizantes/biosíntesis , Anticuerpos Neutralizantes/aislamiento & purificación , Línea Celular Tumoral , Proliferación Celular/efectos de los fármacos , Factor de Crecimiento de Hepatocito/genética , Factor de Crecimiento de Hepatocito/metabolismo , Células Endoteliales de la Vena Umbilical Humana/citología , Células Endoteliales de la Vena Umbilical Humana/efectos de los fármacos , Células Endoteliales de la Vena Umbilical Humana/metabolismo , Humanos , Masculino , Ratones , Ratones Desnudos , Fosforilación/efectos de los fármacos , Próstata/efectos de los fármacos , Próstata/metabolismo , Próstata/patología , Neoplasias de la Próstata/genética , Neoplasias de la Próstata/metabolismo , Neoplasias de la Próstata/patología , Unión Proteica/efectos de los fármacos , Proteínas Proto-Oncogénicas c-met/genética , Proteínas Proto-Oncogénicas c-met/metabolismo , Conejos , Transducción de Señal , Relación Estructura-Actividad , Ensayos Antitumor por Modelo de XenoinjertoRESUMEN
OBJECTIVE: It is recommended that transurethral resection of the prostate (TURP) after brachytherapy should not be performed at an early stage after implantation. Herein we report our experiences and the results of channel TURP (cTURP) within six months post-implant for patients with refractory urinary retention. METHODS: One hundred and ninety patients with localized prostate cancer of clinical stages T1c to T2c were treated by brachytherapy as monotherapy at our institution from February 2009 to July 2013. Nine patients who developed refractory urinary retention and underwent cTURP within six months after brachytherapy were retrospectively reviewed and analyzed. RESULTS: The median interval between prostate brachytherapy and cTURP was three months (range 1.5 to 5.0 months). There were no intraoperative or postoperative complications and no incontinence resulting from the surgery. All urinary retention was relieved per the American Brachytherapy Society urinary symptom score. With a mean follow-up time of 16 months (range 6 to 26 months) after cTURP, no patient experienced biochemical recurrence. The mean serum prostate-specific antigen (PSA) of the patients who underwent cTURP was 0.42 ng/ml (range 0.08 to 0.83 ng/ml) at the end of their follow-up. CONCLUSIONS: Early cTURP was found to be safe and effective in relieving urinary retention after brachytherapy and could be performed without compromising its therapeutic efficacy.
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Braquiterapia/efectos adversos , Neoplasias de la Próstata/radioterapia , Neoplasias de la Próstata/cirugía , Resección Transuretral de la Próstata/métodos , Retención Urinaria/etiología , Retención Urinaria/cirugía , Anciano , Anciano de 80 o más Años , Humanos , Calicreínas/sangre , Masculino , Antígeno Prostático Específico/sangre , Neoplasias de la Próstata/sangre , Estudios Retrospectivos , Factores de TiempoRESUMEN
The purpose of the present study was to increase the knowledge of angiomyofibroblastoma (AMF)-like tumors in males by describing the second case of this rare lesion in the Chinese population with a long period of follow-up and by reviewing the literature. AMF-like tumor is a rare, circumscribed, slow-growing mesenchymal tumor that occurs predominantly in the vulva, perineum and pelvis of females. The present report presents a case of left scrotal AMF-like tumor in a 37-year-old male. Complete surgical excision was performed. The tumor was composed of spindle-shaped cells and small vessels proliferating in the edematous stroma. Immunohistologically, the tumor cells stained positive for smooth muscle actin and negative for S-100, CD34 and actin. Following seven years of follow-up the patient was asymptomatic and no evidence of tumor was found. In addition, the current literature was reviewed and the characteristics of this tumor were summarized. AMF-like tumors must also be distinguished from spindle cell lipoma, solitary fibrous tumor and aggressive angiomyxoma.
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Eosinophilic cystitis (EC) is a rare inflammatory disorder. We herein report a case of EC in an asthmatic female patient who had a recent exacerbation with none known allergen. She was administered montelukast sodium orally for four weeks and received complete remission. This medication was successfully discontinued after a three-month follow up period. This case report about successful treatment of an adult EC patient using montelukast sodium may provide a new option for EC patients with allergic history.
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OBJECTIVE: To evaluate clinical outcomes and values of transperitoneal laparoscopic ureterolithotomy. METHODS: A total of 1171 patients with upper ureteral calculi were recruited during September 1999 to February 2012. The etiologies included impacted calculi (n = 1100), non-impacted calculi (n = 71), multiple ureteral calculi (n = 51) and combined small calculi in unilateral kidney (n = 139). Maximum diameter of calculi was 1.5 (0.8-2.6) cm. All patients underwent transperitoneal laparoscopic ureterolithotomy and double J stent was implanted intraoperatively. RESULTS: Two cases were converted into open operation. Calculi moving up into pelvis occurred in 27 cases. And 25 cases converted into laparoscopic pyelolithotomy and stones were removed successfully. Two cases received extra extracorporeal shock wave lithotripsy postoperatively. The remaining 1142 cases were treated successfully with an operative duration of 56.1 (26-160) min and an estimated volume of blood loss at 45.2 (10-250) ml. The period of drainage tube was 3.1 (1-7) days. Postoperative hospitalization stay was 4.8 (3-9) days. One patient suffered urine leakage and healed at Day 6 days post-operation. Ten cases suffered D-J stent bladder non-arrival or retraction and double J stents were extracted by ureteroscopy. One case suffered paralytic ileus and recovered 7 days later. Another case suffered severe hematuria. No intestine or adjacent viscera injury was observed. The follow-up period of 827 cases was 7.3 (24-108) months. Among 12 cases of ureteral stricture, ureteral dilation (n = 7) and ureteral anastomosis (n = 3) were performed. For 5 cases of renal atrophy, 3 underwent nephrectomy because of recurrent lumbago or persistent urinary infection. CONCLUSIONS: Transperitoneal laparoscopic ureterolithotomy has the advantages of minimal morbidity, little postoperative discomfort and high stone clearance rate over open surgery. It should be widely adopted for the patients with upper ureteral impacted calculi.
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Laparoscopía , Cálculos Ureterales/cirugía , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Ureteroscopía , Adulto JovenRESUMEN
OBJECTIVE: To describe the early surgical repair of iatrogenic ureterovaginal fistula (UVF) secondary to gynecologic surgery, and evaluate the efficacy and feasibility of early surgical intervention. METHODS: Data were retrospectively reviewed for 52 patients with iatrogenic UVF who underwent early surgical repair between January 1996 and January 2011 at the Sir Run Run Shaw Hospital, Hangzhou, China. Preoperative patient characteristics and postoperative endpoints, including type of index procedure, repair technique, operative time, perioperative complications, and postoperative follow-up data were assessed. RESULTS: All early surgical repairs were uneventful. The mean time from diagnosis to surgery was 15.7days (range, 14-21days). The mean operative time was 73.4min (range, 51-110min) for ureteroneocystostomy, and 104min (range, 91.5-153min) for Boari flap procedure. The mean estimated blood loss was 57.8mL (range, 35-80mL). No major intraoperative complications occurred, although 5 patients had postoperative surgical site infections. Forty-three patients were followed for a mean of 18.4months (range, 10.5-24.0months). Ureteral stricture with asymptomatic hydronephrosis occurred in 2 (4.7%) patients. Ipsilateral renal function was preserved in all patients. CONCLUSION: Early surgical repair of UVF secondary to gynecologic surgery was safe and effective, and preserved ipsilateral renal function.
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Procedimientos Quirúrgicos Ginecológicos/efectos adversos , Enfermedades Ureterales/cirugía , Fístula Urinaria/cirugía , Fístula Vaginal/cirugía , Adulto , Pérdida de Sangre Quirúrgica , China , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Enfermedad Iatrogénica , Complicaciones Intraoperatorias/epidemiología , Pruebas de Función Renal , Persona de Mediana Edad , Tempo Operativo , Estudios Retrospectivos , Factores de Tiempo , Enfermedades Ureterales/etiología , Fístula Urinaria/etiología , Fístula Vaginal/etiología , Adulto JovenRESUMEN
We present a rare case of colonic metastasis of renal cell carcinoma (RCC) and review the literature. A 54-year-old male was referred to our hospital with a history of bloody stools and fever. A right kidney tumor measuring about 10 cm in diameter was found by abdominal computed tomography. Right radical nephrectomy and a right hemicolectomy with ileotransversostomy were performed. Pathological diagnosis was chromophobe RCC with sarcomotoid change involving the colon. Chromophobe RCC with sarcomotoid change is very rare.
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Carcinoma de Células Renales/complicaciones , Carcinoma de Células Renales/diagnóstico , Neoplasias del Colon/diagnóstico , Neoplasias del Colon/secundario , Neoplasias Renales/complicaciones , Neoplasias Renales/diagnóstico , Humanos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To introduce a novel surgical technique for correction of adult congenital webbed penis. METHODS: From March 2010 to December 2011, 12 patients (age range: 14-23 years old) were diagnosed as having a webbed penis and underwent a new surgical procedure designed by us. RESULTS: All cases were treated successfully without severe complication. The operation time ranged from 20 min to 1 h. The average bleeding volume was less than 50 ml. All patients achieved satisfactory cosmetic results after surgery. The penile curvature disappeared in all cases and all patients remained well after 1 to 3 months of follow-up. CONCLUSIONS: Adult webbed penis with complaints of discomfort or psychological pressure due to a poor profile should be indicators for surgery. Good corrective surgery should expose the glans and coronal sulcus, match the penile skin length to the penile shaft length dorsally and ventrally, and provide a normal penoscrotal junction. Our new technique is a safe and effective method for the correction of adult webbed penis, which produces satisfactory results.
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Enfermedades de los Genitales Masculinos/cirugía , Pene/anomalías , Pene/cirugía , Procedimientos de Cirugía Plástica/métodos , Adolescente , Enfermedades de los Genitales Masculinos/patología , Humanos , Masculino , Escroto/patología , Escroto/cirugía , Resultado del Tratamiento , Adulto JovenRESUMEN
Severe hemorrhage following a prostatectomy is a rare and serious complication. A 63-year-old male with severe hemorrhage following radical prostatectomy which led to hypovolemic shock presented at our department and was treated with superselective internal iliac arterial embolization. At 6 months follow-up, the patient had recovered well, regained excellent urinary continence and the pelvic hematoma was absorbed using ultrasound examination. We concluded that rapid diagnosis by computed tomography angiography and early superselective embolization of internal iliac artery should be considered as the treatment of choice in severe hemorrhage cases following radical prostatectomy.
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BACKGROUND: Retrocaval ureter is a rare congenital abnormality. Operative repair is always suggested in cases of significant functional obstruction. Laparoscopic procedures have been employed as the minimally invasive therapeutic option for retrocaval ureter. However, the laparoscopic techniques for retrocaval ureter might be technically challenging to some surgeons. The aim of this article was to present our experience and surgical techniques of pure transperitoneal laparoscopic pyelopyelostomy and ureteroureterostomy in nine patients with retrocaval ureter. METHODS: A total of nine patients of retrocaval ureter underwent pure laparoscopic pyelopyelostomy or ureteroureterostomy. The operation was performed with the patients placed in the 70-degree lateral decubitus position via a three port transperitoneal approach with two 10-mm and one 5-mm ports. The distal part of the dilated renal pelvis was transected at the ureteropelvic junction and the ureter was relocated anterior to the inferior vena cava. The tension-free pyeloureteral or ureteroureteral anastomosis was completed with the intracorporal freehand suturing and in situ knot-tying techniques combined with interrupted and continuous fashion. A double J ureteral stent was inserted in an antegrade manner during laparoscopy. Intravenous urography or computerized tomography and renal ultrasonography were performed after 3 months postoperatively. RESULTS: All operations were completed laparoscopically, and no open conversion was required. The mean operative time was 135 minutes (range, 70 - 250 minutes), with minimal blood loss (less than 60 ml). No intra-operative complications or significant bleeding occurred. All patients presented mild postoperative pain and quick convalescence. The symptoms disappeared and hydronephrosis decreased substantially after surgery. CONCLUSIONS: Pure transperitoneal laparoscopic correction for retrocaval ureter was associated with an excellent outcome, minimal invasiveness and short hospital stay. It is technically feasible and reliable for retrocaval ureter treatment. Laparoscopic surgery could be the standard treatment for retrocaval ureter.
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Laparoscopía/métodos , Uréter/cirugía , Adulto , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Obstrucción Ureteral/cirugía , Adulto JovenRESUMEN
We studied the efficacy of culture-specific antibiotic therapy for chronic bacterial prostatitis (CBP) patients with or without prostatic calculi. This study included 101 patients (21-62 years old) who met the consensus criteria for CBP (National Institutes of Health category II). According to the results of transrectal ultrasonography (TRUS), all patients were divided into two groups: Group 1, CBP with prostatic calculi, n=39; Group 2, CBP without prostatic calculi, n=62. All patients received optimal antimicrobial therapy for 4 weeks and followed up for a minimum of 3 months (range: 3-8 months). In addition to expressed prostatic secretions (EPS) and urine culture, all patients were asked to complete the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the subjective global assessment (SGA). The microbiological eradication rate at the end of treatment were 32/39 (82.1%) and 54/62 (87.1%), while the rates for continued eradication at the end of study were 17/39 (43.6%) and 45/62 (72.6%) in Group 1 and Group 2 (P<0.01), respectively. We observed a decrease in the total NIH-CPSI score median values from 24 to 19 in Group 1 and from 24 to 11 in Group 2. The pain subscore (P<0.01), urinary sunscore (P<0.05) and quality of life (QoL; P<0.05) as well as the total NIH-CPSI score (P<0.01) were significantly improved after antimicrobial treatment in Group 2 compared to Group 1. Response, defined as a decrease of the NIH-CPSI total score by at least 50%, was seen in Group 1 versus Group 2 in 38.5% and 58.1% (P<0.01), respectively. Our results showed that prostatic calculi influence the antimicrobial efficacy in men with CBP. There was a noticeable decrease in the cure rate of CBP patients with prostatic calculi due to relapse after antimicrobial therapy.
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Antibacterianos/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Cálculos/complicaciones , Enfermedades de la Próstata/complicaciones , Prostatitis/tratamiento farmacológico , Adulto , Infecciones Bacterianas/complicaciones , Infecciones Bacterianas/microbiología , Cálculos/diagnóstico por imagen , Enfermedad Crónica , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Próstata/diagnóstico por imagen , Prostatitis/complicaciones , Prostatitis/microbiología , UltrasonografíaRESUMEN
AIM: The treatment of adrenal metastasis using laparoscopic surgery is evolving. The aim of this study was to evaluate the feasibility of laparoscopic adrenalectomy (LA) in patients who have adrenal metastases. METHODS: From September 1998 to November 2010, 12 patients underwent LA for adrenal metastatic tumors. Three cases were bilateral and 9 were unilateral. We retrospectively reviewed the clinical and histopathologic data of all 12 patients. RESULTS: The operations of all the 12 cases were successful. There were no intraoperative complications. The mean follow-up time was 17.2 months (range, 2 to 56 mo). We found no intraperitoneal and/or port-site recurrence. One patient had died from metastatic disease. CONCLUSIONS: Our experience leads us to feel that LA is feasible when the primary tumor is well controlled, there are no other metastases clinically and radiologically, when the adrenal metastasis is confined to the adrenal gland, and there is no radiologic evidence of local extension into tissue around the adrenal gland.
Asunto(s)
Neoplasias de las Glándulas Suprarrenales/secundario , Neoplasias de las Glándulas Suprarrenales/cirugía , Adrenalectomía/métodos , Laparoscopía/métodos , Neoplasias de las Glándulas Suprarrenales/diagnóstico , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Peritoneo , Estudios Retrospectivos , Factores de Tiempo , Resultado del TratamientoRESUMEN
OBJECTIVE: To investigate the transvesical approach to the surgical treatment of seminal vesicle mass. METHODS: Transvesical removal of seminal vesicle mass was performed for 5 patients aged 45-69 (mean 51) years. The clinical symptoms included those involving the lower urinary tract such as frequent micturition and urgency in 3 cases (1 accompanied with dyschezia), hematospermia in 1, and lower abdominal and perineal malaise in the other. Two masses were in the left side and the other 3 in the right, ranging from 3 to 10 cm (mean 5 cm) in size, detected by transrectal ultrasonography, CT, MRI or digital rectal examination. The mean course of disease was 9 (2-18) months. RESULTS: All the 5 patients were treated successfully and uneventfully, with a mean operation time of 75 minutes, a mean blood loss of 140 ml and a mean hospital stay of 10 days. Pathological examinations revealed 2 cases of seminal vesicle cyst with infection, 1 cystadenoma, 1 phyllode tumor and 1 prostatic hyperplasia. A 3-72 months follow-up showed that all the patients were free of symptoms and had normal sexual function. CONCLUSION: Transvesical removal of seminal vesicle mass, with small incisal opening, good visual field and easy operation, is an effective surgical procedure for seminal vesicle disease.