[Technique of running urethrovesical anastomosis during radical laparoscopic prostatectomy: separate application of two needles].

OBJECTIVE: To study the value and feasibility of a novel method of urethrovesical anastomosis during radical laparoscopic prostatectomy. METHODS: From 2008 to 2009, 10 patients with local prostate cancer (LPC) underwent radical laparoscopic prostatectomy through the placement of two separate needles for running urethrovesical anastomosis. The first step comprised the first stitch placed in the posterior wall of anastomosis (at 4 o'clock) and then clockwise running suture from 4 to 12 o'clock position. The next steps entailed another needle, stitching at 3 o'clock position and counterclockwise running suture. Two sutures would meet at 12 o'clock position for the third and final knot. When the position of urinary leak was observed, an additional suture would be performed. RESULTS: This technique was performed in 10 patients with a mean anastomosis duration of 30 minutes (range: 25 - 45) and a mean operative duration of 220 minutes (range: 200 - 300). The Foley catheter was implanted for 14 days. Neither bladder neck stricture nor urinary leak was observed with a follow-up period of 3 - 24 months. CONCLUSIONS: The described technique is a feasible and safe method for urethrovesical anastomosis with a low rate of complications. And it may be quickly mastered so as to lower the learning curve of a novice.

[Retroperitoneal laparoscopic nephron-sparing surgery for renal tumors].

OBJECTIVE: To evaluate the feasibility and clinical efficacy of employing a homemade lasso to control the renal blood flow in retroperitoneal laparoscopic nephron-sparing surgery for the treatment of renal tumors. METHODS: Eight patients with benign renal tumors and 14 with malignant renal tumors underwent enucleation and wedge resection of renal tumors through retroperitoneal laparoscopy. Of these 22 patients, 15 were males and 7 females with a mean age of 45 years old. The mean tumor diameter was 3.2 cm. RESULTS: All the procedures were technically successful without conversion to open surgery in all 22 patients. The mean operative time was 150 min and mean blood loss 80 ml. The mean postoperative hospital stay was 8 days. No intraoperative or postoperative complication occurred. All 14 cases of malignant renal tumors had a negative surgical margin. With a follow-up of 5-29 months, no recurrence occurred. CONCLUSION: Retroperitoneal laparoscopic partial nephrectomy is feasible and safe for selective patients with renal tumors. Using a homemade lasso to control the renal blood flow in retroperitoneal laparoscopic partial nephrectomy is simple and less interferential.

[Comparative study on transperitoneal retroperitoneal laparoscopic adrenalectomy and open adrenalectomy for adrenal tumours].

OBJECTIVE: To compare and evaluate the clinical value among transperitoneal, retroperitoneal laparoscopic adrenalectomy and open adrenalectomy for the treatment of adrenal tumours. METHODS: From January 1996 to June 2002, transperitoneal laparoscopic adrenalectomy (TLA) was performed for 19 cases, 17 cases were successful (Group A), retroperitoneal laparoscopic adrenalectomy (RLA) for 21 cases, 19 cases were successful (Group B), during the same period 41 patients with adrenal tumours under 6 cm in diameter underwent open adrenalectomy (Group C). The procedure was evaluated and compared in the respects of tumors weight, operation time, blood loss, recovery time of GI function, hospital stay, complications transferable rate and indications among three groups. RESULTS: Average tumors weight was (13.86) g in group A, (15.66) g in group B and (18.03) g in group C; mean operating time: group A was 17.21 min longer than group B, group A. B was 48.53 min longer and 31.32 min longer han group C respectively, mean blood loss in group A. B was less diminished by 121.55 ml and 137.05 ml than group C, and the blood loss in group B was less diminished by 15.50 ml than group A; mean recovery of Gl function, group A and B was 1.87 day and 2.17 day earlier than group C respectively, group B was 0.3 day earlier than group A, mean hospital stay was 2.60 day and 3.87 day shorter than group C, group B was 1.27 day shorter, than group A; transferable rate of operation was 10.5% (group A) and 9.5% (group B). Postoperative complication rate was 10.5%, 14.3% and 9.7% in group A. B and C respectively. CONCLUSIONS: TLA and RLA were better than open method. On the hand of approach to adrenal gland disturbs to abdominal organ and postoperative recovery on RLA have some slight advantage.

[Modification of recombinant human augmenter of liver regeneration with urea studied by maldi-tof mass spectrometry].

To investigate the modification of recombinant human augmenter of liver regeneration (rhALR) by the urea in purification processes and the biological activity of rhALR and modified rhALR, the molecular weight of proteins and tryptic peptides were determined by matrix-assisted laser desorption time of flight mass spectrometry (MALDI-TOF-MS), and the biological activity of rhALR and modified rhALR was also observed by in vivo experiments. A 30 kD homodimer of rhALR was purified under denaturing conditions. The molecular weight of rhALR is 30 780 if urea was used to denature the inclusion bodies; when the denaturant was guanidine hydrochloride, the molecular weight of rhALR was 30 087. The results of MALDI-TOF-MS of digested rhALR that have been modified by urea showed that peptides that contained lysyl were 43 larger than the theoretical value. Proteins purified by different processes were all able to promote the survival rate of CCl(4)-intoxicated mice. It could be concluded that cyanate, the cleavage product of urea, could react with the epsilon-amino group of lysyl in rhALR, and the modified rhALR had the same biological activity as natural rhALR.