[Outcomes of Laparoscopic Radical Prostatectomies by a Single Surgeon Alternating Operating Position].

The clinical outcome of laparoscopic radical prostatectomy (LRP) was retrospectively investigated taking into consideration the surgeon's position during the procedure. The study cohort included 184 consecutive patients who had undergone LRP performed by a single surgeon from February 2013 to July 2018. During the study period,the surgeon stood alternately on either the left or right side of the patient. The D'Amico risk classification was low,intermediate and high in 26 (14.1%),45 (24.5%) and 113 (61.4%) patients,respectively. Mean surgical duration was 203.5 minutes and mean estimated blood loss was 437.6 ml. Nerve sparing (NS) was implemented in 82 (44. 6%) patients. The mean period of having an indwelling urethral catheter was 5. 0 days. Perioperative Clavien-Dindo degree ≥IIIa complications occurred in three (1.6%) patients. Except for cases with presurgical hormonal treatment,surgical margins were positive in 41 (22.3%) patients,among whom 23 (17.4%) had pT2 disease. The 5-year biochemical recurrence-free survival rate was 81.4%,and 84.8% of patients regained urinary continence at 12 months after surgery. Where the surgeon stood during LRP was not associated with significant differences in any parameter. However,the margin positive rate was higher on the side away from where the surgeon stood than the side closer to the surgeon (70.7% vs 29.3%). In conclusion,the position of the surgeon during LRP does not influence the outcome.

[Effectiveness of skin icing for reducing pain associated with luteinizing hormone-releasing hormone agonist injection].

We evaluated the effect of using the cooling method on pain at the site of luteinizing hormone-releasing hormone(LH-RH) agonist injection in 181 prostate cancer or premenopausal breast cancer patients by using a numerical rating scale(NRS)and a questionnaire survey with open-ended questions. According to the NRS, 38.1% of the patients experienced a reduction in pain, 37.5% experienced no change, and 24.4% experienced an increase in pain. Therefore, use of the cooling method did not have a statistically significant effect in terms of pain reduction(p=0.123). However, on analyzing pain reduction according to the answers in the questionnaire survey, 53.2% of the patients experienced a reduction in pain, 38.5% experienced no change, and 8.3% experienced an increase in pain. These findings were different from those obtained on using the NRS. In addition, irrespective of using the cooling method, needle thickness and patient obesity strongly influenced the pain experienced. The skin icing method was effective in reducing pain at the site of LH-RH agonist injection. This method is simple, inexpensive, and safe, and is hence recommended.

Scoliosis associated with Prader-Willi syndrome.

BACKGROUND CONTEXT: Prader-Willi syndrome is a rare disease associated with a variety of musculoskeletal abnormalities, including scoliosis, joint hyperlaxity, and delayed bone age. To the authors' knowledge, only a few cases of surgical treatment for scoliosis associated with Prader-Willi syndrome have been reported. PURPOSE: To report a rare case of scoliosis associated with Prader-Willi syndrome and the effect of surgical treatment and to review the literature on this condition. STUDY DESIGN/SETTING: Case report of a patient treated in Gifu, Japan. METHODS: The patient, a 16-year-old girl with Prader-Willi syndrome, had severe scoliosis with triple curves (T1 to T5, 43 degrees T5 to T11, 60 degrees; T11 to L3, 52 degrees), making it difficult for her to maintain balance while standing or walking. She underwent surgical correction and fusion for the scoliosis via the posterior approach. She was followed up for 2 years, and her clinical symptoms and plain X-ray films were evaluated. RESULTS: The thoracic curve was corrected to 21 degrees (correction rate, 65%) and the lumbar curve to 28 degrees (correction rate, 46%). Her symptoms were relieved. CONCLUSION: A case of scoliosis with Prader-Willi syndrome was successfully treated surgically using a posterior approach and minimizing possible risks associated with surgery in patients with this syndrome.