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1.
Nature ; 581(7809): 406-410, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32461648

RESUMO

The production of large single-crystal metal foils with various facet indices has long been a pursuit in materials science owing to their potential applications in crystal epitaxy, catalysis, electronics and thermal engineering1-5. For a given metal, there are only three sets of low-index facets ({100}, {110} and {111}). In comparison, high-index facets are in principle infinite and could afford richer surface structures and properties. However, the controlled preparation of single-crystal foils with high-index facets is challenging, because they are neither thermodynamically6,7 nor kinetically3 favourable compared to low-index facets6-18. Here we report a seeded growth technique for building a library of single-crystal copper foils with sizes of about 30 × 20 square centimetres and more than 30 kinds of facet. A mild pre-oxidation of polycrystalline copper foils, followed by annealing in a reducing atmosphere, leads to the growth of high-index copper facets that cover almost the entire foil and have the potential of growing to lengths of several metres. The creation of oxide surface layers on our foils means that surface energy minimization is not a key determinant of facet selection for growth, as is usually the case. Instead, facet selection is dictated randomly by the facet of the largest grain (irrespective of its surface energy), which consumes smaller grains and eliminates grain boundaries. Our high-index foils can be used as seeds for the growth of other Cu foils along either the in-plane or the out-of-plane direction. We show that this technique is also applicable to the growth of high-index single-crystal nickel foils, and we explore the possibility of using our high-index copper foils as substrates for the epitaxial growth of two-dimensional materials. Other applications are expected in selective catalysis, low-impedance electrical conduction and heat dissipation.

2.
Phys Rev Lett ; 132(7): 076503, 2024 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-38427879

RESUMO

Transition metal dichalcogenide superlattices provide an exciting new platform for exploring and understanding a variety of phases of matter. The moiré continuum Hamiltonian, of two-dimensional jellium in a modulating potential, provides a fundamental model for such systems. Accurate computations with this model are essential for interpreting experimental observations and making predictions for future explorations. In this work, we combine two complementary quantum Monte Carlo (QMC) methods, phaseless auxiliary field quantum Monte Carlo and fixed-phase diffusion Monte Carlo, to study the ground state of this Hamiltonian. We observe a metal-insulator transition between a paramagnet and a 120° Néel ordered state as the moiré potential depth and the interaction strength are varied. We find significant differences from existing results by Hartree-Fock and exact diagonalization studies. In addition, we benchmark density-functional theory, and suggest an optimal hybrid functional which best approximates our QMC results.

3.
Pharmacol Res ; : 107302, 2024 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-39004242

RESUMO

Bladder cancer stands as a prevalent global malignancy, exhibiting notable sex-based variations in both incidence and prognosis. Despite substantial strides in therapeutic approaches, the formidable challenge of drug resistance persists. The genomic landscape of bladder cancer, characterized by intricate clonal heterogeneity, emerges as a pivotal determinant in fostering this resistance. Clonal evolution, encapsulating the dynamic transformations within subpopulations of tumor cells over time, is implicated in the emergence of drug-resistant traits. Within this review, we illuminate contemporary insights into the role of clonal evolution in bladder cancer, elucidating its influence as a driver in tumor initiation, disease progression, and the formidable obstacle of therapy resistance.

4.
Surg Endosc ; 38(6): 3455-3460, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38755463

RESUMO

BACKGROUND: Laparoscopic anatomical resection of segment 7 (LARS7) remains a technically challenging procedure due to the deep anatomical location and the potential risk of injury to the right hepatic vein (RHV). Herein, we initiated an innovative technique of caudo-dorsal approach combined with the occlusion of the RHV and Pringle maneuver for LARS7 and presented the outcomes of our initial series. METHOD: Since January 2021, the patients who underwent LARS7 by using this novel technique were enrolled in this study. The critical aspect of this technique was the interruption of communication between the RHV and the inferior vena cava. Meanwhile, the Pringle maneuver was adopted to control the hepatic inflow. RESULT: A total of 11 patients underwent LARS7 by using this novel technique, which included 8 hepatocellular carcinoma, 2 bile duct adenocarcinoma and one focal nodular hyperplasia. The median operative time was 199 min (range of 151-318 min) and the median blood loss was 150 ml (range of 50-200 ml). The main trunk of the RHV was fully exposed on the cutting surface in all cases and no patient received perioperative blood transfusion. No procedure was converted to open surgery. Of note, no indications of CO2 gas embolism were observed in these cases after the introduction of double occlusion. Only one patient suffered from postoperative complications and healed after treatment. The median postoperative stay was 5 days (range of 4-7 days). The 90-day mortality was nil. At a median follow-up period of 19 months, all of the patients were alive without any evidence of tumor recurrence. CONCLUSION: The caudo-dorsal approach combined with the occlusion of RHV and the Pringle maneuver may be a feasible and expected technique for safe exposure of RHV in LARS7. Further validation of the feasibility and efficacy of this technique is needed.


Assuntos
Carcinoma Hepatocelular , Hepatectomia , Veias Hepáticas , Laparoscopia , Neoplasias Hepáticas , Humanos , Laparoscopia/métodos , Masculino , Veias Hepáticas/cirurgia , Feminino , Pessoa de Meia-Idade , Neoplasias Hepáticas/cirurgia , Idoso , Hepatectomia/métodos , Carcinoma Hepatocelular/cirurgia , Duração da Cirurgia , Adulto , Neoplasias dos Ductos Biliares/cirurgia , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Perda Sanguínea Cirúrgica/prevenção & controle , Hiperplasia Nodular Focal do Fígado/cirurgia , Adenocarcinoma/cirurgia
5.
Molecules ; 29(8)2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38675674

RESUMO

The water produced during the oxidative esterification reaction occupies the active sites and reduces the activity of the catalyst. In order to reduce the influence of water on the reaction system, a hydrophobic catalyst was prepared for the one-step oxidative esterification of methylacrolein (MAL) and methanol. The catalyst was synthesized by loading the active component Au onto ZnO using the deposition-precipitation method, followed by constructing the silicon shell on Au/ZnO using tetraethoxysilane (TEOS) to introduce hydrophobic groups. Trimethylchlorosilane (TMCS) was used as a hydrophobic modification reagent to prepare hydrophobic catalysts, which exhibited a water droplet contact angle of 111.2°. At a temperature of 80 °C, the hydrophobic catalyst achieved a high MMA selectivity of over 95%. The samples were characterized using XRD, N2 adsorption, ICP, SEM, TEM, UV-vis, FT-IR, XPS, and water droplet contact angle measurements. Kinetic analysis revealed an activation energy of 22.44 kJ/mol for the hydrophobic catalyst.

6.
HPB (Oxford) ; 2024 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-38955633

RESUMO

BACKGROUND: Minimally invasive hepatectomy for difficult lesions located in posterosuperior segments (segments I, IVa, VII and VIII) remains challenging. The value of robotic liver resection (RLR) compared with laparoscopic liver resection (LLR) for posterosuperior segments is controversial. Therefore, we performed this meta-analysis to validate the safety and efficacy of RLR in posterosuperior segments. METHODS: The Medline, Embase, Web of Science, and Cochrane Library electronic databases were searched to identify available research published up to October 2023. Statistical analysis was performed with RevMan software version 5.3. RESULTS: Six studies with a total of 2289 patients (RLR: n = 749; LLR: n = 1540) were included in this meta-analysis. The RLR group had less intraoperative blood loss (WMD = -119.54 ml, 95% CI: -178.89 to -60.19, P < 0.0001), fewer blood transfusions (OR = 0.56, 95% CI: 0.39 to 0.80, P = 0.001), a lower conversion rate (OR = 0.37, 95% CI: 0.23 to 0.61, P < 0.0001), and a shorter operative time (WMD = -27.16 min, 95% CI: -35.95 to -18.36, P < 0.00001). DISCUSSION: Compared with LLR, RLR for lesions in the posterosuperior segments could be safe and effective, and it has superior surgical outcomes.

7.
Chin J Cancer Res ; 36(3): 341-350, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38988484

RESUMO

Aging and circadian rhythms have been connected for decades, but their molecular interaction has remained unknown, especially for cancers. In this situation, we summarized the current research actuality and problems in this field using the bibliometric analysis. Publications in the PubMed and Web of Science databases were retrieved. Overall, there is a rising trend in the publication volume regarding aging and circadian rhythms in the field of cancer. Researchers from USA, Germany, Italy, China and England have greater studies than others. Top three publication institutions are University of California System, UDICE-French Research Universities and University of Texas System. Current research hotspots include oxidative stress, breast cancer, melatonin, cell cycle, calorie restriction, prostate cancer and NF-KB. In conclusion, results generated by bibliometric analysis indicate that many approaches involve in the complex interactions between aging and circadian rhythm in cancer. These established and emerging research directions guide our exploration of the regulatory mechanisms of aging and circadian rhythms in cancer and provide a reference for developing new research avenues.

8.
Phys Rev Lett ; 130(7): 076102, 2023 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-36867819

RESUMO

We survey the phase diagram of high-pressure molecular hydrogen with path integral molecular dynamics using a machine-learned interatomic potential trained with quantum Monte Carlo forces and energies. Besides the HCP and C2/c-24 phases, we find two new stable phases both with molecular centers in the Fmmm-4 structure, separated by a molecular orientation transition with temperature. The high temperature isotropic Fmmm-4 phase has a reentrant melting line with a maximum at higher temperature (1450 K at 150 GPa) than previously estimated and crosses the liquid-liquid transition line around 1200 K and 200 GPa.

9.
Int J Mol Sci ; 24(10)2023 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-37239852

RESUMO

Extracellular vesicles (EVs) play important roles in (patho)physiological processes by mediating cell communication. Although EVs contain glycans and glycosaminoglycans (GAGs), these biomolecules have been overlooked due to technical challenges in comprehensive glycome analysis coupled with EV isolation. Conventional mass spectrometry (MS)-based methods are restricted to the assessment of N-linked glycans. Therefore, methods to comprehensively analyze all glyco-polymer classes on EVs are urgently needed. In this study, tangential flow filtration-based EV isolation was coupled with glycan node analysis (GNA) as an innovative and robust approach to characterize most major glyco-polymer features of EVs. GNA is a molecularly bottom-up gas chromatography-MS technique that provides unique information that is unobtainable with conventional methods. The results indicate that GNA can identify EV-associated glyco-polymers that would remain undetected with conventional MS methods. Specifically, predictions based on GNA identified a GAG (hyaluronan) with varying abundance on EVs from two different melanoma cell lines. Enzyme-linked immunosorbent assays and enzymatic stripping protocols confirmed the differential abundance of EV-associated hyaluronan. These results lay the framework to explore GNA as a tool to assess major glycan classes on EVs, unveiling the EV glycocode and its biological functions.


Assuntos
Vesículas Extracelulares , Melanoma , Humanos , Glicosaminoglicanos/metabolismo , Ácido Hialurônico/metabolismo , Melanoma/diagnóstico , Melanoma/metabolismo , Polissacarídeos/metabolismo , Vesículas Extracelulares/metabolismo
10.
Molecules ; 28(22)2023 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-38005214

RESUMO

Distiller's grains (DGs) are solid mixtures that remain after the production of alcoholic beverages. A large amount of DGs is produced each year during the brewing process. Currently, they are mostly used as a feedstock or substrate in the feed industry. However, the lack of a comprehensive understanding of the chemical composition of DGs is a major constraint on their further development and application for high-value-added usages. Some studies were published on the bioactive constituents of DGs in several different types of journals. Data were therefore collated to provide a comprehensive overview of these natural products. DGs are rich in phenols, phytosterols, and fatty acids, in addition to general lipid and protein constituents. These compounds and their related extracts possess diverse biological activities, including antioxidant, anti-inflammatory, and anti-hyperglycaemic effects. We hope that this review will provide research incentives for the further development and utilisation of DGs to develop high-value-added products.


Assuntos
Bebidas Alcoólicas , Proteínas , Antioxidantes/farmacologia , Grão Comestível , Estruturas Vegetais , Ração Animal
11.
Surg Endosc ; 36(12): 8927-8934, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35672503

RESUMO

BACKGROUND: Liver parenchymal transection is the most critical step for laparoscopic liver resection (LLR). Ultrasonic scalpel (Harmonic) is a common used energy instrument in LLR; however, it is only recommended for superficial layer transection and the Cavitron Ultrasonic Surgical Aspirator (CUSA) is recommended for deep layer dissection. We herein introduce the "Harmonic mimic CUSA" technique for LLR. METHODS: We retrospectively reviewed the medical records of the patients who underwent LLR using CUSA or the "Harmonic mimic CUSA" for parenchymal transection between July 2018 and October 2020 at West China Hospital of Sichuan University. Observation indicators included general demographic information, operative time, intraoperative blood loss, blood transfusion volume, complication rate, hospital stay, and the costs. Perioperative data was compared between the two groups by propensity score matching analysis (PSM). RESULTS: A total of 298 patients, including 192 in Harmonic group and 106 in CUSA group, were enrolled in this study. After a 1:1 PSM, 99 patients using "Harmonic mimic CUSA" were matched with 99 patients via CUSA for parenchymal transection in LLRs. The Harmonic group had significantly less intraoperative blood loss (mean, 150 ml vs. 250 ml, P < 0.001), shorter operative time (mean 170 min vs. 250 min, P < 0.001) and less costs (mean 6723$ vs. 8307$, P < 0.001). The conversion to laparotomy, length of postoperative hospital stay, complications were comparable between the two groups. There perioperative mortality was nil. CONCLUSION: The "Harmonic mimic CUSA" technique is safe, simple and feasible for LLR, which may be an alternative to CUSA for LLR.


Assuntos
Laparoscopia , Neoplasias Hepáticas , Humanos , Perda Sanguínea Cirúrgica , Estudos Retrospectivos , Ultrassom , Hepatectomia/métodos , Fígado/cirurgia , Neoplasias Hepáticas/cirurgia , Tempo de Internação
12.
J Nanobiotechnology ; 18(1): 162, 2020 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-33160390

RESUMO

BACKGROUND: Cancer cell-derived extracellular vesicles (EVs) have previously been shown to contribute to pre-metastatic niche formation. Specifically, aggressive tumors secrete pro-metastatic EVs that travel in the circulation to distant organs to modulate the microenvironment for future metastatic spread. Previous studies have focused on the interface between pro-metastatic EVs and epithelial/endothelial cells in the pre-metastatic niche. However, EV interactions with circulating components such as low-density lipoprotein (LDL) have been overlooked. RESULTS: This study demonstrates that EVs derived from brain metastases cells (Br-EVs) and corresponding regular cancer cells (Reg-EVs) display different interactions with LDL. Specifically, Br-EVs trigger LDL aggregation, and the presence of LDL accelerates Br-EV uptake by monocytes, which are key components in the brain metastatic niche. CONCLUSIONS: Collectively, these data are the first to demonstrate that pro-metastatic EVs display distinct interactions with LDL, which impacts monocyte internalization of EVs.


Assuntos
Neoplasias Encefálicas/metabolismo , Vesículas Extracelulares/metabolismo , Lipoproteínas LDL/metabolismo , Neoplasias Encefálicas/patologia , Neoplasias da Mama , Linhagem Celular Tumoral , Células Endoteliais , Humanos , Macrófagos , Monócitos , Células THP-1 , Microambiente Tumoral
14.
J Am Chem Soc ; 140(45): 15279-15289, 2018 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-30347983

RESUMO

Cathodes of lithium-rich layered oxides for high-energy Li-ion batteries in electrically powered vehicles are attracting considerable attention by the research community. However, current research is insufficient to account for their complex reaction mechanism and application. Here, the structural evolution of lithium-manganese-rich layered oxides at different temperatures during electrochemical cycling has been investigated thoroughly, and their structural stability has been designed. The results indicated structure conversion from the two structures into a core-shell structure with a single distorted-monoclinic LiTMO2 structure core and disordered-spinel/rock salt structure shell, along with lattice oxygen extraction and lattice densification, transition- metal migration, and aggregation on the crystal surface. The structural conversion behavior was found to be seriously temperature sensitive, accelerated with higher temperature, and can be effectively adjusted by structural design. This study clarifies the structural evolution mechanism of these lithium-rich layered oxides and opens the door to the design of similar high-energy materials with better cycle stability.

15.
Biochem Cell Biol ; 96(3): 332-341, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29024602

RESUMO

It has been suggested that cell migration inducing hyaluronan binding protein (CEMIP) contributes to the carcinogenesis of colorectal cancer (CRC). Cancer cells can adapt to endoplasmic reticulum (ER) stress by initiating an unfolded protein response (UPR). This study aimed to investigate whether CEMIP affects the UPR of CRC cells, with a focus on 78 kDa glucose-regulated protein (GRP78, a major ER chaperone). We found that knockdown of CEMIP inhibited cell proliferation and induced a G1 arrest in SW480 CRC cells. The levels of cyclin D1 and cyclin E1 and phospho-retinoblastoma, which are known to promote the cell cycle progression from G0 or G1 into S phase, were decreased in CEMIP-silenced cells. CEMIP shRNA induced apoptosis and inhibited GRP78 expression in SW480 and Colo205 cells. The basal UPR of cancer cells was attenuated by CEMIP shRNA, as evidenced by the decreased expression of UPR sensors, protein kinase R-like endoplasmic reticulum kinase (PERK), inositol requiring enzyme 1 (IRE1), and activating transcription factor 6 (ATF6). Furthermore, CEMIP silencing sensitized CRC cells to thapsigargin-induced apoptosis. Our study demonstrates that the in-vitro anti-proliferative and pro-apoptotic effects in CRC cells that were induced by silencing CEMIP may be associated with GRP78 repression and UPR attenuation.


Assuntos
Apoptose/genética , Proliferação de Células/genética , Proteínas de Choque Térmico/metabolismo , Proteínas/metabolismo , Linhagem Celular Tumoral , Neoplasias Colorretais/genética , Neoplasias Colorretais/metabolismo , Regulação para Baixo , Retículo Endoplasmático/metabolismo , Chaperona BiP do Retículo Endoplasmático , Estresse do Retículo Endoplasmático/genética , Técnicas de Silenciamento de Genes/métodos , Proteínas de Choque Térmico/genética , Humanos , Hialuronoglucosaminidase , Proteínas/genética , Transdução de Sinais/efeitos dos fármacos , Resposta a Proteínas não Dobradas/genética
16.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 49(4): 635-639, 2018 Jul.
Artigo em Zh | MEDLINE | ID: mdl-30378319

RESUMO

OBJECTIVE: To investigate the effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) on the recurrence of non-muscle-invasive bladder cancer (NMIBC). METHODS: Clinical data of 388 patients with NMIBC undergoing transurethral resection of bladder tumor during Jan. 2009 to Dec. 2011 were retrospectively reviewed. Recurrence-free survival was analyzed, and the risk factors of recurrence were explored by Cox multivariate regression analysis. RESULTS: All patients were managed with postoperative intravesical chemotherapy, but 82 of them only received maintenance instillation without immediate instillation. There were 161 patients diagnosed of hypertension, 107 of them were treated with ACEIs or ARBs. No significant differences in age, sex, history of smoking, pathological stage, pathological grade, tumor diameter and post-operation immediate instillation were observed between the patients treated with (drug-use group) or without ACEIs/ARBs (control group). There was also no statistically significant difference among aforementioned indexes after the stratification by hypertension and medication (ACEIs/ARBs). During a median follow up of 60 months, there were 36 and 129 patients found recurrence in drug-use group and control group, respectively. The recurrence free survival times of the patients treated with and without ACEIs/ARBs were (48.43±23.50) and (41.15±23.64) months, respectively (P=0.007). The 5-year recurrence-free survival rate was 66.36% in drug-use group and 54.09% in the controls (P=0.027). Multivariate regression analysis revealed that no ACEIs/ARBs treatment [standardized regression coefficient (ß) =0.174] was independent risk factor of recurrence (P<0.05). The weight of no ACEIs/ARBs treatment was behind to no immediate instillation (ß=0.131), tumor multiplicity (ß=0.128), tumor diameter ≥3 cm (ß=0.193), grade 3 tumor (ß=0.181), and smoking status (ß=0.191). CONCLUSION: Theadministration of ACEIs/ARBs may decrease the recurrence of NMIBC after transurethral resection of bladder tumor.


Assuntos
Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Recidiva Local de Neoplasia/prevenção & controle , Sistema Renina-Angiotensina , Neoplasias da Bexiga Urinária/tratamento farmacológico , Intervalo Livre de Doença , Humanos , Estudos Retrospectivos
17.
BMC Cancer ; 17(1): 31, 2017 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-28061845

RESUMO

BACKGROUND: Multiple studies have reported evidence of an inverse association between parity and bladder cancer risk. However, a comprehensive and quantitative assessment of this association has never been conducted. We conducted this study to clarify this issue. METHODS: Systematic search of PubMed and Embase was performed to identify all the studies. Studies were selected based on strict screening with inclusion and exclusion criteria. Summary relative risks (RR) with 95% confidence intervals (CI) were calculated by using a fixed-effect model, and the generalized least squares trend estimation was employed to compute study-specific RR and 95% CI per live birth increase. Heterogeneity and publication bias were also evaluated. RESULTS: Twelve studies (6,214 cases and 2,693,350 non-cases) were eligible in this meta-analysis. The pooled RR of bladder cancer for parous versus nulliparous women was 0.76 (95% CI: 0.70-0.82). Results were similar in the studies that adjusted for BMI(RR = 0.66; 95% CI: 0.53-0.81), cigarette smoking (RR = 0.67; 95% CI: 0.57-0.79), and age (RR = 0.77; 95% CI: 0.71-0.84). The dose-response meta-analysis showed a lower bladder cancer risk (RR = 0.95; 95% CI: 0.92-0.98) for each live birth increase in parous women. No evidence of publication bias or significant heterogeneity was detected in the above-mentioned analyses. CONCLUSIONS: The finding from current meta-analysis suggest that parity may be related to decreased risk of bladder cancer.


Assuntos
Paridade , Neoplasias da Bexiga Urinária/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Medição de Risco , Neoplasias da Bexiga Urinária/etiologia , Neoplasias da Bexiga Urinária/fisiopatologia
19.
BMC Urol ; 17(1): 9, 2017 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-28100225

RESUMO

BACKGROUND: To compare the treatment outcomes between percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for the management of stones larger than 2 cm in patients with solitary kidney. METHODS: One hundred sixteen patients with a solitary kidney who underwent RIRS (n = 56) or PCNL (n = 60) for large renal stones (>2 cm) between Jan 2010 and Nov 2015 have been considered. The patients' characteristics, stone characteristics, operative time, incidence of complications, hospital stay, and stone-free rates (SFR) have been evaluated. RESULTS: SFRs after one session were 19.6% and 35.7% for RIRS and PCNL respectively (p = 0.047), but the SFR at 3 months follow-up comparable in both groups (82.1% vs. 88.3%, p = 0.346). The calculated mean operative time for RIRS was longer (p < 0.001), but the mean postoperatively hospital stay was statistically significantly shorter (p < 0.001) and average drop in hemoglobin level was less (p = 0.040). PCNL showed a higher complication rate, although this difference was not statistically significant. CONCLUSIONS: Satisfactory stone clearance can be achieved with multi-session RIRS in the treatment of renal stones larger than 2 cm in patients with solitary kidney. RIRS can be considered as an alternative to PCNL in selected cases.


Assuntos
Cálculos Renais/cirurgia , Rim/anormalidades , Rim/cirurgia , Nefrostomia Percutânea , Feminino , Humanos , Cálculos Renais/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
20.
BMC Urol ; 17(1): 75, 2017 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-28859655

RESUMO

BACKGROUND: Percutaneous nephrolithotomy (PCNL) remains the standard procedure for large (≥2 cm) renal calculi; however, laparoscopic pyelolithotomy (LPL) can be used as an alternative management procedure. The aim of present study was to compare LPL and PCNL in terms of efficacy and safety for the management of large renal pelvic stones. METHODS: A literature search was performed in Jan 2016 using electronic databases (Cochrane Central Register of Controlled Trials, Medline, and EMBASE) to identify relevant studies for the meta-analysis. Only comparative studies investigating LPL versus PCNL were included. Effect sizes were estimated by pooled odds ratio (ORs) and mean differences (MDs) with 95% confidence intervals (CIs). RESULTS: Five randomized and nine non-randomized studies were identified for analysis, involving a total of 901 patients. Compared with PCNL, LPL provided a significantly higher stone-free rate (OR 3.94, 95% CI 2.06-7.55, P < 0.001), lower blood transfusion rate (OR 0.28, 95% CI 0.13-0.61, P = 0.001), lower bleeding rate (OR 0.20, 95% CI 0.06-0.61, P = 0.005), fewer hemoglobin decrease(MD -0.80, 95% CI -0.97 to -0.63, P < 0.001), less postoperative fever (OR 0.38, 95% CI 0.21-0.68; P = 0.001), and lower auxiliary procedure rate (OR 0.24, 95% CI 0.12-0.46, P < 0.001) and re-treatment rate (OR 0.20, 95% CI 0.07-0.55, P = 0.002). However, LPL had a longer operative time and hospital stay. There were no significant differences in conversion to open surgery and prolonged urine leakage rates between LPL and PCNL. CONCLUSIONS: Our present findings suggest that LPL is a safe and effective approach for management of patients with large renal stones. However, PCNL still suitable for most cases and LPL can be used as an alternative management procedure with good selection of cases.


Assuntos
Cálculos Renais/cirurgia , Pelve Renal/cirurgia , Laparoscopia , Nefrolitotomia Percutânea , Humanos , Cálculos Renais/patologia
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