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ABSTRACT: Transurethral resection of the bladder tumor (TURBT) remains the gold standard for non-muscle-invasive bladder cancer (NMIBC). Laser techniques have been widely used in urology. This analysis aimed to assess the safety and efficacy of holmium resection of the bladder tumor (HoLRBT) vs. TURBT.
A systemic search of MEDLINE, Embase, Web of Science, and The Cochrane Library as well as manual bibliography searches were performed to identify the relevant studies. The pooled estimates of operation time, obturator nerve reflex rate, bladder perforation rate, bladder irrigation rate, catheterization time, hospital stay, and one- and two-year recurrence free survivals were calculated.
Five studies were enrolled into our meta-analysis. No significant difference was observed in the operation time between groups (weighted mean difference (WMD) 1.01, 95% confidential interval (95%CI) -3.52 - 5.54, P = 0.66). The significant difference in the obturator nerve reflex (OR 0.05, 95%CI 0.01 - 0.04, P = 0.004), bladder perforation (OR 0.14, 95%CI 0.03 - 0.61, P = 0.009), bladder irrigation (OR 0.13, 95%CI 0.04 - 0.45, P = 0.001), catheterization time (WMD -0.96, 95%CI -1.11 to -0.82, P < 0.00001), and hospital stay (WMD -1.46, 95%CI -1.65 to -1.27, P < 0.00001) showed advantages of HoLRBT over TURBT. The 2-year recurrence free survival rate favors the HoLRBT group (OR 1.46, 95%CI 1.02 - 2.11, P = 0.04).
As a promising technique, HoLRBT is safe and efficient, and showed several advantages over TURBT. HoLRBT can be used as an alternative procedure for TURBT in terms of low-grade papillary urothelial carcinoma or low-grade early TNM-stage urothelial carcinoma.
Chinese medical journal 05/2013; 126(9):1761-5. · 0.86 Impact Factor
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Chinese medical journal 04/2013; 126(7):1246. · 0.86 Impact Factor
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ABSTRACT: Renal cell carcinoma (RCC) during pregnancy is rare. We present a case of retroperitoneal laparoscopic radical nephrectomy for RCC in a 32-year-old pregnant female. The tumor was excised en bloc. Retroperitoneal laparoscopic radical nephrectomy appears to be a feasible and safe treatment option for RCC in pregnancy.
Urologia Internationalis 02/2013; · 0.99 Impact Factor
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ABSTRACT: Objectives: To evaluate the efficacy and safety of HoLEP versus TURP for relief of bladder outlet obstruction (BOO) on benign prostatic hyperplasia (BPH). Methods: A systematic literature search for randomized controlled trials (RCTs) comparing HoLEP and TURP in several databases from 1996 to 2011 were performed. Meta-analysis was conducted with the Review Manager Software. Results: Of 248 potential citations, 6 RCTs were included into our meta-analysis. There was no significant difference between the two groups in maximum urinary flow rate (Qmax) and international prostate symptom score (IPSS) at 1 month (p=0.41 and p=0.87) or 6 months (p=0.07 and p=0.37) after treatment. However, at 12 months postoperatively, the Qmax and IPSS in the HoLEP group were significantly better than those in the TURP group (p<0.0001 and p=0.01). The results also suggested a benefit of HoLEP over TURP in blood loss (p=0.001), catheterization time (p < 0.0001), hospital stay (p=0.001) and blood transfusion rate (p=0.04), while The results favored TURP over HoLEP for duration of operation (p=0.001) and the incidence of postoperative dysuria(p=0.003). Conclusions: Comparing with TURP, HoLEP showed slightly better postoperative results in Qmax and IPSS during 12 months' follow-up, as well as significantly better perioperative results and similarly low complication rates. However, the operative time and the incidence of postoperative dysuria favors TURP. Generally, HoLEP is a promising minimal invasive alternative to TURP for treatment of BPH.
Journal of endourology / Endourological Society 11/2012; · 1.75 Impact Factor
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ABSTRACT: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Despite high morbidities, TURP is still considered as the 'gold standard' for treatment of BPH. Photoselective vaporization of the prostate (PVP) is a promising technique that is emerging as a possible alternative to TURP. However, there remains some debate about the advantages of PVP over TURP and whether PVP will be able to replace TURP as the first-line surgical treatment. We conducted a meta-analysis of recent papers on this subject and herein provide the overall efficacy and safety of PVP for treatment of BPH. OBJECTIVE: To assess the overall efficacy and safety of photoselective vaporization of the prostate (PVP) vs transurethral resection of the prostate (TURP) for treating patients with lower urinary tract symptoms (LUTS) secondary to benign prostate hyperplasia (BPH). PATIENTS AND METHODS: A systematic search of the electronic databases, including MEDLINE, Embase, Web of Science and The Cochrane Library, as well as manual bibliography searches were performed. The pooled estimates of maximum flow rate (Q(max) ), postvoid residual (PVR), quality of life (QoL), International Prostate Symptom Score (IPSS), operation duration, blood loss, catheterization time, hospital stay, capsule perforation, transfusion, transurethral resection (TUR) syndrome, urethral stricture and reintervention were calculated. RESULTS: At the 3-month follow-up, there was no significant difference in Q(max) , PVR, QoL and IPSS between the TURP and PVP groups. At the 6-month follow-up, the pooled QoL favoured TURP, but there was no significant difference in the other variables between the two groups. PVP was associated with less blood loss, transfusion, capsular perforation, TUR syndrome, shorter catheterization time and hospital stay, but longer operation duration and higher reintervention rate. CONCLUSIONS: The efficacy of PVP was similar to that of TURP in relation to Q(max) , PVR, QoL and IPSS, and it offered several advantages over TURP. As a promising minimal invasive technique, PVP could be used as an alternative surgical procedure for treating BPH.
BJU International 11/2012; · 2.84 Impact Factor
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Xun-Gang Li,
Dong-Xu Zhang,
Xin-Gang Cui,
Dan-Feng Xu,
Yi Hong,
Yao Li,
Yi Gao,
Yu-Shan Liu, Lei Yin,
Fa-Jun Qu,
Jun-Kai Wang,
Ming Chen,
Jie Chen,
Lu Chen,
Kai Wang
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ABSTRACT: Although many midterm oncologic data have been reported for extraperitoneal laparoscopic radical prostatectomy (ELRP) in western countries, few oncologic data of the extraperitoneal procedure was published in China. The aim of the study was to evaluate the oncologic outcomes of patients treated with ELRP in China.
From January 2005 to March 2010, a total of 152 consecutive patients diagnosed with clinically localized prostate cancer were included in this study and treated with ELRP. The patients were staged according to the TNM (tumor, nodes, metastases) system. Median and mean postoperative follow-up were 28.1 months and 27.0 months, respectively. The patients were retrospectively analyzed for progression-free survival.
One hundred and twelve cases (73.7%) were postoperatively diagnosed as pT2 in, and 40 cases (26.3%) as pT3. Positive lymph nodes were shown in 5 patients (3.3%). Gleason score was < 7 in 49 men (32.2%), 7 in 69 men (45.4%), and > 7 in 34 men (22.4%). Positive surgical margins (PSM) were observed in 15 patients (9.9%), which included 32.0% of all pT3a cases and 46.7% of all pT3b cases, respectively. The overall prostate-specific antigen recurrence-free survival rate was 86% in all patients. The recurrence-free survival rates were 91.8% and 62.2% in pT2N0 patients and pT3N0 patients, respectively. Preoperative prostate-specific antigen, surgical margins, tumor stage, and lymph nodal status were identified as independent predictors of biochemical recurrence-free survival using multivariate Cox proportional hazard model.
ELRP is a precise, safe and effective procedure at this particular Chinese institution. The prognostic power of prostate-specific antigen relapse after ELRP is not identical to that described previously with transperitoneal or open retropubic approaches.
Chinese medical journal 05/2012; 125(9):1529-35. · 0.86 Impact Factor
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ABSTRACT: Ectopic Cushing’s syndrome caused by pheochromocytoma is rare. We reported a 15-year-old female patient who was admitted to hospital with typical Cushing’s syndrome. She had not started menstruation. Her plasma adrenocorticotropic hormone (ACTH) and 24-hour urinary free cortisol levels were extremely high. Gonadal and progestational hormone levels were also abnormal. Abdominal computed tomography scans and enhanced scans revealed multiple irregular tumors in the right adrenal. Pelvic echogram showed an infantile uterus, while the ovaries were at an immature stage of development. Retroperitoneal laparoscopic right adrenalectomy was performed without intraoperative complications. Histology and immunohistochemistry of the tumor were consistent with pheochromocytoma. Retroperitoneal laparoscopic adrenalectomy is a safe procedure with satisfactory outcomes and allows for rapid recovery.
Chinese medical journal 03/2012; 125(6):1193-6. · 0.86 Impact Factor
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ABSTRACT: Laparoscopic radical prostatectomy is considered the first treatment of choice for local prostate cancer due to its minimal invasion advantage. To further achieve the goal of minimal invasion, single port laparoscopic radical prostatectomy has been developed to minimize the complications associated with puncture tracks. The aim of this study was to illustrate the technique for single port laparoscopic radical prostatectomy and evaluate its efficacy and safety. We reported 8 cases of radical prostatectomy with excellent early outcome carried out in Shanghai Changzheng Hospital from June 2009 to August 2009 using a home-made multiple instrument access port and adding an additional small incision at McBurney point.
Chinese medical journal 05/2011; 124(10):1580-2. · 0.86 Impact Factor
