- Email: [email protected]
UP-3.190: Simultaneous Transperitoneal and Retroperitoneal Hand-Assisted Laparoscopic Nephroureterectomy
UNMODERATED POSTER SESSIONS
pulled out in 1 to 3 days. The urethral catheter can be pulled out in 3 to 5 days. The phenomenon of macroscopic hematuria will be last for 3 to 5 days. Hospital stay is usually 5 to 7 days after operation, and double “J” tube can be pulled out after 3 to 4 weeks under the cystoscope. Hydronephrosis becomes better or recover by ultrasonic examination after 3 to 15 months fixed examination. Conclusions: The character of laparoscopy set used for ureterolithotomy has good curative effect, small cut, little pain and quick recovery. It is superior to open surgery and can be widely applied in clinical practice.
UP-3.188 Diagnostic Accuracy of Ureteroscopic Biopsy Combined with Selective Upper-Tract Cytology for Prediction of Muscle Invasion in Upper Urinary Tract Urothelial Carcinoma Takazawa R, Kitayama S, Tsujii T Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan Introduction and Objective: To determine whether ureteroscopic biopsy combined with selective upper-tract cytology can predict muscle invasion in upper urinary tract urothelial carcinoma (UUT-UC) considering radical nephroureterectomy. Materials and Methods: Between November 2006 and October 2008, 18 consecutive patients, suspected to have UUT-UC by radiological examinations, underwent ureteroscopic inspection and biopsy and selective upper-tract cytology. Biopsy data and cytology were compared to the actual T stages of surgical specimens in total 8 patients treated by radical nephroureterectomy. Results: Biopsy samples were staged and graded as Ta (G1, G2, G3) in 3, T1 (G2) in 1, T2 (G2) in 2 and T0 (dysplasia) in 2 of 8 patients. Biopsy stage proved to be identical in 4 patients and under-estimated in 4 patients. Selective upper-tract cytology was positive for malignancy in 5 patients including 2 patients who have biopsy stage T0 (dysplasia). Supposition that patient with biopsy grade 3 or biopsy stage T2 or positive upper-tract cytology expected to be surgical stage ⱖT2 can apply in 7 of 8 patients (87.5%). Conclusion: Although this study is small cohort, it confirms previous findings that ureteroscopic inspection and biopsy provides accurate information regarding actual stage of UUT-UC. Combination with selective upper-tract cytology improves the predictive power for muscle invasion.
UP-3.189, Table Parameters Lt / Rt Op.times (mins) Hosp.stays (days) Blood loss (cc) NSAID (person) Diet resumption (days) Drain remove (days) Conversion to open surgery Transfusions Complications Recurrences
HALNU 9/12 203⫾87 (185⬃295) 7.5 (6⬃11) 155⫾135 (95⬃330) 21 2.5⫾3.5 (1⬃5) 2.7 (2⬃5) 0 0 3 0
UP-3.189 Ureteroscopic Biopsy in Differential Diagnosis of Ureteral Stricture: Value and Pitfall Liang J, Qi J, Chen J, Kong L, Wang W Xinhua Hospital Affiliated To Medical School of Shanghai Jiaotong University, Shanghai, China Introduction and Objective: To discuss the value of endoscopic biopsy through ureteroscopy in differential diagnosis of benign and malignant ureteral stricture. Materials and Methods: Retrospectively analyzed the clinical data of 23 cases of benign ureteral stricture/ureteral transitional cell carcinoma (UTCC) diagnosed between Dec. 2007 and Jan. 2009. Results: Among the 23 cases, 15 were diagnosed as UTCC and 8 benign ureteral strictures. of the 15 UTCC, 6 were established diagnosis based on radiography or tomography, 6 on biopsy through ureteroscopy and 3 by inspectional surgery. Of the 8 benign ureteral strictures, 6 were diagnosed through ureteroscopy and 2 following radiography. Conclusions: Endoscopic biopsy through ureteroscopy has its value in the differential diagnosis of benign and malignant ureteral stricture. Possibility of false negative results, however, exists in certain circumstances. Therefore, an inspectional surgery is warranted in these cases.
UP-3.190 Simultaneous Transperitoneal and Retroperitoneal Hand-Assisted Laparoscopic Nephroureterectomy Jung S1, Kim S1, Yoon S2, Chung J3 1 Department of Urology, College of Medicine, Dong-A University, Busan, South Korea; 2Department of Urology, College of Radiology, Dong-A University, Busan; 3 Department of Urology, College of Radiology, Inje University, Gimhae
UROLOGY 74 (Supplment 4A), October 2009
Introduction and Objectives: The goals of managing upper urinary tract tumors are to control cancer, as well as to improve the quality of life including reducing pain and skin incision. The aims of this study are to present the clinical outcomes of 21 patients who underwent simultaneous transperitoneal and retroperitoneal hand-assisted laparoscopic nephroureterctomy (HALNU) and to evaluate efficiency of this operative method. Materials and Methods: HALNU was performed for 21 cases of cT1-2N0M0 upper urinary tract tumors. We evaluated the operation times, blood loss, transfusion episodes, severity of pains, difference of pain control method, hospital stays, diet resumption, complications and recurrences of tumors. HALNU was performed according to the simultaneous transperitoneal and retroperitoneal approach with paraumbilical muscle-splitting skin incision. The nephrectomy was done by transperitoneal hand-assisted laparoscopic approach. The lower ureter was resected retroperitoneally by open surgical approach through the same paraumbilical skin incision, after suturing of peritoneal opening. The resected specimen was removed through the same skin incision retroperitoneally. Results: Conclusions: HALNU has good operative outcomes. During follow-up periods, we had no recurrent cases. We could achieve the goals of cancer control, as well as improving the quality of life including reducing pain and small skin incision. UP-3.191 Clinical Significance of Bacteria in Prostate in Patients with Benign Prostatic Hyperplasia Choi S1, Park S1, Jeong H1, Rim J1, Kim S2, Kwon D2, Rho J3, Rho J4, Kim M5 1 Wonkwang University Hospital, Iksan, South Korea; 2Chonnam University Hospital, Gwangju, South Korea; 3Chosun University Hospital, Gwangju, South Korea; 4Gwangju Christian Hospital, Gwangju, South Korea; 5Chonnbuk University Hospital, Jeonju City, South Korea Introduction and Objective: BPH is the most common benign diseases of the prostate gland, but their etiologies are not exactly elucidated yet. We evaluated the association of benign prostate hyperplasia, bacteria in prostate tissue from the culture of the chips of transurethral prostate. Materials and Methods: This prospective study included 63 consecutive patients diagnosed with BPH and scheduled for TURP. During the TURP, 1-2 g chips
S353
pulled out in 1 to 3 days. The urethral catheter can be pulled out in 3 to 5 days. The phenomenon of macroscopic hematuria will be last for 3 to 5 days. Hospital stay is usually 5 to 7 days after operation, and double “J” tube can be pulled out after 3 to 4 weeks under the cystoscope. Hydronephrosis becomes better or recover by ultrasonic examination after 3 to 15 months fixed examination. Conclusions: The character of laparoscopy set used for ureterolithotomy has good curative effect, small cut, little pain and quick recovery. It is superior to open surgery and can be widely applied in clinical practice.
UP-3.188 Diagnostic Accuracy of Ureteroscopic Biopsy Combined with Selective Upper-Tract Cytology for Prediction of Muscle Invasion in Upper Urinary Tract Urothelial Carcinoma Takazawa R, Kitayama S, Tsujii T Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan Introduction and Objective: To determine whether ureteroscopic biopsy combined with selective upper-tract cytology can predict muscle invasion in upper urinary tract urothelial carcinoma (UUT-UC) considering radical nephroureterectomy. Materials and Methods: Between November 2006 and October 2008, 18 consecutive patients, suspected to have UUT-UC by radiological examinations, underwent ureteroscopic inspection and biopsy and selective upper-tract cytology. Biopsy data and cytology were compared to the actual T stages of surgical specimens in total 8 patients treated by radical nephroureterectomy. Results: Biopsy samples were staged and graded as Ta (G1, G2, G3) in 3, T1 (G2) in 1, T2 (G2) in 2 and T0 (dysplasia) in 2 of 8 patients. Biopsy stage proved to be identical in 4 patients and under-estimated in 4 patients. Selective upper-tract cytology was positive for malignancy in 5 patients including 2 patients who have biopsy stage T0 (dysplasia). Supposition that patient with biopsy grade 3 or biopsy stage T2 or positive upper-tract cytology expected to be surgical stage ⱖT2 can apply in 7 of 8 patients (87.5%). Conclusion: Although this study is small cohort, it confirms previous findings that ureteroscopic inspection and biopsy provides accurate information regarding actual stage of UUT-UC. Combination with selective upper-tract cytology improves the predictive power for muscle invasion.
UP-3.189, Table Parameters Lt / Rt Op.times (mins) Hosp.stays (days) Blood loss (cc) NSAID (person) Diet resumption (days) Drain remove (days) Conversion to open surgery Transfusions Complications Recurrences
HALNU 9/12 203⫾87 (185⬃295) 7.5 (6⬃11) 155⫾135 (95⬃330) 21 2.5⫾3.5 (1⬃5) 2.7 (2⬃5) 0 0 3 0
UP-3.189 Ureteroscopic Biopsy in Differential Diagnosis of Ureteral Stricture: Value and Pitfall Liang J, Qi J, Chen J, Kong L, Wang W Xinhua Hospital Affiliated To Medical School of Shanghai Jiaotong University, Shanghai, China Introduction and Objective: To discuss the value of endoscopic biopsy through ureteroscopy in differential diagnosis of benign and malignant ureteral stricture. Materials and Methods: Retrospectively analyzed the clinical data of 23 cases of benign ureteral stricture/ureteral transitional cell carcinoma (UTCC) diagnosed between Dec. 2007 and Jan. 2009. Results: Among the 23 cases, 15 were diagnosed as UTCC and 8 benign ureteral strictures. of the 15 UTCC, 6 were established diagnosis based on radiography or tomography, 6 on biopsy through ureteroscopy and 3 by inspectional surgery. Of the 8 benign ureteral strictures, 6 were diagnosed through ureteroscopy and 2 following radiography. Conclusions: Endoscopic biopsy through ureteroscopy has its value in the differential diagnosis of benign and malignant ureteral stricture. Possibility of false negative results, however, exists in certain circumstances. Therefore, an inspectional surgery is warranted in these cases.
UP-3.190 Simultaneous Transperitoneal and Retroperitoneal Hand-Assisted Laparoscopic Nephroureterectomy Jung S1, Kim S1, Yoon S2, Chung J3 1 Department of Urology, College of Medicine, Dong-A University, Busan, South Korea; 2Department of Urology, College of Radiology, Dong-A University, Busan; 3 Department of Urology, College of Radiology, Inje University, Gimhae
UROLOGY 74 (Supplment 4A), October 2009
Introduction and Objectives: The goals of managing upper urinary tract tumors are to control cancer, as well as to improve the quality of life including reducing pain and skin incision. The aims of this study are to present the clinical outcomes of 21 patients who underwent simultaneous transperitoneal and retroperitoneal hand-assisted laparoscopic nephroureterctomy (HALNU) and to evaluate efficiency of this operative method. Materials and Methods: HALNU was performed for 21 cases of cT1-2N0M0 upper urinary tract tumors. We evaluated the operation times, blood loss, transfusion episodes, severity of pains, difference of pain control method, hospital stays, diet resumption, complications and recurrences of tumors. HALNU was performed according to the simultaneous transperitoneal and retroperitoneal approach with paraumbilical muscle-splitting skin incision. The nephrectomy was done by transperitoneal hand-assisted laparoscopic approach. The lower ureter was resected retroperitoneally by open surgical approach through the same paraumbilical skin incision, after suturing of peritoneal opening. The resected specimen was removed through the same skin incision retroperitoneally. Results: Conclusions: HALNU has good operative outcomes. During follow-up periods, we had no recurrent cases. We could achieve the goals of cancer control, as well as improving the quality of life including reducing pain and small skin incision. UP-3.191 Clinical Significance of Bacteria in Prostate in Patients with Benign Prostatic Hyperplasia Choi S1, Park S1, Jeong H1, Rim J1, Kim S2, Kwon D2, Rho J3, Rho J4, Kim M5 1 Wonkwang University Hospital, Iksan, South Korea; 2Chonnam University Hospital, Gwangju, South Korea; 3Chosun University Hospital, Gwangju, South Korea; 4Gwangju Christian Hospital, Gwangju, South Korea; 5Chonnbuk University Hospital, Jeonju City, South Korea Introduction and Objective: BPH is the most common benign diseases of the prostate gland, but their etiologies are not exactly elucidated yet. We evaluated the association of benign prostate hyperplasia, bacteria in prostate tissue from the culture of the chips of transurethral prostate. Materials and Methods: This prospective study included 63 consecutive patients diagnosed with BPH and scheduled for TURP. During the TURP, 1-2 g chips
S353