“Zero ischemia”laparoscopic partial nephrectomy by high-power GreenLight laser enucleation for renal carcinoma:A single-center experience

BACKGROUND Laparoscopic partial nephrectomy has been widely used in renal cell carcinoma treatment.The efficacy of GreenLight laser on Laparoscopic partial nephrectomy is still unknown.AIM To present the first series of laparoscopic partial nephrectomy(LPN)by GreenLight laser enucleation without renal artery clamping.Due to the excellent coagulation and hemostatic properties of the laser,laser-assisted LPN(LLPN)makes it possible to perform a“zero ischemia”resection.METHODS Fifteen patients with T1a exogenous renal tumors who received high-power GreenLight laser non-ischemic LPN in our hospital were retrospectively analyzed.All clinical information,surgical and post-operative data,complications,pathological and functional outcomes were analyzed.RESULTS Surgery was successfully completed in all patients,and no open or radical nephrectomy was performed.The renal artery was not clamped,leading to no ischemic time.No blood transfusions were required,the average hemoglobin level ranged from 96.0 to 132.0 g/L and no postoperative complications occurred.The mean operation time was 104.3±8.2 min.The postoperative removal of negative pressure drainage time ranged from 5.0 to 7.0 d,and the mean postoperative hospital stay was 6.5±0.7 d.No serious complications occurred.Postoperative pathological results showed clear cell carcinoma in 12 patients,papillary renal cell carcinoma in 2 patients,and hamartoma in 1 patient.The mean creatinine level was 75.0±0.8μmol/L(range 61.0-90.4μmol/L)at 1 mo after surgery,and there were no statistically significant differences compared with pre-operation(P>0.05).The glomerular filtration rate ranged from 45.1 to 60.8 mL/min,with an average of 54.0±5.0 mL/min,and these levels were not significantly different from those before surgery(P>0.05).CONCLUSION GreenLight laser has extraordinary cutting and sealing advantages when used for small renal tumors(exogenous tumors of stage T1a)during LPN.However,use of this technique can lead to the generation of excessive smoke.

van der Waals Interactions in Bimolecular Reactions

The van der Waals (vdW) interaction is very important in fields of physics, biology and chemistry, and its role in reaction dynamics is an issue of great interest. In this review, we focus on the recent progresses in the theoretical and experimental studies on the vdW interaction in bimolecular reactions. In particular, we review those studies that have advanced our understanding of how the vdW interaction can strongly influence the dynamics in both direct activated and complex-forming reactions, and further extend the discussion to the polyatomic reactions involving more atoms and those occurring at cold and ultracold temperatures. We indicate that an accurate description of the delicate vdW structure and long-range potential remains a challenge nowadays in either ab initio calculations or the fitting of the potential energy surfaces. We also present an explanation on the concept of vdW saddle proposed by us recently which may have general importance.