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 ...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.展开更多
Greenlight photoselective vaporisation of the prostate (GPVP) is progressively becoming an established treatment in patients with LUTS because it is a minimally invasive technique that achieves efficient haemostasis, ...Greenlight photoselective vaporisation of the prostate (GPVP) is progressively becoming an established treatment in patients with LUTS because it is a minimally invasive technique that achieves efficient haemostasis, making it the ideal technique for patients at high surgical risk. Material and Methods: To study of 133 patients with an ASA surgical risk score of 3 or 4, undergoing GPVP, with an analysis of perioperative outcome, IPSS, Qmax, IIEF-5 and complications during a five-year follow-up. Results: At 5 years the mean annual improvement in IPSS was stable, and at 5 years there was a 15.2 point improvement versus the preoperative score (p 0.05). The Qmax showed an improvement of 14.9 ml/sec and was maintained at five years after surgery (p 0.05). No patients were transfused or suffered urinary incontinence. 2.25% suffered major complications and there were no deaths. 3.1% of patients suffered de novo urgency. In the 5-year follow-up, five patients had to be reoperated. The quality of sexual health assessed by IIEF-5 before the procedure was scored at 14 points;the 5-year follow-up covering the preoperative period and all revisions did not show any worsening in the IIEF-5 score (p > 0.05). Conclusions: Due to its physical characteristics, in our opinion GPVP is now the treatment of choice in patients at high surgical risk. In our series, the risk of major/minor complications and transfusions was much lower than the same risks in conventional techniques. The objective results (Qmax and quality of life questionnaire) are equivalent to conventional techniques and persist over a 5-year follow-up.展开更多
目的探讨三沟逆切法直出绿激光前列腺汽化切除术(photoselective vaporesection of the prostate,PVRP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的临床疗效及安全性。方法回顾性分析2014年6月~2016年7月PVRP治疗BPH 167...目的探讨三沟逆切法直出绿激光前列腺汽化切除术(photoselective vaporesection of the prostate,PVRP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的临床疗效及安全性。方法回顾性分析2014年6月~2016年7月PVRP治疗BPH 167例资料,采用140 W直出绿激光手术系统,于前列腺颈部5点、7点、12点位置切三条沟,深至被膜直至精阜,连接三条深沟后由精阜逆行汽化切除前列腺组织。结果手术时间(41.8±15.1)min,术中出血量(43.7±16.3)ml,术后膀胱冲洗时间(17.1±4.3)h,留置尿管时间(2.5±1.0)d。术后随访3~6个月,国际前列腺症状评分、生活质量评分、最大尿流率及残余尿量较术前均有明显改善。结论绿激光三沟逆切法PVRP治疗BPH安全,快捷,有效。展开更多
目的探讨绿激光汽化剜除术治疗大体积前列腺增生的疗效和安全性。方法选取手术治疗的124例良性前列腺增生患者(前列腺体积≥80 m L),按照手术方式分为观察组(45例)和对照组(79例),观察组采用绿激光汽化剜除术,对照组采用经尿道前列腺切...目的探讨绿激光汽化剜除术治疗大体积前列腺增生的疗效和安全性。方法选取手术治疗的124例良性前列腺增生患者(前列腺体积≥80 m L),按照手术方式分为观察组(45例)和对照组(79例),观察组采用绿激光汽化剜除术,对照组采用经尿道前列腺切除术,对比两组患者手术情况、临床疗效及并发症情况。结果两组患者手术时间比较,差异无统计学意义(P>0.05)。两组血红蛋白丢失量、膀胱冲洗时间和平均住院时间相比,差异有统计学意义(P<0.05)。观察组与对照组患者手术后的IPSS、QOL及Qmax均较手术前明显改善(P<0.05),但两组差异无统计学意义(P>0.05)。观察组术后并发症低于对照组。结论绿激光汽化剜除术治疗大体积前列腺增生安全性高,并发症少,住院时间短,疗效显著,但需要较熟练的操作技巧。展开更多
基金Supported by the Program of Shanghai Academic/Technology Research Leader,No.19XD1405100the Clinical Research Plan of SHDC,No.SHDC2020CR4025Hospital Funded Clinical Research,Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,No.21XHDB06.
文摘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.
文摘Greenlight photoselective vaporisation of the prostate (GPVP) is progressively becoming an established treatment in patients with LUTS because it is a minimally invasive technique that achieves efficient haemostasis, making it the ideal technique for patients at high surgical risk. Material and Methods: To study of 133 patients with an ASA surgical risk score of 3 or 4, undergoing GPVP, with an analysis of perioperative outcome, IPSS, Qmax, IIEF-5 and complications during a five-year follow-up. Results: At 5 years the mean annual improvement in IPSS was stable, and at 5 years there was a 15.2 point improvement versus the preoperative score (p 0.05). The Qmax showed an improvement of 14.9 ml/sec and was maintained at five years after surgery (p 0.05). No patients were transfused or suffered urinary incontinence. 2.25% suffered major complications and there were no deaths. 3.1% of patients suffered de novo urgency. In the 5-year follow-up, five patients had to be reoperated. The quality of sexual health assessed by IIEF-5 before the procedure was scored at 14 points;the 5-year follow-up covering the preoperative period and all revisions did not show any worsening in the IIEF-5 score (p > 0.05). Conclusions: Due to its physical characteristics, in our opinion GPVP is now the treatment of choice in patients at high surgical risk. In our series, the risk of major/minor complications and transfusions was much lower than the same risks in conventional techniques. The objective results (Qmax and quality of life questionnaire) are equivalent to conventional techniques and persist over a 5-year follow-up.
文摘目的探讨三沟逆切法直出绿激光前列腺汽化切除术(photoselective vaporesection of the prostate,PVRP)治疗良性前列腺增生(benign prostatic hyperplasia,BPH)的临床疗效及安全性。方法回顾性分析2014年6月~2016年7月PVRP治疗BPH 167例资料,采用140 W直出绿激光手术系统,于前列腺颈部5点、7点、12点位置切三条沟,深至被膜直至精阜,连接三条深沟后由精阜逆行汽化切除前列腺组织。结果手术时间(41.8±15.1)min,术中出血量(43.7±16.3)ml,术后膀胱冲洗时间(17.1±4.3)h,留置尿管时间(2.5±1.0)d。术后随访3~6个月,国际前列腺症状评分、生活质量评分、最大尿流率及残余尿量较术前均有明显改善。结论绿激光三沟逆切法PVRP治疗BPH安全,快捷,有效。
文摘目的探讨绿激光汽化剜除术治疗大体积前列腺增生的疗效和安全性。方法选取手术治疗的124例良性前列腺增生患者(前列腺体积≥80 m L),按照手术方式分为观察组(45例)和对照组(79例),观察组采用绿激光汽化剜除术,对照组采用经尿道前列腺切除术,对比两组患者手术情况、临床疗效及并发症情况。结果两组患者手术时间比较,差异无统计学意义(P>0.05)。两组血红蛋白丢失量、膀胱冲洗时间和平均住院时间相比,差异有统计学意义(P<0.05)。观察组与对照组患者手术后的IPSS、QOL及Qmax均较手术前明显改善(P<0.05),但两组差异无统计学意义(P>0.05)。观察组术后并发症低于对照组。结论绿激光汽化剜除术治疗大体积前列腺增生安全性高,并发症少,住院时间短,疗效显著,但需要较熟练的操作技巧。
