Background: Salvage radiotherapy has been used as the treatment for patients with local recurrence after radical prostatectomy. However, the therapy is time-consuming and it experiences adverse effects of some kind. S...Background: Salvage radiotherapy has been used as the treatment for patients with local recurrence after radical prostatectomy. However, the therapy is time-consuming and it experiences adverse effects of some kind. Simple and less invasive treatment is highly anticipated. Objectives: To evaluate the outcomes of salvage transrectal high-intensity focused ultrasound (HIFU) therapy for patients with localized recurrence of a vesicourethral anastomosis (VUA) after radical prostatectomy. Material and methods: Sixteen patients with suspected local recurrence of a VUA after prostatectomy were treated with HIFU. All patients had prostate-specific antigen (PSA) failure (>0.2 ng/ml), positive findings of a VUA with biopsy and/or MRI, TRUS and CT, and no distant metastasis by CT, MRI and bone scintigraphy before HIFU. Recurrence after HIFU was determined by PSA failure (>0.2 ng/ml), histological findings, metastasis and start of systemic therapies. Results: HIFU treatments were performed in 16 patients, and followed-up for 7 - 159 months (median 46.5). The pre-HIFU PSA levels ranged from 0.318 to 3.1 ng/ml. Sonication time ranged from 9 - 42 min. All patients had a decline of PSA after HIFU, and 88% of the PSA nadir was Conclusion: HIFU therapy for local recurrence after prostatectomy may become a feasible salvage therapeutic option because of its ease and simple procedure. For salvage HIFU therapy, further research and additional follow-up are required to evaluate and correct the diagnosis of recurrence areas and to provide the sufficient sonication.展开更多
The Italian team from Verona,questions the place of total pancreatectomy(TP)as an alternative to pancreaticoduodenectomy(PD)in patients at high risk of pancreatic fistula in a monocentric retrospective study running f...The Italian team from Verona,questions the place of total pancreatectomy(TP)as an alternative to pancreaticoduodenectomy(PD)in patients at high risk of pancreatic fistula in a monocentric retrospective study running from July 2017 to December 2019(1).A total of 702 patients were included,566 PD of which 101 were at high risk of pancreatic fistula(HR-PD),136 TP of which 86 were PD converted to TP(C-TP)for positive margin of pancreatic section for malignancy(49%),extensive vascular resection(14%)or technical reasons(27%)such as residual non-reconstructible pancreas/friable pancreas/microscopic Wirsung’s duct,10% for other reasons(bleeding......)Patients in the HR-PD group received externalized stent of the Wirsung duct.展开更多
目的探讨腹腔镜Sandwich法尿道及周围组织重建技术对高风险组前列腺癌根治术后早期尿控的疗效。方法纳入2011年1月至2015年9月于本院治疗的高风险前列腺癌患者71例,采用腹腔镜Sandwich法尿道及周围组织重建技术47例,采用单纯尿道吻合技...目的探讨腹腔镜Sandwich法尿道及周围组织重建技术对高风险组前列腺癌根治术后早期尿控的疗效。方法纳入2011年1月至2015年9月于本院治疗的高风险前列腺癌患者71例,采用腹腔镜Sandwich法尿道及周围组织重建技术47例,采用单纯尿道吻合技术24例,对比两组患者年龄、体质量指数、前列腺体积、术前前列腺特异性抗原(prostate specific antigen,PSA)、临床分期、手术时间、术后引流管拔除时间、术后尿管拔除时间、病理分期、Gleason评分、术后切缘阳性率、淋巴结阳性率及拔除尿管后第2、4、12、24、52周尿控恢复情况。结果两组患者间年龄、体质量指数、前列腺体积、术前PSA、临床分期、病理分期、Gleason评分、术后切缘阳性率、淋巴结阳性率、术后引流管拔除时间的差异均无统计学意义(P>0.05);Sandwich法尿道及周围组织重建组手术时间长于对照组(P=0.024)、术后尿管拔除时间显著早于对照组(P<0.001),拔除尿管第12周尿控恢复显著优于对照组(P=0.023)。结论腹腔镜Sandwich法尿道及周围组织重建技术安全可行,显著改善高风险组前列腺癌根治术后早期尿控。展开更多
文摘Background: Salvage radiotherapy has been used as the treatment for patients with local recurrence after radical prostatectomy. However, the therapy is time-consuming and it experiences adverse effects of some kind. Simple and less invasive treatment is highly anticipated. Objectives: To evaluate the outcomes of salvage transrectal high-intensity focused ultrasound (HIFU) therapy for patients with localized recurrence of a vesicourethral anastomosis (VUA) after radical prostatectomy. Material and methods: Sixteen patients with suspected local recurrence of a VUA after prostatectomy were treated with HIFU. All patients had prostate-specific antigen (PSA) failure (>0.2 ng/ml), positive findings of a VUA with biopsy and/or MRI, TRUS and CT, and no distant metastasis by CT, MRI and bone scintigraphy before HIFU. Recurrence after HIFU was determined by PSA failure (>0.2 ng/ml), histological findings, metastasis and start of systemic therapies. Results: HIFU treatments were performed in 16 patients, and followed-up for 7 - 159 months (median 46.5). The pre-HIFU PSA levels ranged from 0.318 to 3.1 ng/ml. Sonication time ranged from 9 - 42 min. All patients had a decline of PSA after HIFU, and 88% of the PSA nadir was Conclusion: HIFU therapy for local recurrence after prostatectomy may become a feasible salvage therapeutic option because of its ease and simple procedure. For salvage HIFU therapy, further research and additional follow-up are required to evaluate and correct the diagnosis of recurrence areas and to provide the sufficient sonication.
文摘The Italian team from Verona,questions the place of total pancreatectomy(TP)as an alternative to pancreaticoduodenectomy(PD)in patients at high risk of pancreatic fistula in a monocentric retrospective study running from July 2017 to December 2019(1).A total of 702 patients were included,566 PD of which 101 were at high risk of pancreatic fistula(HR-PD),136 TP of which 86 were PD converted to TP(C-TP)for positive margin of pancreatic section for malignancy(49%),extensive vascular resection(14%)or technical reasons(27%)such as residual non-reconstructible pancreas/friable pancreas/microscopic Wirsung’s duct,10% for other reasons(bleeding......)Patients in the HR-PD group received externalized stent of the Wirsung duct.
文摘目的探讨腹腔镜Sandwich法尿道及周围组织重建技术对高风险组前列腺癌根治术后早期尿控的疗效。方法纳入2011年1月至2015年9月于本院治疗的高风险前列腺癌患者71例,采用腹腔镜Sandwich法尿道及周围组织重建技术47例,采用单纯尿道吻合技术24例,对比两组患者年龄、体质量指数、前列腺体积、术前前列腺特异性抗原(prostate specific antigen,PSA)、临床分期、手术时间、术后引流管拔除时间、术后尿管拔除时间、病理分期、Gleason评分、术后切缘阳性率、淋巴结阳性率及拔除尿管后第2、4、12、24、52周尿控恢复情况。结果两组患者间年龄、体质量指数、前列腺体积、术前PSA、临床分期、病理分期、Gleason评分、术后切缘阳性率、淋巴结阳性率、术后引流管拔除时间的差异均无统计学意义(P>0.05);Sandwich法尿道及周围组织重建组手术时间长于对照组(P=0.024)、术后尿管拔除时间显著早于对照组(P<0.001),拔除尿管第12周尿控恢复显著优于对照组(P=0.023)。结论腹腔镜Sandwich法尿道及周围组织重建技术安全可行,显著改善高风险组前列腺癌根治术后早期尿控。
