To discuss renovascular reconstruction during l iving related donor kidney transplantation (LDKT). Methods Seventy-seven cases of LDKT from April 2006 to March 2008 were retrospectively analyzed, including 63 cases in single renal artery group and 14 cases in multi ple artery group. In multi ple artery group, there were 3 cases of three arteries and 11 cases of double arteries; 9 cases of donated left kidneys and 5 cases of donated right kidneys. Potential donors underwent fully medical evaluation before operation, including donor-reci pient human leucocyte antigen matchingand a cross match test. The donor’s operation of the incision either underneath the 12th rib approaching the dorsal lumbar was performed and the transplantation operation adopted the extraperitoneal approach in the contralateral fossa il iac. The arteries in the multiple artery group were implanted onto the external (or common) il iac artery different from the orthodox method. Results In multiple artery group, no blood transfusion during operation was performed, no compl ication occurred after operation and all donors were discharged after 7-9 days of postoperation. After a follow-up of 3 months to 1 year, all the recipients kept normal kidney function without renal tubule necrosis, renal artery embol ism, vascular stenosis, urinary fistula and ureter necrosis. The ultrasound examination showed that the transplanted kidney had good blood supply. There was no significant difference in the time of urine secretion, serum creatinine level after 1 week of operation, length of hospital ization between the multiple artery group and the single artery group (P gt; 0.05). Conclusion The accurate treatment of multiple artery anastomosis are critical for the safety of the LDKT.
目的 观察腹膜后巨淋巴结增殖症的治疗效果，探讨其临床表现、影像学特点、诊断、病理及治疗方法。 方法 30岁女性患者1例，因反复腹泻、右上腹胀2个月余，发现右侧腹膜后肿物20 d，于2011年8月22日入院。患者在全麻下行腹膜后肿物切除术。手术3个月后，复查腹部CT、血常规、生化等检查。并结合文献进行综述。 结果 手术过程顺利，完整切除肿物，术后病理检查示病变为巨淋巴结增殖症，透明血管型。术后3个月患者门诊随访，恢复良好，复查腹部CT未见肿物复发，血常规、生化等检查均无异常。 结论 该病较为少见，病因尚不明确，确诊需依赖病理组织学活检，手术切除为首选治疗，且预后好。
ObjectiveTo compare the clinical efficacy of transurethral plasmakinetic resection of bladder tumors (PKRBT) and holmium laser resection of bladder tumors (HOLBT), and discuss the effcacy, safety, indication, and complications of PKRBT for the treatment of bladder tumors compared with HOLBT. MethodsA hundred patients with bladder tumors were divided into two groups randomly, who were selected from patients in the Department of Urology of West China Hospital from March 2011 to March 2013. Among all the 100 cases, half of them were treated with PKRBT, and all others treated with HOBLT. The significant markers in both groups were recorded and evaluated, including the situation of before operation, during operation and after operation. The data recorded consisted of the general records of patients' medical background, concomitant disease, laboratory examination, and the position, amount, pathology of the tumor, total operative duration, the time of gross hematuria, the time of postoperative bladder irrigation and catheterization, the length of stay, postoperative complications and patients' conditions at month 3, 6, and 12 during the follow-up. ResultsAll operations were successfully performed, and there was no significant diTherences between the two groups in preoperative indexes (P>0.05). No abnormalities were detected in the postoperative laboratory examinations. The diTherences in operatative duration, time of bladder irrigation, duration of indwelling catheter, and postoperative length of stay between the two groups were not significant (P>0.05). But the mean time of gross hematuria was significantly shorter after operation in the HOLBT patients [(6.1±7.6) hours] than in those treated with PKRBT [(15.3±17.2) hours] (P<0.05). There was no significant diTherence between the two groups in the recurrence rate 3, 6, and 12 months after operation (P>0.05). ConclusionHOLBT can be used safely and effectively in treating bladder tumors, and it is easy for clinical manipulation. HOLBT is as effective and safe as PKRBT with similar adverse side-effect rate within and after operation.
Objective To retrospectively analyze the clinical information of a series of patients with atypical adrenal phaeochromocytoma in order to improve the diagnosis of atypical phaeochromocytoma. Methods Ninety patients diagnosed pathologically as adrenal phaeochromocytoma from January 1998 to December 2004 in the Affiliated Hospital of Inner Mongolia Medical College were included in the study. Patients with phaeochromocytoma were classified into the typical group and atypical group based on their clinical manifestations. The differences were analyzed between the two groups in terms of patient age, tumor location and maximal diameter, incidence of hypertension, and plasma catecholamine level. Results About 24.4% (22/90) of the patients with phaeochromocytoma were classified as atypical. There was no significant difference in the maximal tumor diameter between the two groups. The plasma norepinephrine level of the atypical group was significantly lower than that of the typical group (P=0.001), and the positive rate of plasma norepinephrine of the atypical group was also lower than that of the typical group (P=0.003). Conclusion Compared with typical phaeochromocytoma, atypical phaeochromocytoma is associated with a lower plasma norepinephrine level. The size of adrenal tumor cannot contribute to the diagnosis of atypical phaeochromocytoma. Based on atypical manifestations, CT examination results, and plasma catecholamine level, most atypical phaeochromocytoma should be diagnosed correctly.