Background:Bladder cancer (BCA) shows significant prognostic differences between non-muscle-invasive (NMIBC) and muscle-invasive (MIBC) forms. While NMIBC frequently recurs and can progress to invasive disease, reliable biomarkers to monitor this transition are lacking. Extracellular matrix (ECM) remodeling is a critical factor influencing tumor aggressiveness, yet the key regulators of ECM changes across BCA stages remain unclear. In this study, we investigate the role of COL1A2 in ECM-related tumor biology and its potential as a prognostic biomarker for BCA progression. Methods:We utilized a multi-step bioinformatics pipeline, analyzing RNA-seq data from TCGA and GEO datasets to identify molecular differences between NMIBC and MIBC. Prognostic markers were prioritized via differential expression analysis, Cox regression, and Kaplan-Meier survival analysis. The regulatory network was explored using protein-protein interaction analysis, and ECM-related activity was quantified through ssGSEA. Cell-type-specific insights were gained through single-cell RNA-seq analysis, and intercellular communication was deciphered using CellChat. Functional validation was performed through in vitro knockdown experiments in BCA cell lines. Results:COL1A2 emerged as a key prognostic ECM-related gene associated with MIBC. Single-cell RNA-seq analysis revealed that COL1A2 and ECM components were predominantly enriched in matrix cancer-associated fibroblasts (CAFs), with PTK2 (FAK, focal adhesion kinase) upregulated in epithelial cells undergoing epithelial-mesenchymal transition (EMT). CellChat analysis uncovered a dominant COL1A2-mediated signaling axis from matrix CAFs to EMT epithelial cells via COL1A1/2-SDC1/4 ligand-receptor interactions. Functional assays confirmed that COL1A2 knockdown significantly impaired MIBC cell invasion and migration by suppressing ECM remodeling and EMT. Conclusion:Our results suggest that the COL1A2-ECM-FAK signaling axis plays a critical role in MIBC progression, and COL1A2 could serve as a potential biomarker and therapeutic target for muscle-invasive bladder cancer.

Previous studies have identified that lens epithelium-derived growth factor (LEDGF) interacts with SETD2-dependent histone H3 trimethylated at lysine 36 (H3K36me3) to mediate transcriptional elongation. However, the original LEDGF recognition H3K36me3 epigenetic regulatory axis no longer exists in SETD2 mutant clear cell renal cell carcinoma (ccRCC) patients, and a new transcription system needs to be discovered. In this study, the authors demonstrated the novel interaction between LEDGF and H3R17me2a. In detail, Asn38 and Asp57 of LEDGF Proline-Tryptophan-Tryptophan-Proline (PWWP) domain are the key binding sites validated by peptide pull-down assays. Subsequently, a series of in vitro and in vivo experiments showed that PPAT, PAICS, GART, ADSL, and ADSS2 are key target genes. Collectively, LEDGF binds H3R17me2a to regulate purine nucleotide metabolism in SETD2 mutant ccRCC cells, promoting tumor proliferation, and may be an effective therapeutic target.

PurposeTo investigate the role of Biglycan(BGN) in the progression and metastasis of clear cell renal cell carcinoma(ccRCC).MethodsBased on multiple public databases, we investigated the expression level of BGN in ccRCC, its clinical significance, and its association with immune cells. Real-time fluorescence quantitative polymerase chain reaction(PCR) was employed to validate BGN expression in tumor and adjacent normal tissues from ten patients. We utilized RNA sequencing results for further analysis, including differential gene analysis, GO-KEGG analysis, and GSEA analysis, to identify the signaling pathways through which BGN exerts its effects. BGN knockdown cells(786-0 and Caki-1) were generated through lentiviral transfection to examine the impact of BGN on ccRCC. Cell proliferation, migration, and invasion were assessed using CCK8, colony formation, wound healing, Transwell migration, and invasion assays, respectively.ResultsOur findings from database analysis and PCR revealed a significant upregulation of BGN expression in kidney cancer tissues compared to normal tissues. Further analysis demonstrated a correlation between high BGN expression and ccRCC progression and immune infiltration. In vitro experiments confirmed that BGN silencing effectively inhibited cell proliferation, migration, and invasion of ccRCC. Mechanistically, these effects may be mediated through the MAPK signaling pathway.ConclusionBGN potentially plays a pivotal role in the progression and metastasis of ccRCC, possibly acting through the MAPK signaling pathway. Therefore, BGN holds promise as a potential therapeutic target for ccRCC.

This case highlights the effective use of retroperitoneal laparoscopic partial nephrectomy (RLPN) in a 73-year-old female with two large renal carcinomas in her solitary kidney, including a 7 cm deeply infiltrating mass. The RLPN procedure successfully resected both tumors with a thermal ischemia time of 28 minutes, 110 minutes of surgery, and only 30 mL of blood loss. The patient’s postoperative recovery was excellent, with no hemorrhage or urine leakage and only a mild increase in serum creatinine levels. Discharged after 10 days without dialysis, this case supports RLPN as a safe, effective method for similar renal tumors.

The rising global incidence of bladder cancer and chemotherapy resistance necessitate novel therapies. Plant-derived compounds, owing to their diverse biological activities and favorable safety profiles, are considered promising candidates for cancer treatment. In this study, we investigated Bousigonine D, a monoterpene indole alkaloid isolated from the roots of Bousigonia mekongensis, for its potential as a therapeutic agent for bladder cancer. Our results show that Bousigonine D effectively inhibits cell proliferation and clonogenic formation, and induces cell cycle arrest at the G0/G1 phase in murine and human bladder cancer cells. Furthermore, Bousigonine D significantly promotes apoptosis in these cells, surpassing the apoptosis-inducing efficacy of cisplatin. Mechanistically, Bousigonine D enhances the generation of reactive oxygen species, disrupts calcium homeostasis, and impairs mitochondrial function, leading to cytoskeletal collapse and caspase-dependent apoptotic cell death. In vivo, Bousigonine D effectively suppresses tumor growth in an orthotopic MB49 mouse model, and importantly, it retains strong anti-tumor efficacy in cisplatin-resistant bladder cancer. Notably, Bousigonine D exhibits low toxicity in major organs, similar to cisplatin, underscoring its potential as a safe and effective treatment for bladder cancer. This study highlights the promising role of plant-derived compounds in cancer therapy and supports further development of Bousigonine D as a novel therapeutic option for bladder cancer.

Objective With the increasing of extraperitoneal laparoscopic radical cystectomy (ELRC) and ileal orthotopic neobladder (ION), we described perioperative management, complications and management of postoperative complications for patients with ELRC and ION. Methods We retrospectively collected perioperative managements, complications and management of postoperative complications for patients after ELRC and ION from January 2020 to December 2023 in our center. Results Totally 81 patients with bladder tumor underwent ELRC and ION. 48patients suffered from postoperative complications. According to Clavien-Dindo class, 21 patients were identified as 1, 18 patients were identified as 2, and 7 patients were identified as 3. Only 2 patient was identified as 4. The mean follow-up was 31 ± 17.64 months. Overall survival was 97.53%. Recurrence-free survival was 92.59%. The main short-term complications were infection(23.46%), ileus(3.70%), leakage of urine(17.28%), lymph fistula(8.64%), anemia and hypoproteinemia(9.88%). Medium- and long-term complications were Chronic hydronephrosis(8.64%), Anastomotic stoma stricture of ureter (2.47%), Anastomotic stoma stricture of urethra(6.17%), stone(4.94%) and incontinence (9.88%). Conclusions Most of complications after ELRC and ION were informidable and solvable. Invasive approaches need to be considered and performed by experienced urologists.

Abstract Clear cell renal cell carcinoma (ccRCC) is known for its high heterogeneity and tendency to metastasize through the bloodstream, leading to limited treatment options and poor overall survival rates. To overcome these challenges, it is crucial to acquire a comprehensive understanding of the underlying biology of ccRCC. Therefore, we conducted a thorough analysis using single-cell RNA sequencing data obtained from samples of non-metastatic and metastatic ccRCC. Our analysis revealed significant differences in the composition of infiltrating immune cells within the primary tumor lesions between metastatic and non-metastatic ccRCC cases. Additionally, we identified two distinct tumor cell states, particularly proximal tubule cells, which exhibited significant enrichment in metastatic ccRCC cases. We found that MDK was highly expressed in metastatic ccRCC and exhibited significant prognostic value for patients. In metastaic ccRCC, we observed enhanced interactions between tumor cells and macrophages mediated by MDK, resulting in the polarization of macrophages towards an angiogenic and immune-suppressive M2-like phenotype. Furthermore, we observed notable differences in the interactions between macrophages and CD8 + T cells in non-metastatic and metastatic ccRCC. Metastatic ccRCC exhibited stronger interactions mediated by immune inhibitory molecules such as SPP1 and CD24, potentially contributing to immune suppression within tumor microenvironment. These dignificant findings provide valuable insights into the molecular and cellular signatures associated with metastatic ccRCC. Moreover, they open up promising opportunities for the development of novel biomarkers and therapeutic targets, specifically tailored to address the challenges posed by metastatic ccRCC.

Circular RNA (circRNA), a type of noncoding RNAs, has been demonstrated to act vital roles in tumorigenesis and cancer deterioration. Although tumor-associated macrophages are involved in tumor malignancy, the interactions between circRNAs and tumor-associated macrophages in prostate cancer (PCa) remain unclear. In the present study, we found that hsa_circ_0094606 (subsequently named circ_0094606) could promote proliferation, epithelial-mesenchymal transition (EMT) as well as migration of PCa cells through cell viability and migration assays and the determination of EMT markers. Mass spectrometry analysis after RNA pull-down experiment identified that circ_0094606 bound to protein arginine methyltransferase 1 (PRMT1) in PCa cells, and further functional assays revealed that circ_0094606 promoted the malignant progression of PCa by binding to PRMT1. Moreover, co-immunoprecipitation (Co-IP), glutathione-S-transferase (GST) pull-down and immunofluorescence showed that PRMT1 mediated arginine methylation of ILF3 to stabilize the protein. Bioinformatics analysis combined with data from RNA-binding protein immunoprecipitation and RNA pull-down suggested that ILF3 could stabilize IL-8 mRNA, which promoted the M2 polarization in coculture study. Finally, in vivo experiments showed that circ_0094606 subserve PCa growth and promoted the M2 polarization of macrophages through the PRMT1/ILF3/IL-8 regulation pathway, supporting circ_0094606 as a potential novel effective target for PCa treatment.

Objective We aimed to investigate the optimized measures of retroperitoneal laparoscopic partial nephrectomy (RLPN) for central renal carcinoma. Methods The clinical data of 78 patients with central renal carcinoma treated with RLPN were retrospectively analyzed in the study group. And for the control group, 71 patients with central renal neoplasms and without optimal RLPN were selected. Results The operations performed on members of the study group were successfully completed, while 11 control cases were changed to open surgery. There were significant differences in the operation time, intraoperative blood loss, and warm ischemia time between the study group and the control group ( P <0.05). There was no recurrence in either group after the operation. Conclusions The optimized RLPN can reduce the difficulty of the operation, the amount of intraoperative blood loss, the time of renal ischemia, operation length, and the occurrence of postoperative complications. Therefore, optimized RLPN has important clinical value for the retention and recovery of postoperative renal function.

To assess the feasibility and effectiveness of total laparoscopic nephroureterectomy for upper urinary tract urothelial carcinoma (UUTUC) under a single surgical position. The medical data of 89 UUTUC patients were collected, who were treated in our institution from Jan 2016 to Jun 2018. The 45 cases that underwent total laparoscopic nephroureterectomy with a single position were allocated in the test group, while the 44 patients who received retroperitoneal laparoscopy combined with hypogastric oblique incision were assigned in the control group. We compared the two groups in perioperative indicators and tumor recurrence rate and analyzed the clinical effect of the new surgical treatment of UUTUC. All 89 operations for UUTUC were successful and had no conversion to open surgery. No obvious complications occurred during the perioperative period. The test group had significantly shorter average operation time (96.58 ± 8.56 min versus 147.45 ± 9.16 min), less blood loss (39.58 ± 4.15 ml versus 46.50 ± 4.58 ml), earlier ambulation (7.47 ± 1.01 h versus 11.39 ± 1.82 h), and shorter length of stay in hospital (6.98 ± 1.14 days versus 9.89 ± 1.51 days) (P < 0.05). The visual analogue scale (VAS) scores of the test group at 1 h, 12 h, and 24 h after operation were lower compared with those of the control group (P < 0.05). No significant difference was found in the tumor stage, tumor grade, postoperative gastrointestinal function recovery time, follow-up time, and tumor recurrence rate between the two groups. Compared with the traditional surgical methods, the total laparoscopic treatment of UUTUC under a single surgical position had advantages of shorter operation time, less blood loss, and early postoperative ambulation. The new operative method could shorten the length of stay and accelerate recovery of patients, and it is a viable surgical procedure which deserved clinical application and promotion. Our trial was approved and has been registered in the ethics committee of the Yantai Yuhuangding Hospital (Approval NO.[2015]171) .

PTEN-Long is a translational variant of PTEN (Phosphatase and Tensin Homolog). Like PTEN, PTEN-Long is able to antagonize the PI3K-Akt pathway and inhibits tumor growth. In this study, we investigated the role PTEN-Long plays in the development and progression of clear cell renal cell carcinoma (ccRCC) and explored the therapeutic possibility using proteinaceous PTEN-Long to treat ccRCC. We found that the protein levels of PTEN-Long were drastically reduced in ccRCC, which was correlated with increased levels of phosphorylated Akt (pAkt). Gain of function experiments showed overexpression of PTEN-Long in the ccRCC cell line 786-0 suppressed PI3K-Akt signaling, inhibited cell proliferation, migration and invasion, and eventually induced cell death. When purified PTEN-Long was added into cultured 786-0 cells, it entered cells, blocked Akt activation, and induced apoptosis involving Caspase 3 cleavage. Furthermore, PTEN-Long inhibited proliferation of 786-0 cells in xenograft mouse model. Our results implicated that understanding the roles of PTEN-Long in renal cell carcinogenesis has therapeutic significance.

Objectives. To investigate the safety and feasibility of sorafenib neoadjuvant therapy combined with retroperitoneoscopic radical nephrectomy (RRN) in treating T2 large renal cell carcinoma (RCC). Methods. Retrospectively analyzed 5 cases (2 males and 3 females, aged 52–73 years) of T2 stage large RCC who receive preoperative sorafenib targeted treatment (400 mg bid for 1–3 months) and RRN between March, 2013, and July, 2014. Patient information, therapeutic regimen, drug adverse effect, tumor changes before and after surgery, and perioperative parameters were recorded. Results. During the sorafenib therapy adverse effects included 2 cases of hypertension (Grade I toxicity), 1 case of hand-foot syndrome (Grade I), and 1 case of diarrhea (Grade II), which were all tolerable for patients. CT scan and histopathological tests confirmed significant reduction in the longest dimension (LD) and medium density (MD) of the tumor after therapy as well as tumor hemorrhage, necrosis, and cystic degeneration. All 5 patients received RRN surgery successfully around 2 weeks after drug discontinuation with only 1 case of perioperative complication. Conclusions. Sorafenib neoadjuvant therapy could significantly reduce the size and aggressiveness of T2 large renal tumors, thus reducing the operative challenge and enabling patients who were previously disqualified for operation to receive surgical treatment.

Background: Prostate stem cell antigen (PSCA) is upregulated in prostate cancer tissues. Here we aimed to study the therapeutic efficacy of a monoclonal antibody of PSCA-labeled I-131 (I-131-PSCA-mAb) in orthotopic mouse models of prostate cancer. Methods: The proliferation, apoptosis and invasion abilities of PC-3 and LNCaP cells treated with I-131-PSCA-mAb were measured by methyl thiazolyl tetrazolium assay, flow cytometry and transwell culture, respectively. The human prostate cancer models were established by orthotopic implantation of PC-3 and LNCaP cells in nude mice. I-131-PSCA-mAb distribution and tumor cell apoptosis in the tumor-bearing nude mice were measured. Results: The inhibitory and apoptosis rates of PC-3 and LNCaP cells treated with I-131-PSCA-mAb reached a maximum of 84%, 80% and 50%, 46%, respectively, which were obviously higher than in the cells treated with I-131-IgG or PSCA-mAb. The invaded number of PC-3 and LNCaP cells treated with I-131-PSCA-mAbe was significantly reduced (P < 0.01) compared with the control group. The ratios of I-131-PSCA-mAb in tumor to intramuscular I-131-PSCA-mAb (T/NT) in tumor-bearing nude mice were increased with time and reached the highest level after 8 h. T/NT stayed above 3.0 after 12 h, and the tumor could still be developed after 24 h. The number of apoptotic cells in tumor tissue of nude mice treated with I-131-PSCA-mAb was larger than that in the control group. Conclusion: I-131-PSCA-mAb has the potential to become a new targeted therapy drug for the treatment of prostate cancer.

The androgens and androgen receptor (AR) play key roles in the prostate cancer (PCa) development and progression via epithelium-stroma cross talk. Prostate cancer-associated fibroblasts (CAFs) are dominant components in PCa stroma and are essential in the malignant progression by supporting tumorigenesis and metastasis. However, the AR roles in CAFs are still obscure. We isolated and immortalized the CAFs from human PCa tissues and found the CAFs are AR positive. We then knocked down their AR with siRNA and co-cultured the resultant CAFs with PCa cell line PC3. The MTT, invasion, and colony formation assays were performed to study the PC3 biological behavior. The results showed that the PCa epithelial growth, invasion, and colony formation abilities decreased when knocking down the CAFs AR. By using the real-time quantitative polymerase chain reaction, we found the IGF1, FGF7, FGF10, SDF1, HGF, and TGFb2 expression levels decreased in the AR knocked down CAFs. These results suggested that the AR in CAFs promoted PCa epithelial growth and invasion via regulating a series of growth factors. Targeting the AR in CAFs might be a potential therapeutic option for PCa in future.

Objective: To determine the efficacy and safety of a novel minimally invasive design for treating bulky vesical calculi and large benign prostatic hyperplasia (BPH) simultaneously. Methods: 76 patients with large bladder stones (>4 cm) and large BPH (≥50 cm3) were treated from August 2008 to January 2011. 38 patients (group 1) underwent transurethral cystolithotripsy followed by transurethral resection of the prostate (TURP), 38 patients (group 2) received percutaneous cystolithotripsy within a laparoscopic entrapment bag and TURP by two surgeons simultaneously. 72 patients were followed up for 1 year. Patient demographics, perioperative parameters and follow-up data were compared. Results: Patient baseline characteristics were comparable in the two groups. In group 1, 3 patients converted to open surgery and received blood transfusion, 4 patients had postoperative fever, 2 had residual stones and 1 developed urethral stricture postoperatively. In group 2, the mean total operative and the operative times for stone management were 71.6 and 30.1 min, respectively, the mean hemoglobin decrease was 0.80 g/dl, no patients received blood transfusion and no complications occurred, significantly superior to group 1. Conclusions: Percutaneous cystolithotripsy using a laparoscopic entrapment bag associated with TURP by two surgeons simultaneously is a highly effective, safe and minimally invasive method for managing large vesical calculi and large BPH.

Objective To investigate the clinical outcome of laparoscopic nephroureterectomy (LUNT) for native upper tract urothelial carcinoma (UC) in renal transplant (RT) recipients.Methods We conducted a retrospective analysis on 1130 RT recipients,and 9 patients (0.8％,9/1130) with native upper tract UC were identified. UC was confirmed pathologically in the 9 patients,including 3 cases of unilateral ureter tumor (2 on the right,and 1 on the left),4 cases of unilateral renal pelvis tumor (2 on the right,2 on the left),1 case of bilateral ureter tumor and 1 case of tumor in the right ureter and left kidney.Females predominated (8/9) in the 9 patients with upper tract UC.The patients with left upper urinary tract cancer underwent LUNT using a retroperitoneal approach with a technique of transurethral circumcision of the ureteral orifice.The patients with right upper urinary tract cancer were subjected to nephroureterctomy with ureterectomy and bladder cuff excision by complete laparascopy through a transperitoneal approach. Immunosuppressive protocol conversion from calcineurin inhibitors to sirolimus was performed on all cases. Results In the 9 patients,11 LUNTs were performed successfully without conversion to open surgery.The follow-up period was from 6 to 48 months. One patient died of lung metastasis at 8th month after tumor excision,and 1 patient displayed ductal cancer of the left breast at 7th month after LNUT.Another seven patients showed no evidence of disease during the follow-up period with normal renal function.Conclusion Our present clinical experience suggested that LNUT for the native upper tract cancer in renal transplant recipients is feasible,safe,and effective.

Objective To detect the safety and feasibility of the laparoscopic live donor nephrectomy-transplantation model in beagle canine. Methods8 beagle dogs were randomly divided into two groups : the experimental group of laparoscopic nephrectomy for the left kidney, and the control group with open nephrectomy. In the 2 groups,all kidneys were placed in the left side of the iliac fossa, and all the right kidneys were removed at the same time. The operation time, blood loss, warm ischemia time,length of incision, the time of renal arteriovenous anastomosis, the blood creatinine and urea nitrogen levels after operation were monitored. Results The laparoscopic donor nephrectomy were performed successfully in the experimental group with the average nephrectomy time (61.5 ± 11. 0) min,blood loss (13. 9 ±6. 8) ml,renal warm ischemia time (81.4 ±9. 3) s; The open nephrectomy were performed successfully in the control group with the average nephrectomy operative time (66. 1 ± 13. 5) min,blood loss (32. 7 ±4. 8) ml,renal warm ischemia time (28. 5 ± 5.6) s; All the surgeries of kidney transplantation were successful with average operation time (87.3 ± 13. 9) min, blood loss ( 13.5 ± 5.2) ml, arterial anastomosis time ( 19. 8 ±6. 7 ) min, venous anastomosis time ( 22. 8 ± 3.5 ) min. After 1 month of observation period, no leakage of urine, bleeding, infection or other complications were occurred. Three days after surgery, the creatinine and urea nitrogen recovered to normal. Conclusion Beagle canine laparoscopic live donor kidney-transplantation model is simple and practicable with high survival rate.

BACKGROUND:Some patients with exophytic renal masses less than 4 cm and suboptimal renal function, or a solitary kidney and bilateral renal tumors are considered for laparoscopic partial nephrectomy (LPN), which is feasible for early-stage renal tumors, although it is still considered technically difficult and time consuming. Shortening the time of the operation and renal warm ischemia are required urgently. In this study, we report our initial experiences of LPN, especially with some improved surgical techniques.METHODS:Between July 2005 and October 2009, 74 patients with T(1a) renal tumor were treated by LPN, 39 using transperitoneal approach and 35 using retroperitoneal approach. In all cases, the tumor was removed with a margin of 0.5 cm. We compared glomerular filtration rate (GFR) preoperatively and postoperatively, and renal warm ischemia time between traditional ligature and Hem-o-lok methods.RESULTS:All operations were completed successfully, and there was no conversion to open surgery. Mean operation time was 76 minutes (range, 68 - 120), mean time of renal warm ischemia was 23 minutes (range, 15 - 32), and mean blood loss was 65 ml (range, 40 - 300). No hemorrhage or urine leak was observed in two cases with the collecting system sewn. Thirteen cases used Hem-o-lok to clamp the suture instead of traditional ligature, and mean time of renal warm ischemia was (16.5 ± 2.3) minutes (range, 12 - 18). Mean postoperative hospital stay was 6.3 days (range, 5 - 12). Sixty-seven cases had renal clear cell carcinoma, six papillary renal cell carcinoma, and one renal collecting duct carcinoma. All the tumor margin specimens were negative. The mean follow-up was 30.6 months (range, 3 - 51), and no recurrence or metastasis was observed.CONCLUSIONS:LPN for pT(1) stage renal tumor was safe and feasible. Hem-o-lok instead of traditional ligature to clamp the suture when sewing the renal wound could shorten the warm ischemia time.

OBJECTIVE:To report our initial experiences of laparoscopic partial nephrectomy (LPN) for small renal tumors.METHODS:From July 2005 to December 2008, 59 patients with small renal tumors were resected by laparoscopic partial nephrectomy.RESULTS:All operations were successfully accomplished. Twenty-seven patients were treated via a transperitoneal approach and the other 32 cases a retroperitoneal approach. The average operative duration was 72 minutes (range: 60 -) and the average kidney ischemia time 19 minutes (range: 15 - 32). The estimated blood loss was from 20 - 50 ml and no patient needed transfusion. The collecting system closure was performed by suture in 2 patients, and no complication of hemorrhage or urine leak was found. Thirteen cases used Hemo-lok to clamp the suture instead of traditional ligature. And the mean time of renal warm ischemia was 13 minutes (range: 10 - 18). These patients included 55 with clear cell renal carcinoma, 3 with granule cell renal carcinoma and 1 with oxyphil cell renal carcinoma. All renal tumors were completely removed with a negative surgical margin. The mean postoperative hospital stay was 6.2 days (range: 5 - 10). The postoperative ECT and creatinine were normal and there was no significant difference as compared with the preoperative findings (P < 0.05). None patient had any local recurrence during a mean follow-up period of 24.6 months (range: 3 - 42).CONCLUSIONS:LPN for pT(1) stage renal tumor is both safe and feasible. Mastering the skilled laparoscopic techniques may facilitate operation. Employing Hemo-lok instead of traditional ligature to clamp the suture while sewing renal wound shortens the warm ischemia time.

OBJECTIVE:To evaluate the safety of living related donors in short term after transplantation.METHODS:Two hundred and fifty-one cases of living related donor kidney transplantation from May 2000 to July 2007 were analysed retrospectively. There were 117 male and 134 female aged from 22 to 72 years old, with a mean of 46.6 years old. The indexes were compared including serum creatinine (SCr), creatinine clearance (CCr), glomerular filtration rate (GFR) and quality of life before and after donation. Surgical complications were followed-up.RESULTS:Donors' SCr was (75.9 +/- 17.2) micromol/L before donation, (107.4 +/- 21.2) micromol/L on 7 d after donation, (130.4 +/- 58.2) micromol/L at the 1(st) month and (116.1 +/- 24.1) micromol/L at the 3(rd) month. There were significant difference between any 2 time points (P < 0.01). CCr was (94.4 +/- 17.5) ml/min before donation and (63.5 +/- 17.8) ml/min on 10 d after donation (P < 0.01). In 62 donors, total GFR was (82.4 +/- 21.8) ml/min before donation. On 10 d after donation, GFR of remaining kidney was (57.4 +/- 14.1) ml/min which was 34.7% higher than GFR of this kidney before donation (42.6 +/- 11.8) ml/min. There was no significant difference in quality of life before living related donors and non-donor populations (P = 0.116). Surgical complications included splenic rupture in 1 case, descending colon rupture in 1 case and wound infection in 5 cases.CONCLUSION:Living donor kidney transplantation is safe for donors, although part of indexes would vary within normal range during the early time after donation.