Objective:To introduce our experience and technique of laparoscopic radical cystectomy for invasive bladder carcinoma.Method:From July 2008 to December 2010,9 male and 1 female underwent laparoscopic radical csctectomy,age ranged from 64 to 80,mean 69 years old.5 cases were performed laparoscopic radical systectomy with orthotopic ileal neobladder,5 cases were performed laparoscopic radical systectomy and ureterostomy.The operation time,the blood loss,the intestine function recovered time the complication and healing effect were retrospectively reviewed.Result:All operations were successful with the operation time 170-290 min,mean 210 min.the blood loss 150-950 ml,mean 250 ml.The intestine function recovered about 72 h after operation.All ureteral catheters were removed 3 weeks after surgery,there were no colorectal injuries,intestinal fistula and anastomosis stricture and fistula,severe complication such as perioperative death.The IVU showed no abnormality 3 months after 3 weeks after surgery.Conclusion:Laparoscopic radical cystectomy for invasive bladder cancer is safe and effective,with andvantages of good operating field,less invasion,less complications,short hospital stay and rapid recovery.With the improvement of Equipment and the development of technology,the operation will become a promising approach for radical cystectomy.

<正>患者,男,29岁。主因"肛内肿物2年余,排尿困难、大便变细半年余"入院。曾因间断便血于外院诊断为直肠肿物行相应治疗,疗效欠佳。入院后直肠指检:直肠前壁可触及黏膜下一质韧肿物,下缘距肛缘约3 cm,未及上缘;肿物表面光滑,活动度差,无触痛,指套无血染。尿动力学检查提示膀胱出口梗阻,前列腺部尿道延长。B超报告前列腺后方低回声结构,大小8.3 cm×5.7 cm×4.9 cm,内

Objective:The objective was to describe the last 5 years' information of the patients with perinephritis or perinephric abscesses and discuss our experience of the diagnosis and treatment of perinephritis and perinephric abscesses at our hospital.Methods:The medical records of 20 patients with perinephritis or perinephric abscesses treated at our hospital from January 2005 to August 2010 were reviewed.The data collected included symptoms and physical examination,laboratory and radiologic evaluation,treatment,and clinical outcome.Results:Perinephritis were found in 5 patients,Perinephric abscesses were found in 15.The main symptoms and physical examination were lumbar or(and) abdominal pain、fever、flank or abdominal mass,respective 16(80%),12(60%)、5 (25%),The others were haematuria 3(15%)、frequent micturition、urgent micturition odynuria(10%)、nausea&.vomiting 1(5%).Urolithiasis(25%)、chronic pyelonephrins 7(35%)and diabetes mellitus 5(25%) were the most common complication.The others are transitional cell carcinoma of ureter 1(5%),retroperitoneal fibrosis 1(5%)and UPJO(5%).The results of urine culture and(or) blood culture and(or) abscess culture were available in 7 patients.The positive rate was 71.4%(5).Of all the patients,5 only received antibiotic therapy (25%).The others received an interventional treatment;percutaneous drainage 6(30%),surgical drainage 5 (25%) and nephrectomy 4(25%).Escherichia cob,Klebsiella pneumonia and Proteus mirabilis have become the most frequent isolated microorganisms.19 patients were cured on discharge from hospital.1 emerged sinus,and none died.Conclusions:The improvement and widespread availability of imaging studies(CT and US) in recent decades improved the diagnosis and treatment of perinephritis and perinephric abscesses.Early and absolute drainage and enough antibiotic therapy is the key point in the outcome of perinephritis and perinephric abscesses.

Objective:To summarize the experience of single-site transumbilical surgery of partial adrenalectomy and explore its feasiblility.Methods:6 patients of adrenal adenoma underwent partial adrenalectomy by laparo-endoscopic single-site transumbilical surgery with home-made multi-channel single-port equipment from Oct.2009 to Jan.2011.4 males,2 females.3 in left and 3 in right..The mean age was 50.7(39-59) years,the mean size of adrenal masses was(2.3±0.5)(0.5-3.2) cm.4 cases with refractory hypertension,3.Results:6 cases were completed successfully.The mean operative time(123.3±23.4)(90-160)min,,the mean blood loss(86.5±12.4)ml, Pathologically confirmed adrenal adenoma.6 patients were followed up for 3-12 months,the umbilical incision healed well and no umbilical hernia and other complications,review the B-and abdominal CT,no recurrence.Conclusions: The Laparoendoscopic single-site transumbilical surgery of partial adrenalectomy is safe and feasible,scar hidden,good cosmetic results and could be a new clinical treatment of adrenal adenoma.

Objective:To summarize the experience of single-site transumbilical laparoscopic surgery for kidney and ureter disease and explore its feasibility.Methods:From Aug.2009 to Jan.2010,with self-made multi-channel single-port equipment,6 cases of non-functioning kidney patients and 12 cases of ureteral calculi patients underwent laparoscopic single-site transumbilical surgery.2cm peri-umbilical incision was made,self-made multi-channel single-port equipment,common laparoscopic equipment and flexible operating equipments were inserted into the abdominal cavity and specimens was removed from the umbilical incision.Results:Seventeen laparoscopic single-port operations were completed successfully.The mean operative time was(123.3±23.4)min,mean blood loss was(86.5±12.4)ml.1 case with abdominal aortic injury was converted to open surgery.The mean postoperative hospital stay was 7d,mean duration of drainage catheter was 3.5d,the patients were followed up 2-14 months,during which no complications occurred.Conclusions:The laparoscopic single-site transumbilical surgery for upper urinary tract lesions is safe and feasible,scar hidden,has good cosmetic results and can be a new clinical treatment method.

>前列腺结核临床极为少见,因其症状不典型及影像学无特异性表现等特点,诊断困难,临床上误诊漏诊率较高。2006年1月至2010年10月,我院收治前列腺结核9例,均有误诊漏诊史,现报告如下。对象与方法本组9例,年龄58～90岁,平均69岁。病程7 d～5年,平均13个月。1例既往有肾结核史行肾切除

Objective:To discuss the safety,feasibility and advantages of transumbilical single port laparoscopic pyelolithotomy or ureterolithotomy.Methods:The clinical documents of the patients who had been admitted into our hospital and undergone transumbilical single port laparoscopic(group A,n=12) and conventional laparoscopic pyelolithotomy or ureterolithotomy(group B,n = 16) in the period of January 2010 to December 2010 were reviewed. Their operation time,blood loss,hospital stay after operation,the recovery time of bowel function after operation,drainage time,cosmetic result,complications rate and the total cost were contrasted.Results:All operations were successful no post-operative complications occurred in both groups,as to blood loss,group A and B had no significant difference(P>0.05).As to post-operative hospital stay and the total hosp ital cost,group A was much superior to group B(P< 0.05).However,as to the recovery time of bowel function after surgery,group B was superior to group A(P<0.05).Conclusions transumbilical single port laparoscopic pyelolithotomy or ureterolithotomy is a safe and feasible operation.It has the advantages of mini invasion,rapid recovery,short hospitalization and less total hospital cost than conventional laparoscopic pyelolithotomy or ureterolithotomy.It will demonstrate the superiority and become one of the promising surgery methods.