中华泌尿外科杂志最新文献

{"title":"The nephrogenic adenoma of the bladder: 8 cases and literature review","authors":"L. Yiming, Shannon Zhang, Guohui Huang, K. Xia, P. Shengmeng, Wan-xin Wu, Fan Huiyang, Lei Zhen, Zheng-hui Guo","doi":"10.3760/CMA.J.CN112330-20191023-00466","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112330-20191023-00466","url":null,"abstract":"Objective \u0000To analyze the clinical characteristics of nephrogenic adenoma of the bladder. \u0000 \u0000 \u0000Methods \u0000The clinical and pathological data of 8 patients with bladder nephrogenic adenoma, during the period from July 2016 to June 2019, were retrospectively analyzed. Patients’ age were 33 to 71 years old and the average age was 55, including 5 males and 3 females. The clinical manifestations were hematuria in 7 cases, urinary tract irritation in 6 cases, and no obvious symptoms in 1 case. There were 7 cases with cystitis, 3 cases with urolithiasis, 2 cases with bladder cancer, 1 case with invasive colonic mesentery fibroma, and 1 case without other complications. 5 cases had the history of urological operation. The predilection site was the lateral wall with 5cases; 5 cases were solitary; the average maximum diameter of the tumor was 0.9 cm (range 0.1-1.8 cm). Under cystoscope, papillary mass can be seen, the surface is bright red, the pedicle is not obvious, the papilla is thick and short, easy to bleed when touching; some of them are scattered and lichen like changes. All patients received transurethral resection of bladder mucosa. \u0000 \u0000 \u0000Results \u0000Pathological examination shows that the bladder mucosa showed chronic inflammation, interstitial edema, granulation tissue hyperplasia, eosinophil infiltration and metaplasia of mesonephroid epithelium. All of the 8 patients were followed up by telephone for 2 to 38 months, with an average of 17.1 months. So far, neither recurrence has been detected. \u0000 \u0000 \u0000Conclusions \u0000The diagnosis of nephrogenic adenoma of the bladder depends on pathological examination. It must be totally removed during operation. The recurrence and malignancy should be treated in time after operation. \u0000 \u0000 \u0000Key words: \u0000Urinary bladder neoplasms; Nephrogenic adenoma; Pathology","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"41 1","pages":"190-193"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42256386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of inflammatory myofibroblastic tumor of the ureter","authors":"Dong Wang, Kai Liu, Hong-wei Du, Kai Li, Xiangning Luo","doi":"10.3760/CMA.J.CN112330-20191030-00481","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112330-20191030-00481","url":null,"abstract":"Inflammatory myofibroblastic tumor (IMT) is a mesenchymal neoplasm. Although this desease may occur in any site of body, the ureter is occasionally involved. Its clinical manifestations and imaging lack specificity. The diagnosis depends on pathological results. The main treatment is surgical resection. Recurrence and metastasis seem to be rare. A rare case of ureteral IMT managed with segmental ureterectomy and ureterostomy under general anesthesia was reported. \u0000 \u0000Key words: \u0000Ureteral neoplasms; Inflammatory myofibroblastic tumor; Ureter; Diagnosis; Treatment","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"41 1","pages":"225-226"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47826411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Value of contrast-enhanced ultrasound in diagnosis of atypical renal space occupying lesions","authors":"Xun Kong, Xiu-mei Zhang, Yi Liu, G. Shan, Lei Chen, Ze Peng","doi":"10.3760/CMA.J.CN112330-20191107-00497","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112330-20191107-00497","url":null,"abstract":"Objective \u0000To evaluate the diagnostic value of contrast-enhanced ultrasound(CEUS) in renal atypical space occupying lesions. \u0000 \u0000 \u0000Methods \u0000The images of conventional ultrasound and CEUS in 44 patients with 47 renal atypical space occupying lesions from May 2015 to June 2019 were retrospectively analyzed, including 26 males and 18 females. The mean age of patients was(55.9±13.7)years old, ranged from 27 to 79 years old. The mean size of the lesions in conventional ultrasound was (2.5±1.3)cm, ranged from 1.0 to 6.0 cm. The location, size, echo, boundary and color flew signals of renal lesions were observed by conventional ultrasound.The degree and the pattern of enhancement, presence or absence of a clear capsule sign were analyzed by CEUS. The ultrasound diagnosis results were compared with the pathological or clinical diagnosis. \u0000 \u0000 \u0000Results \u0000Of the 47 lesions, 15 were malignant and 32 were benign. 19 lesions were diagnosed by operation pathology, including 13 renal cell carcinomas, 2 renal lymphomas, 3 renal cysts and 1 inflammatory granuloma; the other 28 benign tumors or pseudotumors were diagnosed by enhanced CT or MRI, and were followed up for more than 1 year, including 5 angiomyolipomas, 15 cysts, 3 renal junction cortex defects, 2 renal column hypertrophies, 1 local non-atrophic renal parenchyma, 1 hump kidney and 1 scar. Most of the renal cell carcinomas were hypoechoic (8/13), \"fast wash-in and fast wash-out \" (9/13), heterogeneous hypoenhancement (6/13), 9 with pseudocapsule and 6 with necrosis. 2 renal lymphomas were hypoechoic, \"fast wash-in and fast wash-out\" , 1 isoenhancement and 1 hypoenhancement. The angiomyolipomas were hyperechoic, \"slow wash-in and slow wash-out\" (4/5), 2 hypoenhancement, 2 hyperenhancement and 1 isoenhancement. Most renal cysts were anechoic(16/18). There was no enhancement in simple renal cysts. The wall or septum of complex renal cysts was thin and homogeneous enhanced, showing \"slow wash-in and slow wash-out\" with isoenhancement or hypoenhancement. Inflammatory granuloma was cystic-solid. The solid part was hypoenhancement. Renal column hypertrophy, hump kidney and local non-atrophic renal parenchyma were hypoechoic, showing the same enhancement pattern as renal parenchyma by CEUS. The junctional parenchyma defect and renal scar were hyperechoic, showing no enhancement. The sensitivity, specificity, accuracy and the area under the ROC curve of conventional ultrasound and CEUS in the diagnosis of benign and malignant lesions were 86.7%, 87.5%, 87.2%, 0.871 and 100.0%, 96.9%, 97.9%, 0.984.There were significant differences in the diagnosis of renal atypical space occupying lesions between two methods (P=0.03). \u0000 \u0000 \u0000Conclusions \u0000CEUS was better than conventional ultrasound in the diagnosis of renal atypical space occupying lesions. CEUS had advantages in the differential diagnosis of benign and malignant tumors, benign lesions and anatomical variants mimicking a renal tumor. \u0000 \u0000 \u0000Key words: \u0000Kidney neoplasms","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"41 1","pages":"185-189"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47432799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report of primary leiomyosarcoma of the spermatic cord","authors":"Hui Xu, Jin-qi Song, Ya-nan Zhou, Chang-Li Xu, Gang Tu, Xing Zhao, Zhi-yong Wang","doi":"10.3760/CMA.J.CN112330-20190919-00415","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112330-20190919-00415","url":null,"abstract":"This study retrospectively analyzed the clinical data of 1 case of spermatic cord leiomyosarcoma admitted to the urology department of the Affiliated Hospital of Chengde Medical College. The clinical characteristics, diagnosis, treatment and prognosis was discussed with the literature review. Radical resection of the left testicle and high ligation of the left spermatic cord were performed. Postoperative pathology was spermatic cord leiomyosarcoma. Its clinical manifestations are painless masses, which are mainly confirmed by pathological examination. The treatment is mainly radical resection, and postoperative radiotherapy can improve the prognosis and reduce recurrence. \u0000 \u0000Key words: \u0000Spermatic cord; Primary; Leiomyosarcoma","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"41 1","pages":"231-232"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42172563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Historical review of the development of urinary continence cause in China","authors":"Jianye Wang","doi":"10.3760/CMA.J.CN112330-20200320-001","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112330-20200320-001","url":null,"abstract":"Urinary continence is an important branch of the urology and one of the most complex fields. The scientific research and clinical works in the field of urinary continence in China started late and from a low starting point. Over the past 40 years, with the joint efforts of our colleagues in the field of urology, the field of urinary continence in China has developed rapidly in the fields of urodynamics, urinary incontinence, overactive bladder, neurourology, functional urology, pelvic floor dysfunction, etc., and a significant progress has been made; but there are still some gaps compared with the international level. The Chinese Journal of Urology has been following the development of urinary continence in China. On the occasion of the 40th anniversary of the publication of the Journal, we made a review based on the retrieved papers published in this journal, in order to congratulate the Chinese Journal of Urology on its 40th birthday, and to urge and encourage the urinary continence workers to make more efforts, to promote the Chinese cause of urinary continence to a higher level. \u0000 \u0000Key words: \u0000Urinary continence; Development; China; The fortieth anniversary; Chinese Journal of Urology","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"41 1","pages":"161-167"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47549781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the prognostic factors of renal function after nephron sparing surgery","authors":"Pengfei Liu, G. Hou, Jianxin Ni, Fengqi Yan, D. Wei, Yu Zheng, Jia Wang, Shuai-jun Ma, Xiaojian Yang, Guojun Wu","doi":"10.3760/CMA.J.CN112330-20190530-00254","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112330-20190530-00254","url":null,"abstract":"Objective \u0000To investigate the prognostic factors of renal function after nephron sparing surgery (NSS) in renal tumor patients. \u0000 \u0000 \u0000Methods \u0000The data of 115 patients who underwent NSS in our hospital from December 2016 to December 2018 were retrospectively analyzed. There were 75 males and 40 females, aged (49.50±12.94) years. The body mass index was (24.59±3.59) kg/m2. The maximum diameter of the tumor was (3.66±1.32) cm. The R. E.N.A.L. score was (6.43±1.60). Laparoscopic partial nephrectomy was performed in 61 cases and robot-assisted laparoscopic partial nephrectomy was performed in 54 cases, and all of which were successfully completed. Operative time, WIT and postoperative pathological results were recorded. Blood creatinine value, GFR of affected kidney, GFR of healthy kidney, total GFR, GFR preserving rate (the ratio of postoperative GFR to preoperative GFR), functioning parenchymal volume (FPV) of the affected kidneys, and FPV preserving rate of the affected kidneys (the ratio of postoperative FPV and preoperative FPV) were recorded 6 months after surgery. FPV was measured by the ellipsoid approximation on CT images before and after surgery. Paired sample t test was used to compare GFR and FPV before and after surgery. Spearman rank correlation analysis was used to evaluate the correlation between the study factors and GFR preserving rate of the affected kidneys. Multivariate linear regression models were used to analyze independent predictors of renal function of the affected kidneys. Independent sample t test was used for comparison between group of WIT≤25 min and group of WIT>25 min. \u0000 \u0000 \u0000Results \u0000All of the 115 patients in this study underwent successfully operations, with the median operation time of 135(75-245) min, and WIT(24.57±5.51) min. Postoperative GFR of the affected kidneys(35.50±7.81)ml/(min·1.73 m2) was significantly different from preoperative GFR(P 25 min group had a significantly lower GFR preserving rate of the affected kidneys than WIT≤25 min group [(68.77±10.88)% vs.(79.34±8.88)%, P<0.001]. \u0000 \u0000 \u0000Conclusions \u0000In the case of short WIT (<30 min), the reservation of normal renal tissue is the most important variable prognostic factor of renal function after NSS, and short WIT plays a secondary role. Under the premise of complete tumor resection, normal renal tissue should be reserved as much as possible and WIT should be controlled within 25 min. \u0000 \u0000 \u0000Key words: \u0000Kidney neoplasms; Nephron sparing surgery; Renal function; Warm ischemia","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"41 1","pages":"179-184"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47499852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aquablation—image-guided robot-assisted water-jet ablation of the prostate: current advance","authors":"Menghao Lu, Jun Mi","doi":"10.3760/CMA.J.CN112330-20190605-00263","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112330-20190605-00263","url":null,"abstract":"In recent years robot system has been widely introduced into prostatic hyperplasia treatment. Rather than pay attention to traditional laparoscopic robot, this paper focused on Image-Guided Robot-Assisted Prostate Ablation Using Water Jet-Hydrodissection. This treatment system was very mini-invasive and easy to learn. Therefore, it reduced learning curve, operation time and related complications. This paper summarized current advance on the above fields. \u0000 \u0000Key words: \u0000Benign prostatic hyperplasia; Aquablation; Minimally invasive robotic surgery; Water-jet ablation; Transurethral resection of prostate","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"41 1","pages":"237-240"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44487771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment and validation of nomogram for positive surgical margin of prostate cancer","authors":"Wanli Cheng, C. Pang, Xinda Song, Chunlong Fu, H. Hou, Liqun Zhou, Lulin Ma, Xu Gao, D. He, Jianye Wang, Ming Liu","doi":"10.3760/CMA.J.CN112330-20190821-00378","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112330-20190821-00378","url":null,"abstract":"Objective \u0000To establish a nomogram model for predicting positive resection margins after prostate cancer surgery, and to perform the corresponding verification, in order to predict the risk of positive resection margins after surgery. \u0000 \u0000 \u0000Methods \u0000A total of 2 215 prostate cancer patients from The First Affiliated Hospital of Naval Medical University, Hospital, Peking University First Hospital, Peking University Third Hospital, Peking University, and First Affiliated Hospital of Xi′an Jiaotong University were included in the PC-follow database from 2015 to 2018, and a simple random sampling method was used. They were divided into 1 770 patients in the modeling group and 445 patients in the verification group. In the modeling group, the age ( 70 years), PSA ( 20 ng/ml), pelvic MRI (negative, suspicious, positive), clinical stage of the tumor (T1-T2, ≥T3), percentage of positive needles (≤33%, 34%-66%, >66%), Gleason score of biopsy pathology (≤6 points, 7 points, ≥8 points). Univariate and multivariate logistic analysis were performed to screen meaningful indicators to construct a nomogram model. The model was used for validation in the validation group. \u0000 \u0000 \u0000Results \u0000The results of multivariate analysis showed that preoperative PSA level (OR=2.046, 95%CI 1.022 to 4.251, P=0.009), percentage of puncture positive needles (OR=1.502, 95%CI 1.136 to 1.978, P=0.002), Gleason score of puncture pathology (OR=1.568, 95%CI 1.063 to 2.313, P=0.028), pelvic MRI were correlated (OR=1.525, 95%CI 1.160 to 2.005, P=0.033). Establish a nomogram model for independent predictors of positive margin of prostate cancer. The area under the receiver operating characteristic (ROC) curve of the validation group is 0.776. The area under the ROC curve of the preoperative PSA level, percentage of puncture positive needles, puncture pathology Gleason score, pelvic MRI, postoperative pathology Gleason score were 0.554, 0.615, 0.556, 0.522, and 0.560, respectively. The difference between the nomogram model and other indicators was statistically significant (P<0.05). \u0000 \u0000 \u0000Conclusions \u0000The constructed nomogram model has higher diagnostic value than the preoperative PSA level, percentage of puncture positive needles, Gleason score of puncturing pathology, pelvic MRI, and postoperative pathological Gleason score in predicting positive margin. \u0000 \u0000 \u0000Key words: \u0000Prostatic neoplasms; Prostate cancer; Positive surgical margin; Models statistical","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"41 1","pages":"205-209"},"PeriodicalIF":0.0,"publicationDate":"2020-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42216663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors predicting 2014 ISUP pathology grade upgrading from prostate biopsy to radical prostatectomy pathology","authors":"Y. Ouyang, Dong-Han Chen, Yonghong Li, Zhiyong Li, Y. Ye, Zhiming Wu, Li-juan Jiang, Yijun Zhang, Zhiling Zhang, Yun Cao, F. Zhou","doi":"10.3760/CMA.J.ISSN.1000-6702.2020.02.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2020.02.007","url":null,"abstract":"Objective \u0000To investigate the risk factors predicting pathology grade upgrading after radical prostatectomy using the 2014 International Society of Urologic Pathology (ISUP) grading system. \u0000 \u0000 \u0000Methods \u0000A total of 205 patients who underwent biopsy and radical prostatectomy from January 2017 to December 2018 were reviewed retrospectively. The median and range of the patients’age, PSA level, prostate volume, number of biopsy core examined, Gleason score and ISUP grade were 66(45-81)years old, 17.16(0.89-1254.00)ng/ml, 36.4(4.1-152.1)ml, 10(1-15), 7(6-10), and 3(1-5) respectively. The patients were divided into group of upgrading ISUP grade and group without upgrading ISUP grade. Multivariate Logistic regression analysis and receiving operating characteristic curve analysis were performed to identify predictors of ISUP upgrading and determine the optimal cut off value respectively. \u0000 \u0000 \u0000Result \u0000The median and range of Gleason score and ISUP grade after radical prostatectomy were 7(6-10), and 3(1-5) respectively. The radical prostatectomy ISUP grade upgraded in 73(35.6%)out of 205 cases when compared with biopsy ISUP grade. Radical prostatectomy ISUP grades were concordant in 91 cases (44.4%) and downgraded in 41 cases(20.0%). Of 101 with biopsy ISUP grades less than or equal to 2, the ISUP grade of radical prostatectomy upgraded in 58 cases(57.4%), while radical prostatectomy ISUP grade upgraded in only 18(26.9%) of 67 patients with biopsy ISUP grades of 3 or 4. Biopsy ISUP grades represent an independent predictor for ISUP grade upgrading after radical prostatectomy(OR=0.496, P<0.001). \u0000 \u0000 \u0000Conclusion \u0000Patients with biopsy ISUP grades less than or equal to 2 are at great risk of ISUP grade upgrading after radical prostatectomy. \u0000 \u0000 \u0000Key words: \u0000Prostatic neoplasms; Prostate cancer; Radical prostatectomy; Biopsy; Pathology upgrading","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"41 1","pages":"114-119"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48852065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of enhanced recovery after surgery protocols to robotic assisted radical cystectomy with intracorporeal urinary diversion using orthotopic U-shape ileal neobladder","authors":"Q. Wo, X. Qi, Feng Liu, Qi Zhang, Zujie Mao, Fei Xiang, Jia Lyu, Linyi Hu, Liping Wang, Xiang He, Da-hong Zhang","doi":"10.3760/CMA.J.ISSN.1000-6702.2020.02.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1000-6702.2020.02.004","url":null,"abstract":"Objective \u0000To discuss outcome and safety after implementation of enhanced recovery after surgery(ERAS) protocols to patients who underwent robotic assisted radical cystectomy(RARC) with intracorporeal orthotopic \"U\" shaped ileal neobladder creation using STAPLER technique. \u0000 \u0000 \u0000Methods \u0000Between October 2014 and April 2019, 71 patients(59 males and 12 females)with MIBC(Muscle Invasive Bladder Cancer) who underwent RARC with intracorporeal urinary diversion using orthotopic \"U\" shaped ileal neobladder in Zhejiang Provincial People's Hospital(People's Hospital of Hangzhou Medical College)were studied retrospectively. They had an average age of (65.2±5.6)y and BMI of (22.18±3.75)kg/m2. The median age-adjusted charlson comorbidity index(aCCI) was 4, median ASA score was 2. All patients underwent these inspections pre-RARC: chest Xray, vascular ultrasound(jugular vein included), abdominal ultrasound, CT urography, cystoscopy with biopsy or TURBT(trans-urethral resection of a bladder tumour). All patients were pathological diagnosed with MIBC, with no evidence of systemic metastasis and no history of radiotherapy, systemic chemotherapy and open abdominal surgery before RARC. All 71 patients received RARC with intracorporeal orthotopic \"U\" shaped ileal neobladder creation using STAPLER technique. Between October 2014 and September 2016, 37 cases(29 males and 8 females) were managed without ERAS protocols perioperatively. They had an average age of (65.3±5.7)y and BMI of (23.66±3.47)kg/m2. The median aCCI was 4, median ASA score was 2. Between October 2016 and April 2019, another group of 34 cases (30 males and 4 females) were managed with ERAS protocols including nutritional assessment, thrombosis prevention, pain assessment and management, perioperative diet management etc. They had an average age of (64.5±4.3)y and BMI of (21.87±4.85)kg/m2. The median aCCI was 4, median ASA score was 2. There were no statistical significance between the two groups with regard to general information. Surgical and follow-up data were collected for all patients. \u0000 \u0000 \u0000Results \u0000Surgeries were successful in all 71 cases with postoperative follow up for 3-51 months. In ERAS group, there were 22 cases in pT2 and 12 cases pT3 according to classification of malignant tumours: with 2 cases of incidental prostate cancer (IPCa). In non-ERAS group, pT2 in 25 cases and pT3 in 12 cases: with 1 case of IPCa. Statistical significance were observed between groups with regard to the first anal exhaust time [(20.5±18.7)h vs.(29.9±17.4)h, P=0.032], the first defecation time [(72.6±27.1)h vs.(88.7±35.8)h, P=0.004], length of hospital stay after surgey [(14.1±3.3)d vs.(16.2±4.8)d, P=0.037], numeric rating scales (NRS) Pain Score 8.0, 24.0, 48.0 h after surgery [(3.2±0.5)vs.(3.6±0.8), P=0.015; (1.9±0.3)vs.(2.2±0.6), P=0.011; (1.3±0.4)vs.(1.6±0.7), P=0.032], respectively. There were no significance between groups with regard to operating time [(290±65)min vs.(282±46)min, P=0.549], intraoperativ","PeriodicalId":10343,"journal":{"name":"Chinese Journal of Urology","volume":"41 1","pages":"95-101"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43513262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}