Laparoscopic Retroperitoneoscopic Partial
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Abstracts / Urological Science 27 (2016) S36eS52 S47 Purpose: The study aimed to evaluate the possibility of applying 18F- Tzu-Hsin Yang. Division of Urology, Department of Surgery, Chiayi Chang fluorodeoxyglucose positron-emission tomography (FDG PET/CT) for Gung Memorial Hospital, Chiayi, Taiwan detecting upper tract cancer. Materials and Methods: 37 patients who had undergone preoperative. Purpose: To report our experience with radical cystectomy by open or FDG PET/CT for their suspected upper tract urothelial cancer from January laparoscopy method as applied to an older patient population with regard 2010 to December 2015, were retrospectively enrolled for comparison with to perioperative measures and pathologic outcomes. the postoperative histological findings of nephroureterectomy. Materials and Methods: A total of 48 patients underwent cystectomy and Results: The histological findings revealed 39 urothelial malignancies in extracorporeal urinary diversion at our institution from September 2008 37 nephroureterectomy specimens. The sensitivity of FDG PET CT was through March 2016 for clinically localized bladder cancer. The clinical 87.1% (34/39) in detecting the primary upper tract urothelial cancer. 2 characteristics, operative outcomes, and pathologic results of the consec- patients without FDG PET/CT avid tumor were diagnosed with Ta, low utive cases were categorized by age (younger, age <65 years vs older, age grade urothelial cancer. In two patients with two separated upper tract S65 years). tumors by histology of nephroureterectomy, only one avid tumor was Results: The outcomes of the 21 younger and 27 older patients, including found in FDG PET/CT. In one patient with annular type T3 ureteral cancer, 10 patients S 80 years old, were assessed. The number of patients received no definite evidence of FDG-avid tumor was found in the ureter. cystectomy by open vs. laparoscopy method in the younger and older Conclusion: FDG PET/CT may serve as a feasible supplementary method groups were 7 vs. 14 and 12 vs.11, respectively. The numbers of different for the diagnosis of upper tract urothelial malignancies but may miss low urine diversions methods (young vs .old) were1vs. 5 (ureter- grade, low stage, small size or annular type of urothelial cancer. ocutaneostomy), 10 vs. 10 (ileal conduit), 4 vs.6 (neobladder). No differ- ences were observed between the 2groups in American Society of Moderated Poster-5 Anesthesiologists score, operation time, blood loss, time to discharge, complication rate, open conversion rate, 30-D and 90-D mortality rate. Oncology Also, no significant differences were found in the surgical pathologic MP5-1. findings, including the organ-confined rate and lymph node yield. ROBOTIC-ASSISTED RETROPERITONEOSCOPIC PARTIAL NEPHRECTOMY Conclusion: Older patients do not appear to have any significant differ- FOR RENAL ANGIOMYOLIPOMA ences or compromises with regard to the perioperative and pathologic outcomes after radical cystectomy by either open or laparoscopy method Ng Woei Ming 1, Steven Kuan-Hua Huang 2, Kau Han Lee 1, Wei-Hong Lai 3. and urine diversion with or without neobladder. Thus age alone should not 1 Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, preclude radical cystectomy or for certain type of urine diversion. Taiwan; 2 Division of Uro-Oncology, Chi Mei Medical Center, Tainan, Taiwan; 3 Division of Urology, Department of Surgery, Ditmanson Medical Foundation MP5-3. Chia-Yi Christian Hospital, Chia-Yi, Taiwan PROGNOSTIC FACTORS OF THE UPPER TRACT UROTHELIAL CARCINOMA PT3 PATIENTS. SINGLE CENTER EXPERIENCE 192CASES IN TAIWAN Purpose: Renal AML is considered as a benign kidney tumor with hamar- tomatous features. However,itoften leads to hemorrhagic complications such Guan-Lin Huang, Hao-Lun Luo, Po-Hui Chiang. Department of Urology, as retroperitoneal hematoma orhematuria if large size. Invasive interventions Kaohsiung Chang Gung Memorial Hospital, Taiwan including embolization, nephron-sparing surgery, or even nephrectomy were suggested for larger tumor. Robotic-assisted laparoscopic partial nephrec- Purpose: Adjuvant therapy for post-operative locally advanced upper tract tomy helps in reducing surgical time, warm ischemia time, surgical technique urothelial carcinoma (UTUC) is still controversial. We are wondering if difficulty, intraoperative blood loss comparing to traditional laparoscopic there is any prognostic factors on the recurrence of T3 UTUC for clinical partial nephrectomy. Retroperitoneal approach provides better identification decision on post-operative adjuvant therapy. to renal pedicle control; prevent bowel injury and sooner bowel recovery. Materials and Methods: Medical records of 192 pT3 UTUC patients from However, there was less literature in reporting the robotic-assisted laparo- 2005e2013 were reviewed. Collected variables as age, follow up time, scopic partial nephrectomy via retroperitoneal approach for angiomyoli- gender, tumor location, nodal status, smoking, grade, lymphovascular in- poma. Hence, we are here to share our hospital’s clinical experience. vasion (LVI), ESRD, tumor subtype and recurrence. Multivariate analysis of Materials and Methods: In Chi-Mei Medical Center, we performed robotic- the prognostic factors on the tumor recurrence. assisted retroperitoneoscopic partial nephrectomy since August 2012, there Results: 192 patients with median follow up duration 35.6 months were were 15 patients met the surgical indication of angiomyolipoma (tumor > analyzed. 95 patients (49%) with systemic recurrence were noted in the 4cm or symptomatic) and underwent the nephron-sparing surgery with follow up duration. Multivariate analysis of the risk factors for the recur- single surgeon, as the inclusion criteria. The tumor’s characteristic, intra- rence showed significance on nodal status, smoking and lymphovascular operative statuses, post-operative follows up outcome were analysis. invasion (LVI). We classified the patients into 3 groups as 1. lymph nodes Results: From august 2012 to September 2015, there were 3 male and 12 negative 2. lymph nodes negative with LVI or smoking 3.lymph nodes female patients met the inclusion criteria. The mean age was 53-year-old. positive. The Kaplan-Meier recurrence free survival curve showed signif- Most of them were asymptomatic (86%) but larger tumor, the average tumor icant difference on the 3 groups. size was 5.22cm (2.3-13). The average nephrometry score was 6.35; Console Conclusion: For patients with clinical PT3 UTUC, lymph nodes metastasis, time was 121mins (40e238); warm ischemia time was 15 min (5e28); lympho-vascular invasion and smoking status were independent poor estimated blood loss was 550ml (100e1300). Only 2 (13%) of patients need prognostic factors. These results may be used to counsel patients towards intraoperative transfusion; 2 (13%) patients need post-operative emboliza- post-operative adjuvant therapy. tion (grade 3a complication). The average post-operative estimated glomerular filtration rate loss was 24% (7e40). The mean length of hospital MP5-4. stay was 4 days (2e8). There was no readmission rate within 30 days. Only 1 LAPAROSCOPIC RETROPERITONEOSCOPIC PARTIAL NEPHRECTOMY patient (6%) showed residual tumor during follow up imaging study FOR RENAL ANGIOMYOLIPOMA Conclusion: Robotic-assisted retroperitoneoscopic partial nephrectomy has acceptable morbidity and outcomes, it is safe and feasible in patient of Chye-Yang Lim 1,2, Steven Kuan-Hua Huang 1, Kau Han Lee 1,2, Wei-Hong benign renal angiomyolipoma. Lai 2. 1 Division of Urology, Department of Surgery, Division of Uro- Oncology, Chi Mei Medical Center, Tainan, Taiwan; 2 Division of Urology, MP5-2. Department of Surgery, Ditmanson Medical Foundation Chia-Yi Christian FEASIBILITY AND OUTCOMES OF RADICAL CYSTECTOMY FOR BLADDER Hospital, Chia-Yi, Taiwan CANCER IN THE OLDER PATIENTS (AGE>65 Y/O) Purpose: Nephron-sparing surgery for renal tumor was the standard Chao-An Chen, Wei-Yu Lin, Kuo-Hsiung Chiu, Yin-Lun Chang, Kuo-Cai procedure for the resectable renal tumor in order to preserve renal func- Huang, Jian-Hui Lin, Yung-Chin Huang, Dong-Ru Ho, Chih-Shou Chen, tion. It was evolved from open surgery to the minimal invasive surgery S48 Abstracts / Urological Science 27 (2016) S36eS52 which resulted in smaller wounds and rapid recovery. This operation can Hospital, Taipei, Taiwan; 2 Department of Urology, School of Medicine, be performed using either transperitoneal or retroperitoneal techniques. National Yang-Ming University, Taiwan; 3 Zhongxiao Branch, Taipei City The advantages of retroperitoneal approach were avoidance of bowel Hospital, Taiwan manipulation and it could be direct access to the kidney. Thus the aim of our study was to evaluate the experience of laparoscopic retroperitoneo- Purpose: The etiology of chronic prostatitis/chronic pelvic pain syndrome scopic partial nephrectomy for angiomyolipoma in our center. (CP/CPPS) is unknown, and there are still no established treatments that Materials and Methods: We retrospectively analyzed the medical records consistently relieve patients' symptoms. Endocannabinoids serves as of 20 patients (17 females and 3 males) who underwent retroperitoneal important modulators of tissue inflammation and pain perception. laparoscopic partial nephrectomies for benign renal tumor (pathology: Manipulation of cannabinoid system had been shown to reduce inflam- angiomyolipoma) in Chi-Mei Medical Center from June 2012 to July 2015. mation and lessen pain perception in some inflammatory disorders. This