[Clinical outcome of radical prostatectomy and pelvic lymph node dissection].

Between September, 1987 and September, 1993, a total of 44 consecutive patients had undergone radical retropubic prostatectomy and pelvic lymphadenectomy for the treatment of prostate cancer. The patients were between 56 and 77 years (mean, 68 years). Eleven patients had clinical state A2 disease, 21 had stage B disease, and 12 had stage C disease.

[Treatment of stone street after extracorporeal shock wave lithotripsy of staghorn calculi].

During ESWL monotherapy for staghorn calculi, the formation of a stone street in the ureter is often encountered, and can be a troublesome problem. At the Komaki Shimin Hospital, 75 patients with staghorn calculi were treated with ESWL monotherapy using a Dornier HM-3 lithotriptor between October 1987 and August 1992. Among them, three patients had involvement of both collecting systems.

Transurethral ureteroscopic ureterotomy assisted by a prior balloon dilation for relieving ureteral strictures.

We developed a procedure to correct ureteral obstruction that consists of transurethral ureteroscopic balloon dilation of the stenotic segment followed by a ureteroscopic ureterotomy. Since February 1989 we treated 20 ureters in 19 patients with upper urinary tract obstruction, with an 85% success rate. Stenosis was primary in 4 patients, and secondary to a prior operation in 10, calculi in 4 and endometriosis in 2.

[The efficacy of endopyeloureterotomy via a transpelvic extraureteral approach].

To evaluate the efficacy of endopyeloureterotomy via a transpelvic extraureteral approach for the treatment of ureteropelvic junction obstruction or upper ureteric stenosis, we analysed the results of 85 patients treated with this procedure between Aug. 1988 and June 1993. Eighty-five patients underwent 87 procedures.

Endoscopic trigonoplasty for primary vesico-ureteric reflux.

Objective: To investigate the surgical results of endoscopic trigonoplasty in patients with primary vesicoureteric reflux.

Patients And Methods: Records were reviewed for 12 patients who underwent endoscopic trigonoplasty between February 1992 and February 1994. Of the 12 patients, 11 were female; one was a child and nine had unilateral disease.

Laparoscopic nephrectomy using a retroperitoneal approach: comparison with a transabdominal approach.

To evaluate the efficacy of the retroperitoneal approach in laparoscopic nephrectomy, our procedures involving laparoscopic nephrectomy using a retroperitoneal approach are described and the clinical results of six patients treated in this way are compared with those of 32 transabdominally nephrectomized patients. Of the six retroperitoneally nephrectomized patients, six kidneys were successfully removed without severe complication, and 28 kidneys were successfully removed in the 32 intraabdominally approached group. Three of the 28 patients had complications requiring open laparotomy.

Laparoscopic nephrectomy, radical nephrectomy and adrenalectomy: Nagoya experience.

A total of 37 patients with various renal and adrenal diseases underwent laparoscopic nephrectomy, radical nephrectomy and adrenalectomy since July 1991. The underlying diseases included renal calculi, vesicoureteral reflux, ureteropelvic junction obstruction, ureteral stenosis, ectopic ureter, vascular disease, renal cell carcinoma and adrenal tumors. Twenty-nine kidneys (including 5 with renal cell carcinoma) and 5 adrenal glands were removed successfully.

Laparoscopic radical nephrectomy for renal cell carcinoma: early experience.

We developed a laparoscopic radical nephrectomy for malignant disease of the kidney and successfully performed the operation in six patients between July 1992 and October 1993. This procedure is basically derived from that of Clayman and associates. A CO2 pneumoperitoneum is induced, and five trocars are introduced into the abdominal cavity through the lateral abdominal wall.

Laparoscopic nephrectomy without morcellation for renal cell carcinoma: report of initial 2 cases.

We recently developed a new laparoscopic procedure of nephrectomy for renal cell carcinoma and successfully removed the kidney in 2 patients. A carbon dioxide pneumoperitoneum is induced and 5 trocars are introduced into the abdominal cavity through the lateral abdominal wall. The kidney is removed en bloc together with the adrenal gland, perirenal fat and Gerota's fascia.

[Laparoscopic nephrectomy; results of initial 14 cases and procedure for renal cell carcinoma].

Since July 1991, we have performed laparoscopic nephrectomy for removal of damaged kidneys in thirteen patients. In addition, we recently developed a new procedure of laparoscopic nephrectomy for renal cell carcinoma and successfully removed the kidney with renal cell carcinoma. Patients' age ranged from 18 to 80 years with the average being 50 years.

[Transrectal hyperthermia for chronic prostatitis].

Transrectal hyperthermia was performed on 13 patients with chronic non-bacterial prostatitis which failed to respond to the conventional treatments. We used "Prostathermer" (Biodan-Medical system, Israel) for heating the prostate gland. The prostate was heated at 42 degrees C-43 degrees C, for 60 minutes in 1 session.

[Clinical results in the treatment for primary carcinoma of the renal pelvis and ureter].

One hundred and five patients with renal pelvic and ureteral tumor entered our treatment program between 1982 and 1991. Of 105 patients, 81 had resectable transitional cell carcinoma and were treated with radical or total nephroureterectomy (57 vs. 24) and/or lymph node dissection (66).

[Endopyeloureterotomy via transpelvic extraureteral approach].

Endopyelotomy has been established as a valuable procedure to relieve the obstruction of ureteropelvic junction or upper ureteral stenosis. However, in a case with a long stenotic segment and in a case with high insertion type of ureteropelvic junction obstruction, we had often poor results by the conventional technique. To resolve these problems, we developed a new technique of endopyeloureterotomy via transpelvic extraureteral approach.

[Complications of Kock continent reservoir. Report of 103 cases].

We installed a Kock continent reservoir in 103 patients after radical cystectomy or pelvic exenteration between Feb. 1986 and Dec. 1989.

[Laparoscopic nephrectomy. Preliminary report].

Laparoscopic surgery has been widely performed for removing the gallbladder and the pelvic lymph-nodes in recent years. We have applied laparoscopy technique to nephrectomy and here we describe our procedures and the clinical results. The patient is placed in the supine position under general anesthesia.

[A case of testicular tumor arising in the undescended testis].

A 42-year-old man with testicular tumor arising in the left undescended testis is reported. The patient had bilateral cryptorchidism and was admitted to our clinic on March 20, 1989, complaining of a mass in the lower abdomen. Colography indicated complete obstruction at the sigmoid colon, and computed tomography showed a larger mass in the lower abdomen and paraaortic lymph node swelling, as well as left hydronephrosis.

Endopyeloureterotomy via a transpelvic extraureteral approach.

Endopyeloureterotomy has been accepted as a procedure to relieve obstruction of the ureteropelvic junction and upper ureteral stenosis. However, in patients with a long stenotic segment poor results are often obtained with the conventional technique. To resolve this problem we developed a new technique using a 22F urethrotome and a transpelvic extraureteral approach.

[A case with arteriovenous fistula from renal injury].

We report on a 58-year-old male treated with transcatheter embolization for arteriovenous fistula due to renal injury. The patient was transferred to our hospital on December 10, 1989, with left renal injury and left temporal bone fractures. Enhanced CT revealed parenchymal fracture with peri-renal hematoma in the left kidney.

Combination chemotherapy for advanced urothelial-tract carcinoma.

Between December 1982 and November 1990, 31 patients with advanced urothelial carcinoma were treated with one of two combination chemotherapy regimens. A total of 20 patients were treated with 3 mg/m2 mitomycin C and 300 mg/m2 cyclophosphamide given intravenously every 10-14 days and with 180 mg/m2 5-fluorouracil (5-FU) given intravenously every day for as long as possible (CF-Mito regimen). After the patient had been discharged from the hospital, the same treatment with CF-Mito was performed except that 180 mg/m2 5-FU was replaced by 400 mg/m2 UFT (a mixture of tegafur and uracil) given orally.

[Distribution of ciclosporin in the lymphoid tissue].

To clarify the distribution and the kinetics of ciclosporin (CSA) in the lymphatic system, we measured the CSA level of the lymph from the thoracic duct drainage (TDD) and that of the peripheral blood after oral or intravenous administration of CSA in 13 TDD pretreated patients. We also measured the CSA level of the iliac lymph nodes in 20 patients undergoing transplant surgery. The mean CSA level of the lymph was 1,647 ng/ml in the first 2 hours, 1,551 mg/dl in the next 10 hours and 254 ng/dl in the last 12 hours in orally administered patients and the mean CSA level of the peripheral blood was 746 ng/ml at 2 hours, 263 ng/ml at 12 hours and 119 ng/ml at 24 hours later.

[Extracorporeal shock wave lithotripsy monotherapy in the treatment of staghorn calculi].

From October, 1987 to September, 1989, 53 staghorn calculi of 51 patients underwent extracorporeal shock wave lithotripsy (ESWL) monotherapy by using Dornier HM3 lithotriptor. All patients were treated with double J stenting preoperatively. Mean number of shock waves was 6092 and mean number of sessions was 2.

[Percutaneous endoscopic surgery for obstructive diseases in the upper urinary tract--preliminary report].

Fifty-two patients with obstructive diseases of the upper urinary tract were treated by percutaneous endoscopic surgery between May, 1986 and July, 1989. Fifty-nine procedures consisting of endopyelotomy (24 procedures), endopyeloureterotomy (29) and balloon dilation under direct vision (6) were performed in 54 units of the urinary drainage system. Causative diseases were congenital in 24 units, scar due to calculi in 17, scar due to previous surgery in 11 and tuberculous ureteritis in 2.

[Thoracic duct drainage pretreatment in living related kidney transplantation--long-term results of low dose steroid and azathioprine immunosuppression].

The long term results of 28 HLA 1-haploidentical donor kidney transplant recipients receiving preoperative lymphocyte deletion through thoracic duct drainage and low dose of steroid and azathioprine immunosuppressive treatment were presented. The number of removed lymphocytes was 129.9 +/- 38.

Long-term results of transurethral lithotripsy with the rigid ureteroscope: injury of intramural ureter.

We treated 208 patients with ureteral calculi via transurethral lithotripsy using the rigid ureteroscope between March 1985 and April 1988. A total of 220 ureteroscopic procedures was performed in 217 ureters. Complete removal was achieved after 180 procedures (81.