Abstract:Objective:To investigate the effect of percutaneous nephrolithotomy with holmium laser lithotripsy on stress response and renal function of patients with complex renal calculus.Methods:Ninety patients with com-plex renal calculus were randomly divided into observation group(n=45)and control group(n=45).The pa-tients in observation group underwent percutaneous nephrolithotomy with holmium laser lithotripsy,and those in control group were treated with open renal lithotomy.The operation time,intraoperative blood loss,and postoper-ative complications in two groups were recorded.The changes in cortisol(Cor),noradrenaline(NE),adrenocorti-cotrophic hormone(ACTH)and blood urea nitrogen(BUN),serum creatinine(SCr),neutrophil gelatinase-asso-ciated lipocalin(NGAL)levels in two groups before and after operation were analyZed.Results:The operative time, activity out of bed days and hospital stay in observation group were significantly shorter than those in control group(P<0.05).One day after operation,the serum Cor,NE,and ACT H levels in two groups were significantly increased as compared with those before operation,and those indexes in control group were significantly higher than in observation group(P<0.05).The serum BUN,SCr and NGAL levels in observation group at 1st week and 1st month after opera-tion were significantly lower than those in control group(P<0.05).The incidence of postoperative complications was significantly lower,and the stone clearance rate was significantly higher in the observation group than in the control group (P<0.05).Conclusions:Percutaneous nephrolithotomy with holmium laser lithotripsy has precise curative effect in the treatment of complex renal calculus.It can reduce the stress response and kidney function injury.

Abstract:Objective:To summarize the experienceinthe earliest robotic-assistedlaparoscopic surgeryin urology and discuss its applied value .Methods:500 patients underwent robot-assisted laparoscopic urological surgery during 2007 October to 2013 Nove mber .Results:497 of 500 cases were operated successfully .The upper tract surgery was performedon135cases,accountingfor27.16 %,including2casesofadrenalectomy (0.4 %),60casesofpartialne-phrecto my (12.07 %),37 cases of radical nephrecto my (7.44 %),6 cases of nephroureterecto my (1.21 %),3 cases of unroofing of cyst of kidney (0.6 %),11 cases of pyeloplasty (2.21 %),14 cases of ureterovesical rei mplantation (2.82 %),1 case of ureterolysis (0.2 %),and 1 case of resecction of ureteral stenosis and ureteral anasto mosis (0.2 %).The lower urinary surgery was perfor med on 362 cases ,accounting for 72.84 %,including 319 cases of prostatecto my (64.19 %),24 cases of radical cystecto my and ileal conduit (4.83 %),7 cases of radical cystecto my and neobladder (1.41 %),3 cases of ureterocutaneosto my (0.6 %),3 cases of pelvic neoplas mresection (0.6 %),4 cases of excision of se minal vesicle neoplas m (0.8 %),1 case of lithotripsy of bladder calculus (0.2 %),and 1 case of sacrocolpopexy (0.2 %).Three cases were converted to open surgery (0.6 %),including the retroperitoneal fibro-sis release in 1 case ,radical prostatectomy in 1 case ,and cystectomy in 1 case .All the patients recovered without any complication.Conclusions:Following the principles and dissecting anatomical surface of open and laparoscopic surgery ,the robotic-assisted laparoscopic surgery is safe and effective technically ,and can gain satisfied clinical treatmentoutcomes,withthe manyadvantagessuchas withasmalltrauma,clearoperationfield,lessbloodloss and short learning curve .

Abstract:Objective:To compare the effect of transurethral resection of prostate (TURP)and transurethral bipolar plasma kinetic resection of prostate (PKRP)on the urodynamics of patients with benign prostatic hyper-plasia.Methods:From August 2013 to December 2014 in our hospital,76 cases of BPH were enrolled in this stud-y,and divided into TURP group and PKRP gourp by random number table,n=38 each.The operative indicators, postoperative urodynamic indexes,the quality of life and complications were compared between two groups.Re-sults:In PKRP group,intraoperative blood loss was less and catheter indwelling time was shorter in TURP group than in TURP group (both P<0.05).There was no significant difference in urodynamic indexes including maxi-mum urinary flow rate Qmax ,maximum detrusor pressure (MDP),maximum bladder urine volume (VMCC), bladder compliance (BC)and residual urine (PVR)in both two groups before and after treatment (P>0.05).The incidences of complications in PKRP group was 7.89% was significantly lower than that in TURP group (26.32%)(χ2=4.547,P<0.05).Conclusions:Both TURP and PKRP can be effective in the treatment of BRH,and can significantly improve the urodynamics,PKRP has advantages in operative time,intraoperative blood loss,and control of complications.

Abstract:Radical prostatectomy is one of the most difficult urological surgeries due to the limited pelvic space,multiple adjacent vital organs,and supreme objective of this operation.Based on accumulated rich experi-ence of early laparoscopic and robotic surgeries,the author made further exploration on the key techniques for the preservation of continence and potency in robotic radical prostatectomy,effectively reducing the difficulty and in-creasing the effectiveness of the surgery.