Percutaneous cryosurgery was performed successfully in two patients with hypervascular renal tumours. Cryo-immunological activity was assumed to have contributed to the temporary improvement in their condition. These results suggest that percutaneous cryosurgery might be useful as minimally invasive treatment in a limited number of patients with advanced renal carcinoma.

Objectives : To report our initial experience of hand-assisted retroperitoneoscopic radical nephrectomy for stage T1 renal tumors. Methods : The clinical data on 22 consecutive patients who had undergone hand-assisted retroperitoneoscopic radical nephrectomy and 22 who had undergone open radical nephrectomy were reviewed. The operation was performed with a hand placed retroperitoneally through a pararectal longitudal 7-7.5 cm incision using a LAP DISC.Results : The total operating time was between 2.3 and 5.8 h (mean: 3.4 h). The estimated blood loss was between 15 and 650 mL (mean: 170 mL). The complication rate was 9% (2/22). No conversions to open procedure occurred. In comparison to open radical nephrectomy, the operating time was similar (3.4 vs 3.9 h) whereas the estimated blood loss was significantly less in this procedure (170 vs 495 mL). During the convalescence period the patients revealed significantly less postoperative pain, shorter intervals to resuming oral intake and more rapid return to normal activities compared to the open radical nephrectomy patients. Conclusion : Hand-assisted retroperitoneoscopic radical nephrectomy is an effective and safe procedure for T1 renal tumors.

Background: The present study was designed to ascertain retrospectively the validity of ursodeoxycholic acid (UDCA) in the treatment of prostate cancer in terms of prophylactic effects on the occurrence of flutamide-induced hepatopathy in a large number of patients surveyed in a multi-center cooperative study. Methods: One hundred and eighty-one patients (74.1 ± 4.9 years) with prostate cancer treated with flutamide with (n = 70) or without (n = 111) UDCA were retrospectively evaluated and the occurrence of hepatopathy was compared between these two patient groups. Results: Between patients treated with UDCA and those without it, no significant differences were noted in age, clinical stage, grade, duration of flutamide administration and serum prostate-specific antigen (PSA) levels before treatment. However, there were significant differences in the presence or absence of previous treatments and treatments used together with flutamide. The incidence of hepatopathy was 11.4% (8/70) in patients with UDCA and 32.4% (36/111) in those without it, showing a statistically significant difference (P < 0.05). The hepatopathy-free rate obtained by the Kaplan-Meier method was also significantly higher in patients with UDCA (88.4% 1 year following flutamide administration) than that in those without it (59.6%) (P < 0.005). Conclusion:These results suggest that UDCA has a prophylactic effect against flutamide-induced hepatopathy in patients with prostate cancer.

We treated 105 consecutive patients with bladder calculi by microexplosion lithotripsy, with a success rate of 100 per cent. The weight of the removed calculi averaged 18 gm., with a range of 2 to 305 gm. For the procedure spinal anesthesia was used in 78 patients, while general anesthesia was used in 24. Minor extraperitoneal bladder perforation occurred only once and it resolved spontaneously several days later. Presently, we consider microexplosion lithotripsy to be the treatment of first choice for bladder calculi.

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