Current practice of autologous fat transfer for soft tissue augmentation is limited by poor long-term graft retention. Adipose-derived regenerative cells (ADRCs) contain several types of stem and regenerative cells, which may help improve graft retention through multiple mechanisms. Using a murine fat transplantation model, ADRCs were added to transplanted fat to test whether ADRCs could improve the long-term retention of the grafts. This study showed, at both 6 and 9 months after transplantation, ADRCs not only increased graft retention by 2-fold but also improved the quality of the grafts. ADRC-supplemented grafts had a higher capillary density, indicating ADRCs could promote neovascularization. Further cell tracking and gene expression studies suggest ADRCs may promote angiogenesis and adipocyte differentiation and prevent apoptosis through the expression of various growth factors, including VEGFA and IGF-1. Taken together, these results suggest a potential clinical utility of ADRCs in facilitating autologous fat transfer for soft tissue augmentation.

Background: To evaluate the surgical effects and oncological outcomes of modified ileal conduit (IC) after radical cystectomy (RC) for bladder cancer.Methods: A single-centre cohort of 211 consecutive bladder cancer patients who underwent RC + modified IC from September 2012 to August 2019 were retrospectively studied. Demographic data, perioperative results, complications 30 and 90 days after surgery and oncological outcomes were recorded. Kaplan–Meier method was used to plot the stage-specific survival results. The 5-year recurrence-free survival (RFS）and overall survival (OS) rate was calculated. Univariate and multivariate Cox regression analyses assessed the predictive risk factors on survival rate.Results: Overall, 211 patients received modified IC after RC. The median operative time (OT) was 315 minutes (IQR, 260–375 minutes), and the median estimated blood loss (EBL) was 500 ml (IQR, 300–900 ml). There were a total of 103 (48.8%) complications. There were 35, 54, 11, and 2 cases of grade I, II, III, and IV complications, respectively; of which 89 cases were grade I and II, accounting for 87.3% of total cases. There were 38 cases of preoperative hydronephrosis and 22 cases of postoperative hydronephrosis. There were 19, 24, 108, 40, and 20 cases of PT0, T1, T2, T3, and T4, respectively, in postoperative pathological stages. The median lymphadenectomy was 14 (IQR, 6–18), and lymph node was found positive in 18 patients. The median follow-up time was 26 months (IQR, 13–43), with a total survival of 177 (83.9%), an RFS of 171 (81%), and 34 deaths. The estimated 5-year OS and RFS rates were 76.80% and 79.10%. Preoperative comorbidities, pathological stage, grade, and lymph node involvement were important influencing factors for OS, while preoperative comorbidities and high pathological grade were important influencing factors for RFS.Conclusions: Modified IC after RC not only can achieve lower postoperative complications, especially the lower incidence of uretero-ileal anastomosis and stoma-related complications but can also achieve the established oncological outcomes of critical radical surgery.

Background: We report our modified surgical technique of retroperitoneal laparoscopic radical nephrectomy (RLRN) and assess its perioperative outcomes and postoperative complications, with a focus on operative time (OT). Methods: We retrospectively analyzed a single-center, single-surgeon cohort of 130 consecutive patients who underwent RLRN between January 2015 and March 2019. A study group of 65 patients who received modified RLRN was compared with a control group of 65 patients who received classical RLRN. OT, estimated blood loss ( EBL ), perioperative complications, postoperative first exhaust time (PFET), pathological stage, and postoperative hospital stay (PHS) were compared between the two groups. Results: All demographic, clinical, and pathological variables were comparable between the groups. No differences were observed in perioperative complications (p=0.648), peritoneal injuries (p=0.843), PFET (p=0.448), pathological stage (p=0.767), and PHS (p=0.304). The modified RLRN group resulted in a significantly reduced overall OT (53.8±8.4 min vs. 60.5±10.6 min, p=0.000), peritoneal injury intervention subgroup OT (56.3±9.8 min vs. 75.2±12.4 min, p=0.000), and EBL (55.7±10.1 mL vs. 62.3±11.6 mL, p=0.001) compared with the classical RLRN group. We observed a significant reduction in OT and EBL but no increase in postoperative complications, PFET, or PHS with modified versus traditional RLRN for localized renal carcinoma.Conclusions: Findings from this study present a modified RLRN surgical technique that is standardized, more precise, and has better practicability.