Management of Bladder Cancer following Solid Organ Transplantation

Objective. Present our experience managing bladder cancer following liver and renal transplantation. Methods. Single institution retrospective review of patients diagnosed with bladder urothelial carcinoma (BUC) following solid organ transplantation between January 1992 and December 2007. Results. Of the 2,925 renal and 2,761 liver transplant recipients reviewed, we identified eleven patients (0.2%) following transplant diagnosed with BUC. Two patients with low grade T1 TCC were managed by TURBT. Three patients with CIS and one patient with T1 low grade BUC were treated by TURBT and adjuvant BCG. All four are alive and free of recurrence at a mean follow-up of 51 ± 22 months. One patient with T1 high grade BUC underwent radical cystectomy and remains disease free with a follow-up of 98 months. Muscle invasive TCC was diagnosed in four patients at a median of 3.6 years following transplantation. Two patients are recurrence free at 24 and 36 months following radical cystectomy. Urinary diversion and palliative XRT were performed in one patient with un-resectable disease. Conclusions. Bladder cancer is uncommon following renal and liver transplantation, but it can be managed successfully with local and/or extirpative therapy. The use of intravesical BCG is possible in select immunosuppressed patients

High-field magnetization and electron spin resonance in the spin-gap system η -Na 1.286 V 2 O 5

International audienceIn this work, we report results of high-field magnetization and electron spin resonance ESR measurements performed on-Na 1.286 V 2 O 5 , a compound that shows a spin gap. This system may be regarded as an assembly of weakly interacting magnetic entities, each of which containing, at low temperature, 18 antiferromagnetically AF-coupled S = 1 2 spins. The purpose of this work is to determine the gap value and to probe the low-lying energy levels in this compound. On the one hand, the high-field magnetization measurements, performed at temperatures down to 1.7 K on powder samples, suggest a spin gap, , of approximately 39 K, a value which is quite close to the earlier estimate of 35 K, which some of us deduced from the susceptibility measurements at low field Duc et al., Phys. Rev. B 69, 094102 2004. On the other hand, these measurements show a magnetization step at one ninth of the saturation magnetization, giving strong support to the assumption that this system may be regarded as a finite-size system composed of 18 AF-coupled S = 1 2 spins. A theoretical fit of the magnetization indicates the necessity to include couplings to second or more distant neighbors. The ESR data at various frequencies from 9.6–980 GHz and at temperatures ranging from 4.2–150 K, obtained on powder samples as well as on single crystals, are in accordance with the gap value mentioned above. In addition, these ESR data indicate that the closure of the gap is not accompanied by any detectable mixing between the singlet level and the lowest-lying level of the first excited triplet. This implies the absence of any appreciable Dzyaloshinskii-Moriya interaction in this compound

Robot-assisted pancreatic surgery:a systematic review of the literature

<p>Background To potentially improve outcomes in pancreatic resection, robot-assisted pancreatic surgery has been introduced. This technique has possible advantages over laparoscopic surgery, such as its affordance of three-dimensional vision and increased freedom of movement of instruments. A systematic review was performed to assess the safety and feasibility of robot-assisted pancreatic surgery.</p><p>Methods The literature published up to 30 September 2011 was systematically reviewed, with no restrictions on publication date. Studies reporting on over five patients were included. Animal studies, studies not reporting morbidity and mortality, review articles and conference abstracts were excluded. Data were extracted and weighted means were calculated.</p><p>Results A total of 499 studies were screened, after which eight cohort studies reporting on a total of 251 patients undergoing robot-assisted pancreatic surgery were retained for analysis. Weighted mean operation time was 404 +/- 102?min (510 +/- 107?min for pancreatoduodenectomy only). The rate of conversion was 11.0% (16.4% for pancreatoduodenectomy only). Overall morbidity was 30.7% (n = 77), most frequently involving pancreatic fistulae (n = 46). Mortality was 1.6%. Negative surgical margins were obtained in 92.9% of patients. The rate of spleen preservation in distal pancreatectomy was 87.1%.</p><p>Conclusions Robot-assisted pancreatic surgery seems to be safe and feasible in selected patients and, in left-sided resections, may increase the rate of spleen preservation. Randomized studies should compare the respective outcomes of robot-assisted, laparoscopic and open pancreatic surgery.</p>

Long-term evaluation of oncologic and functional outcomes after laparoscopic open-assisted radical cystectomy: a matched-pair analysis.

To evaluate peri- and postoperative morbidity, and long-term oncologic and functional results of our laparoscopic radical cystectomy (LRC) technique, comparing it with our standard open approach.JOURNAL ARTICLEinfo:eu-repo/semantics/publishe