Torsten Gruschwitz

Laser-Supported Partial Nephrectomy for Renal Cell Carcinoma

OBJECTIVES The extirpation of peripherally seated renal tumors by partial nephrectomy is an established method. To decrease the disadvantages of vascular hilar clamping, we proved the use of a laser for partial nephrectomy. To date, this laser application has only been described in the animal model. METHODS With an exophytic position of the renal tumor, we successfully performed nephron-sparing surgery without clamping of the renal vessels in 5 patients. RESULTS Regular ultrasound monitoring showed no evidence of postoperative hemorrhage. The serum creatinine, hemoglobin, and hematocrit were nearly unaltered before and after surgery. CONCLUSIONS The results of our study have shown that laser-supported partial nephrectomy without clamping of the renal vessels, particular in carefully selected patients, is a safe alternative to classic partial nephrectomy.

689 FISH ANALYSIS OF WASHING URINE FROM THE UPPER URINARY TRACT IN THE DETECTION OF CORRESPONDING UROTHELIAL CANCERS

165 patients of whom 26 (15%) developed de novo bladder cancer following upper-tract surgery. A variety of salvage upper-tract therapies were utilized, although the majority of cases progressed to nephroureterectomy. 5-year cancer specific survival was dependent on primary tumor pathology and ranged between 50% and 100%. CONCLUSIONS: Pooled analysis of the literature highlights that approximately 15% of patients will suffer ipsilateral upper-tract or bladder recurrences after segmental resection of ureteral or renal pelvic tumors. These rates of recurrence should be discussed prior to surgery and underscore the need for vigilant post-operative surveillance.

2134 DIFFERENCES IN PROTEIN PROPERTIES OF POSTOPERATIVE URINE SAMPLES ENABLE THE PREDICTION OF EARLY ALLOGRAFT REJECTION

failure rate to convert computer-identified KPD matches into transplants due to a variety of reasons. Understanding these reasons has allowed us to modify our software to incorporate a centralized tissue typing laboratory and develop a process of offering preliminary combinations for transplant center evaluation prior to optimizing a final solution. Thus, only acceptable and crossmatch negative one-way combinations are used to construct more robust final offers. As a result, we have substantially improved our conversion rate and the number of transplants so that as of November 2011 we have performed a total of 110 transplants.