In order to evaluate safety and morbidity aspects of additional systematic prostate biopsies, we have conducted a retrospective review of patients who had undergone transurethral resection of the prostate (TUR-P) combined with additional systemic prostate needle biopsies at the Chang Gung Memorial Hospital. To this end, the records of 80 men presenting consecutively at our institution between February 2001 and January 2004 inclusively were examined. These 80 individuals included patients experiencing obstructive voiding symptoms and those featuring suspicious screening parameters, all of whom were to undergo transurethral resection of the prostate for symptomatic benign prostatic hyperplasia (BPH), all procedures being performed by a single surgeon. A total of 20 (25%) specimens were found to be positive for prostate cancer. Cancer was detected in the transrectal prostate biopsy specimen of 16 of 57 men (28%) who had not undergone a previous prostate biopsy, and for four of 23 (17%) who had undergone at least one previous (benign) biopsy. Mild complications associated with transurethral prostrate resection, such as hematuria and hemospermia, were reported frequently, featuring rates of 10% and 2.5%, respectively; more severe complications being noted far less frequently. Fever, usually of a low grade, was observed post-operatively for six (7.5%) patients, but a prompt return to normal temperature following antibiotic treatment for one day was revealed. Four (5%) patients remained admitted to the hospital for a prolonged period following surgery. A review of the literature concerning transrectal biopsies and TUR-P has shown that surgery-associated complication rates are slightly lower than was the case for our study. Additional systematic prostate biopsies for patients undergoing TUR-P would appear to be a relatively safe treatment procedure. Identification of risk factors for post-surgery complications might further improve the safety of the screening procedure.
Introduction: The aim of the study is to compare the changes in the serum glucose levels and the amount of dextrose loads infused between pediatric vs adult patients undergoing living donor liver transplantation(LDLT). Methods and patients: Six hundred fifty six patients who underwent LDLT were compared retrospectively. The serum glucose levels before operation, after the induction of anesthesia, 2-3 hours after skin incision, during the anhepatic phase, 10 min after reperfusion, and at the end of the operation were performed. During the surgical procedure, two of the five infusion lines were 5% dextrose in 0.225 saline. The infusion rates of these two lines were regulated according to the serum glucose levels aiming to maintain it between 100-200 mg/dl. The changes of the serum glucose levels and the total amount of dextrose loads between groups were compared by using Mann Whitney U test. Data were converted to kg basis for comparison. A p-value < 0.05 was regarded as statistically significant. Results: One hundred ninety three pediatric patients were grouped in group 1 (GI) and 463 adulst patients in group 2 (GII). Table 1 shows that the changes of the serum glucose levels of both groups, up to anhepatic phase were able to maintain within 100-200 mg/dl, at reperfusion and the end the operation pediatric patients tended to have higher serum glucose in comparison to that of GII. GI required significantly higher dextrose load with a value 2.5 + 1.7 and 0.46 + 0.4 mg/kg/min for GI and GII respectively, indicating that much more dextrose load is required pediatric patients in maintaining serum glucose level between 100-200 mg/dL.[Table 1 Patients' characteristics between groups]Conclusion: Fuids management and dextrose load to maintain blood glucose levels between 100-200 mg/dl between pediatric and adult patients undergoing LDLT was significantly different.
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