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Objective To investigate the hemostatic effect of transanal prostatic resectoscope technology on massive rectal bleeding after transrectal prostate biopsy. Methods From May 2016 to March 2022, 483 patients underwent transrectal prostate biopsy, 5 patients of them had hemodynamic deterioration due to massive rectal bleeding within 3 to 8 hours after operation. After active rehydration and blood transfusion, transanal prostatic resectoscope technology was applied to check the biopsy region and coagulate the active bleeding point. After hemostasis, the anal tube was retained for drainage for 24 to 72 hours and then removed. Results The average bleeding volume was about 440 mL (400 mL -1 000 mL) ; Average blood transfusion volume; RBC 2. 0 U/case, homoplasma 520 mL/case; The average operation time was 25 minutes (20-30 minutes) ; Rebleeding, local infection, hyponatremia and hypokalemia was not observed; The mean hospital stay was 4. 5 days (3-7 days) . Conclusion Transanal prostatic resectoscope technology is an effective method for rapid control of massive rectal bleeding after transrectal prostate biopsy. This method has obvious advantages in direct vision, clea vision, visible bleeding point, accurate and reliable hemostasis. [ABSTRACT FROM AUTHOR]

Tumour‐infiltrating mast cells (TIMs) have been reported to play functional roles in the tumour microenvironment. However, controversial evidences exist regarding their impact in different cancers. In order to study their role in metastatic renal cell carcinoma (mRCC), we have investigated the prognostic value of TIMs and their association with tumour‐infiltrating lymphocytes (TILs) in patients with mRCC treated with sunitinib or sorafenib. Baseline clinical characteristics and follow‐up data were collected from 231 patients with mRCC; TIMs (mast cells density positive to tryptase), along with CD8+ and CD4+ TILs, were evaluated by immunohistochemistry using a tissue microarray. The log‐rank test and univariate and multivariate COX regression models were used for survival analyses. Our results revealed that patients with high mast cell density had significantly better overall and progression‐free survival (OS, P =.008, and PFS, P =.016, respectively) than those with low mast cell density. Additionally, multivariate COX regression analyses identified TIMs as an independent prognostic factor for OS (HR = 0.624, 95% CI: 0.420‐0.927, P =.020) and PFS (HR = 0.658, 95% CI: 0.466‐0.930, P =.019). Further, combining TIMs with the International mRCC Database Consortium (IMDC) risk model achieved statistically significant and better predictive ability for one‐ and two‐year OS (P =.002 and P =.004, respectively). Moreover, the cases with high mast cell density were associated with a high density of CD8+ and CD4+ TILs (P =.008 and P =.001, respectively). Thus, better OS in patients with mRCC exhibiting a high mast cell density population may be attributed to the co‐existence of CD8+ and CD4+ TILs, which have anti‐tumour effects on activation status. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to determine whether CD8+ T lymphocyte and its checkpoint-associated module programmed cell death protein 1 (PD-1)/main ligand of PD-1 (PD-L1) pathway impact overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) treated with tyrosine kinase inhibitors (TKIs).Materials and methods: A total of 231 mRCC patients, from 2007 to 2017, treated with sunitinib or sorafenib in Zhongshan Hospital, Fudan University were included in the study analyses. CD8, PD-1, and PD-L1 was assessed by immunohistochemistry on continuous paraffin-embedded slides. Kaplan–Meier method and COX regression model were applied in the survival analyses.Results: Baseline characteristics were comparable between the training (n=118) and validation (n=113) sets. Patients with high CD8+ T lymphocytes infiltration and low PD-1 expression had longer survival in both sets (P=0.0106 and P=0.0047 in training set, P=0.0291 and P=0.0011 in validation set, respectively). However, survival stratified by PD-L1 was only insignificant or marginally significant. Multivariable analyses verified that CD8+ T lymphocytes, together with PD-1, but not tumor infiltrating mononuclear cells or tumor cells PD-L1, were independent prognostic factors (training set [HR 3.202, 95% CI 1.433–7.153, P=0.011] and validation set [HR 4.012, 95% CI 2.354–6.838, P [ABSTRACT FROM AUTHOR]

The treatment of complex intestinal fistulas has been a challenge in general surgery. A complex fistula is defined as a fistula with more than one abnormal connection between the gastrointestinal tract and skin, or a fistula with multiple bowel loops. The present case report describes the minimally invasive treatment of a complex intestinal fistula. Briefly, a 51-year-old man presented with an intestinal fistula. Following adequate anti-infective drainage of the abdominal abscess, transurethral prostate resection instrumentation was used to flush and drain the intestinal drainage tubes. On reduction of leakage, a drainage tube was inserted into the intestinal tract to serve as an internal stent. Imaging confirmed the successful cessation of intestinal leakage and a satisfactory recovery. The drainage tube was removed under colonoscopy, restoring normal small intestine function. To summarize, after sufficient drainage, the leakage gradually decreased, promoting healing; the patient achieved full recovery upon removal of the internal stent via colonoscopy and the establishment of a small intestinal stoma. In conclusion, transurethral prostate resection instrumentation enables safe and minimally invasive placement of intestinal stents, ensuring effective drainage for managing intestinal fistulas., Competing Interests: The authors declare that they have no competing interests., (Copyright: © 2024 Wang et al.)

Purpose: The aim of this study was to determine whether CD8 + T lymphocyte and its checkpoint-associated module programmed cell death protein 1 (PD-1)/main ligand of PD-1 (PD-L1) pathway impact overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) treated with tyrosine kinase inhibitors (TKIs)., Materials and Methods: A total of 231 mRCC patients, from 2007 to 2017, treated with sunitinib or sorafenib in Zhongshan Hospital, Fudan University were included in the study analyses. CD8, PD-1, and PD-L1 was assessed by immunohistochemistry on continuous paraffin-embedded slides. Kaplan-Meier method and COX regression model were applied in the survival analyses., Results: Baseline characteristics were comparable between the training (n=118) and validation (n=113) sets. Patients with high CD8 + T lymphocytes infiltration and low PD-1 expression had longer survival in both sets ( P =0.0106 and P =0.0047 in training set, P =0.0291 and P =0.0011 in validation set, respectively). However, survival stratified by PD-L1 was only insignificant or marginally significant. Multivariable analyses verified that CD8 + T lymphocytes, together with PD-1, but not tumor infiltrating mononuclear cells or tumor cells PD-L1, were independent prognostic factors (training set [HR 3.202, 95% CI 1.433-7.153, P =0.011] and validation set [HR 4.012, 95% CI 2.354-6.838, P <0.001]). Subsequent analysis revealed that the PD-1 high/CD8 low group had shorter survival (16 months) than PD-1 low/CD8 high group (51 months, P <0.0001). Combining the International Metastatic Renal Cancer Database Consortium system with the PD-1/CD8 model exhibited much better accuracy for the prediction of OS., Conclusion: Our findings suggest that abundant CD8 + T cells are significantly associated with longer OS in mRCC patients treated with TKIs. The most influential checkpoint-associated molecule, PD-1, assisted CD8 + T cell-stratified patients and could be used as a better predictive and prognostic factor for the mRCC patients., Competing Interests: Disclosure The authors report no conflicts of interest in this work.