Postoperative nausea and vomiting (PONV) is a common complaint after plastic and reconstructive surgery. Transdermal scopolamine is a commonly used agent for prevention of PONV. Anisocoria from transdermal scopolamine use is an adverse effect that has not been reported in the plastic surgery literature. We present a series of 3 craniofacial patients in which ipsilateral mydriasis occurred and spontaneously resolved after removal of the scopolamine patch. Given the various causes and potentially grave implications of unilateral mydriasis, we discourage the use of transdermal scopolamine in craniofacial surgery, and especially in orbital surgery. However, if transdermal scopolamine is decided to be used for PONV prophylaxis, we recommend educating the patient, the operating room staff, and the surgical team regarding this potential adverse effect and to avoid finger-to-eye contamination after patch manipulation.

introduction & objectives:To compare oncological results of elective nephronsparing surgery (NSS) and radical nephrectomy (RN) in patients with pT1 renal cell carcinoma (RCC). Materials & Methods:The Surveillance And Treatment Update Renal Neoplasms (SATURN) study collected the data of 5463 patients with RCC treated at 16 Italian institutions from 1995 to 2007. In the present analysis, we evaluated 3320 patients with pT1a/pT1b pN0/Nx M0 who underwent RN or elective NSS. The Kaplan-Meier method was used to calculate survival functions, and differences were assessed with the log-rank statistic. From 1987From to 2007 patients underwent surgery at our institution for pT1b sporadic, localized RCC, with a normal contralateral kidney (RN, n=194; PN=63). Renal function was evaluated by the estimated glomerular filtration rate (eGFR), comparing the variables to investigate the probability of renal function worsening (eGFR < 60 ml/min/1.73m2 ). The outcome was evaluated and compared with Cox proportional hazards regression models. results: 35,6% of patients who underwent RN had renal function worsening, compared to 16% of patients undergoing PN (p=0,006). A multivariate analysis including type of surgery, age, Fuhrman grade, Charlson Index, sex, hypertension, smoking, preoperative eGFR showed significativity only for type of surgery (p=0,017) and age (p=0,001). We then stratified the cohort by year of surgery (cutoff: 1997), considering the increasing use of PN in the last decade: after 1997, only type of surgery (p=0,015) and age (p=0,011) were statistically significative, instead of hypertension (p=0,052), smoking (p=0,941) Charlson Index (p=0,495), Fuhrman grade 8p=0,384) and preoperative eGFR (p=0,490). The strong significativity of age was evident even when stratifying for age quartiles (p=0,000), with a progressive worsening of renal function through the age quartiles. Furthermore,

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