OBJECTIVES To report our experience with laparoscopic radical prostatectomy (LRP) for the treatment of localized prostate carcinoma in two renal transplant recipients and a review of the literature. PATIENTS AND METHODS We retrospectively identified all patients who had undergone LRP for clinically localized prostate cancer between 2002 and 2008 at our institution (n = 1150). Of these patients, two were renal transplant recipients (one with donor renal transplant cadaver and the other with prior transplantectomy). We reviewed all available clinicopathological data and the scientific literature. RESULTS The two patients underwent successful LRP with no major complications. The mean (range) operative time was 200 (180–220) min with a mean estimated blood loss of 300 (200–400) mL. There were no changes in renal graft function as measured by serum creatinine level. At pathology, the surgical margins were negative and disease was organ‐confined in each case. The two patients tolerated the procedure well and had a mean (range) hospital stay of 3.5  (3–4) days. CONCLUSIONS The data from our two patients suggest that LRP, as an accepted minimally invasive treatment for a middle‐aged man with organ‐confined prostate cancer, is a technically feasible and safe treatment of localized prostate cancer in renal transplant recipients.

BACKGROUND AND PURPOSEExpression of a7 nicotinic acetylcholine receptors (nAChRs) and their role in exocytosis have not yet been examined in human chromaffin cells. EXPERIMENTAL APPROACHTo characterize these receptors and investigate their function, patch-clamp experiments were performed in human chromaffin cells from organ donors. KEY RESULTSThe nicotinic current provoked by 300 mM ACh in voltage-clamped cells was blocked by the nicotinic receptor antagonists a-bungarotoxin (a-Bgtx; 1 mM; 6 Ϯ 1.7%) or methyllycaconitine (MLA; 10 nM; 7 Ϯ 1.6%), respectively, in an irreversible and reversible manner, without affecting exocytosis. Choline (10 mM) pulses induced a biphasic current with an initial quickly activated (5.5 Ϯ 0.4 ms rise time) and inactivated component (8.5 Ϯ 0.4 ms time constant) (termed a7), which was blocked by a-Bgtx or MLA, followed by a slower component (non-a7). a7 nAChR currents were dissected by blocking the non-a7 nAChR current component of the ACh and choline response with the a6* nAChR blocker a-conotoxin (a-Ctx) MII[S4A, E11A, L15A]. PNU-282987, an a7 nAChR-specific agonist, elicited rapidly activated and rapidly inactivated currents. a7 nAChR-positive allosteric modulators, such as 5-hydroxyindole (1 mM) and PNU-120596 (10 mM), potentiated responses that were blocked by a-Bgtx or MLA. Exocytosis was evoked by depolarization-elicited a7 nAChR currents, using choline in the presence of a-Ctx MII[MS4A, E11A, L15A] or PNU-282987 as agonists. CONCLUSIONS AND IMPLICATIONSOur electrophysiological recordings of pure a7 nAChR currents elicited by rapid application of agonists demonstrated that functional a7 nAChRs are expressed and contribute to depolarization-elicited exocytosis in human chromaffin cells. IntroductionWe previously showed that nicotinic acetylcholine receptors (nAChRs; nomenclature follows Alexander et al., 2011) in human chromaffin cells control several stages of the stimulus-secretion coupling process that occurs when these cells are activated with short or long pulses of ACh (Pérez-Alvarez and Albillos, 2007). Also, human chromaffin cells mainly exhibit an 'adrenergic phenotype' (Pérez-Alvarez et al., 2008), i.e., they release more adrenaline than noradrenaline, confirming previous data (Takiyyuddin et al., 1994). Thus, nAChRs play an essential role in the fast and more sustained catecholamine secretion that takes place under stress situations in humans.In relation to the fast response elicited by short pulses of ACh, nAChRs in human chromaffin cells play a prominent role in exocytosis according to the following evidence from our laboratory (Pérez-Alvarez and Albillos, 2007): (i) 200 ms pulses of ACh elicited a nicotinic current, fully abolished by mecamylamine, that contributed to overall exocytosis at hyperpolarized membrane potentials; this contribution was as large as that of voltage-dependent Ca 2+ channels (VDCC) at depolarized potentials; and (ii) this ACh-evoked nicotinic current triggered plasma membrane depolarization, recruiting VDCC and eliciting exocytosis.From a m...

After the implementation of the CP, there have been better results in patient care, such as reduction in the duration of catheterization and thromboprophylaxis. In comparison with other studies, we observed a clear reduction in length of stay and operative time. However, there is still room for improvement in reducing the duration of catheterization.

IntroductionRadical cystectomy in elderly patients is a controversial issue that has noticed an increase in importance overtime because of the lengthening average life span. Our objective was to determine if there were significant differences in the perioperative outcomes of patients over 70 years with bladder cancer treated with laparoscopic radical cystectomy (LRC) compared to those of younger patients.Material and methodsWe selected 180 patients who underwent LRC in our department in the period between 2005-2012. We divided them into 2 groups: 57% <70 years and 43% >70 years, and we compared the different parameters such as: comorbidities, intraoperative and post-operative complications, TNM stage and overall survival.ResultsThe group <70 years had less comorbidities when compared with the group >70 years. Heterotopic urinary diversion was the diversion of choice in the elderly patients (97.4%). Paralytic ileus and the worsening of renal function were the only complications with statistical differences between the groups. Mean hospital length of stay was not significantly different between the groups. Younger and older patients had similar pathological staging : pT1 or less: 26,2 vs. 18.2%, pT2: 19.4 vs. 16.9%, pT3 38.8 vs. 37.7% and pT4 15.6 vs. 17.2%. Kaplan-Meier curves did not show significant differences in survival.ConclusionsLaparoscopic radical cystectomy in the elderly patient has similar rates of perioperative morbidity when compared with the younger patient and may be offered as a treatment option in selected elderly patients.