1. Feasibility And Renal Function Changes Of One-stage Flexible Ureteroscopic Lithotripsy In The Treatment Of Solitary Renal Nephrolithiasis. 2. Progress In Local Treatment Of Prostate Cancer

INTRODUCTION:We aim to compare perioperative outcomes and long-term renal function changes between prior stenting(PS)and not prior stenting(NPS)before flexible ureteroscopy lithotripsy(f-URS)for solitary kidney patients.METHODS:Solitary kidney patients with renal stones were enrolled in this study.Perioperative parameters and complications were compared.Stone-free was defined as the absence of any residual stones.A decrease in the e GFR over 20% was identified as ‘deterioration' in renal function.The follow-up period was at least 6 months.Logistic regression was used to identify risk factors of renal function deterioration.RESULTS:In total,76 patients were enrolled in this study,including40 patients in the PS group and 36 patients in the NPS group.All patients ranged in age from 29 to 80 years old.The average stone diameter was16.8±4.7 mm,ranging from 10.0 to 28.4 mm.The success rates of indwelling ureteral access sheath(UAS)in the PS group and the NPS group were 100% and 94.4%,respectively(p = 0.221).The mean surgical time was 49.9±22.3 min,which was 48.6±22.6 min in the PS group and51.4±22.1 min in the NPS group.There was no significant difference in the operative time between the two groups(p = 0.570).In the PS group and the NPS group,the initial SFR was 85.0% and 83.3%(p = 0.842),respectively.After the second operation,the SFR increased to 97.5% and 94.4%(p =0.926).Twelve patients experienced postoperative complications,mainly minor complications such as transient fever or pain,and the difference between the two groups was not statistically significant(p = 0.666).At 6months postoperatively,7 patients developed renal function deterioration.Surgical time in minutes was identified as a risk factor for renal function deterioration(OR = 1.061,95% CI: 1.015–1.109,p = 0.009,per minute).CONCLISONS:It appears that one-stage f-URS without PS might be feasible for renal stones in solitary kidney patients,and less surgical time could be beneficial to protect renal function.With the widespread use of serum prostate specific antigen(PSA)level and multi-parameter magnetic resonance imaging,the number of patients diagnosed with localized prostate cancer has increased.Active surveillance,radical prostatectomy,and radiotherapy have been used to manage prostate cancer.Focal therapy is a relatively new approach,mainly characterized by focal ablation of prostate cancer and preservation of surrounding normal tissue.Compared with whole-gland therapy,focal therapy has relatively satisfactory medium-term outcomes and fewer complications.At present,common focal therapies mainly include cryotherapy,high intensity focused ultrasound,laser ablation,photodynamic therapy,and irreversible electroporation.This article reviews the focal therapy of prostate cancer based on the existing literature.