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Copyright of Canadian Journal of Surgery is the property of CMA Impact Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Salvage cryotherapy is a guideline-recommended treatment of localized prostate cancer recurrence after radiation therapy. There is little published evidence analyzing the outcomes of salvage cryotherapy for recurrent prostate cancer following different primary therapy energy modalities. Methods: We performed a retrospective analysis of patients who received whole gland salvage cryotherapy from 2007-2017 at a large tertiary referral center after either primary radiation therapy (RT) or primary whole gland cryotherapy. Primary outcome was biochemical failure, defined as per the Phoenix criteria (prostatespecific antigen [PSA] nadir + 2.0 ng/ml). Secondary outcomes included time to biochemical failure and development of metastatic disease. Results: Fifty-eight of 391 patients who received cryotherapy were identified as having received salvage cryotherapy (after RT, n=37; after primary cryotherapy, n=21). Biochemical recurrence occurred in 21 (57%) patients with previous RT and in 17 (81%) patients with previous cryotherapy (p=0.001). Median time to biochemical recurrence was 18 months for patients with previous RT and 13 months for patients with previous cryotherapy (p=0.002). The biochemical-free survival rate for primary radiation therapy patients was 71% at two years compared to 23% at two years for patients who underwent primary cryotherapy (p<0.01). There was no difference in the development of metastatic disease between groups (19% vs. 18%, cryo vs. radiation, p=0.34). Conclusions: These results suggest that salvage cryotherapy may offer more durable oncological control to patients after radiation compared to primary cryotherapy, with a lower rate and longer duration before biochemical recurrence. [ABSTRACT FROM AUTHOR]

The article focuses on the report from the Kidney Cancer Research Network (KCRNC) with an update from the fourth Canadian Kidney Cancer Forum held in January 2013 in Toronto, Canada. It states that renal cell carcinoma (RCC), a lethal genitourinary malignancy results in the death of thousands of Canadians a year. It also states that the forum includes cancer control, genetic testing, and awareness of cancer and the personalized medicine for the kidney cancer were proposed.

Pain control following major abdominal surgery remains a significant barrier to patient comfort. Although thoracic epidurals have been used to provide analgesia for these surgeries, the transversus abdominis plane (TAP) block is gaining popularity. The TAP catheter insertion method has transformed over the past two decades from a blinded technique to one conducted primarily under ultrasound guidance by anesthesiologists. Recently, however, interest has increased on the potential for direct surgical insertion of catheters into the TAP plane following flank incisions due to anatomical considerations. Proposed advantages include a reduction in operating time, requirement of minimal expertise and increased accuracy of catheter placement. In this report, we describe the rationale and the technique of surgical insertion of TAP catheters following open nephrectomies as performed by urologists at our institution.

A 26-year-old male body builder diagnosed with renal artery stenosis and middle aortic syndrome underwent an autotransplantation with bench reconstruction and end-to-end anastomosis using the hypogastric artery. Shortly after the procedure, the patient developed rhabdomyolysis and renal insufficiency, possibly related to his increased muscle mass, potentially greater susceptibility to hypertrophic skeletal muscle cells or his unique vascular condition. We review the risk factors, diagnosis, management and outcome of a case of rhabdomyolysis in a male patient who underwent autotransplantation for renal vascular hypertension.