To exploratively analyze the efficacy and safety of combined laparoscopy and cystoscopy in the treatment of bladder diverticula.

Clinical data of patients who received bladder diverticulectomy in Peking Union Medical College Hospital from March 2007 to September 2022 were retrospectively collected.The patients were divided into open/laparoscopy alone group and combined laparoscopy and cystoscopy group based on surgical approach.Surgery-related outcomes and complication rates were compared.

A total of 11 patients with bladder diverticula who met the inclusion and exclusion criteria were enrolled in thestudy, including 6 patients in the open/laparoscopy alone group and 5 patients in the combined laparoscopy and cystoscopy group.The median maximum diameter of diverticula in the open/laparoscopy alone group and combined laparoscopy and cystoscopy group were 7.5(4.5, 11.5) cm and 5.2(5.0, 7.9) cm, respectively, and the median diameter of diverticula neck were 1.1(1.0, 1.6) cm and 1.5(1.1, 1.8) cm, respectively.Operations were successfully performed in both two groups and the patients had normal urination after drawing the catheter.No recurrence of bladder diverticulum at 6 to 60 months of follow-up.The median operative time[150.0(142.5, 180.0) min vs. 160.0(108.8, 300.0) min], blood loss[50.0(35.0, 50.0) mL vs. 50.0(45.0, 62.5) mL]and indwelling time of drainage tube[5.0(3.5, 5.5) d vs. 4.5(4.0, 6.8) d]were similar between the two group.Compared to the open/laparoscopy alone group, the combined laparoscopy and cystoscopy group had a shorter postoperative hospital stay[6.0(6.0, 8.5) d vs. 9.5(7.0, 16.0) d]and longer indwelling time of urinary catheter[14.0(10.5, 14.0) d vs. 11.5(6.5, 13.3) d].No complications occurred in the combined laparoscopy and cystoscopy group.In the open/laparoscopy alone group, 2 patients underwent postoperative complications, including 1 patient with deep vein thrombosis of the lower extremities and 1 patient with hyperpyrexia.

Preliminary results show that cystoscopy combined with laparoscopic resection for bladder diverticula can achieve similar outcomes as open surgery alone or laparoscopic surgery, and with greater safety and faster postoperative patient recovery.

To explore the expression of insulin-like growth factor 2 (IGF2) in urinary exosomes of patients with bladder urothelial carcinoma, and to evaluate its clinical value in the diagnosis of bladder urothelial carcinoma.

Patients with bladder urothelial carcinoma or non-urothelial carcinoma diagnosed and treated by Peking Union Medical College Hospital from September to December 2020 were prospectively selected as the research subjects. Fluorescence quantitative reverse transcription PCR was used to detect the expression levels of IGF2 in the urine exosomes of the two groups. The sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of IGF2 in urinary exosomes for diagnosing bladder urothelial carcinoma were calculated, using pathological results as the gold standard.

A total of 35 patients with bladder urothelial carcinoma and 60 non-urothelial carcinoma patients who met the inclusion and exclusion criteria were selected. The positive expression rate of IGF2 in urinary exosomes in patients with bladder urothelial carcinoma was significantly higher than that in patients with non-urothelial carcinoma (71.4% vs. 10.0%, P=0.000). The sensitivity of IGF2 in urinary exosomes for diagnosing bladder urothelial carcinoma was 71.43% (95% CI: 53.48%-84.76%), the specificity was 90.00% (95% CI: 78.83%-95.87%), the positive likelihood ratio was 7.14 (95% CI: 3.25-15.70), the negative likelihood ratio was 0.32 (95% CI: 0.19-0.54).

IGF2 is highly expressed in urinary exosomes of patients with bladder urothelial carcinoma, which has high diagnostic specificity for bladder urothelial carcinoma, but a slightly lower sensitivity. IGF2 is expected to be used as a primary screening index for bladder urothelial carcinoma.