laparoscopic approach in urologic oncol- ogy surgery. In our center, we began lapa- roscopy in 2001. Since then, there has been a progressive increase in the number of laparoscopic procedures. We review the evolution from open to laparoscopic surgery and the hospital stay in the most frequent oncological surgical procedures at our center in the last ten years. Material and Methods: This is a retro- spective study, from 1997 to 2006, that includes 3539 surgeries (exluding endo- scopic procedures): 2454 (69%) open sur- gery, 948 (26 %) laparoscopic and 137 (4%) robotic. Results: We compare the number and percentage of open and laparoscopic sur- geries of the last ten years versus the last year (table). We present the average hos- pital stay in both periods. In the last 12 months, open access in kidney surgery has been performed in 28% of the cases corresponding to very complex situations (vena cava thrombus, pyonephrosis, etc.). In radical prostatectomy, the change has been mainly due to the introduction of the robotic surgery. Conclusions: During the last ten years there has been a progressive introduction of the laparoscopic access. In kidney sur- gery, the open approach is decreasing and it is only used in complex cases. Related to prostatic surgery, the introduction of robotic surgery in 2005 has changed the options of treatment. Globally, there has been a decrease in the average hospital stay with the incorporation of laparo- scopic surgery. MP-6.11 Antegrade Mini-invasive Nephroureterectomy (AMNUE- Laparoscopic Nephrectomy, Transurethral Excision of Ureterovesical Junction and Lower Abdomen Incision) Hora M, Klecka J, Eret V, Urge T, Ferda J, Hes O Department Of Urology, Radiology and Pathology, University Hospital, Plzen, Czech Republic Introduction and Objectives: We de- scribed in 2005 the novel technique of NUE – AMNUE. Procedure starts with laparoscopic nephrectomy. The ureter is liberated into the region of the small pel- vis. The kidney is left in the abdominal cavity in a bag with an undivided ureter. The patient is shifted to the lithotomy position. The ureterovesical junction is excised transurethrally with a diathermy Collins’ knife. A lower abdomen incision enables the removal of the kidney speci- men intact and liberation of the distal part of the ureter. Two drains are introduced into the kidney’s bed and into the small pelvis. A permanent bladder catheter is removed on the 5-6 th postoperative day. We present results of these techniques. Materials and Methods: Since 2005 to 4/2008, 26 patients underwent nephroure- terectomy: 5 as an open procedure, 8 laparoscopic NE with open nephrectomy, 1 complete laparoscopic NUE with Liga- sure. Twelve (46.2 %) were admitted into AMNUE. They are evaluated in details. Results: Seven men and 5 women: mean age 717 (54-81) years; 6 times on both sides; mean time of operation 165  32 (105-210) min.; mean blood loss 150 91 (50-400); mean weight of specimen 541  177 (300 – 810) g. Histology 11 x urothe- lial cancers, 1x papillary renal cell carci- noma. AMNUE was 1x combined with TURT and 1x with TURP. Complications were rare; only in one patient hematoma of abdominal wall. Conclusions: The described technique is simple and does not need special equip- ment. The technique eliminates the risk of spillage of the tumourous cells in the urine which is possible in techniques where the ureter is excised with a Collins’ knife as the first procedure. AMNUE can be used as well when complete laparo- scopic NUE isn’t technically feasible due MP-6.12 Mismatch Repair Expression in Testicular Cancer Predicts Recurrence and Survival Velasco A 1 , Riquelme E 5 , Vidal I 2 , Frederick L 4 , Castillo O 2,3 , Majerson A 5 , Mendez G 5 , Balbontin F 1 , Cabello R 1 , Foneron A 2 1 Department of Urology, Clinica Santa Maria, Santiago, Chile; 2 Department of Urology, Clinica Indisa, Santiago, Chile; 3 Facultad de Medicina, Universidad de Chile, Santiago, Chile; 4 Alpha-Zeta Bio- Medical, Sugar Land, USA; 5 Pontificia Universidad Cato ´lica de Chile, Santiago, Chile Introduction and Objectives: We inves- tigated mismatch repair (MMR) gene ex- pression in testicular cancer as a molecu- lar marker for clinical outcome (recurrence, response to chemotherapy and death) using protein expression and specific genetic alterations associated with the presence or absence of MMR activity. Materials and Methods: One hundred sixty-two cases of paraffin embedded tes- tis cancer specimens were subjected to immunohistochemical analysis using monoclonal antibody for MLH1 and MSH2 MMR proteins and genetic analysis using specific polymorphic markers. The degree of MMR immunoreactivity and genetic instability in the form of loss of heterozy- gosity (LOH) and/or microsatellite instabil- ity (MSI) were determined by comparing matched normal and tumor tissue. Results: The degree of immunohisto- chemical staining for MMR expression was associated with a shorter time to tu- mor recurrence, resistance to chemother- apy and death. Furthermore, clinical re- lapse and cancer specific death was also associated with tumors exhibiting a high degree of MSI, p=0.01 and 0.04 respec- tively. In contrast, LOH was not associ- ated with recurrence, resistance to che- motherapy or death. Conclusions: Therefore, MMR expression defines testis cancers with distinct molec- Table, MP-6.10 Procedure Number Laparoscopic Surgery (%) 1997-2006 Laparoscopic Surgery (%) Last 12 m. Average Hospitalization (days) Period 1997 - 2006 Average Hospitalization (days) Last 12 Months Nephrectomy 329 81/258 (31.8%) 71/98 (72%) 5.73 (2-25) 5.42 (3-12) Nephrectomy living donor 131 95/102 (93%) 36/36 (100%) 9.03 (3-40) 7.52 (3-15) Nephroureterectomy 149 121/430 (28.1%) 28/30 (92.85%) 8.24 (2-48) 6.54 (3-21) Partial nephrectomy 86 66/210 (31.3%) 20/22 (88%) 6.2 (2-16) 6.29 (3-16) Radical prostatectomy Laparosc. 364 211/1198 (17.6%) 153/294 (52%) 5.14 (3-39) Robot (2005-06) 137 81/1800 (4.5%) 56/207 (27%) 4.96 (2-21) MODERATED POSTER SESSIONS S102 UROLOGY 72 (Supplement 5A), November 2008