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Ben Eddy

Publications and source records attributed to Ben Eddy.

3 recordsLinked to original sources
PubMed2005

Laparoscopic nephrectomy.

OBJECTIVE: To present our experience of laparoscopic nephrectomy or nephroureterectomy performed over a 4-year period in terms of feasibility and complications. MATERIAL AND METHODS: A total of 103 patients (58 females, 45 males; median age 58 years) underwent laparoscopic nephrectomy or nephroureterectomy between 1 October 1999 and 1 October 2003. The indications were renal cell cancer (n = 39), transitional cell cancer (n = 23), end-stage pyelonephritis (n = 26), end-stage hydronephrosis (n = 11) and renovascular hypertension (n = 4). Ninety-eight patients were operated on transperitoneally and five retroperitoneally. All procedures were done in the lateral position. RESULTS: Seven procedures had to be converted to open procedures for the following reasons: poor visualization of the renal hilum (n = 5); bleeding from a splenic laceration (n = 1); and difficulty finding the kidney via a retroperitoneal approach (n = 1). The median operating time was 190 min, which decreased with experience. The median blood loss was 150 ml. There were two major complications (one small bowel perforation and one port-site herniation, both necessitating re-exploration) and seven minor complications (five infections, one case of temporary hip pain and one of surgical emphysema). Conclusions. Laparoscopic nephrectomy is a technically demanding procedure with the risk of serious complications, especially in the initial learning phase. However, after gaining experience the procedure can be performed with an acceptable operating time, minimal morbidity and a short hospital stay. Laparoscopic nephrectomy should be the standard procedure in most cases, both malignant and benign, with the possible exception of tumours > 10 cm. In order to expand the use of the technique, it is important to focus specifically on laparoscopic training in the education of trainee urologists.

Adolescent↗
PubMed2005

Prostate-specific antigen testing in general practice: a survey among 325 general practitioners in Denmark.

OBJECTIVES: Prostate-specific antigen (PSA) is a well-known and -utilized tumor marker for prostate cancer. Elevated PSA values are not specific for prostate cancer as they may be caused by other benign conditions. PSA testing is widely used by urologists and non-urologists. Interpretation of test results is difficult but important. Referral of patients for further work-up on suspicion of prostate diseases is mainly done by general practitioners (GPs). As the GP remains the gatekeeper between the patient and the urologist in terms of diagnosing prostate diseases, basic knowledge of PSA testing is crucial. The purpose of this study was to evaluate the basic use and knowledge of PSA testing and to give an estimate of the need for further education in PSA testing amongst GPs in our area. MATERIAL AND METHODS: A questionnaire regarding PSA testing and associated needs for education was mailed to all GPs in the Northern County of Denmark. Non-respondents were contacted by mail. RESULTS: Of the contacted GPs, 90% responded. Only 28% of GPs measured PSA in all males complaining of lower urinary tract symptoms (LUTS). Of patients seen as part of a general health check-up, PSA testing was done in 10%. The median PSA value for referral to urologists for further work-up was 5 ng/ml, but the decision was influenced by PSA value (79%), age (65%) and findings on digital rectal examination (DRE) (87%). Opportunistic screening for prostate cancer was done by 14% of GPs. Of the GPs who responded, 24% stated that they did not need any further education regarding PSA testing. CONCLUSIONS: The results of this study demonstrate that PSA testing is not standardized in our area. GPs do not test patients on the basis of recommendations provided by national or international societies. PSA testing is not used as a standard test in men with LUTS, and patients are not referred to urologists at a sufficiently low PSA level to improve the early diagnosis and work-up of patients with suspected prostate cancer. However, the decision of many GPs to refer patients to urologists for further work-up is influenced by the findings of a DRE, the age of the patient and the PSA value itself. Further education regarding PSA testing amongst GPs in our area would seem to be appropriate.

Adult↗