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C Chaussy

Publications and source records attributed to C Chaussy.

At least 19 recordsLinked to original sources
PubMed2000

High-intensity focused ultrasound in prostate cancer: results after 3 years.

BACKGROUND: Local high-intensity focused ultrasound (HIFU) is a minimally invasive method of coagulation (85 degrees C) that ablates prostatic tissue with high precision. PATIENTS AND METHODS: Over a 3-year period, 184 patients with organ-confined prostate cancer have undergone 232 sessions of transrectal HIFU therapy (mean duration 90 minutes) under spinal anesthesia at 2.25 or 3.0 MHz, 50 W, with a penetration depth of 25 mm. RESULTS: Follow-up sextant biopsies (mean 1.9) were cancer free in 80% of patients, and in patients with residual cancer, the tumor mass was reduced more than 90%. The nadir value of prostate specific antigen (PSA) was <4 ng/mL in 97%, including 61% who had values <0.5 ng/mL. After primary HIFU, no severe side effects (fistula, grade 2 or 3 incontinence, rectal mucosal burn) were seen. All patients had a suprapubic tube (mean 29 days), and 33% needed transurethral resection of debris (mean 7 g). Hospital discharge was within 23 hours after treatment. CONCLUSION: Transrectal HIFU enables minimally invasive local prostate tissue ablation with high rates of negative biopsies, low PSA nadir, and low complication rate. Further follow-up is needed to define the efficacy of disease control.

Aged↗
PubMed2000

High-intensity focused ultrasound: complications and adverse events.

BACKGROUND: Transrectal high-intensity focused ultrasound (HIFU) is under investigation as a minimally invasive therapeutic option for elderly men with prostatic cancer. METHODS: From November 1996 to April 1999, 315 HIFU treatments with the Ablatherm (EDAP/TMS) were performed. A questionnaire including 50 theoretically possible adverse events was developed. Every patient complaint was recorded, including the physician's and patient's assessment, before and after therapy. Start date, end date, and period of every complaint were analyzed. RESULTS: As major adverse events after primary HIFU, there were six cases of stress incontinence grade 1. After repeat treatments with HIFU, rectourethral fistulas occurred in five patients, stress incontinence grade 1 in eight, and, after additive transurethral resection, grade 2 in one and grade 3 in two patients. Post-HIFU rectal mucosa burn decreased from 15% in 1996 to 0 within the last year. In all treatments, obstruction was avoided by suprapubic urinary diversion. Urinary tract infections (UTIs) were recorded initially in 58% of patients but later in only 8%. CONCLUSION: Transrectal HIFU proved to be a secure, minimally invasive therapeutic option for elderly men to avoid hormonal ablation or to postpone its first use.

Burns↗
PubMed1999

Transrectal high-intensity focused ultrasound using the Ablatherm device in the treatment of localized prostate carcinoma.

OBJECTIVES: High-intensity focused ultrasound (HIFU) consists of focused ultrasound waves emitted from a transducer that are capable of inducing tissue damage. The histologic effects and clinical outcome of the HIFU treatment were studied in two different groups of men with prostate carcinoma. METHODS: The HIFU treatment was performed under regional or general anesthesia with the Ablatherm device. In one group, HIFU was performed 7 to 12 days before radical prostatectomy, and meticulous histopathologic examination of the radical prostatectomy specimens was performed. The second group consisted of patients with localized prostate carcinoma for whom radical prostatectomy was not an option and who received HIFU treatment alone. RESULTS: In 14 patients treated with HIFU before radical prostatectomy, complete necrosis was seen in the treated region in all cases. On the dorsal border, however, incomplete destruction of tissue was noted, and in 4 cases a small vital tumor focus was seen. In the second group, of those patients in whom the entire prostate was treated, a negative biopsy result and a prostate-specific antigen (PSA) level less than 4 ng/mL was obtained in 60% and a PSA nadir less than 0.5 ng/mL in 55% of patients. CONCLUSIONS: HIFU treatment results in the two groups clearly demonstrate the potential of this modality in the treatment of localized prostate carcinoma. This study showed that extensive coagulative necrosis can be obtained in the treated areas; however, exact targeting is crucial and a prerequisite for extended clinical application of HIFU.

Aged↗
PubMed1997

[Urolithiasis].

Explore the source record for details and available documents.

Animals↗
PubMed1997

[Extracorporeal shockwave lithotripsy today--an assessment of current status].

Extracorporeal shock wave lithotripsy (ESWL) is standard therapy for urolithiasis. With comparable technical principles, various lithotripters have been developed and are in routine use. Renal pelvic stones, calyceal stones, ureteral stones, and other special forms can be treated with varying results. Currently, the so-called clinically insignificant residual fragments and the recurrence of calculi are under discussion. Whereas the side effects of ESWL are well known, studies comparing ESWL with other endourological procedures are still lacking.

Humans↗
PubMed1997

[Ureteral calculi. In situ ESWL treatment with booster technique].

After treatment of more than 3000 kidney and ureteral stones with the Siemens Lithostar Multiline the results of the first 1400 ureteral stone treatments using the "Booster technique" and 3-month follow-up findings are reported. There was a disintegration rate of 98% directly after treatment; 1 week after "Booster technique" treatment 96% of the patients were free of stones and without any symptoms. The 3-month follow-up showed a stone-free rate of 97%. Only in 13% of the cases auxiliary procedures were necessary, 7% of them before extracorporeal shock wave lithotripsy (ESWL) and 6% after ESWL. 43% of the treatments were performed without any premedication, anaesthesia or sedoanalgesia. Our data even prove that in situ ESWL is a safe and effective method for the treatment of ureteral stones. In comparison to endoscopic procedures, it is superior in regard to invasivity, side effects, complications and necessity of analgesia, while being just as efficient. Therefore it is recommended as first choice method in the treatment of ureteral stones.

Adolescent↗
PubMed1997

[Complications with portable ESWL--a multicenter study].

An increasing number of urological departments are taking advantage of portable lithotripsy units if a system is not available in their clinic or purchase does not seem feasible; however, infrequent application of ESWL in such a setting should not increase the rate of complications. From 1993 to 1995, up to 54 urological departments using mobile lithotripsy units collected data concerning all major complications. A total of 12,901 treatments were performed which led to 85 major complications (0.66%). Of them 64 were intrarenal or perirenal hematomas. There was no fatal complication. In three patients nephrectomy had to be performed subsequently. The probability of complications can be calculated according to these data. Overall, less frequent application of ESWL does not yield higher complication rates than those at ESWL centers where larger numbers of treatments are performed.

Equipment Design↗
PubMed1996

[Fibroepithelial polyp of the kidney pelvis].

Benign fibroepithelial polyps of the renal pelvis are rare. Because of suspected malignancy in imaging procedures an ureteronephrectomy was carried out in the reported case. Histology, however, yielded no evidence of malignancy. The diagnosis of benign fibroepithelial polyp was entertained. It remains an open question whether the pathologic changes represent a hamartoma or a reactive postinflammatory process, revealing primitive myxoid stroma within the polypous portion and increasing fibrosis with diffuse submucosal involvement of the ureteral basis.

Diagnosis, Differential↗
PubMed1996

Side effects of high-energy shockwaves in the human kidney: first experience with model comparing two shockwave sources.

The side effects of high-energy shockwaves (HESW) from two different sources on kidney parenchyma obtained from 10 patients treated by radical nephrectomy for renal cell carcinoma were examined. Immediately after nephrectomy, the kidneys were perfused with cold HTK solution and kept in hypothermia (8 degrees C) for a maximum of 4 hours. In five cases, the tumor-free parenchyma was treated at the upper or lower renal pole with 2000 shocks, energy output 21 kV, in an experimental electromagnetic shockwave system (Siemens Co., Erlangen). In the other five cases, the upper or lower poles were treated with 2000 shocks, energy output 24 kV, in an electrohydraulic spark gap system (MFL 5000; Dornier Medizintechnik, Germering). The resulting tissue defects were analyzed by histologic examinations. Changes after treatment with the electromagnetic system were found mainly in the tubules and midsized blood vessels in a well-defined focal area. Treatment with the electrohydraulic system was followed by tubular and glomerular lesions combined with vessel defects in a patchy pattern. The model is able to define the side effects of HESW in the human kidney and to test the side effects of different lithotripters.

Aged↗
PubMed1994

[Current status of extracorporeal shockwave lithotripsy].

Extracorporeal shockwave lithotripsy has become an established standard procedure for the treatment of nephrolithiasis. Almost 100 lithotripters are installed in large and medium-sized urological departments in Germany. The number of treatments per year averages 660 ESWL sessions per hospital. Multifunctional use and non-urological ESWL therapy ensure maximum utilization of the lithotripter units. In additional hospitals mobile lithotripsy is provided. At present there is a trend toward ambulatory ESWL treatment.

Ambulatory Care↗
PubMed1991

[Ureteral stents].

Due to the increasing clinical importance of ureteral stents, the advantages and disadvantages of the different materials used are described and discussed. The spectrum of indications includes palliative, curative and auxiliary uses of ureteral stents. In spite of the low complication rate, the advisability of clinical application of stents should always be critically considered before the final decision is made. The possibility of treating the basic disease should be considered in each patient, to lessen the likelihood of "permanent stent patients".

Female↗
PubMed1989

Short-term changes of laboratory values after extracorporeal shock wave lithotripsy: a comparative study.

Since the inception of extracorporeal shock wave lithotripsy 9 years ago treatment strategies have changed. Patients currently are receiving larger numbers of higher voltage shock waves. However, upper limits of safety for these treatments have not been established. In an attempt to address this question a comparative study of effects of extracorporeal shock wave lithotripsy on laboratory values between 2 stone centers, Munich and Tucson, using different treatment strategies 3 to 4 years apart was done to identify possible differing effects. Patient stone burdens were similar. However, Tucson patients received almost twice the number of shock waves. Both groups showed a significant decrease in hematocrit (by 8.7 per cent in Munich and 6.4 per cent in Tucson). Both groups had a significant increase in white blood count (14.5 per cent in Munich and 22.7 per cent in Tucson). In addition, both groups had increased serum levels of glutamic oxaloacetic transaminase of 43.3 and 59.7 per cent, respectively. However, only the Tucson group showed increases in serum glutamic pyruvic transaminase, lactic dehydrogenase and total bilirubin in 51.5, 40.8 and 46 per cent of the patients, respectively. Further analysis indicated that extracorporeal shock wave lithotripsy was associated with 2 significant short-term changes of blood or serum laboratory values: 1) those presumed to be dilutional from related infusions, rather than extracorporeal shock wave lithotripsy treatments themselves and 2) those presumed to be related to cellular injury after high energy treatments. Elevated serum glutamic pyruvic transaminase, lactic dehydrogenase and total bilirubin values of Tucson patients clearly were related to higher kilovolts and number of shocks or to treatments on the right side.(ABSTRACT TRUNCATED AT 250 WORDS)

Arizona↗
PubMed1989

[Extracorporeal shock wave lithotripsy: the evolution of a revolution].

Extracorporeal shockwave lithotripsy has now been in clinical use for 8 years, and it has replaced other treatment techniques for the majority of surgical calculi in the upper urinary tract. For the first time it provides a completely noninvasive method for the treatment of renal and ureteral calculi. The current range of indications means that approximately 70% of nonselected urinary stone patients can be treated by this method, while 25% of the patients with more complex stones in the upper urinary tract can receive treatment with the lithotripter combined with endourological procedures. The clinical role of this method is determined by a high success rate and minimal complications. This has led to a rapid worldwide acceptance in the urological community, and up to now more than 1.5 million patients with urinary stone disease have been treated.

Combined Modality Therapy↗
PubMed1989

[Prevalence and incidence of arterial hypertension in patients with kidney calculi treated by extracorporeal shock wave lithotripsy].

Follow-up studies were conducted on 806 patients to investigate the question of whether or not arterial hypertension can develop subsequent to ESWL. First of all, it was determined that 509 of 518 patients who were subjected to ESWL treatment from December 1985 to December 1986 still had normotension (n = 410) or hypertension (RR greater than or equal to, 160/95, n = 99) prior to and on an average of 9.3 months after ESWL. Six hypertensive patients became normotensive subsequent to ESWL. Only 1 patient developed hypertension following ESWL. Secondly, the 288 patients who were subjected to ESWL treatment from May 1982 to May 1984 revealed a 3.1% incidence of arterial hypertension within a period of 3.6 years following ESWL. This incidence, however, only illustrates that there was a pronounced age-related increase in the prevalence of hypertension (0.8% per year) in these study groups.

Adult↗
PubMed1989

[Long-term experiences following extracorporeal shockwave lithotripsy in patients with urinary calculi].

A report is given on the experience we have had over a period of up to 7 years following ESWL treatment in urinary stone patients. 131I-hippuran clearance studies were conducted on 19 patients prior to and 6.6 years subsequent to ESWL. There was no evidence of any degree of deterioration in total renal function or of any form of dysfunction in the kidney treated. Follow-up examinations on 247 patients showed a 7% recurrent stone rate within a period of 3.6 years following ESWL. In 16% of the cases, residual concretions were found 6 months after ESWL, only 4% of which were larger than 5 mm in diameter. In 22%, concretions were discovered 3.6 years after ESWL 36% of which were larger than 5 mm. This size increase in the fragments accounts for the stone growth.

Adult↗
PubMed1987

Transurethral ultrasonic ureterolithotripsy using a solid-wire probe.

A multicenter study evaluates a new technique for transurethral ultrasonic ureterolithotripsy utilizing a solid-wire probe. The transverse vibrations of the probe cause greater stone disintegration. A small ureteroscope is used and a basket is not required. There was a 96.6 per cent success rate in 118 cases. This technique has significantly improved ultrasonic lithotripsy. It has proved to be useful for upper ureteral stones not amenable to extracorporeal shock-wave lithotripsy and lower ureteral stones including "steinstrasse."

Evaluation Studies as Topic↗