Biomedical subjects

D E Patterson

Publications and source records attributed to D E Patterson.

At least 55 records · Page 3Linked to original sources

PubMed1985

Percutaneous removal of kidney stones: review of 1,000 cases.

We report the results of 1,000 consecutive patients who underwent percutaneous removal of renal and ureteral stones. Removal was successful for 98.3 per cent of the targeted renal stones and 88.2 per cent of the ureteral stones. Complications, evolution and technique are discussed. Percutaneous techniques are an effective way to handle the majority of renal calculi and these techniques will continue to be important as shock wave lithotripsy becomes more widespread in the United States.

Blood Transfusion↗

PubMed1985

The etiology and treatment of delayed bleeding following percutaneous lithotripsy.

In 1,032 percutaneous stone manipulations the incidence of significant, documented or presumed vascular injuries was 0.9 per cent. Seven cases of pseudoaneurysm, arteriovenous fistula or vascular lacerations were found, all of which were diagnosed angiographically. The patients were treated successfully with transcatheter embolization techniques. Two additional patients experienced delayed bleeding, presumably from vascular injuries, which resolved spontaneously with conservative therapy. Arteriography should be performed in these patients with serious postoperative bleeding. Embolization of the peripheral vessel is preferable to flank exploration.

Aged↗

PubMed1985

Pelvic lymphadenectomy and radical cystectomy for transitional cell carcinoma of the bladder with pelvic nodal disease.

Past and present methods of treatment for patients with stage D1 (T1-4 N+ MO) transitional cell cancer of the urinary bladder have proved to be largely ineffective. This report on 57 patients with stage D1 disease confirms this impression and demonstrates that radical operation alone is associated with a 5-year survival rate of only 10%. Survival is related to tumour grade and to the number of pelvic lymph nodes involved; furthermore, complete lymphadenectomy may contribute to improved patient survival. Effective treatment programmes for stage D1 bladder cancer are lacking and efforts should be directed toward developing treatment protocols that combine radical cystectomy and meticulous pelvic node dissection with an effective adjuvant systemic treatment programme.

Adult↗

PubMed1985

Colon perforation following percutaneous nephrostomy and renal calculus removal.

Two patients had colonic perforation as a result of percutaneous nephrostomy placement followed by track dilatation and renal calculus removal. We present the technical aspects of nephrostomy placement and stone removal, as well as the clinical diagnosis and management of these cases. Both patients recovered well with conservative therapy and required no surgical intervention. This report reviews the anatomic considerations for percutaneous nephrostomy in patients undergoing renal stone removal.

Adult↗

PubMed1985

Percutaneous removal of small ureteral calculi.

Percutaneous renal and ureteral stone removal procedures are widely practiced. A new technique is described for removal of small symptomatic ureteral calculi using small (less than or equal to 14 French) tearable sheaths and standard stone retrieval baskets placed through acute percutaneous nephrostomy tracks. This fluoroscopically-guided technique was successful in 60 of 64 patients, who ranged from 16 to 88 years old. Subsequent endoscopic percutaneous calculus removal was successful in the four failures. The use of these small sheaths over previously described large tracks has produced no major complications, short hospital stays, and minimal patient disability.

Humans↗

PubMed1984

Testicular adnexal fibrous pseudotumors.

Fibrous pseudotumors of the testicular adnexae presenting clinically as a testicular malignancy are uncommon. Although fibrous pseudotumors are benign, they are usually diagnosed after radical orchiectomy. Radical orchiectomy occasionally may be avoided if this benign process is considered in the differential diagnosis of testicular neoplasms.

Adult↗

PubMed1984

Bilateral pelvic lymphadenectomy and radical retropubic prostatectomy for Stage C adenocarcinoma of prostate.

A series of 105 patients with surgical Stage C adenocarcinoma of the prostate underwent pelvic lymphadenectomy and radical retropubic prostatectomy and were followed up from one and one-half to fifteen years; 33 (31%) of the 105 had clinical Stage C disease. Of the 105 patients, 92 were at risk for greater than or equal to two years, 42 for greater than or equal to five years, and 12 for greater than or equal to ten years. Survival and disease progression were related to tumor grade (Mayo grades 1 through 4) and tumor bulk (less than 3, 3 to 10, greater than 10 cm3) but not to seminal vesicle involvement. Twenty-seven patients received adjuvant treatment (orchiectomy, DES, radiation, or combinations of these); it was administered to patients with higher tumor grades, larger tumor bulk, and/or residual cancer. Overall actuarial survival at five and ten years was 85 per cent and 72 per cent, respectively; five-year nonprogression rate was 64 per cent. Local recurrence was noted in only 8 patients (7.6%). Radical surgical treatment for nonbulky Stage C disease of the prostate is associated with favorable survival results and good local control. Adjuvant treatment may favorably affect disease outcome. Clinical seminal vesicle involvement with negative urethrocystoscopy should not necessarily deter the surgeon from planning radical prostatectomy. Prospective adjuvant treatment protocols need to be developed to identify the value of adjuvant hormone and/or radiation therapy.

Adenocarcinoma↗

PubMed1984

Endoscopic evaluation and treatment of patients with idiopathic gross hematuria.

We evaluated 4 patients with long-standing unilateral essential gross hematuria by newer endourological techniques. All 4 patients underwent ureterorenoscopy and 3 underwent percutaneous nephroscopy. Nephroscopy identified a bleeding site in 3 patients and ureteroscopy in 1. The bleeding sites were fulgurated and the hematuria has not recurred during followup. Percutaneous nephroscopy and/or ureterorenoscopy should be considered in selected patients with unilateral essential gross hematuria.

Adult↗

PubMed1984

Percutaneous nephrostomy for stone removal.

Percutaneous nephrostomy placement was performed in 700 patients as the initial procedure in renal or ureteral calculus removal. The ease or complexity of the subsequent calculus removal procedure is directly dependent on precise nephrostomy placement. The most important technical factors in nephrostomy placement for calculus removal are selection of the nephrostomy track course, the track entry site into the renal collecting systems, intrarenal catheter and guidewire manipulations, and the final catheter positioning across the ureteropelvic junction and down the ureter.

Catheters, Indwelling↗

PubMed1984

Rapid dilatation of percutaneous nephrostomy tracks.

Dilatation of a percutaneous nephrostomy track is essential for procedures such as stone or foreign-body removal and nephroscopy. In 140 patients, a technique was used of rapid dilatation to 24 French. It required only a few minutes. This procedure proved to be safe, easy to master, and the materials are readily available. Rapid track dilatation under general anesthesia, immediately followed by nephroscopy, has been a major contribution to success in renal calculus removal, resulting in considerably shortened patient and physician time.

Anesthesia, General↗

PubMed1984

Percutaneous ultrasonic lithotripsy.

Percutaneous ultrasonic lithotripsy, endoscopically guided calculus fragmentation and removal through a percutaneous track, is the most widely used technique in the United States for removal of symptomatic upper urinary tract calculi. This article reviews the establishment of percutaneous renal access, track dilatation, and stone removal methods that constitute this technique.

Humans↗

PubMed1984

Perioperative complications of pelvic lymphadenectomy and radical retropubic prostatectomy for Stages C and D1 prostate cancer.

The complications experienced by 205 consecutive patients who underwent bilateral pelvic lymphadenectomy and radical retropubic prostatectomy for surgical Stages C and D1 prostate cancer were analyzed. One hundred five patients had pathologic Stage C disease, and 100 patients had pathologic Stage D1 disease. Seven patients had thromboembolic complications. Wound or pelvic hematomas developed in 6 patients. Only two lymphoceles were detected. Rectal injuries occurred in 6 patients, of whom 4 required colostomies. The overall incidence of perioperative complications was 17 per cent. There was one postoperative death.

Adult↗

PubMed1983

Leiomyosarcoma of urinary bladder.

A retrospective analysis of 5 cases of primary leiomyosarcoma of the bladder seen during 1958 through 1978 revealed that segmental resection is curative in selected cases but that more extensive extirpation may be warranted, depending on the stage of the disease. Radiation therapy had no effect on regional disease. Early diagnosis and aggressive surgical therapy are important.

Aged↗

PubMed1983

The Nesbit procedure for Peyronie's disease.

We treated 8 patients with severe Peyronie's disease with the Nesbit procedure. All patients had had partial to full erections and all had been unable to achieve vaginal penetration because of pronounced curvature of the penis. After penile straightening all patients were able to resume normal coitus. We recommend the Nesbit procedure as the first step in the surgical treatment of patients with Peyronie's disease who have severe penile deformity but good erections.

Adult↗

PubMed1983

The Jonas prosthesis--technical considerations and results.

We analyzed 100 patients who underwent implantation of the Jonas penile prosthesis because of impotence, complications, and patient and partner satisfaction. Data were gathered by direct patient contact and mailed questionnaires, and at followup ranging from 4 to 18 months. Complications occurred in 7 patients. Of the 100 patients 90 were satisfied with the results and would choose the same operation again, although 20 claimed to have some difficulty with concealment of the penis. A total of 56 patients underwent implantation of the prosthesis under local anesthesia, which has resulted in diminished patient risk as well as reduced cost and duration of hospitalization.

Adult↗

PubMed1983

Percutaneous lithotripsy.

We have performed percutaneous extractions of renal pelvic stones in 194 patients via the Wolf percutaneous universal nephroscope. At 1 session, with the patient under general anesthesia, a percutaneous tract is dilated to 24F and the stone is removed immediately. We have removed 185 stones successfully by ultrasonic lithotripsy, basket retrieval and/or use of forceps. Average operating time was 54 minutes and mean hospitalization was 5 days. The advantages of this technique are that a skin incision of only 1 cm. is required to remove the stone, hospital days are fewer than with open procedures and postoperative morbidity is minimal. In selected situations this method represents a significant advance over standard open surgical procedures for removal of renal pelvic stones.

Angiography↗

PubMed1983

Primary realignment of posterior urethral injuries.

The records of 34 patients with posterior urethral disruptions secondary to blunt pelvic trauma who were treated with primary realignment were reviewed. Among the 29 evaluable patients there was a 38 per cent incidence of stricture (11 of 29), a 3 per cent incidence of incontinence (1 of 29) and a 15 per cent incidence of impotence (4 of 27). Primary realignment has a low morbidity and an acceptable rate of incontinence, impotence and stricture formation, and is recommended in the treatment of posterior urethral injuries.

Adolescent↗

PubMed1982

Bilateral pelvic lymphadenectomy and radical retropubic prostatectomy for adenocarcinoma of prostate with regional lymph node involvement.

Ninety-nine patients with adenocarcinoma of the prostate and regional lymph node involvement underwent pelvic lymphadenectomy. Therapeutic results were analyzed in 70 patients who subsequently underwent radical retropubic prostatectomy with or without concomitant therapy (usually hormonal) and in 29 patients who received radiation or hormonal treatment only but without prostatectomy. Follow-up ranged from one to fourteen and one-half years. The over-all projected survival rates (Kaplan-Meier) at five and ten years (88 per cent and 71 per cent, respectively) in the prostatectomy series were comparable to those of an age-matched control group. Concomitant bilateral orchiectomy provided a high projected (76 per cent at ten years) nonprogression rate. Over-all survival rates in the nonprostatectomy series were poor. Only the number of nodes involved was associated with survival and time to disease progression. Patient age, tumor bulk, seminal vesicle involvement, and tumor grade (Mayo and Gleason scores) had no definite relationship to survival. Pelvic lymphadenectomy and radical retropubic prostatectomy for prostatic adenocarcinoma may be therapeutic in some patients with limited (less than or equal to two positive nodes) nodal disease.

Adenocarcinoma↗