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Biomedical subjects

D M Albala

Publications and source records attributed to D M Albala.

12 recordsLinked to original sources
PubMed1992

Percutaneous management of urolithiasis during pregnancy.

A total of 6 pregnant women with obstructing urinary calculi was managed by percutaneous nephrostomy drainage placed under ultrasound guidance with the patient under local anesthesia. All patients initially had relief of acute obstruction. However, occlusion of the percutaneous nephrostomy tubes with debris necessitated tube changes in 5 of 6 patients. In 2 patients recurrent nephrostomy tube obstruction, fever and pain led to percutaneous stone removal during pregnancy. In the remaining 4 patients the nephrostomy tubes were left indwelling through delivery. During the postpartum period 3 patients successfully underwent ureteroscopic stone extraction and 1 passed the stone spontaneously. Bacteriuria developed in each patient despite the use of preventive antibiotics. All 6 women had uncomplicated vaginal deliveries of healthy newborns and are currently asymptomatic with no evidence of obstruction. Percutaneous drainage of an acutely obstructed kidney in a pregnant woman is an effective temporizing alternative to ureteral stent placement until definitive treatment can be performed.

Adolescent↗
PubMed1992

Long-term comparison of renal function in patients with solitary kidneys and/or moderate renal insufficiency undergoing extracorporeal shock wave lithotripsy or percutaneous nephrolithotomy.

We compared the long-term effects of extracorporeal shock wave lithotripsy (ESWL) and percutaneous nephrolithotomy monotherapy on renal function in 31 patients with a solitary kidney and/or chronic renal insufficiency who were all more than 2 years after treatment (mean 41.5 months). The change in the reciprocal of serum creatinine was used as an index to estimate changes in the glomerular filtration rate. A change of 20% or greater in the glomerular filtration rate was considered a clinically significant deterioration of renal function. The rate of deterioration of renal function in patients with a solitary kidney and creatinine of less than 2 mg./dl. was 22% for ESWL and 29% for percutaneous nephrolithotomy, respectively. All patients with a creatinine between 2 and 3 mg./dl. demonstrated long-term improvement of renal function regardless of the treatment modality. All 4 patients with creatinine greater than 3 mg./dl. undergoing ESWL had short-term improvement but eventual long-term deterioration of renal function. Indeed, 3 of these patients required dialysis within 2 years from the treatment dates. One patient with creatinine greater than 3 mg./dl. who underwent percutaneous nephrolithotomy demonstrated stabilization of the renal function after treatment. From our data, no convincing evidence could be found to suggest that ESWL results in long-term deterioration of renal function in patients with chronic renal insufficiency or a solitary kidney. We conclude that the choice between ESWL and percutaneous nephrolithotomy should be based on the stone composition, stone location and stone burden, rather than on the preexisting renal function or presence of a solitary kidney.

Adult↗
PubMed1992

Endoureterotomy for treatment of ureteral strictures.

Advances in endosurgical technology have provided the urological surgeon with an alternative to open surgery for the treatment of ureteral strictures. We report the use of an endoscopic intraureteral incision (endoureterotomy) followed by balloon calibration to treat benign ureteral strictures in 13 patients. With an average subjective and objective followup among successful endoureterotomies of 20 months (all cases 12 months or greater), the overall success rate for this procedure is 62%. Of these patients 5 also received triamcinolone injections into the stricture bed following incision and dilation. This method appeared to influence favorably subsequent ureteral patency. The only operative complication was a urinoma, which resolved without intervention. Endoureterotomy appears to be a safe and reasonably effective modality for the treatment of ureteral stricture disease.

Adult↗
PubMed1992

Laparoscopic nephrectomy: a review of 16 cases.

Laparoscopic nephrectomy is a new procedure in which the entire kidney is removed via an endoscopic technique using a surgical sack entrapment method in combination with a recently developed high-speed 10-mm electrical tissue morcellator. Since June 25, 1990, this procedure has been successfully accomplished in 16 consecutive patients. The average operating room time was 5.6 h. Two patients received a blood transfusion (one and three units, respectively). The average hospital stay was 4.6 days, and convalescence was completed within an average of 12 days. We believe the methods developed for laparoscopic nephrectomy will allow surgeons in other disciplines to broaden their indications for laparoscopic surgery as the entrapment sack and morcellator can potentially be applied to the removal of many other solid intraabdominal and pelvic tissues.

Adolescent↗
PubMed1991

Hemorrhagic myelolipoma of adrenal gland after blunt trauma.

A case of adrenal myelolipoma is reported in a patient in whom symptoms of hematuria and flank pain developed after the patient had sustained blunt trauma. Adrenal myelolipomas are usually found incidentally at autopsy. However, the symptomatic presentation of this patient was probably caused by traumatic intratumor hemorrhage. The etiology and pathogenesis of these tumors are discussed in relation to their occasional symptomatic presentation and to their differential diagnosis.

Accidental Falls↗
PubMed1991

Laparoscopic nephroureterectomy: initial clinical case report.

Using a 12-mm GIA laparoscopic stapling device, a method of organ entrapment, and a recently developed high-speed electrical tissue morcellator, laparoscopic nephroureterectomy was accomplished in an 82-year-old male with a low-grade transitional cell cancer of the renal pelvis.

Aged↗
PubMed1989

Ventriculoperitoneal shunt migration into the scrotum.

Children with hydrocephalus are commonly treated with a ventriculoperitoneal shunt for diversion of cerebrospinal fluid. We report a unique complication: the migration of the ventriculoperitoneal shunt into the scrotum three weeks after placement.

Cerebrospinal Fluid Shunts↗