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Biomedical subjects

N K Bissada

Publications and source records attributed to N K Bissada.

At least 37 records · Page 2Linked to original sources
PubMed1998

Favorable experience with a simple technique to create a concealed umbilical stoma.

PURPOSE: After using different sites for continent urinary diversion stomas the umbilicus became the preferred site. Experience with a simple technique to place the continent diversion stoma at the umbilical site is reported. MATERIALS AND METHODS: Cutaneous continent urinary diversion was performed in 95 patients with placement of the stoma at the umbilical site. A triangular skin flap is elevated to the right of the umbilicus, a 1 cm. piece of the umbilical scar is excised and the apex of the skin flap is anastomosed to the spatulated appendix, tapered ileum or gastric tube. RESULTS: All patients had satisfactory cosmetic results, 3 required simple revision and 4 needed dilation. These 7 patients as well as all others easily catheterized the urinary pouch. CONCLUSIONS: This simple technique results in good cosmesis and it is associated with a minimal need for stomal revision.

Follow-Up Studies↗
PubMed1997

Radiologic evaluation of small and indeterminant renal masses.

A common problem in radiologic and urologic practice today is what to do with the small or indeterminant renal mass. Whether found incidentally or sought after because of patient symptomatology, these lesions present a challenge in diagnosis and management. This article outlines the scope of the problem, illustrates representative lesions, suggests imaging and management strategies culled from personal experience, and provides a review of available literature.

Humans↗
PubMed1995

Ureterosigmoidostomy: is it a viable procedure in the age of continent urinary diversion and bladder substitution?

Between January 1977 and June 1985, 63 patients requiring supravesical diversion underwent ureterosigmoidostomy with an antireflux technique. Of the patients 49 had bladder cancer and 14 had other conditions. Two patients died in the postoperative period. Postoperatively, all patients were instructed to empty the rectum frequently, and received bicarbonate and potassium supplementation. Median followup was 41 months (range 3 to 70). Renal function remained stable in 92% of the patients. Radiographic deterioration occurred in 23% of the renal units, which was severe in 7%. These results indicate that the short and intermediate followup results with ureterosigmoidostomy are comparable to those of an ileal conduit. The method has the added advantage of being a form of continent diversion. We believe that ureterosigmoidostomy remains a viable and convenient alternative in select patients with bladder cancer who are not suitable for other forms of continent diversion or bladder substitution.

Adolescent↗
PubMed1995

Adult Wilms' tumor: prognostic and management considerations.

Wilms' tumor is the most common malignant tumor of the urinary tract in children but is rare in adults. Although histologically the tumors appear to be the same, successful treatment with multimodal therapy is much more common in childhood. We report on 2 patients with adult, anaplastic, Stage IV Wilms' tumor, one of which was discovered during pregnancy and was managed successfully with chemotherapy, including ifosfamide, carboplatinum, and etoposide. As more patients are properly identified and treatment outcomes with chemotherapeutic regimens documented, better therapeutic approaches in adult Wilm's tumor will be developed, resulting in improved survival.

Adult↗
PubMed1995

Complete remission of hormone refractory adenocarcinoma of the prostate in response to withdrawal of diethylstilbestrol.

The phenomenon of regression of adenocarcinoma of the prostate after the withdrawal of antiandrogens is well documented. However, to our knowledge we report the first case of durable complete remission of hormone refractory prostate cancer after cessation of diethylstilbestrol. The drug was discontinued because the patient had disease progression while on diethylstilbestrol and withdrawal resulted in durable remission. In more than 3 years of followup since discontinuing diethylstilbestrol there has been no evidence of clinical or biochemical recurrence.

Adenocarcinoma↗
PubMed1994

Laparoscopic retroperitoneal lymphadenectomy: multi-institutional analysis.

Modified unilateral laparoscopic retroperitoneal lymph node dissection was attempted in 20 patients with nonseminomatous testicular cancer. The procedure was completed in 18 men at a median operative length of 6 hours. Median estimated blood loss was 250 cc and median number of lymph nodes removed was 14.5. Nodal disease spread was noted in 3 of 18 patients (17%). Most patients were hospitalized for 3 days or less and had returned to normal activity levels within 2 to 3 weeks. Antegrade ejaculation was preserved in all 20 patients. Significant complications occurred in 6 of 20 patients (30%), with bleeding being the most common adverse event encountered. In 2 patients an abdominal incision and completion of the procedure by open retroperitoneal lymph node dissection were required due to significant bleeding following injury to the gonadal vessels. With a median followup of 10 months (range 2 to 25), 2 men had pulmonary disease recurrence and none had abdominal recurrence. Laparoscopic retroperitoneal lymph node dissection can be completed successfully in patients with stage I testicular cancer and may be most appropriate in those with limited risk of metastatic disease spread. The morbidity may be largely attributed to a steep learning curve. The efficacy of laparoscopic retroperitoneal lymph node dissection compared with standard techniques and determination of its role in patients with testicular cancer will require longer followup in larger groups of patients.

Adolescent↗
PubMed1994

Endoscopic treatment of vesicoileal anastomotic stricture.

A 26-year-old man with anastomotic stricture at the junction of an ileal ureter and the bladder was managed successfully by endoureterotomy. Follow-up at 18 months indicated the absence of recurrent stricture. To our knowledge, endourologic management of an ileovesical anastomotic stricture has not been reported previously.

Adult↗
PubMed1994

Primary neoplasms of the penile shaft.

Squamous cell carcinoma of the penis usually arises from the glans, corona, or prepuce. We present an unusual patient with two primary carcinomas arising on the penile shaft.

Aged↗