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Biomedical subjects

T W Chong

Publications and source records attributed to T W Chong.

5 recordsLinked to original sources
PubMed2000

Calyceal diverticula. Ureteroscopic management.

In selected cases, RIRS management of calyceal diverticula and its related problems has been shown to be more efficacious than ESWL monotherapy and avoids the potential complications and discomfort of percutaneous and laparoscopic procedures. The advent of the Holmium laser energy source, with innovations such as the flexible ureteroscope and the tipless stone basket, have expanded the role of RIRS in the management of calyceal diverticula and associated problems. Presently, RIRS is the initial treatment choice for the management of low to moderate stone burdens that are contained in calyceal diverticula or trapped behind any narrowed intrarenal segment (e.g., infundibular stenosis). If repair of the stenotic segment is not successful, thereby excluding stone treatment, then under the same anesthesia, the patient undergoes a percutaneous antegrade renal surgery. The authors feel that the percutaneous approach as a first choice is more suitable for posteriorly located diverticula with a large stone burden. In selected cases of anteriorly located diverticula with large stone burdens, the laparoscopic approach is more expedient.

Catheterization↗
PubMed2000

Simultaneous bilateral simple nephrectomy.

Bilateral simultaneous nephrectomy is a rare procedure usually performed for end-stage renal disease, most often because of persistent hypertension after renal transplantation. Four trocars generally are inserted, with a lower abdominal and a subcostal port being used by the surgeon. An intra-abdominal pressure of 8 to 10 mm Hg is used during the procedure. The first kidney is left in situ while the other one is being dissected. Unless there is infection or malignancy, a retrieval sac is not used. In our series of 13 cases, the operating times ranged from 240 to 390 minutes (mean 320 minutes), and the mean 125 mL. Surgical discharges criteria usually were met on postoperative day 1 or 2. Laparoscopic bilateral nephrectomy in a single session is feasible in nearly all properly selected cases, even in patients with previous abdominal surgery or peritoneal dialysis. The operation takes longer than open surgery and may have a higher complication rate, but recovery is faster.

Adult↗
PubMed1999

The role of the bladder tumour antigen test in the management of gross haematuria.

BACKGROUND: The bladder tumour antigen (BTA) test has been found to be more sensitive than urine cytology for the detection of recurrent bladder cancer. We chose to evaluate the role of the bladder tumour antigen test in the management of gross haematuria on initial presentation. METHODS: A prospective analysis over a 3-month period of consecutive cases of gross haematuria was conducted. Routine investigations including intravenous urogram, flexible cystoscopy, urine cytology testing and BTA testing were performed. Results were correlated with the final diagnosis, and also with histology and tumour stage in the cases of malignant outcome. RESULTS: The prevalence of malignancy in our series was 25.5%. Sensitivity of the BTA test was 67% and specificity 66%. This was compared to cytology which yielded a sensitivity of 66% and specificity of 100%. There were 12 cases of falsely positive results on BTA testing, giving a positive predictive value of 40%. Four cases of falsely negative results were all from superficial tumours. CONCLUSION: In view of its poor sensitivity and positive predictive value, the BTA test has a limited role in the initial management of gross haematuria.

Adult↗
PubMed1980

Vaginal bleeding as a presenting symptom of synovial sarcoma.

A case is reported of a woman who presented with bleeding from a vaginal extension of a synovial sarcoma. The patient was unaware of the primary tumor in the left thigh and histologically, the tumor resembled a carcinosarcoma. Awareness of the physical and radiologic findings allowed the correct pathologic diagnosis to be made. The manner of presentation of the tumor is believed to be unique.

Adenocarcinoma↗