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Biomedical subjects

W G Bowsher

Publications and source records attributed to W G Bowsher.

31 records · Page 2Linked to original sources
PubMed1992

Laser ablation of the prostate in patients with benign prostatic hypertrophy.

Seventeen patients with bladder neck obstruction due to benign prostatic hypertrophy have been treated with the Neodymium: YAG laser. We review our experience since the first patient was treated in September 1990. Using a prototype deflecting gold alloy tip on a quartz laser fibre (Lateralase TM), we ablated obstructing prostatic adenoma and constricting bladder neck tissue. Experience with this technique has enabled a patient population to be defined in whom laser therapy for prostatic obstruction may be effective. The treatment is relatively simple, speedy and attended by virtually no blood loss. Laser ablation therapy may offer some advantages over conventional transurethral resection of the prostate (TURP) in a selected subgroup of patients. The advent of new delivery systems may make laser ablation therapy a practical alternative to TURP.

Aged↗
PubMed1992

Laparoscopic pelvic lymph node dissection.

The infiltration of pelvic lymph nodes by carcinoma of the prostate or carcinoma of the bladder is an important factor in disease staging. Until now, this could be accurately assessed only by means of open surgery, an undesirable option as an investigation. Recent advances in laparoscopic instruments and camera systems have allowed the performance of laparoscopic pelvic lymph node dissection. A series of dissections in 14 patients is reported.

Aged↗
PubMed1992

Prediction of response to lithotripsy--the use of scanning electron microscopy and X-ray energy dispersive spectroscopy.

A single urine sample was obtained from each of 38 patients before and immediately after treatment with a Wolf Piezolith 2300. Each sample was analysed for crystals using scanning electron microscopy and X-ray energy dispersive spectroscopy. In all cases it was possible to make a stone diagnosis prior to treatment and there was 100% correlation between the pre- and post-treatment diagnosis. All stones smaller than 90 mm2 on plain X-ray cleared with piezoelectric lithotripsy alone, regardless of composition. Larger stones composed of calcium oxalate were all successfully fragmented, but 5 of 15 mixed or phosphate stones failed to respond.

Adolescent↗
PubMed1989

Clinical experience using the Wolf Piezolith device at 2 British stone centers.

Machines using the principle of piezoelectric extracorporeal shock wave lithotripsy have been developed. This has allowed the prospect of painless treatment for renal and ureteral calculi. The experience with use of 2 Wolf Piezolith machines for 1 year is presented. Different second generation lithotriptors have varying techniques of production of shock waves and different imaging methods. The Wolf Piezolith device uses ultrasound imaging and piezoelectric crystals for shock wave generation. Between June 1987 and May 1988, 545 patients 5 to 84 years old were treated with the Wolf Piezolith device. Of these patients 2-month followup data are available for 367 (398 renal units). Outpatient treatment was used routinely. For renal calculi complete fragmentation (into particles less than 2 mm. in size) was achieved in 94 per cent of the patients, with 53 per cent being completely free of stone at 2 months. For ureteral stones treated in situ the best results were obtained in the upper and lower ureter. Over-all, 62 per cent of the patients required more than 1 treatment, with the number of treatment sessions required increasing with the size of the stone treated. Morbidity was low. Ultrasound imaging has proved to be as effective as x-ray imaging. Compared to Dornier HM-3 lithotripsy, installation and running costs were low. The machine offers a favorable alternative to first generation lithotriptors.

Adolescent↗
PubMed1986

Morbidity, mortality and local recurrence following regional node dissection for melanoma.

Eighty-six patients who underwent regional node dissection (RND) for melanoma were reviewed with respect to short and long term postoperative morbidity, mortality and local recurrence rate. Twenty-eight per cent of dissections were prophylactic and seventy-two per cent therapeutic. There were significant wound related complications which tended to delay hospital discharge, in particular following axillary and groin dissections, but symptomatic long term complications were infrequent. The postoperative mortality rate was 1.2 per cent. Local recurrence in RND scars was particularly common in the neck (33 per cent). RND for melanoma is a safe procedure, with significant short term but relatively little long term morbidity. Both recurrence and morbidity should be borne in mind when considering patients for prophylactic RND. Surgeons should be prepared to use axial or myocutaneous flaps where extensive skin resection is necessary. A controlled trial of prophylactic antibiotics would be useful to try to reduce the incidence of wound infection.

Follow-Up Studies↗
PubMed1986

False aneurysm of the femoral artery: computed tomographic and ultrasound appearances.

Twenty-five patients presenting with pulsating masses in the groin, 1-10 days after diagnostic arterial catheterisation, were investigated by computed tomography (CT), ultrasound (US) or both. False aneurysm was demonstrated in 10, four by CT alone, three by US alone and three by both CT and US. Both methods allowed rapid accurate and non-invasive diagnosis of this uncommon complication of arterial catheterisation.

Aneurysm↗
PubMed1984

Severe facial injury by impalement.

Severe facial trauma is a well recognized hazard of road traffic accidents. We describe severe injuries sustained in an unusual way. A car overturned onto a roadside fencing post, impaling the driver's neck and face. The stake was successfully removed in the operating room, and the fractures were fixed and lacerations sutured.

Accidents, Traffic↗
PubMed1982

A critical appraisal of the Boari flap.

Sixty-two ureters were reimplanted in 54 patients using the Boari flap between 1967 and 1982. The indication was mainly for operative injury to the ureter, but other causes of obstruction to the lower ureter were also found. There was one death from post-operative pulmonary embolism. With attention to details of operative technique--notably to the avoidance of tension and to the provision of adequate splinting and drainage--the procedure may be adapted to a wide variety of difficult surgical problems encountered in the pelvis.

Adolescent↗