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At least 703 records · Page 39Linked to original sources
PubMed1999

Laparoscopic live donor nephrectomy.

Live donor renal transplantation has many advantages including greater graft and patient survival, shorter waiting periods, improved human leukocyte antigen matching, and less cold ischemia. Until recently, disincentives from the operation, such as prolonged hospitalization, postoperative pain, and significant convalescence, have deterred live donor renal transplantation. This article describes the technique of laparoscopic live donor nephrectomy and briefly reports the results. The procedure has resulted in improved postoperative recovery and shorter convalescence, with no effect on recipient renal function.

Humans↗
PubMed2003

Outcome of tension-free vaginal tape (TVT) procedure in women with stress urinary incontinence--patients' perspective.

This was a subjective review of the success of the tension-free vaginal tape procedure in women with stress urinary incontinence. It was a retrospective study using a postal questionnaire for pre-and postoperative evaluation of symptoms. Ninety-six patients were sent the questionnaire and 71% (n=68) patients filled in the questionnaire. They were asked about pre- and postoperative symptoms. The enquiry was about their satisfaction with the procedure and its cure rate. A visual analogue scale was used to assess results at least 3 months postoperatively. Eighty-three per cent (n = 56) of patients considered their surgery to be successful and were cured without complications; 7% (n = 5) claimed partial success and 10% (n = 7) reported failure. The majority of patients found the TVT procedure to be simple and effective. Hospital stay was short. Their convalescence was short with early return to work. These observations show clear benefit to the patients' health and Health Service economy.

Adult↗
PubMedDate not supplied

Laparoscopic nephroureterectomy with bladder-cuff resection: techniques and outcomes.

Advancements in minimally invasive instrumentation and technique have provided the impetus to performing urologic procedures with reduced perioperative morbidity, shorter hospital stays, and, most importantly, efficacious oncologic results. At multiple centers of excellence, laparoscopic nephroureterectomy (LNU) has evolved into a new standard for the management of upper-tract transitional-cell carcinoma (TCC) that is not amenable to endoscopic resection. An LNU may be performed via a transperitoneal or retroperitoneal approach together with excision of the distal ureter and a bladder cuff. Analysis of present-day studies comparing LNU with open techniques demonstrates equivalent oncologic outcomes. In addition, those patients undergoing LNU fare better than their counterparts having open surgery with respect to hospital stay, analgesic requirements, and convalescence. With multiple options for excision of a cuff of bladder, a consensus has not been established. However, LNU has emerged as the new standard of care for the treatment of upper- tract TCC. Review of the techniques and outcomes of LNU from the minimally invasive urology community are described.

Carcinoma, Transitional Cell↗
PubMed1993

Laparoscopic orchiectomy in a patient with complete androgen insensitivity.

Many procedures that were once approached exclusively through large abdominal incisions are now accomplished using operative laparoscopic techniques with shorter, less expensive hospital stays and significantly reduced convalescence. This report describes a laparoscopic orchiectomy in a patient with complete androgen insensitivity and discusses the indications for gonadectomy in phenotypic females with an XY karyotype.

Adult↗
PubMed1999

Laparoscopic donor nephrectomy: standard of care or unnecessary risk of organ loss?

Laparoscopic donor nephrectomy was developed to remove disincentives to live donation. It has been demonstrated to decrease the length of hospitalization, postoperative pain, time to convalescence and activity, while providing an optimal cosmetic result. Initial reports suggest that laparoscopic donor nephrectomy is feasible and equivalent to open donor nephrectomy.

Humans↗
PubMed1994

Laparoscopic nephrectomy: the Washington University experience.

OBJECTIVE: To report our experience of laparoscopic nephrectomy for benign and malignant disease of the kidney. PATIENTS AND METHODS: Since June 25, 1990, 24 patients have undergone laparoscopic removal of the kidney at the Washington University School of Medicine (Barnes Hospital): 20 patients had benign renal disease and four patients had malignant renal disease. RESULTS: Of the 24 procedures, 23 were completed successfully using laparoscopic procedures; one operation had to be converted to an open surgical nephrectomy. The mean operative time was 340 min (benign disease) and 438 min (malignant disease). Postoperatively the mean hospital stay was 4 days; return to work or usual activities occurred after 3.4 weeks, and full recovery was achieved after 6.6 weeks. CONCLUSION: Laparoscopic nephrectomy, albeit time consuming to perform, results in minimal post-operative discomfort, a brief hospital stay and a rapid convalescence.

Adolescent↗
PubMed2004

Prevalence of neutralizing antibodies against different rotavirus serotypes in children with severe rotavirus-induced diarrhea and their mothers.

Neutralizing antibody (NAb) responses to different rotavirus serotypes were compared in 64 convalescent-phase serum samples from hospitalized rotavirus-positive children less than 2 years of age and their mothers. Compared to the child patients, the mothers showed significantly higher NAb positivity to animal rotavirus serotypes G3 simian (96.88%), G6 bovine (85.94%), and G10 bovine (25.0%) and to human rotavirus serotypes G8 (79.69%) and G3 (57.81%) (P < 0.01 for each) but not to human serotypes G1, G2, G4, and G9 (P > 0.05). The overall prevalence of NAb among the child patients was low for human rotavirus serotypes G1 (20.31%) and G3 (21.8%). The comparative NAb response in individual mother-child paired serum samples was analyzed against each rotavirus serotype. A substantial number of child patients showed higher NAb titers than their mothers to serotypes G1, G2, G4, and G9, indicating that these serotypes are the major serotypes causing rotavirus diarrhea among the children of Pune, India. In these cases, the mothers were either negative or had lower titers of NAbs than their children. Correlation was observed between the infecting serotype and child patient serum that showed a homologous NAb response at a higher level than that of the mother. It appears that when the level of NAb to a particular serotype is higher among child patients than among their mothers, that serotype is the infecting serotype, and that low titers of NAb among the mothers predispose the children to infection with that serotype, if the serotype is in circulation.

Adult↗
PubMed2004

Laparoscopic and partial nephrectomy.

Radical nephrectomy is the gold standard curative operation for patients with localized renal cell carcinoma (RCC). Since its introduction in 1990, laparoscopic radical nephrectomy is being increasingly done at numerous institutions worldwide. In the hands of experienced laparoscopic urological surgeons and with adherence to established principles of open radical nephrectomy, laparoscopic radical nephrectomy is now a standard of care for patients with T1-3a N0 M0 RCC. Intermediate-term outcome data indicate equivalent cancer-free survival to open radical nephrectomy in such cases. Nephron-sparing surgery (NSS) is now an established approach for patients with localized RCC when there is a clinically relevant need to preserve renal function. NSS is also indicated in patients with a single, small, unilateral, localized RCC when the opposite kidney is completely normal. The technical success rate with NSS for RCC is excellent, and long-term patient survival free of cancer is comparable with that obtained after radical nephrectomy. We recently reviewed the results of NSS in 107 patients with localized sporadic RCC treated at the Cleveland Clinic before 1988 who were followed up for a minimum of 10 years. Long-term preservation of renal function was achieved in 93% of patients, and the 10-year cancer specific survival rate was 73%. Although open surgical partial nephrectomy remains the gold standard for nephron-sparing treatment of RCC, laparoscopic partial nephrectomy is now available in selected cases. The optimal indications for laparoscopic NSS are in patients with a relatively small and peripheral renal tumor. In such cases, laparoscopic NSS is proving to be an effective, minimally invasive therapeutic approach with respect to renal functional outcome, with additional advantages of reduced postoperative narcotic use, earlier hospital discharge, and a faster convalescence. The laparoscopic approach is associated with longer warm renal ischemia time, more major intraoperative complications, and more postoperative urological complications. Continued efforts are required to develop laparoscopic renal hypothermia techniques and to facilitate intrarenal suturing while minimizing the warm ischemia time.

Carcinoma, Renal Cell↗
PubMed2001

[Tension-free hernioplasty with a plug and a patch. A prospective long-term study of 483 cases of inguinal or femoral hernia].

INTRODUCTION: The aim of this study was to assess the introduction of mesh plug and patch for hernia repair. MATERIALS AND METHODS: A prospective study was carried out on 483 consecutive cases of inguinal or femoral hernia treated at a county hospital in the period November 1993 to April 1997. The final follow-up was done by questionnaire. RESULTS: The operation was performed as a day-in procedure in 59% of the patients, and 35% stayed in the ward overnight. Normal daily activities were resumed within three (2-7) days (median [interquartile range]), and the sick leave was 7 (4-14) days. There were few postoperative complications, and reoperation was done in two cases. The overall recurrence rate was 5%, and for primary hernias 4%. There were no recurrences after operation for femoral hernia. Chronic pain was reported in 17% of the patients, 12% felt pain only during strenuous exercise. The observation at time was 46 (36-56) months (median [interquartile range]). DISCUSSION: Patients operated on with the mesh plug and patch technique had a short hospital stay and a short convalescence. The recurrence rate was acceptable.

Adult↗
PubMed1992

[Hysteroscopically guided endometrial destruction in the treatment of menorrhagia].

Until recently, hysterectomy has been the alternative method of treatment in cases of premenopausal menorrhagia where it has not proved possible to obtain satisfactory regulation of the haemorrhage by medical means. Within recent years, a series of hysteroscopic methods have been developed for selective destruction of the endometrium by means of neodymium-laser, electroresection and coagulation. Compared with hysterectomy, hysteroscopic destruction of the endometrium appears to be a much more rapid, simpler and cheaper form of treatment of menorrhagia and appears to be associated with considerably fewer complications. The duration of hospitalization and the period of convalescence can be reduced considerably but, primarily, a large group of women can avoid hysterectomy. As yet, no controlled investigations of selective destruction of the endometrium as compared with conventional hysterectomy are available. There are no comparative investigations of the different methods nor of the long-term sequelae after destruction of the endometrium. This method of treatment has hitherto only been employed to a limited extent in Denmark. Coordination of the activities in this field in connection with establishing this form of treatment in Denmark should be encouraged.

Dilatation and Curettage↗
PubMed2004

Lift-laparoscopic total hysterectomy as a routine procedure.

In this study, laparoscopic hysterectomy was done with a special lift system that elevates the abdominal wall without carbon dioxide (CO2) insufflation. During this procedure, bipolar diathermy scissors also were used, which disconnected the uterus from its vessels and ligaments. The uterus was then removed through the vagina. In 403 cases, variables including operation time, complication rate, blood loss, postoperative pain, hospital stay, vaginal discharge, and convalescence time were examined. Compared with other laparoscopic methods [laparoscopic-assisted vaginal hysterectomy (LAVH), supracervical hysterectomy, and total laparoscopic hysterectomy], all those examined showed better results. Further advantages of the gasless Lift-laparoscopic total hysterectomy are lower costs and an effective "learning curve." Use of this method routinely could decrease the number of conventional-surgical hysterectomies that result in additional complications.

Adult↗
PubMed2006

Implementation and evaluation of standardized patient observation master to the nursing directions system in health facilities for recuperation.

In this study we developed the observation item list from the evaluation of Nursing Observation Master published by MEDIS-DC with the aim of implementing a nursing observation ordering system for convalescent wards in a general hospital. After development, the nursing observation item list and observation ordering system based on it were implemented in clinics and evaluated by clinical staffs.

Humans↗
PubMedDate not supplied

The visual endourological removal of ureteric calculi.

A prospective study was carried out of new techniques that allow the endoscopic removal of all ureteric calculi. Over 19 months, 50 consecutive patients with ureteric calculi that required surgical intervention were treated initially by 53 visual endourological procedures. This was successful for 45 (90%) patients, which included all patients with calculi in the upper and lower thirds of the ureter. Five patients with mid-ureteric calculi required open ureterolithotomy. The mean stone size was 8.8 mm (range, 5-22 mm). For patients with calculi in the upper third of the ureter, the most effective procedures were retrograde manipulation of calculi which was followed by percutaneous nephrolithotomy and antegrade ureteroscopy, with extraction or ultrasonic lithotripsy. For patients with calculi in the lower third of the ureter, retrograde ureteroscopy with extraction or lithotripsy was successful in all cases. Midureteric calculi presented the greatest problem and may require open ureterolithotomy. Means of improving the success of endoscopic procedures for these stones are discussed. Complications occurred in eight (16%) patients, but were resolved with conservative measures. The mean postoperative length of stay in hospital after a successful endourological procedure was 4.5 days (range, 1-21 days). We conclude that visual endourological techniques are safe and effective, and offer the advantages of the avoidance of open surgery, a reduced hospital stay and a shortened convalescence time.

Adult↗
PubMedDate not supplied

[Hormones, growth factors, and drugs in metabolism and nutrition].

The manipulation of the inflammatory and hormonal responses may produce, on one hand, positive effects, and, on the other hand, potentially negative effects. The modification of the neuro-endocrine-humoral pattern may become more important and effective than the supply of nutrients. In this article we bring an up date of the role of insulin, anabolic steroids, blocking the catabolic hormones, phenobarbital, somatostatin, clenbuterol and metaprorenol, growth factors: GH and IGF-1, cytokines, and anti-cytokines sera. The use of GH, IGF-1, and of the epidermal and or colonic growth factors, along with a blocking of the cytokines, the manipulation of the lipidic mediators, and the supply of classical nutrients, specific to the aggression situation, may improve the protein synthesis and tissue repair. It may at the same time both decrease the loss of body proteins as well as promoting and acceleration of the recovery, shortening the hospital stay and reducing the convalescence time. The future seems to point towards molecular and cellular biotechnology and towards "nutritional" pharmacology, which contemplates the effects of growth factors, the recent advances in the field of cytokine modulation, and the manipulation of the binomer nutrient-medication.

Adrenergic beta-Agonists↗
PubMed1996

Technique of transperitoneal laparoscopic adrenalectomy.

Adrenalectomy can be successfully and safely carried out with a laparoscopic technique, using standard instrumentation via a transperitoneal approach. We describe five tasks to be completed by the surgeon: (a) generation of pneumoperitoneum and port placement, (b) exposure of the adrenal gland, (c) dissection of the adrenal gland, (d) clipping of the adrenal vein, and (e) removal of the adrenal gland and fascial closure of port sites. Each step is described in detail for right and left adrenalectomy. Laparoscopic adrenalectomy is advocated on the same grounds as other laparoscopic procedure, namely, decreased postoperative pain and ileus, a better cosmetic result, decreased hospital stay, and a shorter convalescent period. Some other advantages of the laparoscopic technique are: minimal extent of dissection and excellent visibility and exposure of the adrenal gland.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

Videolaparocholecystectomy: casuistry of 1000 cases.

Despite the ongoing evolution in the medical treatment of biliary pathology, the standard of treatment for gallstones remains cholecystectomy. There are no alternative treatments that have shown the same efficacy as surgery. Current alternative treatments have shown high recurrence and failure rates. Cholecystectomy remains the gold standard for management of gallstones. The surgical access of laparoscopic cholecystectomy accomplished by Mouret in 1987 allows for a reduction in operative trauma, hospital stay, postoperative pain and convalescence. These factors permit a faster return to normal activities. Today, laparoscopic cholecystectomy is performed in almost all medical centers around the world; however, the procedure is not free of complications. The objective of this study was to analyze our first 1000 cases of laparoscopic cholecystectomy, giving emphasis to the morbidity and mortality of the procedure.

Adolescent↗
PubMed2000

Laparoscopic donor nephrectomy.

Live donor renal transplantation provides significant advantages when compared with cadaveric renal transplantation. Unfortunately, there are disincentives associated with donation including prolonged hospitalization, significant postoperative pain, and prolonged convalescence. With the advent of laparoscopic donor nephrectomy, there has been an increase in live donation at centers performing the procedure secondary. Incentives provided by laparoscopic donation include a reduction in hospital stay, less postoperative analgesic requirements, and an earlier return to normal daily activities. Most importantly, graft function and survival are equivalent to open live donation. Laparoscopic donor nephrectomy is evolving to become the preferred method of procuring living donor kidneys.

Humans↗