| The use of endoluminal ultrasonography for preventing significant bleeding during endopyelotomy: evaluation of helical computed tomography vs endoluminal ultrasonography for detecting crossing vessels. | |
| | |
MedLine Citation:
|
PMID: 16536774 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To evaluate, in a prospective study, the efficiency of helical computed tomography (CT) and endoluminal ultrasonography (ELUS) for detecting significant crossing vessels, a major cause of bleeding complications when treating patients with pelvi-ureteric junction (PUJ) obstruction, and to compare our results using ELUS with those of an earlier multicentre study (not using ELUS), to see whether the complication rate decreased. PATIENTS AND METHODS: The study included 27 patients with a PUJ who had isotope renography, intravenous urography, helical CT and ELUS before surgery. Depending on the findings of ELUS, patients were treated with a pure lateral Acucise incision (Applied Medical, Irvine, CA, USA) an Acucise with changed cutting direction, or (later) a laparoscopic pyeloplasty. RESULTS: ELUS detected 15% more crossing vessels than helical CT; 16 patients had Acucise (seven lateral, nine other cutting direction), eight were treated with a laparoscopic pyeloplasty and three with other procedures. By contrast with earlier reports and as a consequence of using ELUS, there was no bleeding, vs 16% in the study not using ELUS. The success rate of 73% of the endourological approach is comparable with previous reports. CONCLUSION: ELUS is more sensitive in detecting relevant crossing vessels than helical CT and therefore the use of ELUS can better prevent bleeding complications. ELUS can also improve the success rate by helping in selecting the correct treatment. Because it is minimally invasive and safe, ELUS combined with Acucise (or other possible endourological techniques, like holmium laser incision) should be the first choice of treatment for PUJ stenosis. |
| | |
Authors:
|
Ad J M Hendrikx; Sven Nadorp; Nicole A M De Beer; Joost B Van Beekum; Stavros Gravas |
Related Documents
:
|
2202484 - Ultrasonic imaging for extracorporeal shockwave lithotripsy: analysis of factors in suc... 7676014 - Helical (spiral) ct of the retroperitoneum. 10350314 - Temporal bone: comparison of isotropic helical ct and conventional direct axial and cor... 8033604 - Computed tomography in predicting the efficacy of oral cholelitholysis with bile acids. 15719074 - Correlation of different mri characteristics of anterior disc displacement with reducti... 7754884 - Enhanced mr imaging of the liver after ethanol treatment of hepatocellular carcinoma: e... |
Publication Detail:
|
Type: Comparative Study; Evaluation Studies; Journal Article; Multicenter Study |
Journal Detail:
|
Title: BJU international Volume: 97 ISSN: 1464-4096 ISO Abbreviation: BJU Int. Publication Date: 2006 Apr |
Date Detail:
|
Created Date: 2006-03-15 Completed Date: 2006-04-24 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 100886721 Medline TA: BJU Int Country: England |
Other Details:
|
Languages: eng Pagination: 786-9 Citation Subset: IM |
Affiliation:
|
Urology, Catharina Hospital, Postbus 1350, 5602 AZ Eindhoven, the Netherlands. ad.hendrikx@cze.nl |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aged Aged, 80 and over Blood Loss, Surgical / prevention & control* Endosonography* Female Humans Kidney Pelvis / blood supply*, radiography, surgery, ultrasonography Male Middle Aged Preoperative Care Prospective Studies Sensitivity and Specificity Tomography, Spiral Computed* / methods Ureter / blood supply, surgery, ultrasonography Ureteral Obstruction* / radiography, surgery, ultrasonography Urologic Surgical Procedures / adverse effects* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Extracorporeally induced ablation of renal tissue by high-intensity focused ultrasound.
Next Document: Risk factors for urinary stone formation in men with spinal cord injury: a 17-year follow-up study.