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Biomedical subjects

A M Deane

Publications and source records attributed to A M Deane.

14 recordsLinked to original sources
PubMed1999

Laparoscopic splenectomy: single-centre experience of a district general hospital.

We report the results of 20 consecutive laparoscopic splenectomies performed on haematology patients for a number of indications. Our series includes patients up to 77 years of age at the time of surgery and removal of spleens weighing up to 3530 g. The most significant benefit is the early rate of discharge post-operatively (median 2 d); however, there is a risk of conversion to open laparotomy (in this series 3/20, 15%). We show that laparoscopic splenectomy can be offered as a therapeutic option to patients unfit for conventional laparotomy and that even large and bulky spleens can be removed safely using this approach.

Adolescent↗
PubMed1990

Computed tomography and magnetic resonance imaging before salvage cystectomy.

Nine patients who developed recurrence of bladder carcinoma following radical radiotherapy were assessed for salvage cystectomy by computed tomography (CT) and magnetic resonance imaging (MRI) to predict extravesical spread. Both tests correctly identified a patient with such advanced local disease that surgery was deemed inappropriate at examination under anaesthesia and both tests indicated that surgery might be difficult in a further patient with inoperable disease. Both tests demonstrated abnormalities in the perivesical and pelvic fat planes in all patients but they had difficulty in distinguishing between malignant infiltration and the effects of radiotherapy. Nevertheless, each test is useful in excluding gross pelvic disease and predicting involvement of adjacent organs. The advantages of the multiplanar images provided by MRI must be balanced against the high cost. CT readily demonstrates the upper abdomen, the kidneys and para-aortic nodes as well as the pelvis and is more widely available.

Aged↗
PubMed1990

Identifiable factors in post-prostatectomy haemorrhage: the role of aspirin.

Post-operative haemorrhagic complications following the ingestion of aspirin have been reported after several types of surgery, most notably coronary artery bypass surgery. In this study, aspirin ingestion also appeared to be a significant aetiological factor in post-prostatectomy haemorrhage. This is explained in terms of its inhibitory effect on platelet aggregation. A history of aspirin ingestion should be carefully sought and its haemorrhagic implications considered prior to prostatectomy.

Aged↗
PubMed1988

Diathermy hook ablation of posterior urethral valves in neonates and infants.

An insulated diathermy hook was used to destroy the posterior urethral valve in 10 boys. The technique needs no anaesthetic, no endoscopic equipment, no perineal urethrostomy and only occasional catheter drainage of the bladder. It is performed in the X-ray department, where the efficacy of the procedure can be checked immediately with a further cystogram. The results are compared with those in 7 other boys whose valves were destroyed by conventional endoscopic means.

Electrocoagulation↗
PubMed1985

Female chronic urinary retention.

Thirty-seven cases of female chronic retention are reviewed. Only 13 patients had neurological disease. The problems encountered in diagnosis and management are presented.

Adolescent↗
PubMed1985

Teflon injection in stress incontinence.

Forty-six patients, 28 females and 18 males, underwent periurethral or perurethral Teflon injection. The results in females were satisfactory, especially where resting anatomy was normal. Male results were disappointing, no patients with post-prostatectomy stress incontinence being cured.

Female↗
PubMed1984

Histological changes in ileal conduits.

The histological appearances of 20 excised ileal conduits are described, 9 of which had been present for more than 10 years. Partial and subtotal villous atrophy associated with a chronic inflammatory infiltrate was seen in all cases. The more severe changes were seen adjacent to the stoma and ureteral orifices, and in the older conduits. The muscularis mucosa was thickened and splintered, and the submucosa showed edema and lymphatic dilatation. These appearances could not be related to the presence of infection or obstruction. The cause of the morphological abnormalities is likely to be multifactorial but the changes are not premalignant. The 2 carcinomas seen were recurrences from primaries elsewhere in the urinary tract.

Atrophy↗
PubMed1983

Idiopathic retroperitoneal fibrosis--the role of autotransplantation.

The presentation and management of 12 patients with idiopathic retroperitoneal fibrosis (IRPF) are described. There was a high incidence of venous thromboembolism. External ureteric drainage was associated with complications. A case treated by autotransplantation is described.

Adult↗
PubMed1983

Bladder instability. Is the primary defect in the urethra?

The urethral response to bladder filling has been studied by synchronous measurement of four points in the proximal urethra and bladder using microtip transducers. Twelve male patients with urodynamically proven bladder instability had falls in urethral closure pressure of 30 cm of water 3 s before the unstable detrusor contraction. There was a lack of awareness of the urethral relaxation, the sensation of urgency occurring only when the detrusor contracted. The suggestion is made that the sequence of events occurring in these patients with bladder instability is fundamentally no different from a normal voiding sequence and that it may be more appropriate to re-educate the muscles of the proximal urethra than to treat the detrusor instability.

Female↗
PubMed1982

Absent vas deferens in association with renal abnormalities.

Absence of the vas deferens, especially if unilateral, should alert the clinician to an underlying renal anomaly, and further urological investigation is mandatory. If the vas is shown to be bilaterally absent in an infant, cystic fibrosis should be excluded. In the context of vasectomy, exploration of the palpably absent side should be unnecessary if intravenous urography detects a combined anomaly, although post-operative seminal analysis will still need to be performed.

Adult↗