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Apostolos Evangelidis

Publications and source records attributed to Apostolos Evangelidis.

5 recordsLinked to original sources
PubMed2006

Evaluation of ureterointestinal anastomosis: Wallace vs Bricker.

PURPOSE: There are no published reports to our knowledge comparing the complication rates of the 2 most frequently used ureterointestinal anastomoses. We compared the Bricker method vs the Wallace method in terms of stricture rate. MATERIALS AND METHODS: A retrospective review of the cystectomy database at our institution covering 1997 to 2003 was conducted. Patients were reviewed in terms of type of anastomosis, stricture formation, intervention, radiation therapy, type of diversion, operating room time, sex and age. RESULTS: A total of 237 patients at our institution underwent cystectomy during the time evaluated. Of these patients, 33 had incomplete data, 2 were anephric and did not require diversion, and 4 patients underwent LeDuc anastomosis. These patients were excluded from analysis, leaving 198 patients, 86 (43%) undergoing Bricker and 112 (56%) undergoing Wallace. Bricker anastomoses were considered 2 anastomotic units while Wallace anastomoses were considered a single unit. Therefore, there were 162 (59%) total Bricker anastomoses compared to 112 (41%) Wallace anastomoses. There was no statistically significant difference between the 2 groups in terms of type of diversion, number of patients undergoing adjuvant or neoadjuvant radiation therapy, operating room time, and days of followup. There were 3 strictures (1.85%) in the Bricker group and 5 strictures (4.46%) in the Wallace group. There was no statistically significant difference between the stricture rate in these 2 groups (p = 0.21). Stricture rates for patients undergoing neoadjuvant or adjuvant radiation were not statistically significant from the patients with no adjuvant therapy. CONCLUSIONS: Overall the stricture rate for ureterointestinal anastomosis was 2.92%. There was no difference in stricture rate between the 2 types of ureterointestinal anastomosis.

Aged↗
PubMed2005

Surgical management of primary bladder diverticula in children.

PURPOSE: The aim of this study was to review the authors' surgical experience with primary bladder diverticula in the pediatric population, with special attention to associated urinary tract infections and voiding dysfunction. METHODS: A retrospective review yielded 21 pediatric patients with primary bladder diverticula treated surgically over a 13-year span. Patients with secondary diverticula were excluded. Charts were reviewed and patients were contacted in regards to several factors. Diverticula were diagnosed preoperatively by radiography on a voiding cystourethrogram. Diverticula, which were only found intraoperatively and not on VCUG, were not included in the study. RESULTS: Mean age at presentation was 8.16 years (range of 0.17-12.91 years). The sex predominance was male, 17 (81%) of 21. Mean follow-up was 44.2 months (range of 6-156 months). The diverticula were associated with ureters requiring reimplantation in 15 of 21 patients (72.4%); only 6 (28.6%) of 21 were isolated diverticula. Nineteen (90.5%) of 21 patients presented with infections, and all 19 (100%) have had complete resolution of infections. Of the total, a subset of 6 patients with isolated diverticula and no evidence of reflux had total resolution of their infections. Twelve patients presented with voiding dysfunction. Eight of these 12 patients had improvement of their voiding dysfunction with complete resolution in 2 patients. CONCLUSIONS: In this series, infections were eliminated with surgical excision of the primary diverticula. Surgical repair was also associated with improvement of voiding dysfunction.

Child↗
PubMed2005

Management of complications after hypospadias repair.

OBJECTIVES: To review our experience with hypospadias complications (seen after 10%-15% of repairs) and to identify factors influencing outcome. METHODS: We reviewed the available medical records of 113 patients who underwent repeat operation for hypospadias complications. Of the 113 patients, 40% had undergone the initial repair at our institution (internal referral); 60% had undergone the initial repair elsewhere before referral (external referral). The variables potentially affecting outcome were reviewed, including the severity of the defect, concomitant disease, age at the initial operation and revisions, type of complications and treatment, and the number of revisions. Outcomes were compared on the basis of specialty and experience. RESULTS: Isolated hypospadias was present in 81% and other genitourinary abnormalities in 10%. External referral patients were older at the first revision (7.3 versus 4.2 years, P = 0.027). Complications included fistula (73%), stricture (12%), breakdown of repair (10%), and diverticulum formation (11%). Successful revision was independent of the initial defect. The first, second, and third revision was successful in 77%, 64%, and 67% of patients, respectively. The cumulative success rate was 77%, 92%, and 97% after each respective repair attempt. The success of the repair was independent of the patient's age at the initial operation/revision and of the interval from the initial repair to reoperation. Internal referral and external referral patients had similar results. Specific experience with the repair of hypospadias complications correlated with a successful outcome (P <0.001). CONCLUSIONS: Complications after hypospadias repairs are common, with fistula accounting for approximately 75%. The outcome in our series was independent of hypospadias severity, patient age at repair, number of revisions, stent use, and referral status. Repairs performed by an experienced pediatric urologist were associated with improved outcomes (P <0.001).

Child↗
PubMed2004

Incomplete bladder duplication presenting antenatally.

We report a case of an incomplete bladder duplication diagnosed by prenatal ultrasonography at 35 weeks of gestation. The patient was followed until bladder neck obstruction and high-grade vesicoureteral reflux of a solitary kidney prompted definitive repair at 6 months of age. Bladder duplication is a rare anomaly. To our knowledge this is the first documented case of an incomplete bladder duplication discovered antenatally.

Abnormalities, Multiple↗