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Biomedical subjects

G A Farrow

Publications and source records attributed to G A Farrow.

13 recordsLinked to original sources
PubMed1995

Impact of pathologic extraprostatic disease on local and systemic progression following radical prostatectomy.

Fifty patients underwent radical prostatectomy for localized prostate cancer (Stages A2, B) between 1977 and 1982. Surgical specimens were examined for tumor grade and extraprostatic extension of the disease. Forty-one of the 50 patients had capsular involvement (82%), 26 (52%) positive margins and 14 (28%) seminal vesicular involvement. Six patients progressed locally, six systematically and three both. Eight patients progressed at five years and an additional seven at ten years. In all 15 progressors tumor involved the capsule yet four patients with capsular involvement alone progressed. Eleven of the 26 patients (42%) with positive margins progressed. Five of the 14 patients (37%) with seminal vesicle involvement progressed, all five had positive margins as well. None of the patients with disease confined within the capsule progressed. Gleason score for non-progressors ranged between three and nine with a median of six while for progressors it ranged between five and nine with a median of seven. Long rank test and Cox Proportional Hazard Model statistical analysis were employed among all the factors: capsular involvement, positive margins, positive seminal vesicles and grade of tumor. Positive margins was the only statistically significant factor affecting local progression of the disease in both univariate and multivariate analysis at a 95% confidence (p=0.04). All factors were statistically insignificant in affecting systemic progression (p>0.5).

Journal Article↗
PubMed1995

The polypropylene pubovaginal sling for the treatment of recurrent stress urinary incontinence.

PURPOSE: The significance of a 2-team approach to the problems of recurrent incontinence in patients with extensive pelvic scarring from previous surgery is emphasized. MATERIALS AND METHODS: We reviewed 88 consecutive patients who presented between January 1986 and November 1992. The demonstration of a scarred, wide open, proximal urethra or drain pipe urethra was the important selection criterion. Two teams, 1 operating abdominally and 1 vaginally, released the bladder neck from its bed of scar under direct vision and set the sling in place with minimal tension at the bladder neck. RESULTS: Of the women 75 (85.2%) were cured of the stress urinary incontinence and 8 (9.1%) had improvement with mainly urge incontinence, while 5 (5.7%) operations failed. There was a significant association between chronic chest disease and failure. CONCLUSIONS: The 2-team polypropylene (Marlex) mesh approach continues to be an effective treatment for women with complicated stress urinary incontinence.

Adult↗
PubMed1992

Renal artery aneurysms.

Renal artery aneurysms, previously considered to be rare, have been diagnosed more frequently in recent years mainly due to the extensive use of angiography. Fifty-six patients with 67 aneurysms were evaluated, 5 of these were dissecting aneurysms. Most cases were manifestations of medial hyperplasia or atherosclerosis of the renal arteries. Symptomatology is not pathognomonic. Expanding aneurysm, intractable hypertension, hematuria, and renal infarction represent the most common indications for surgical repair. Reconstruction and repair of these aneurysms, with preservation of the kidney, is the preferred treatment. Surgery was performed on 17 patients (30%): 14 patients had primary repair, while 3 patients underwent nephrectomy for associated carcinoma and end-stage kidney disease. Temporary occlusion of the renal artery with hypothermic perfusion allows surgical repair safely to both patient and kidney. Autotransplantation into the ipsilateral iliac fossa was employed for dissecting aneurysms after resection and repair of the diseased segment. Nine of 12 hypertensive patients required no treatment for hypertension following aneurysmal repair, while 3 patients had improved control.

Age Factors↗
PubMed1985

The Marlex sling operation for the treatment of recurrent stress urinary incontinence: a 16-year review.

Between 1968 and 1983, 281 patients with recurrent stress urinary incontinence and nine patients with primary stress urinary incontinence were treated with a two-team (suprapubic vaginal) Marlex urethral sling operation. Selection was based on the patient's history and the clinical demonstration of an anatomic defect in the closure mechanism of the urethra. The operative technique as described in 1970 remains unchanged. The bladder neck is released from the scar and replaced in a midretropubic position on a hammock of Marlex mesh attached to Cooper's ligaments. Patients with a sloughed urethra had a sling operation in conjunction with the reconstruction of a neourethra. The overall success rate based on a minimum 5-year follow-up of 208 patients was 77.4%. There was a high failure rate in the sloughed urethra group. Significant overall complications include bladder neck obstruction and chronic cystitis.

Female↗
PubMed1982

Percutaneous transluminal dilatation of the renal artery: follow-up studies on renovascular hypertension.

Percutaneous transluminal dilatation of 80 renal artery stenoses was attempted in 68 patients. The procedure was technically successful in 58 (85%) patients. Fifty (86%) of the 58 patients were initially cured or improved. Life-table analysis of this group gives a cumulative success rate of 81% for a 3 year period. Hypertension recurred in only seven patients. There were no deaths related to the procedure, but four major complications occurred, including two secondary nephrectomies.

Adolescent↗
PubMed1979

Autotransplantation for treating renovascular hypertension.

Autotransplantation is presented as a surgical technique for the repair of diseases of the renal artery causing hypertension. Investigation of patients with renovascular hypertension is reviewed stressing the importance of radiologic studies. The author discusses the results obtained in 31 patients who underwent renal autotransplantation. In his experience the procedure has proven to be particularly effective for repairing renal artery stenosis and in patients presenting with severe renovascular hypertension. Associated lesions of the renal artery requiring extensive reconstruction may be repaired with greater safety to both the patient and the kidney using this technique.

Adolescent↗
PubMed1978

The sloughed urethra syndrome.

Sloughing of the urethra following obstetric trauma or pelvic surgery usually results in total urinary incontinence. Nine patients in a series of 2,000 investigated for incontinence presented with this syndrome. A technique of urethral reconstruction from the vaginal wall using a supporting bulbocavernosus graft and a Marlex sling is presented and results are discussed.

Adult↗
PubMed1977

Traumatic rupture of the supramembranous urethra.

We reviewed 38 patients treated by an immediate realignment of the urethra after a traumatic rupture by urethrography, panendoscopy and clinical assessment. Of these 38 patients 19 have not required urethral dilatation for 4 years or more and 26 for 2 years or more, thus accomplishing with 1 operation satisfactory urinary tract function without stricture. We believe that an immediate repair offers the best results to patients with minimum surgical procedures insofar as the formation of strictures is concerned. Evaluation of the interference with potency will have to await further study.

Endoscopy↗
PubMed1977

Recurrent stress urinary incontinence in the female.

1,500 females presenting with recurrent urinary incontinence were investigated in depth. 27% required further surgery, 127 of whom were treated with a 2-team Marlex sling. Careful assessment is the key to treatment including cystoscopy and good radiological documentation. One must be aware of the capabilities and limitations of the various procedures employed for stress incontinence and select the correct procedure for the given problem. When dealing with recurrent stress incontinence the surgical procedure must take down all periurethral scar, anteriorly and posteriorly and adequately elevate the urethrovesical junction so it is not the dependent point at the base of the funnel. The Marlex sling procedure fulfills the above criteria, has been singularly effective, and remarkably free of complications.

Cystoscopy↗