Biomedical subjects

G J Neerhut

Publications and source records attributed to G J Neerhut.

5 recordsLinked to original sources

PubMed2001

The management of testicular cancer in Victoria, 1988-1993. Urology Study Committee of the Victorian Co-operative Oncology Group.

OBJECTIVES: To evaluate the patterns of care and management of testicular cancer in Victoria. DESIGN AND SETTING: Retrospective analysis of all cases of testicular cancer in Victoria from 1988 to 1993 identified through the Victorian Cancer Registry. MAIN OUTCOME MEASURES: Description of patient characteristics, staging investigations, initial management, and outcome. RESULTS: 667 eligible cases of testicular cancer were identified and questionnaires were returned for 633 of these patients (94.9% response rate). There were 357 (56.4%) patients with pure seminoma; 271 (42.8%) with non-seminomatous germ cell tumours, 3 (0.5%) with stromal tumours, and 2 (0.3%) with other tumours. The median age was 32 years (range, 0-80 years). Preoperative marker levels were not available for 8% of patients, and initial staging was considered inadequate in 6%. Surveillance programs used for patients with Stage I disease were considered inadequate in most. Relative survival at five years was 99% for patients with seminoma and 91% for non-seminoma. CONCLUSIONS: There was considerable variation in the investigation, treatment, and follow-up of these patients, which is likely to have resulted in unnecessary morbidity. Clinical practice guidelines should be developed and implemented to promote optimal management.

Adolescent↗

PubMed1990

Is long distance lithotripsy effective?

The outcome and morbidity of a group of 132 patients living near a lithotriptor was compared with that for a group of 251 patients living at a distance. The two groups were similar in age, stone burden and the need for preliminary procedures. With short follow-up, the main difference between the groups was the overall stone-free rate (20% difference, X2 = 13.5, d.f. = 1, P less than 0.001). This difference was not apparent when patients with residual fragments of 3 mm or less were included and is explained by shorter follow-up in the 'distant' group. After a minimum period of 10 days follow-up there was no significant difference in the stone-free rates. There was no significant difference between the groups in the incidence of complications (18% for the 'local' group versus 19% for the 'distant' group). The stone-free rates and incidence of complications were similarly related to stone burden in both groups. It is concluded that, within certain limitations such as inconvenience of travel, 'long distance, second generation lithotripsy' offers no disadvantage.

Adolescent↗

PubMed1989

Management of acute hydronephrosis of pregnancy by ureteral stenting: risk of stone formation.

Acute hydronephrosis of pregnancy has long been managed with ureteral stenting. Although many articles have been published recently concerning stent incrustation none has addressed the etiology. We report a case of accelerated incrustation due to the hypercalciuric state of pregnancy. We propose conservative management with hydration, calcium restriction and close monitoring for infections and stone debris. Antibiotic suppression and stent changes should not be used routinely but rather they should be individualized.

Adult↗

PubMed1989

Extracorporeal piezoelectric lithotripsy for all renal stones: effectiveness and limitations.

An unselected group of patients with renal stones was treated with extracorporeal piezoelectric lithotripsy (EPL) monotherapy. The results showed that this minimally invasive treatment was very effective for patients with stones smaller than 20 mm. After a minimum follow-up of 1 month, 65% of these patients were stone-free and 22% of the remainder had only small fragments. Patients with larger stones (20 mm or larger) required multiple treatment sessions (mean 5.8) and had less favourable results. One month or more after treatment, only 46% of these patients were free of stone and 21% required secondary operative procedures for obstructing ureteric fragments. Most of these patients are better treated initially by percutaneous nephrolithotomy.

Adolescent↗

PubMed1988

Salvage radical prostatectomy for radiorecurrent adenocarcinoma of the prostate.

A total of 16 patients with persistent or recurrent prostate cancer 1 to 10 years after definitive treatment with radiotherapy underwent salvage radical prostatectomy. Patients considered to be candidates for the procedure were in excellent health, with a life expectancy of at least 10 years and with no evidence of extension of tumor beyond the prostate. There was no operative mortality but major complications included rectal injury in 3 patients (19 per cent, 1 requiring colostomy), ureteral transection in 1 (6 per cent), anastomotic stricture in 4 (25 per cent), ureterovesical junction stricture in 1 (6 per cent) and persistent urinary incontinence in 4. Whole organ step-section of the surgical specimen revealed positive surgical margins in 6 patients (37.5 per cent). Margins usually were positive at the apex and not at the bladder neck, so that cystoprostatectomy would not have altered the positive margin rate. Although the followup is too short for analysis of tumor recurrence or patient survival rates, the results indicate that salvage radical prostatectomy, although technically demanding, is feasible and that in the majority of properly selected patients the tumor can be removed completely.

Adenocarcinoma↗