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Jacob Kaneti

Publications and source records attributed to Jacob Kaneti.

7 recordsLinked to original sources
PubMed2006

Renal pelvis flap--guide for ureteral spatulation and handling during dismembered pyeloplasty.

INTRODUCTION: To present a technical modification of the classic dismembered pyeloplasty technique. We have implemented it in 112 pyeloplasties performed during the past 15 years. TECHNICAL CONSIDERATIONS: The technical modification is based on a renal pelvis flap kept undetached from the ureteropelvic junction, and consequently from the ureter, until near completion of the new ureteropelvic anastomosis. This flap is used for ureteral handling (a "no touch" technique) during pyeloplasty and also serves as a very reliable guide for lateral ureteral spatulation, preventing ureteral twisting and subsequent misalignment of the de novo ureteropelvic junction. We experienced early complications in 4 patients (3.6%). Two patients had excessive urinary leakage from the ureteropelvic anastomosis because of misplacement of a Nelaton retroperitoneal tube drain. We have used soft Penrose drains for retroperitoneal drainage since. Two other patients needed reoperation because of a redundant renal pelvis and ureter consequent to a remnant high anastomosis and insertion of the ureter to the renal pelvis with subsequent kinking and obstruction. No other early or late complications attributable to obstruction of the anastomosis resulting from devascularization or misalignment between the ureter and renal pelvis were encountered. CONCLUSIONS: Modification of the classic pyeloplasty technique has proved relatively easy and reliable in our experience. With the increasing popularity of the laparoscopic approach for pyeloplasty, the described technical modification may become useful for laparoscopic handling of the ureter.

Follow-Up Studies↗
PubMed2006

[Epidemiology of transitional cell carcinoma among Israeli Arabs].

INTRODUCTION AND OBJECTIVE: Environmental, nutritional and hereditary factors are known to influence the epidemiology and the course of transitional cell carcinoma of the bladder (TCCB) and hence attribute to major ethnic and national differences. The focus of this study was on the characteristics of TCCB among Israeli Arabs who form a particular ethnic group in the Israeli population and were treated in our medical centers. METHODS: All the Arab patients who presented with TCCB between 1993-2003 to 3 medical centers (Meir, Kfar Saba; Soroka, Beer Sheba and Hillel Yaffe, Hadera) were included in this study. Data was collected retrospectively, with special attention given to epidemiological parameters, risk factors, and treated history of TCCB among these patients. RESULTS: Of 1638 patients who presented with TCCB between 1993 and 2004 at those 3 medical centers, 100 (6.1%) were Israeli Arabs. Male to female ratio among Arabs was 13.4:1 (93 males, 7 females). The prevalence of smoking was 91% and 14% among Arab men and women respectively. The mean age at presentation was 64 (22-93). Arab women were older than men at the time of presentation (mean age 75.7 and 63.1 respectively). Eighty-three percent of patients presented with superficial TCCB and 17% were diagnosed with invasive disease: 80% of patients who presented with superficial TCCB did not progress during the follow-up. In 15% of the patients with stage Ta TCCB progressed to stage T1, while 20% of the patients with superficial TCCB progressed to an invasive stage. The distribution of tumor grades at presentation was 21%, 47% and 32% for grades 1, 2 and 3 respectively. CONCLUSIONS: This study demonstrates some major differences in the epidemiology of TCCB among Israeli Arabs in comparison to the general Jewish population. The male to female ratio is significantly skewed towards male predominance. The mean age of the Arab men at presentation with TCCB is younger in comparison to Jewish men as well as to Arab women. The prevalence of smoking among Arab men who present with TCCB is especially high. On the other hand, the treated history and course of TCCB among Arabs seems to follow the known figures of TCCB. Environmental, life style, nutritional and hereditary factors characteristic to the Israeli Arab population may be associated with these ethnic epidemiological differences.

Arabs↗
PubMed2004

Fluorescence in situ hybridization performed on exfoliated urothelial cells in patients with transitional cell carcinoma of the bladder.

OBJECTIVES: To evaluate comparatively fluorescence in situ hybridization (FISH) and cytology performed on exfoliated urothelial cells obtained from voided urine and bladder washings as a method of diagnosis and follow-up in patients with transitional cell carcinoma (TCC) of the bladder. METHODS: Thirty patients with confirmed bladder TCC, 10 patients enrolled in cystoscopy follow-up for previous bladder tumors, and 10 patients with bladders free of tumor without a previous history of bladder TCC underwent cytologic examination and FISH performed on voided urine and bladder washing specimens. The FISH probes were targeted to chromosomes 7 and 9. RESULTS: FISH had a sensitivity of 92% for high-grade tumors in both voided urine and bladder washing specimens, significantly greater than that of cytology at a sensitivity of 64% in voided urine and 67% in the bladder washing specimens (P = 0.02). The sensitivity of FISH and cytology were both low and not significantly different statistically from each other for the low-grade tumors. Monosomy of chromosome 9 correlated with early tumor recurrence. Polysomy of chromosomes 7 and 9 correlated with high-grade tumors (80% and 92%, respectively). CONCLUSIONS: According to our results, with the local cytopathology expertise, FISH performed on urothelial cells from voided urine has a sensitivity that supersedes that of cytology, making the former a valuable complementary method in the diagnosis and follow-up of patients with bladder TCC.

Adult↗
PubMed2004

[Biochemical failure after radical prostatectomy].

An elevated or detectable serum PSA after radical prostatectomy for prostate cancer is significant in the great majority of the cases with recurrent or persistent disease. Elevation of serum PSA causes concern for the patient and his physician since the best way to treat these patients is yet unknown. Analysis of large series of patients who underwent radical prostatectomy demonstrates that as many as 30% of patients will experience biochemical relapse represented by elevation of serum PSA. Most of the relapses occur in the first 5 years. However, 10 to 15 years are necessary to ascertain the true clinical progression rate of prostate cancer after radical prostatectomy. The time lag between the biochemical and clinical manifestation of metastatic disease may extend for up to 8 years, followed by an additional 5-year median time until cancer specific death. Radiation therapy may be beneficial as an adjuvant or early salvage if PSA < 1.5 ng/ml and for patients with high probability of local recurrence. Early salvage radiation therapy is a more acceptable option than adjuvant radiation therapy, saving 70% of patients with adverse pathology unnecessary treatment. Hormonal treatment at the time of biochemical relapse is justified in selected patients.

Humans↗
PubMed2002

Non contrast computerized tomography and dynamic renal scintigraphy in the evaluation of patients with renal colic: are both necessary?

OBJECTIVES: To determine the value of the combined use of non contrast computerized tomography (NCCT) and dynamic renal scintigraphy (DRS) in the evaluation of patients with renal colic. METHODS: Forty-nine consecutive patients with renal colic were evaluated with abdominal plain films (KUB), NCCT and DRS with Tc-99m DTPA or MAG-3. NCCT results showed size and location of the urolithiasis, as well as secondary signs of obstruction. DRS was used to determine the degree of obstruction in the affected renal unit. Patients were submitted to urologic intervention or followed, decision made on the basis of clinical symptoms, degree of obstruction, size, and location of the stone. RESULTS: Three patients had other etiologies than stone for their symptoms and were excluded from the study. Of the remaining 46 patients, KUB detected stones in 24 (52.2%), while NCCT in all. NCCT showed secondary signs of obstruction in 35 patients (76%). Seven patients in this group (15%) had severe hydronephrosis on NCCT and complete obstruction on DRS. Twenty-eight patients (61%) showed moderate hydronephrosis and/or peri-renal and peri-ureteral stranding on the NCCT. In this latter group, DRS diagnosed complete obstruction in 5 (18%) patients, partial obstruction in 16 (57%) and no signs of obstruction in 7 (25%) patients. Overall 34% (12/35) of the patients with secondary signs of obstruction on NCCT had complete obstruction on DRS. NCCT revealed no secondary signs of obstruction in 11 patients (24%) with partial obstruction diagnosed by DRS in one of them (9%). All 12 patients with complete obstruction on the DRS underwent early intervention. Of the 16 patients with partial obstruction of the DRS, two patients (12.5%) necessitated ureteric stent insertion. Three patients with no obstruction on the RNS underwent elective extracorporal shock wave lithotripsy (ESWL) while the rest of the patients were followed and passed their stones spontaneously. CONCLUSIONS: The combination of non-enhanced helical CT and DRS assesses both anatomy and function. When NCCT shows no secondary signs of obstruction, NCCT as the sole imaging study performed may be adequate. If there are secondary signs of obstruction on NCCT, DRS can distinguish patients with different degrees of obstruction and together with the clinical course, size, and location of the lithiasis may help in selecting patients who need earlier intervention from those who may be safely observed.

Adult↗