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Ken Anson

Publications and source records attributed to Ken Anson.

7 recordsLinked to original sources
PubMed2006

Plastic within renal pelvis on nephroscopy: a potential hazard during percutaneous nephrolithotomy.

The use of adhesive plastic drapes is common throughout laparoscopic and percutaneous surgery. We report a case in which a significant portion of the plastic drape was translocated into the renal pelvis during tract dilation for percutaneous nephrolithotomy. The complication was recognized only on endoscopy and the plastic successfully removed. The potential for morbidity in other patients in the future remains, and we recommend operators be aware of this unusual, but entirely preventable, complication. We highlight some measures to help avoid and check for this complication before the end of the procedure.

Adult↗
PubMed2006

Time to rebrand transurethral resection of the prostate?

PURPOSE OF REVIEW: Transurethral resection of the prostate remains the gold standard treatment for benign prostatic obstruction. Owing to the significant morbidity traditionally associated with the procedure, a large number of expensive, high-energy alternative treatments have been developed, which have enjoyed varying degrees of success. At the same time, transurethral resection of the prostate has evolved into a safer operation whilst maintaining its excellent efficacy. This review aims to outline the major advances that have occurred recently in transurethral resection of the prostate. RECENT FINDINGS: Optimizing each stage of transurethral resection of the prostate can result in reduced morbidity. Preoperative treatment with oral antiandrogens and 5-reductase inhibitors appears to reduce intraoperative bleeding, appropriate prophylactic antibiotic regimens reduce postoperative infection rates, improved instrumentation and diathermy delivery can reduce intraoperative bleeding and hence reduce postoperative irrigation requirements, and alcohol monitoring of irrigant absorption can eliminate transurethral resection syndrome. Careful patient selection, meticulous surgical technique combined with an aggressive postoperative irrigation and catheter removal policy can result in transurethral resection of the prostate being performed safely on a day-case basis. SUMMARY: Whilst our attention has been distracted by the many alternative treatments brought to the market over the past decade or so, transurethral resection of the prostate has been undergoing a quiet evolution. With fine tuning of all aspects of the patient journey we can now offer a procedure with excellent long-term efficacy combined with reduced morbidity and inpatient stay.

Anesthesia, Conduction↗
PubMed2005

Three-dimensional planning of percutaneous renal stone surgery in a horseshoe kidney using 16-slice CT and volume-rendered movies.

Percutaneous management of calculi within horseshoe kidneys can be difficult because of the abnormal renal anatomy. We report our use of 16-slice CT scans to obtain three-dimensional (3D) volume-rendered (VR) movies of the pelvicaliceal system and stone for planning percutaneous renal stone surgery. The movie is formatted onto a disc, which can be played on a personal computer without additional software. This technique allows user-friendly 3D planning in the operating theatre. Unlike conventional two-dimensional images, the 3D VR movie provides a global appreciation for planning.

Endoscopy↗
PubMed2004

Could the latest generation potassium titanyl phosphate lasers be the ones to make transurethral resection of the prostate an operation of historical interest only?

PURPOSE OF REVIEW: We have witnessed an explosion of interest in surgical alternatives to transurethral resection of the prostate over the past decade. These have predominantly involved the delivery of heat to the prostate to cause either coagulation or vaporization. The latest generation laser technique involves the delivery of the potassium titanyl phosphate wavelength at high powers to cause large volumes of prostatic vaporization. This short review assesses the limited present evidence base supporting its use and asks the question of whether it will relegate transurethral resection of the prostate to an operation of historical interest only. RECENT FINDINGS: The 80 W delivery system clearly results in impressive tissue vaporization with minimal bleeding. There is a learning curve to the procedure with operative times varying between 30 and 120 min. The postoperative recovery appears rapid and generally uncomplicated with early catheter removals. The short-term results suggest equivalent efficacy to transurethral resection of the prostate with improved safety; the lack of phase III trials, however, means that the durability of the procedure cannot be assessed at this early stage. SUMMARY: Like many of the surgical alternatives to transurethral resection of the prostate this procedure shows early promise and represents the latest evolutionary development in the laser prostatectomy story. Only randomized comparisons with transurethral resection will tell us if it is a worthy challenger or simply a young pretender to the throne.

Aged↗
PubMed2004

Success and short-term complication rates of percutaneous nephrostomy during pregnancy.

Outcome of percutaneous nephrostomy creation during pregnancy was retrospectively studied. Catheter insertion was successful in all cases (N = 8; 3% of all nephrostomies over a 5-year period), with one major complication (sepsis) and three minor complications. Catheters remained in situ for a mean of 9.4 days until the stone passed (n = 1) or was removed on ureteroscopy (n = 2) or a ureteral stent was inserted (n = 5). Maternal outcome was normal in all cases, but there were two premature deliveries. Nephrostomy during pregnancy has acceptable technical and clinical results, but the possibility of an increased risk of septic complications (12.5% in this series) necessitates further study.

Adult↗