PubMed Health⌕ Search

Biomedical subjects

L A Taranger

Publications and source records attributed to L A Taranger.

9 recordsLinked to original sources
PubMed2000

Metastatic renal cell cancer after laparoscopic radical nephrectomy: long-term follow-up.

OBJECTIVE: To assess the risk of metastatic disease in longer-term follow-up of patients undergoing laparoscopic radical nephrectomy with morcellation for renal cell carcinoma (RCC). PATIENTS AND METHODS: We present the findings at follow-up at 13.5 to 70 months (mean 33.4 months) of 57 previously reported patients. Three, all of whom initially had clinical stage N0M0 disease, were found to have metastases. One, who had a clinical stage T3 grade III/IV tumor, developed an asymptomatic recurrence in the renal fossa with associated chest metastasis 14 months postoperatively. The second, who had a clinical stage T2 grade II/IV tumor, developed painful bony lesions and a chest metastasis 20 months postoperatively. The third patient, with a clinical stage T3 grade IV/IV tumor, was found to have a solitary port-side abdominal-wall recurrence with no other evidence of metastatic disease at 25 months. CONCLUSIONS: Longer-term follow-up has demonstrated a 5% (3/57) rate of metastases after laparoscopic radical nephrectomy. In two of these patients, the course was consistent with the natural history of RCC; however, the third had a port-site recurrence. Thus, it behooves us to be meticulous with our technique and to follow patients closely after laparoscopic nephrectomy. Several suggestions are made to reduce the likelihood of port-site recurrence.

Aged↗
PubMed1998

Laparoscopic radical nephrectomy with morcellation for renal cell carcinoma: the Saskatoon experience.

OBJECTIVES: To assess safety and effectiveness of laparoscopic radical nephrectomy with specimen entrapment and morcellation in patients with suspected renal cell carcinoma. METHODS: We reviewed 72 patients with solid tumors who were offered an attempt at laparoscopic radical nephrectomy. RESULTS: Of 72 patients approached laparoscopically, 6 were converted to open nephrectomy. In the remaining 66 patients with tumor size on computed tomography scan ranging from 1.0 to 9.0 cm (average 4.5 cm), the nephrectomy was completed laparoscopically and the specimen morcellated for extraction. Eight patients were clinical Stage T1N0M0, 60 were T2N0M0, 3 were T3N0M0, and 1 was T2N0M1. There was one unexplained death but complications otherwise were minimal. Operating time ranged from 1 hour 40 minutes to 4 hours 52 minutes (average 2 hours 55 minutes). The average length of stay was 4.4 days (range 3 to 7 days) for the laparoscopic group. The average specimen weight was 402.5 g (range 115 to 964). Review of histologic findings revealed renal cell carcinoma in 57 patients, benign tumors in 6, and no diagnosis in 3. Follow-up on the malignancies ranges from 1.5 to 58 months (average 21.4), with no port site recurrences and no known disease progression. CONCLUSIONS: At an average follow-up of 21.4 months, laparoscopic radical nephrectomy with specimen entrapment and morcellation appears to be a safe and effective alternative to conventional open radical nephrectomy for renal malignancy.

Adult↗
PubMed1991

Emergency excretory urography in blunt abdominal trauma.

In a prospective study the authors correlated the degree of hematuria and of blunt abdominal trauma with the results of emergency excretory urography. Urograms were obtained for 37 patients who presented with blunt abdominal trauma, no gross hematuria and at least five erythrocytes per high-power field (hpf) on microscopic urinalysis. Microscopic hematuria was defined as an erythrocyte count of more than 5 and fewer than 50 per hpf. Major trauma was defined as shock (systolic blood pressure of less than 90 mm Hg), fracture of the lumbar spine, the pelvis or the lower ribs, ecchymosis in the flank or acute abdominal injury. Contusions and small subcapsular hematomas were defined as nonsignificant renal injuries; all other renal injuries were defined as significant. Of 17 patients with minor blunt abdominal trauma 14 had fewer than 50 erythrocytes per hpf; none of these had a significant renal injury, whereas 1 of the 3 with more than 50 erythrocytes per hpf did have a significant injury. Of 20 patients with major trauma 5 had a significant renal injury. The authors conclude that microscopic hematuria associated with blunt abdominal trauma but without shock or major nongenitourinary injury does not warrant routine excretory urography.

Abdominal Injuries↗
PubMed1977

Three cases of human bladder cancer following high dose cyclamate ingestion.

Vesical implantation and oral feeding studies in animals raised sufficient suspicion of the carcinogenic propensity of cyclamates to result in their withdrawal from sale throughout the world. The structural similarity to known carcinogens, an effect on human chromosomes in tissue culture and a high carcinogenic potential when combined with non-injurious co-carcinogens gave further support to this ban. On the other hand, numerous epidemiological studies failed to support any statistical relationship between cyclamate ingestion and vesical carcinoma in man. Three patients are described in whom vesical carcinoma developed after a prolonged period of ingestion of an unusually high amount of cyclamate sweetener. Moreover, the severity of the disease appeared to be proportional to the dose ingested. Although this is not a conclusive indictment of the role of cyclamates we believe that patients with bladder cancer should be questioned about intake of cyclamates either directly or in diet soft drinks.

Aged↗
PubMed1975

The surgical approach to Peyronie's disease.

Seven patients with Peyronie's disease were treated by surgical exposure of the fibrous plaque and dermo-jet injection of steroids into the plaque under direct vision. Relief of pain was obtained in 2 of 3 patients and curvature was only moderately improved i 2 of 7 patients. One of 4 patients who were unable to perform coitus because of the curvature noted improvement after the injections. The low rate of response in this small series of patients would suggest that there is no additional benefit in the use of the dermo-jet over percutaneous injection of the plaques. The latter procedure can be performed more easily on a repeated basis over a longer period. Two patients whose plaques were excised and repalced by a dermal inlay graft have had a good response to treatment and it would appear that this technique is useful for the patient who has failed to respond to conservative measures and who is significantly disabled by the disease.

Adult↗
PubMed1972

Immunological studies on urinary bladder tumors of rats and mice.

Human neoplasms derived from the same tissue have been previously shown to have tumor associated antigens characterizing that tissue type. Evidence is now presented for the existence of analogous antigens common to both rat bladder papillomas and carcinomas, and for antigens common to mouse bladder carcinomas. Rats immunized with syngeneic urinary bladder papillomas, then challenged with a methylcholanthrene pellet inserted into the bladder, develop (4 to 6 months later) fewer primary bladder tumors than rats immunized with normal bladder tissue.

Animals↗