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Biomedical subjects

R B Sabnis

Publications and source records attributed to R B Sabnis.

11 recordsLinked to original sources
PubMed2002

Fluid absorption during percutaneous nephrolithotomy: does it matter?

BACKGROUND AND PURPOSE: Large amounts of irrigating fluid are used during percutaneous nephrolithotomy (PCNL). This use may be associated with migrating calculus debris, infection, and fluid absorption. This study evaluated the presence of fluid absorption during PCNL, its clinical and biochemical significance, and maneuvers to reduce it. PATIENTS AND METHODS: Fluid absorption during PCNL was evaluated in 148 patients by estimating the expired breath ethanol concentration. Factors thought to affect the amount of fluid absorbed were studied, including the amount of irrigating fluid used, the number of nephrostomy tracts, the presence of a low-pressure system, the presence of existing tracts, and complications such as bleeding or perforation of the pelvicaliceal wall. RESULTS: Fluid absorption was evident in all patients, although no patient had any clinical or biochemical evidence of intraoperative or postoperative electrolyte imbalance. Creating a low-pressure system by using an Amplatz sheath, reducing the amount of irrigating fluid used, and staging the procedure significantly reduced the amount of fluid absorbed. CONCLUSIONS: Fluid absorption does take place during PCNL. This may be clinically significant in patients with compromised cardiorespiratory or renal status and in pediatric patients, leading to fluid overload. Using a low-pressure system, reducing the nephroscopy time and the amount of irrigating fluid used, and staging the procedure for large renal stone burdens, especially in the presence of complications such as perforation of the pelvicaliceal system, reduces fluid absorption and avoids volume overload. Fluid absorption may also be associated with both infective and noninfective pyrexia, necessitating adequate preoperative control of urinary infection.

Absorption↗
PubMed1997

Extracorporeal shock wave lithotripsy for lower calyceal stones: can clearance be predicted?

OBJECTIVE: To determine the influence of pelvicalyceal angle, size of the lower calyx infundibulum and lowerpole calyceal anatomy in predicting the clearance of fragments after extracorporeal shock wave lithotripsy (ESWL) for lower calyceal stones. PATIENTS AND METHODS: The study comprised a retrospective analysis of 133 patients, divided into 92 who were considered to be completely clear of fragments 6 months after ESWL and 41 who had residual stones. The pelvicalyceal angle, diameter of the lower calyx infundibulum and lower-pole calyceal pattern were determined from intravenous urograms. RESULTS: There were residual stones in 64% of the patients with a pelvicalyceal angle < 90 degrees, in 12% of those with an angle > 90 degrees, in 70% of patients with an infundibular diameter < 4 mm, in 16% of those with a diameter > 4 mm, in 78% with a complex calyceal pattern and 12% with a simple calyceal pattern. CONCLUSIONS: These three anatomical factors play a key role in predicting the clearance of stone and they should be assessed during intravenous urography to facilitate the planning of treatment for lower calyceal stones.

Forecasting↗
PubMed1993

A new outlook in the management of complex female urethral injuries.

Management of complex female urethral injuries is challenging. We present our experience of 9 cases over the last 3 years with a mean follow-up of 14 months. The spectrum of clinical problems and results of various forms of innovative management are highlighted. Injuries which could not be managed by primary repair or by applying regular urethroplasty principles of using local vaginal flaps were treated with core-through urethrotomy (2), creation of distal urethrovaginal fistula (5), and continent urinary diversion (2). Individualised treatment technique to fit the special circumstance as presented by each patient is stressed because of the rarity of female urethral injury.

Accidents, Traffic↗
PubMed1993

Primary benign vesical teratoma. A case report.

Primary benign vesical teratomas are rare. Most of the cases reported are paravesical teratomas rupturing into the bladder. A case of primary benign vesical teratoma suspected preoperatively and later confirmed at histopathology is reported.

Adult↗
PubMed1992

Giant ureteral stone.

A 58-year-old man presented with left flank pain and a high grade fever. Investigations revealed left pyonephrosis with a left renal stone and a giant left ureteral stone. Nephroureterectomy was performed. The ureteral stone measured 13 cm. long and weighed 90 gm.

Humans↗
PubMed1992

Instillation of silver nitrate in the treatment of chyluria.

A series of 62 patients with chyluria received instillations of 1% silver nitrate in the renal pelvis over an 8-year period; 51 patients responded well but 11 showed no response to treatment. Follow-up ranged from 2 to 7 years. The treatment was found to be safe, effective and minimally invasive.

Adolescent↗
PubMed1992

Experience of continent urinary diversion with modified Koff's technique.

Continent abdominal neourethrostomy is a procedure in which a bladder flap from the dome is raised, converted into a tube and then brought out on the abdominal wall as a stoma, just below the umbilicus. We have done this procedure on 5 patients of different age groups and for various indications. All our patients are perfectly continent postoperatively during the day as well as night. They are doing regular self-catheterisation. They are dry in periods between self-catheterisations. The maximum follow-up is two years and six months.

Abdominal Muscles↗
PubMed1991

Catheter-less suprapubic cystolithotomy in children.

Bladder stones in children are common in developing countries and the procedure of choice for their removal is suprapubic cystolithotomy. It is standard practice to drain the bladder for a few days post-operatively to prevent urinary leakage. We have observed that, if the bladder is closed meticulously in 2 layers, bladder drainage by means of a catheter is not required. We have analysed 86 children treated by suprapubic cystolithotomy without a catheter. Size of the stones and intra-operative findings were noted and it was found that 85% of the patients had an excellent result; 10% had a satisfactory result and 4.7% were unsatisfactory. The advantages of the procedure and selection of the patients are discussed.

Child↗