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Robert Sabbagh

Publications and source records attributed to Robert Sabbagh.

4 recordsLinked to original sources

Chylous ascites as a complication of laparoscopic donor nephrectomy.

Laparoscopic living donor nephrectomy (LLDN) is a minimally invasive technique for kidney procurement and was developed with the hope of reducing the disincentives associated with live renal donation. Compared with open donor nephrectomy (ODN), this alternative has many advantages including less postoperative pain and earlier return to work. Unfortunately, these benefits are sometimes negated by postoperative complications. Among these, chylous ascites (CA) is a rare but serious problem that is usually managed conservatively. We report the case of a living donor who developed CA refractory to initial conservative management and surgical treatment. We also discuss the role of surgery in the treatment of CA following LLDN.

Chylous Ascites↗

Laparoscopic nephrectomy for emphysematous pyelonephritis.

Emphysematous pyelonephritis is a serious suppurative infection of the renal and extrarenal tissues. Controversies exist surrounding the appropriate management of this life-threatening condition with advocates for both medical management alone and percutaneous drainage combined with nephrectomy. The laparoscopic approach for nephrectomy is quickly becoming the standard of care for benign disease of the kidney and low-stage renal cancers. We report a case of a 60-year-old diabetic male undergoing successful laparoscopic nephrectomy for right emphysematous pyelonephritis, and our procedural technique. To our knowledge, this is the first report of laparoscopic nephrectomy in the setting of emphysematous pyelonephritis. Carefully selected patients with emphysematous pyelonephritis may benefit from the advantages of laparoscopic nephrectomy in centers with sufficient laparoscopic experience.

Diabetic Nephropathies↗

A prospective randomized trial of 1-day versus 3-day antibiotic prophylaxis for transrectal ultrasound guided prostate biopsy.

PURPOSE: To compare the incidence of infection between a 1 day and a 3 day antibiotic prophylaxis regimen for transrectal ultrasound (TRUS) guided prostate biopsy in a prospective, randomized open-label trial. MATERIALS AND METHODS: TRUS examination was performed in the left lateral decubitus position using a Brüel and Kjaer 7 MHz rectal probe. Biopsies were carried out with an 18 gauge Tru-cut needle fired by the hand-held Biopsy gun. An average of eight core biopsies (range 6 to 12) was taken. From May 15, 2000 to May 16, 2001, 363 patients were enrolled in this study. Patients were randomized to receive either 1 day or 3 days of fluroquinolone antibiotic prophylaxis, consisting of either ciprofloxacin or levofloxacin orally. Antibiotics were begun at least 1 hour prior to biopsy. Seven days later, telephone follow-up was obtained. RESULTS: Two (0.55%) of the 363 patients, one in each group, had an episode of sepsis. No urinary tract infection was reported. Traumatic complications were only minor and no significant difference was observed between both groups: hematospermia (p> 0.4), hematuria (p>0.1) and rectorragia (p>0.2) being reported most frequently. CONCLUSION: There is no clinically nor statistically significant difference between a 1 day and 3 day antibiotic prophylaxis regimen for patients undergoing TRUS guided biopsies.

Aged↗

A prospective randomized trial comparing lidocaine and lubricating gel on pain level in patients undergoing transrectal ultrasound prostate biopsy.

PURPOSE: To compare patient reported pain during TRUS guided biopsies using intrarectal lidocaine gel versus lubricating gel. MATERIALS AND METHODS: From May 2000 to May 2001, 360 men undergoing transrectal prostate biopsy were enrolled in this study. Patients were randomized into two groups. In group 1, 180 patients received 10 cc of 2% intrarectal lidocaine gel (Xylocaine 2% jelly, Astra Pharma Inc.) 5 to 10 minutes before the procedure and in group 2, 180 patients received 10 cc of lubricating gel. No other sedation or analgesia was given. Pain level immediately after the last biopsy was assessed using a 10-point linear visual analog pain scale. RESULTS: The median pain score during transrectal prostate biopsy was 2 (range 0 to 8) and 3 (range 1 to 10) in groups 1 and 2, respectively (p = 0.0001). Only minor complications occurred and complication rates were not significantly different between the groups. CONCLUSION: Rectal administration of lidocaine gel is safe, simple and effective for reducing the pain level associated with transrectal prostate biopsy.

Aged↗