PubMed · 7456791
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W Glinz. 1980. [Arthroscopic operations].. https://pubmed.ncbi.nlm.nih.gov/7456791/
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Endoscopic variceal ligation (EVL) is a new method for treating oesophageal varices, which was developed to reduce the high complication rate seen with endoscopic sclerotherapy. This technique consists of mechanical occlusion and thrombosis applying small elastic bands around the variceal channels in the distal oesophagus. We report 39 patients treated with EVL during the period from April 1995 to December 1996. The average age of patients was 50.1 years, 33 men, 6 women. Portal hypertension was caused by alcoholic liver disease in 36 patients. Seven patients died within 1 month. Varices were eradicated in 28 patients. Variceal eradication required an average of 3, 4 sessions. Active bleeding was controlled by EVL in 11 patients out of 12. Recurrent bleeding occurred in 14 out of 39 patients (35%). One oesophageal perforation occurred in connection with overtube placement. There were no other major complications. In conclusion EVL is an effective treatment for bleeding oesophageal varices.
PURPOSE: To assess the ability of computed tomography (CT) scans and retrograde urethrograms to accurately define the prostatic apex in the craniocaudad dimension, using urethroscopy as a reference. METHODS AND MATERIALS: Plain film radiographs of the pelvis were obtained in 15 patients with early-stage adenocarcinoma of the prostate, with the tip of a urethroscope held in place at the external sphincter, which most closely approximates the prostatic apex. The scope was then withdrawn, and a retrograde urethrogram was performed. Immediately afterwards, a CT scan of the pelvis was obtained. Because differential filling of the bladder and rectum affects the position of the prostatic apex, patients voided prior to rather than in between the three consecutive studies. RESULTS: The urethroscopy-defined prostatic apex was located 4 +/- 8 mm (mean +/- SD) superior to the CT-defined apex, 13 +/- 3 mm (mean +/- SD) superior to the urethrogram tip and 30 +/- 7 mm (mean +/- SD) superior to the ischial tuberosities. There was significant interobserver variability in the location of the prostatic apex as determined by CT scans. Placement of the inferior border of the radiation portals at the ischial tuberosities would have resulted in irradiation of > or = 20 mm bulbar urethra, as defined by the dye column of the retrograde urethrogram, in 6 out of 15 (40%) of the patients and irradiation of < 10 mm bulbar urethra in 2 out of 15 (13%) of the patients. CONCLUSION: Because the prostate blends inferiorly with the urogenital diaphragm, CT scans do not allow one to precisely localize the prostatic apex. Due to anatomic variability, the ischial tuberosities do not allow one to accurately localize the prostatic apex. Retrograde urethrograms provide helpful supplemental information regarding the position of the prostatic apex for radiotherapy treatment planning.
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