0000000000116096
AUTHOR
J.w. Thüroff
Vesikoureteraler und vesikorenaler Reflux
Unterschieden wird zwischen primarem und sekundarem vesikoureteralem und vesikorenalem Reflux. Ja nach Auspragung und Erweiterung auch des Nierenbeckenkelchsystems wird der Reflux nach der International Reflux Study Group in 5 Grade eingeteilt. Der primare Reflux ist durch eine (anatomisch-funktionelle) Storung des ureterovesikalen Ubergangs bedingt, er kann sich mit dem Wachstum des Kindes ruckbilden. Zur Diagnostik gehoren Sonografie, MCU zur Darstellung des Refluxes und der DMSA-Scan zur Dokumentation von Parenchynarben. Ziel der Therapie ist die Vermeidung von Parenchymnarben. Die Therapie ist von den Risikofaktoren abhangig (Alter und Geschlecht des Kindes, Blasen und Darmentleerungsst…
Prognostic Significance of Histopathological Grading and Immunoreactivity for p53 and p21/WAF1 in Grade 2 pTa Transitional Cell Carcinoma of the Urinary Bladder
At present, there are no predictors of tumour behaviour for grade (G) 2 pTa transitional cell carcinomas (TCC) of the bladder. Here we analyse the prognostic relevance of histopathological grading and the immunohistochemical detection of p53 and p21/WAF1.70 patients were newly diagnosed with G2 pTa TCC of the bladder based on transurethral resection specimens. Two pathologists, blinded with respect to the clinical outcome, confirmed the initial grade and subclassified the G2 lesions into G2a and G2b carcinomas based on the degree of nuclear atypia and the number of mitoses. Immunoreactivity for p53 and p21/WAF1 was evaluated semiquantitatively.There were 52 G2a and 18 G2b tumours, mean foll…
Lymphadenectomy in patients with transitional cell carcinoma of the urinary bladder; significance for staging and prognosis
Objective To determine the need to standardize the number and location of lymph nodes to be removed during radical cystectomy in patients with invasive bladder carcinoma. Patients and methods The pelvic lymph nodes from 447 patients (mean age 62.8 years) who underwent radical cystectomy between 1986 and 1997 were evaluated. The number of lymph nodes was correlated with the depth of invasion of the primary tumour (pT), occurrence of nodal metastases, clinical outcome, the operating surgeons and the pathologists dissecting the nodes. Results The clinical follow-up was available for 302 patients (mean follow-up 38.7 months). The mean (range) number of lymph nodes removed was 14.7 (1–46). Th…
Relative advantages and disadvantages of radical perineal prostatectomy versus radical retropubic prostatectomy
In recent years prostate cancer has become the predominant malignancy in men. With the introduction of prostate specific antigen (PSA) the disease can be diagnosed at an early stage, at which surgical therapy can be curative. In the past century, the retropubic and the perineal routes were established as alternatives of surgical access to the gland for clinically localized prostate cancer. The selection of the operative route is mostly decided individually on the basis of surgical training and experience. The revived interest in perineal radical prostatectomy is explained by the fact that this technique has been associated with low morbidity. The differences of both surgical approaches of r…