0000000000131600
AUTHOR
Udo Engelmann
ABH-antigenicity of transitional cell carcinoma of the urinary bladder in patients subjected to topical chemoprophylaxis
Topical chemoprophylaxis with adriamycin was administered to 49 patients with UICC-stages pTA and PT1 (pathological stage 0 and A) of transitional cell carcinoma of the urinary bladder. Tumor specimens obtained prior to initiation of the instillation protocol were evaluated with regard to ABH-antigenicity. ABH-antigens were present in tumors of 19 patients and none of these developed muscle-infiltrating recurrences during or after intravesical chemoprophylaxis. The primary lesions of 30 patients were deleted of antigens; only 5 (16%) developed a progressive recurrence. Compared to a historical control group this is thought to be a true reduction of invasive tumor recurrences in ABH-negative…
Adriamycin Permeability of the Rat Bladder under Different Conditions
Abstract Fifty female Sprague-Dawley rats were treated with 1.4 or 2.4 mg. adriamycin intravesically. Radioimmunological measurement of serum concentrations were performed up to 3 hours post-instillation in normal bladder mucosa, cystitis, and after electrocoagulation, under different filling conditions, as well as with the use of a detergent (Tween 80). The serum concentrations achieved were markedly higher after electrocoagulation or cystitis; altogether they reached only 1/6,000 of the instilled concentration. These studies on the rat bladder suggest that perioperative instillation of adriamycin to prevent recurrence is not contraindicated shortly before or after transurethral resection …
Die intravesikale Rezidiv-Chemoprophylaxe des oberflächlichen Harnblasentumors
Das oberflachliche Harnblasenkarzinom stellt eine Domane der transurethralen Resektion dar. Das maligne Potential dieser Tumoren ist vergleichsweise niedrig und die betroffenen Patienten leiden oft infolge ihres fortgeschrittenen Alters an zusatzlichen internistischen Grunderkrankungen, die im Vordergrund stehen (1). Andererseits nimmt die karzinombedingte Todesrate in Abhangigkeit vom Infiltrationsstadium und der zellularen Entdifferenzierung deutlich zu. So sinkt die 3-Jahresuberlebensrate von Patienten mit Harnblasenkarzinomen des Stadiums T1–3 mit zunehmender histologischer Entdifferenzierung. Sie betragt bei G1-Tumoren noch 76% und sinkt auf 32% bei G3-Tumoren. Ebenso nimmt die Todesra…
The mainz-pouch (mixed augmentation ileum 'n zecum) for bladder augmentation and continent diversion
The ideal urinary reservoir constructed from bowel material should be a low-pressure system with a high capacity, capable of preventing upper tract deterioration resulting from ureteral obstruction or reflux. It should achieve reliable control of continence and assure easy emptying of the reservoir. In the Mainz-pouch, the combination of cecum and ileum, the latter of which is able to absorb pressure waves created by the cecum, produces a low-pressure system with a high capacity immediately postoperatively. By incorporating large bowel in our pouch, ureteral implantation can be done using a simple and reliable standard antireflux technique with a submucosal tunnel. The Mainz-pouch has been …
The Mainz Pouch (Mixed Augmentation Ileum and Cecum) for Bladder Augmentation and Continent Diversion
The ideal urinary reservoir constructed from bowel material should be a low-pressure system with a high capacity, capable of preventing upper tract deterioration resulting from ureteral obstruction or reflux. It should achieve reliable control of continence and assure easy emptying of the reservoir. In the Mainz-pouch, the combination of cecum and ileum, the latter of which is able to absorb pressure waves created by the cecum, produces a low-pressure system with a high capacity immediately postoperatively. By incorporating large bowel in our pouch, ureteral implantation can be done using a simple and reliable standard antireflux technique with a submucosal tunnel. The Mainz-pouch has been …
Follow-up results of embolization therapy for palliation of incurable bladder carcinoma
Embolization therapy of the renal artery (N=10), hypogastric arteries (N=18) and ureter (N=24) was performed in 41 patients with incurable bladder carcinoma for palliation of gross hematuria and severe dysuria. Careful follow-up of the patients until death gave a mean survival time of 12.3 months after embolization; 6 patients are still alive. The results show that embolization therapy is justified for management of bleeding and dysuric complaints. Ureteral occlusion alone has almost no effect on hematuria. Combined embolization procedures yield better results than occlusion of the vessels or the ureter. Ureteral occlusion with a detachable balloon is superior to embolization with tissue ad…
Radical Cystectomy - Often Too Late?
From 1967 to 1985, 246 cystectomies for treatment of transitional cell carcinoma of the urinary bladder were performed. Perioperative mortality decreased from 15% in the early years to 0% in 1985. Preoperative radiotherapy was not given. Patients who underwent cystectomy immediately following the diagnosis of invasive bladder carcinoma had a significantly better prognosis than those having cystectomy after recurrence of a transurethrally resected invasive carcinoma in spite of identical G and T criteria. A total of 26 patients who were cystectomized because of tumor recurrence after definitive radiotherapy (salvage cystectomy) represented the group with the worst prognosis: they had a 5-yea…
Digital Subtraction Angiography in Staging Renal Cell Carcinoma: Comparison with Computerized Tomography and Hlstopathology
Digital subtraction angiography was compared to computerized tomography and histopathological findings for staging renal cell carcinoma in 24 patients. Injection of contrast material through a 16 gauge angiocatheter into the femoral vein provided digital subtraction cavography, digital subtraction arteriography and excretory urography during 1 investigation. Computerized tomography established the diagnosis in all patients, while digital subtraction angiography showed all angiographic signs of renal cell carcinoma in 14 (58 per cent). T staging was correct on computerized tomography in 18 patients and on digital subtraction angiography in 16. Absence or presence of venous involvement was in…