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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  45. Gemeinsame Tagung der Österreichischen Gesellschaft für Urologie und Andrologie und der Bayerischen Urologenvereinigung; 20190509-20190511; Wien; DOC19oegu093 /20190408/
    Publication Date: 2019-04-09
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
    ISSN: 1433-3023
    Keywords: Key words:Female – Functional results – Ileal neobladder – Orthotopic lower urinary tract reconstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: We present our functional experience with orthotopic bladder replacement in female patients dependent on the urethral resection line. Between November 1986 and July 1998 42 women underwent orthotopic urinary tract reconstruction with an ileal neobladder at our institution: 26 patients underwent radical cystectomy (RCx) with subsequent ileal anastomosis to the urethra, and 16 underwent simple cystectomy (SCx) with preservation of the bladder neck. Fourteen of 22 patients following RCx and 3 of 14 patients following bladder neck-sparing cystectomy void naturally. Clean intermittent catheterization is necessary in 8 of 22 and 11 of 14 patients, respectively. Perfect continence with no pads at 1 year postoperatively was achieved in 15 of 18 evaluable patients following RCx and 10 of 11 patients following bladder neck sparing. Incontinence requiring one or more pads is present in 3 of 18 patients and 1 of 11 patients, respectively. Subjectively satisfactory continence was achieved in 16 of 18 patients following RCx and in all patients following bladder neck-sparing surgery. Our conclusions are that radical cystectomy as well as a bladder neck-sparing cystectomy does provide satisfactory functional results in the majority of patients. However, the urethral resection line does slightly influence the rate of incontinence as well as the requirement for intermittent catheterization. RCx does translate into a lesser requirement for CIC, whereas bladder neck sparing results in slightly better continence rates.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We studied the long-term efficacy and safety of medium-molecular-weight hydroxyethyl starch (HES) administered in doses above 20 mlkg−1 during major blood replacement therapy. Blood replacement for 50 patients used 6% HES 200/0.5 (HES group) or 5% albumin (ALB group) and additional blood components according to a defined protocol. We compared safety, efficacy and costs in 4 peri-operative days. Colloid administration on the day of surgery was 38.4 mlkg−1 (HES group) and 35.1 mlkg−1 (ALB group). Haemodynamic, coagulation and renal function parameters were similar. Although total serum protein was still different on the third postoperative day (53.45 gl−1 (HES group) and 60.6 gl−1 (ALB group) (p 〈 0.01)) the colloid osmotic pressure always remained above 19.5 (2.5) mmHg (HES group). Blood loss (3810 (1632) ml (HES group) and 3455 (1733) ml (ALB group)) and the requirement for blood components was comparable. Costs were reduced by 35% (p 〈 0.05) in the HES group. We conclude that using 6% HES 200/0.5 as the only colloid for treatment even of large blood loss is a safe and economic alternative to albumin.
    Type of Medium: Electronic Resource
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