Suprapubic catheterisation (SPC) is a common urological intervention. We present a rare case of ureteric cannulation following SPC catheter change and summarize the literature around this rare ...phenomenon. To our knowledge, our case is the first to have occurred in a patient without a neuropathic bladder.
Urolithiasis is a common condition managed by urologists. We present a rare CASE of a ureteric calculus migrating into the patient's psoas muscle in context of chronic infection and obstruction and ...summarize the literature surrounding this phenomenon. To our knowledge, only four cases have previously been presented in the literature of obstructing calculi migrating into the retroperitoneum. Our case is the first in which there was no associated psoas abscess and the migrated calculus has remained in situ without any further sequelae.
We report a case of a 46-year-old man who presented with recurrent lower urinary tract infections and obstructive voiding symptoms on the background of a proximal hypospadias repair at 4 years of ...age. A mass was later identified at his distal urethra, which on biopsy was found to be a penile squamous cell carcinoma. The lesion was excised en bloc, and at 10 months post-excision, the patient has no evidence of local or regional recurrence.
OBJECTIVE:The aim of this study was to assess long-term health-related quality of life (HRQL) in patients after thoracoscopic and open esophagectomy.
SUMMARY OF BACKGROUND DATA:Trials comparing ...minimally invasive with open transthoracic esophagectomy have shown improved short-term outcomes; however, long-term HRQL data are lacking. This prospective nonrandomized study compared HRQL and survival after thoracoscopically assisted McKeown esophagectomy (TAMK) and open transthoracic Ivor Lewis esophagectomy (TTIL) for esophageal or gastroesophageal junction (GEJ) cancer.
METHODS:Patients with esophageal or GEJ cancer selected for TAMK or TTIL completed baseline and follow-up HRQL assessments for up to 24 months using the EORTC generic and disease-specific measures, QLQ-C30 and QLQ-OES18. Baseline clinical variables were examined between the treatment groups and changes in mean HRQL scores over time estimated and tested using generalised estimating equations with propensity score (generated by boosted regression) adjustment.
RESULTS:Of the 487 patients, 377 underwent TAMK and 110 underwent TTIL. Most clinical variables were similar in the 2 groups; however, there were significantly more patients with AJCC stage 3 disease who underwent TTIL than TAMK (54% vs 32%, P < 0.01) and this was reflected in the survival data.Mean symptom scores for pain were significantly higher in the TTIL group than in TAMK for 2 years postoperatively (P = 0.036). In addition, mean constipation scores were significantly higher for the TTIL group, with a 15-point difference in mean score at 3 months postoperatively (P = 0.037).
CONCLUSIONS:This large comprehensive nonrandomized analysis of longitudinal HRQL shows that TTIL is associated with more pain and constipation than TAMK.
Background
Esophagectomy is the mainstay of curative treatment for localized esophageal cancer. However, what constitutes cure is not well defined. This study was undertaken to characterize actual ...5-year survivors following esophagectomy and to determine prognostic factors for disease-specific survival (DSS) from 60 months.
Materials and Methods
Between 1987 and 2004, 398 consecutive patients underwent esophagectomy and had potential for 5 years follow-up. Clinicopathological factors associated with DSS from 5 years onward were analyzed.
Results
Median DSS was 25 months. Neoadjuvant therapy was administered to 159 of 398 (40%). There were 114 of 398 (29%) actual 5-year survivors. On multivariate analysis, 5-year survivors were significantly more likely to have lower T classification, N classification, and R0 resections compared with patients who died less than 5 years after surgery. There were 66 of 398 patients (17%) with positive margins, and 6 of these were 5-year survivors. Of the 114 5-year survivors, 17 (15%) subsequently died of esophageal cancer. Prognostic factors for DSS after surviving 5 years were age and T classification for patients treated with neoadjuvant therapy and surgery alone, respectively. Powerful prognostic factors from time of treatment, including nodal status, were no longer prognostic factors after surviving to 5 years.
Conclusions
No single clinicopathological variable negated survival to 5 years. Prognostication once surviving 5 years is difficult. The majority of 5-year survivors can be considered cured of esophageal cancer.
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