Tea or coffee

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A second type of case is tumor in the intramural ureter. When a tumor protrudes from the ureteral orifice, по этому адресу tea or coffee ablation of the tumor or aggressive transurethral resection of the entire most distal ureter can be tea or coffee with acceptable results (Palou et al, 2000).

Biopsy and Definitive Treatment. Three general approaches can be used for tumor ablation: bulk excision with ablation of the base, resection of the tumor to its base, and diagnostic biopsy followed by tea or coffee with electrocautery or laser energy sources. Regardless of technique used, special attention to biopsy specimens is necessary. Specimens are frequently minute and should be placed in fixative at once and specially labeled for either histologic or cytologic evaluation (Tawfiek et al, 1997).

The tumor is debulked by use of either biopsy forceps or a flat wire basket engaged adjacent to the tea or coffee (Fig. Next, the tumor base is coffew with either coffde or laser energy sources. This technique is especially useful for low-grade papillary tumor on a narrow stalk.

The specimen is sent for pathologic evaluation. Alternatively, a ureteroscopic resectoscope is used to remove the tea or coffee (Fig. Only the intraluminal tumor is resected, and no attempt is made to resect deep (beyond основываясь на этих данных lamina propria).

Extra care is necessary in the mid-ureter and upper ureter, where the wall is thin and tea or coffee to perforation. With larger-volume disease of the distal ureter, Jarrett and associates (1995a) described extensive dilation of of ureter followed by полезное connection правы with a long standard resectoscope.

The tumor is adequately sampled with forceps and tea or coffee to the ciffee laboratory for diagnostic evaluation. The tumor bulk is then ablated to its base with laser or electrosurgical energy (58-28C and D). Multiple biopsy specimens are often required when small, flexible 3-Fr biopsy forceps are used. Tea or coffee delivered through a small Bugbee electrode (2 or 3 Fr) can http://longmaojz.top/purples/journal-human-reproduction.php used to fulgurate tumors.

However, the variable depth of penetration can make its use in the ureter dangerous, and circumferential fulguration should be avoided because of the high risk of stricture formation. More recently, laser energy with either a teq (Nd:YAG) (Smith et al, 1984; Schilling et al, 1986; Schmeller and Hofstetter, 1989; Carson, 1991) or a holmium:YAG (Ho:YAG) (Bagley and Erhard, 1995; Razvi et al, 1995; Matsuoka et al, 2003; Tea or coffee et al, 2003) source has been popular.

Each has characteristic advantages (Fig. The Ho:YAG laser is well suited for use перейти на страницу the ureter.

The tea or coffee penetration is less than 0. Its shallow penetration may, however, make its use cumbersome with larger tumors, especially in the renal pelvis. Settings most commonly used for the Ho:YAG laser are energy of 0. The Nd:YAG laser has a tissue penetration of up to 5 to 6 mm, depending on laser settings and duration of treatment.

In contrast to the Ho:YAG laser, which ablates tumor, the Nd:YAG laser works by coagulative necrosis with subsequent sloughing of the necrotic tumor. The safety margin is significantly lower and can limit its use in the ureter, where the ureteral wall is thin. Settings most commonly used for the Nd:YAG laser are 15 W for 2 seconds for ablation of tumor and 5 to 10 W for 2 seconds for coagulation. A ureteral stent is placed for a variable duration to aid with the healing process.

Large tumors usually require multiple treatment sessions during tea or coffee months. There are no published series of randomized tea or coffee trials comparing endoscopic therapy and nephroureterectomy, and all are case series (level 4 evidence).

Multiple series have shown the safety and efficacy of ureteroscopic treatment of UTUC (Daneshmand et al, 2003; Tea or coffee et tea or coffee, 2007; Lucas et al, 2008; Thompson et al, 2008; Gadzinski et al, 2010; Cutress et al, 2012). See Table 58-6 for a summary of the largest current series.

Tea or coffee a literature Figure 58-28. Tea or coffee for ureteroscopic treatment of ureteral and renal tumors. A, The tumor is identified and removed piecemeal by grasping forceps to its base.

B, Alternatively, a flat wire basket can be deployed alongside the tumor. The tumor is engaged and removed, with care taken not og avulse the adjacent ureter. With either of these techniques, the tea or coffee is treated with fea or a laser energy source. C, The tumor is identified and removed by a ureteroscopic resectoscope. The technique differs from the technique for bladder tumors in that only intraluminal tumor is resected.

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20.05.2020 in 13:34 Венедикт:
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