New Gold Standard (new + gold_standard)

Distribution by Scientific Domains

Selected Abstracts

Long-term follow-up of patients following negative colposcopy: a new gold standard and its implications for cervical screening

P. D. Da Forno
From 1189 colposcopy referrals in 1997 at a single cervical screening centre, 88 women who had no biopsy taken at colposcopy (negative colposcopy) were identified. We followed up these women for a maximum of 4 years and calculated the positive predictive value (PPV) of a single smear before and after follow-up. Using slide review we attempted to correlate the grade of smear leading to colposcopy referral with final outcome. Our results showed that long-term follow-up alters the PPV of cervical cytology. Analysis showed a strong correlation between the review grade of the referring smear and the final outcome after follow-up. From these results we suggest an evidence-based protocol for cervical screening follow-up after negative colposcopy. [source]

52 Laparoscopic pyeloplasty , evolution of a new gold standard

Objectives:, We report the largest series of laparoscopic dismembered pyeloplasty for treatment of primary and secondary uretero-pelvic junction (UPJ) obstruction, reviewing the current status of this procedure. Methods:, A total of 170 consecutive cases of laparoscopic pyeloplasty (156 for primary and 14 for secondary UPJ obstruction) were performed or supervised by a single surgeon (C.G.E). A four port extraperitoneal approach was used in all but three cases, which were performed transperitoneally. Results:, Median operative time was 140 min. The complication rate was 7.1% and conversion rate was 0.6% with no conversion in the last 161 cases. The median postoperative hospitalisation was 3 nights. Crossing vessels were encountered in 42% of cases and in 11 patients coexisting renal calculi were successfully removed. At a median follow-up of 12 months, the success rate was 96.2%. Conclusions:, Laparoscopic dismembered pyeloplasty produces functional results comparable to that of open surgery with the advantages of a minimally invasive procedure. Our results are consistent with previous series and support the view that laparoscopic pyeloplasty is moving rapidly towards replacing open surgery as the gold standard in treatment of UPJ obstruction. [source]

Buccal mucosal urethroplasty: is it the new gold standard?

S. Bhargava
Whilst techniques for urethral reconstruction have developed in the past few decades the quest for an ideal substitute continues. We critically review the literature on buccal mucosal grafts for substitution urethroplasty, to determine the efficacy and complications arising from its use. Buccal mucosal grafts have proved to be a versatile substitute for strictures attributable to a wide range of causes. Placing the graft dorsally appears to be more successful than ventrally and was successful in 96% of cases; after treating complex urethral strictures with two-stage procedures about a quarter of patients required a revision after the first stage with fewer complications then when skin was used as a substitute. Thus, buccal mucosa is most likely to become the new gold standard for substitution urethroplasty and longer term results with its use are eagerly awaited. [source]