A. Lampel

Universität Witten/Herdecke, Witten, North Rhine-Westphalia, Germany

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Publications (42)25.12 Total impact

  • A Lampel · N Runkel ·
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    ABSTRACT: The incidence of parastomal hernia in ileal conduit urinary diversion ranges from 4% to 16%. Surgical correction is necessary in about one third of cases and different techniques of surgical reconstruction have been described. Primary fascial repair has a high recurrence rate of 46-100% whereas stoma translocation is associated with complication rates of up to 88%. The use of alloplastic material (usually polypropylene meshes) has reduced the recurrence rate by up to 100% for primary fascial repair and 71% for stoma translocation down to 33%.Composite meshes consist of two layers, a polypropylene layer and an expanded polytetrafluoroethylene (ePTFE) layer. The former is placed against the abdominal wall for permanent reinforcement by ingrowing connective tissue and the ePTFE layer is placed against the abdominal organs preventing adhesions with the bowel. The intraperitoneal placement of such composite meshes is a standardized, simplified, gentle and controllable surgical procedure. This article reports experiences with the surgical correction of parastomal hernias in ileal conduits using composite meshes.
    Der Urologe 07/2012; 51(7):965-70. DOI:10.1007/s00120-012-2962-y · 0.44 Impact Factor
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    ABSTRACT: Im Gegensatz zur Ureterosigmoideostomie existieren keine verlässlichen klinischen Daten über das Tumorrisiko in den verschiedenen Formen der Harnableitung unter Verwendung isolierter Darmsegmente. In 44 urologischen Hauptabteilungen in Deutschland konnten Operationszahlen, die Operationsindikationen, Patientenalter und Operationsdaten der verschiedenen Formen der Harnableitung erfasst werden, die zwischen 1970 und 2007 operiert wurden. Ebenso wurden die bis 2009 aufgetretenen sekundären Tumoren in diesen Harnableitungen registriert und unter Bezug auf diese Operationszahlen die Tumorprävalenzen in den verschiedenen Harnableitungen ermittelt. In 17.758 Harnableitungen wurden insgesamt 32 sekundäre Tumoren beobachtet. Das Tumorrisiko in Ureterosigmoideostomien (22-fach) und Zystoplastiken (13-fach) ist signifikant höher als in allen anderen kontinenten Formen der Harnableitung wie Neoblasen und Pouches (p
    Der Urologe 04/2012; 51(4):500, 502-6. DOI:10.1007/s00120-012-2815-8 · 0.44 Impact Factor
  • A. Lampel · J. W. Thüroff · St. Roth ·

    Aktuelle Urologie 09/2001; 32(5):309-313. DOI:10.1055/s-2001-17271 · 0.16 Impact Factor
  • J Humke · A Lampel · S Roth ·

    The Journal of Urology 07/2001; 165(6 Pt 1):1999-2000. DOI:10.1097/00005392-200106000-00045 · 4.47 Impact Factor
  • D Schultz-Lampel · A Lampel ·

    BJU International 06/2001; 87(8):732-40. DOI:10.1046/j.1464-410x.2001.02218.x · 3.53 Impact Factor
  • Alexander Lampel · Joachim W. Thüroff · Stephan Roth ·
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    ABSTRACT: We created a simplified modification of the seromuscular tube technique for continent cutaneous urinary diversion. We applied a simplified modification of our seromuscular tube technique in 1 woman and 2 men with a mean age of 53 years in whom outlet failure developed after continent cutaneous urinary diversion, and in whom adiposity and postoperative adhesions rendered revision difficult. We constructed a continent outlet conduit by imbricating the whole bowel wall and suturing it into a tube. At a followup of 4 to 13 months (mean 7) all 3 patients are completely continent without leakage. Catheterization is performed at 3 to 5-hour intervals (mean 4) with 14 to 16Fr catheters. The wall imbrication technique involves the flap valve principle, as does the seromuscular tube, and it is easy to perform. To date followup is too short for judging the long-term reliability of this continence mechanism. If the outcome stands the test of time in this series, which represents the worst case scenario, application of this technique may be extended to continent cutaneous urinary diversion.
    The Journal of Urology 02/2000; 163(1):201-4. DOI:10.1016/S0022-5347(05)68005-6 · 4.47 Impact Factor
  • J Humke · A Lampel · T Schadt · S Roth ·

    Aktuelle Urologie 01/2000; 31(1):24-26. DOI:10.1055/s-2000-11687 · 0.16 Impact Factor
  • Daniela Schultz-Lampel · Alexander Lampel ·
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    ABSTRACT: Since Sternberg et al. in 1985 first published preliminary results of polychemotherapy in patients with metastatic bladder cancer, it became apparent that transitional carcinoma of the bladder is highly responsive to chemotherapy. Response rates up to 70% with combination therapy regimens like methotrexate, vinblastine, doxorubicin or adriamycin and cisplatin promised that transitional carcinoma might be able to cure even in advanced stages. Chemotherapy has either been applied prior to the local treatment (such as radical cystectomy or radiotherapy) in a neo-adjuvant regimen, or after local therapy in an adjuvant regimen. Although a large number of studies have been published in the past 20 years, the role of the different chemotherapeutic approaches has not been clearly defined. Therefore, neither neo-adjuvant nor adjuvant chemotherapy can be recommended as 'gold standard' treatment for advanced bladder cancer.
    Current Opinion in Urology 10/1999; 9(5):419-24. DOI:10.1097/00042307-199909000-00009 · 2.33 Impact Factor
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    ABSTRACT: To analyse, in a retrospective study, the oncological outcome, pouch-related complications, continence and micturition after radical cystoprostatectomy combined with Mainz pouch orthotopic bladder substitution to the urethra for the treatment of bladder cancer. Between 1986 and 1996, three urological departments contributed 108 male patients to the review. The same exclusion criteria from orthotopic bladder substitution were applied by all centres, i.e. multifocal or concomitant carcinoma in situ, tumour at the bladder neck, positive biopsy from the prostatic urethra, locally advanced tumour and lymph node involvement. In all, 103 patients were evaluable for follow-up, with a mean (range) follow-up of 42 (3-132) months. Pathological examination of the cystectomy specimen revealed 81% organ-confined tumours. During follow-up, 84% of patients remained free of tumour, 7% developed distant metastases, 5% local recurrences, 4% urethral recurrences, and 1% upper tract urothelial cancer; 85% of patients are capable of spontaneous voiding, with a mean pouch capacity of 720 mL. Daytime continence was achieved in 88%, including 17% wearing one safety pad; 9% had stress incontinence and 3% total incontinence; 67% could sleep through the night, with either complete continence (34%) or one safety pad (33%). Nocturnal incontinence occurred in 11%. Uretero-intestinal stenosis occurred in 15 of 205 (7%) renal units, requiring ureteric reimplantations in 11, nephrectomy in three and antegrade dilatation in one. Reflux was not noted in any patient. About half the patients were on anti-acidotic prophylaxis. The large bowel segment in the Mainz-pouch technique of orthotopic bladder substitution provides good reservoir capacity and continence rates, with less ileum used than in all-ileum pouches. The surgical technique is simple and reproducible, and in particular the antireflux ureteric implantation into the caecum protects the upper urinary tracts.
    BJU International 07/1999; 83(9):964-70. DOI:10.1046/j.1464-410x.1999.00049.x · 3.53 Impact Factor
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    ABSTRACT: The centers of the laparoscopy working group of the German Urologic Association collected data to prove the efficacy, safety and reproducibility of laparoscopic nephrectomy. At 14 centers 482 laparoscopic nephrectomies have been performed until December 1996 via a transperitoneal approach in 344 (71%) and a retroperitoneal approach in 138 (29%). All 482 laparoscopic nephrectomies were performed by a total of 20 surgeons with an average of 24 procedures per surgeon (range 4 to 105). The indications for nephrectomy were benign renal pathology in 444 patients (92%), including renovascular disease in 28%, hydronephrosis in 20%, reflux nephropathy in 15%, chronic pyelonephritis in 12%, end stage nephrolithiasis in 11%, renal dysplasia in 4% and renal tuberculosis in 1%. Of the remaining 38 patients (8%) laparoscopic radical nephrectomy was performed for renal cell carcinoma in 5% and for upper tract transitional cell carcinoma in 3%. Operating time depended mainly on the pathology of the kidney (that is small dysplastic organ versus large hydronephrosis) and the learning curve of the surgeon. However, the average operating time did not vary significantly among the different centers (maximum 277.6 and minimum 81.9 minutes). Intraoperative or perioperative complications were noted in 29 patients (6.0%), including bleeding in 22 (4.6%), bowel injury in 3, hypercarbia in 2 and pleura lesion in 1 and pulmonary embolism in 1. The conversion rate was 10.3% (bleeding, bowel injury, difficult dissection), including 4 patients with renal tuberculosis, 2 with xanthogranulomatous nephritis, and 1 each following renal trauma and embolization. The re-intervention rate was 3.4% due to bleeding in 6 cases, abscess formation in 3, intestinal stenosis in 2 and a pancreatic fistula and port hernia in 1. Mean hospital stay was 5.4 days. Laparoscopic nephrectomy has become a well established procedure in those urology departments focusing on laparoscopy. The indications and results are reproducible at these centers. However, for patients with severe perinephritis (that is renal tuberculosis, xanthogranulomatous nephritis, posttraumatic atrophy) a higher likelihood of open conversion must be considered.
    The Journal of Urology 08/1998; 160(1):18-21. DOI:10.1016/S0022-5347(01)63015-5 · 4.47 Impact Factor
  • Alexander Lampel · Joachim W. Thüroff ·
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    ABSTRACT: General use of standardized terminology and assessment of functional characteristics suggested by the International Continence Society will enable better comparison of the results and technical specifications of different continent outlets. According to the basic functional principle, continence mechanisms can be classified into extraluminally and intraluminally located continent outlets. Extraluminal continent outlets are easy to construct, but are associated with the risk of overflow incontinence. The use of invagination or intussusception nipple valves is associated with a long learning curve, tedious surgical technique and high complication rate. There is an increasing tendency to use the flap valve principle for construction of continent outlets, which guarantee a high rate of complete continence with an acceptable complication rate.
    Current Opinion in Urology 06/1998; 8(3):221-6. DOI:10.1097/00042307-199805000-00005 · 2.33 Impact Factor
  • A Lampel · J W Thüroff ·

    Der Urologe 04/1998; 37(2):W207-20. · 0.44 Impact Factor
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    ABSTRACT: Zum Thema Der in der Literatur mitunter vertretene Standpunkt, die monosymptomatische Hmospermie als selbstlimitierendes benignes Geschehen aufzufassen und nicht weiter abzuklren, kann aufgrund der vielfltigen mglichen Ursachen nicht geteilt werden [14]. Dies gilt insbesondere, da es heute meistens mglich ist, die Ursache einer Hmospermie zu ermitteln. Bei Mnnern unter 40 Jahren sind gutartige Vernderungen die Regel, und der Umfang der Diagnostik ist an die Krankengeschichte anzupassen. Bei persistierender Hmospermie, Patienten lter als 40 Jahre oder zustzlich bestehender Makrohmaturie sollte die komplette Stufendiagnostik (s. Tabelle 4) bis zur definitiven Klrung oder zum Ausschlu organpathologischer Vernderungen als Ursache der Hmospermie durchgefhrt werden.
    Der Urologe B 01/1998; 38(1):3-5. DOI:10.1007/s001310050157
  • A Lampel · J W Thüroff ·

    Der Urologe 01/1998; 37(1):93-101. · 0.44 Impact Factor
  • A. Schröder · A. Lampel · R. Golz · J. Thüroff ·

    Aktuelle Urologie 01/1998; 29(01):31-33. DOI:10.1055/s-2008-1065257 · 0.16 Impact Factor
  • A. Lampel · J. W. Thüroff ·
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    ABSTRACT: Zusammenfassung Die Therapie des invasiven Blasenkarzinoms hat sich in den letzten Jahrzehnten nur wenig gewandelt. Standard ist nach wie vor die radikale Zystektomie, wodurch eine adäquate lokale Tumorkontrolle erreicht wird. Limitierend für die Prognose ist allerdings eine bereits zum Operationszeitpunkt vorliegende systemische Tumorausbreitung. Daher gilt auf der einen Seite das Hauptinteresse aktueller experimenteller und klinischer Studien der Suche nach molekularen Tumormarkern zur Früherkennung und Differenzierung potentiell rezidivgefährdeter bzw. vor allem progressionsgefährdeter Patienten, um entsprechende Therapiemaßnahmen “präventiv” zu einem Zeitpunkt einzuleiten, zu dem noch keine systemische Ausbreitung erfolgt ist. Gleichzeitig gilt das Interesse der Möglichkeit, z. B. durch molekularbiologische Untersuchungen eine zum Diagnosezeitpunkt des Blasentumors evtl. bestehende Metastasierung nachweisen zu können, um die Therapiestrategie entsprechend adaptieren zu können. Auf der anderen Seite steht die Suche nach geeigneten adjuvanten Maßnahmen, die flankierend zur lokalen radikalchirurgischen Therapie bei fortgeschrittenem Blasenkarzinom sinnvoll zur Anwendung kommen können. Aus den beschriebenen neoadjuvanten und adjuvanten Therapiemodalitäten scheint derzeit die adjuvante Chemotherapie nach radikaler Zystektomie bei Patienten mit lokal fortgeschrittenem Blasenkarzinom und/oder Lymphknotenmetastasen einen Überlebensvorteil zu erbringen. Der tatsächliche Stellenwert muß allerdings erst noch in weiteren Studien genauer definiert werden. Oberflächliche Blasenkarzinome (Ta, Tis, T1) haben eine Rezidivrate von etwa 50–80%. Je nach Differenzierungsgrad kommt es dabei in 4–30% zu einer muskelinvasiven Progression, die bei entdifferenzierten Tumoren mit Infiltration der Lamina propria (T1G3–4) sogar bei 50% liegt. Etwa 20–30% aller Patienten haben dagegen bereits bei der Erstdiagnose einen muskelinvasiven bzw. organüberscheitenden Tumor (T2–4). Therapie der Wahl des muskelinvasiven Blasenkarzinoms stellt weiterhin die radikale Zystektomie dar. Die Rolle neoadjuvanter und adjuvanter Therapiemodalitäten wie Radiatio oder Chemotherapie ist nach wie vor ungeklärt und Gegenstand laufender klinischer Studien.
    Der Urologe 01/1998; 37(1):93-101. DOI:10.1007/s001200050157 · 0.44 Impact Factor
  • A Schröder · A Lampel · C Eggersmann · J W Thüroff ·

    Der Urologe 10/1997; 36(5):W460-6. · 0.44 Impact Factor
  • D Schultz-Lampel · A Lampel · M Lazica · J W Thüroff ·
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    ABSTRACT: In general, the criteria for treatment of urolithiasis in children are the same as those for adults. Today, extracorporeal shock wave lithotripsy (ESWL) is the method of choice for treatment of most pediatric urinary stones. Stone-free rates between 57% and 97% at short-term follow-up and 57%-92% at long-term follow-up have proven the efficacy of ESWL treatment in children. So far, there is no evidence of negative side effects of ESWL treatment in children in the long-term, confirming the safety of ESWL treatment seen in the short-term results. In particular, neither induction of hypertension nor deterioration of renal function have been detected in children when limitation of shock wave energy and shock wave numbers have been carefully observed.
    Der Urologe 06/1997; 36(3):200-8. · 0.44 Impact Factor
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    ABSTRACT: Bei Erstdiagnose eines Blasenkarzinoms findet sich in 75–85% ein oberflchlicher, auf die Schleimhaut bzw. Submukosa begrenzter Tumor (Ta, Tis, T1), der durch lokale Manahmen wie transurethrale Resektion und/oder topische Chemotherapie kontrollierbar ist [32]. In 15–25% findet sich dagegen bei der Erstdiagnose ein bereits fortgeschrittenes, muskelinvasives Karzinom (≥T2). Neben der als Standardtherapie muskelinvasiver Tumoren geltenden radikalen Zystektomie umfat das Spektrum der Therapiemodalitten des invasiven Blasenkarzinoms eine ganze Palette von Mglichkeiten, die individuell als Mono- oder Kombinationstherapie nach den unterschiedlichen Gegebenheiten und Prferenzen zur Anwendung kommen knnen. Die Entscheidung zur Wahl der definitiven Therapieform bei invasivem Blasenkarzinoms ist dabei von multiplen Faktoren wie Alter, Allgemeinzustand, Tumorstadium, Begleiterkrankungen, soziales Umfeld, Intelligenz, manuelle Geschicklichkeit des Patienten, aber auch von den persnlichen Erfahrungen und Prferenzen des behandelnden Arztes abhngig. Zunehmend finden auch Aspekte der Lebensqualitt und einer steigenden Lebenserwartung Bercksichtigung fr die Therapieplanung.
    Der Onkologe 05/1997; 3(3):248-253. DOI:10.1007/s007610050119 · 0.14 Impact Factor
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    ABSTRACT: Bladder neck suspension using an autologous fascial sling is an established surgical technique for treatment of urinary stress incontinence. However, the biological fate and physical properties of autologous fascial sling yet remain to be determined. Our study was designed to evaluate in an animal model of twenty rabbits fascial slings from free and pedicled fascial flaps of two different widths (7 mm and 15 mm.) and uniform length (60 mm.) in respect to changes of length, width, tensile strength and histological criteria of vitality and integrity 3 months after surgery. The results 3 months after surgery revealed shrinkage in length by 37% (31%-46%) of the original length, shrinkage in width by 63% (60%-69%) of the original width and reduction of tensile strength of 53% (51%-55%) without consistent differences between free and pedicled flaps or 7 mm. and 15 mm. wide flaps. In the groups with 7 mm. wide flaps a total of two dystrophic slings (1 pedicled, 1 free) were seen; however, no dystrophies were seen in 15 mm. wide flaps. On microscopy, all slings were vital regardless of their surgical configuration. In summary, on macroscopic, microscopic and physical examination no gross differences between free and pedicled slings could be detected, so that preferences for use of free or pedicled fascial flaps could not be established for clinical applications in sling surgery. However, 15 mm. wide flaps had a lower incidence of dystrophy and retained greater absolute tensile strength than 7 mm. wide flaps.
    The Journal of Urology 04/1997; 157(3):1039-43. DOI:10.1016/S0022-5347(01)65137-1 · 4.47 Impact Factor