A. Lampel

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

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Publications (46)70.62 Total impact

  • A. Lampel · J. W. Thüroff · St. Roth

    No preview · Article · Sep 2001 · Aktuelle Urologie
  • J Humke · A Lampel · S Roth

    No preview · Article · Jul 2001 · The Journal of Urology
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    D Schultz-Lampel · A Lampel

    Preview · Article · Jun 2001 · BJU International
  • 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.
    No preview · Article · Feb 2000 · The Journal of Urology
  • J. Humke · A. Lampel · T. Schadt · S. Roth
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    ABSTRACT: Introduction: Enterovesical fistulae are mostly complications of inflammatory bowel disease. Even though there seems to be a consensus in respect to the therapeutic regimen, the preoperative investigations necessary for diagnosis are still a matter of controversy. Material and Methods: In order to evaluate a useful diagnostic approach in patients with enterovesical fistulae, 10 patients treated from 1992 to 1997 were analysed retrospectively. Mean patient age was 66 years and all patients had urologic symptoms. Results: Diverticulitis of the sigmoid colon was the most common underlying cause (90%). The most frequent presenting symptoms were dysuria and pneumaturia. Diagnostic procedures with the highest sensitivity for detecting the fistula were cystoscopy (70%) and cystogram (70%) followed by contrast enema (60%) and coloscopy (33%). Intravenous urography and computed tomography were less helpful in detecting enterovesical fistulae. All patients underwent a single-stage operation. After a mean follow-up of 43 months no fistulae recurred. Conclusions: Considering the usefulness and cost of the various studies, basic evaluation of patients suspicious of enterovesical fistulae should include cystoscopy and cystogram. Intestinal diagnostics with contrast enema and coloscopy should include histological samples to rule out a malignant process. Intravenous urography is of no significant use in fistula detection, but is helpful for planning the operation. CT is unnecessary if malignancy has been ruled out. Single-stage repair is the first choice in uncomplicated primary fistulae.
    No preview · Article · Feb 2000 · Aktuelle Urologie
  • ALEXANDER LAMPEL · JOACHIM W. TH??ROFF · STEPHAN ROTH

    No preview · Article · Jan 2000 · The Journal of Urology
  • J Humke · A Lampel · T Schadt · S Roth

    No preview · Article · Jan 2000 · Aktuelle Urologie
  • 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.
    No preview · Article · Oct 1999 · Current Opinion in Urology
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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.
    No preview · Article · Jul 1999 · BJU International
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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.
    No preview · Article · Aug 1998 · The Journal of Urology

  • No preview · Article · Jul 1998 · The Journal of Urology
  • 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.
    No preview · Article · Jun 1998 · Current Opinion in Urology
  • A Lampel · J W Thüroff

    No preview · Article · Apr 1998 · Der Urologe
  • A. Lampel · J.W. Thüroff

    No preview · Article · Mar 1998 · Der Urologe
  • A. Schröder · A. Lampel · R. Golz · J.W. Thüroff
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    ABSTRACT: Patients with bladder exstrophy have a higher risk of developing carcinoma of the bladder. For untreated cases, the incidence of carcinoma is 4-7,5%, most of which develop in the 4 th to 6 th decade of life. 84-95% are adenocarcinomas. We report the case of a 33-year-old patient who developed adenocarcinoma of the bladder after having had a urinary conduit diversion and bladder closure during the first two years of life.
    No preview · Article · Feb 1998 · Aktuelle Urologie
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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.
    No preview · Article · Jan 1998 · Der Urologe B
  • A. Lampel · J. W. Thüroff
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    ABSTRACT: 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.
    No preview · Article · Jan 1998 · Der Urologe
  • A Lampel · J W Thüroff

    No preview · Article · Jan 1998 · Der Urologe
  • A. Schröder · A. Lampel · R. Golz · J. Thüroff

    No preview · Article · Jan 1998 · Aktuelle Urologie

  • No preview · Article · Oct 1997 · Der Urologe

Publication Stats

788 Citations
70.62 Total Impact Points

Institutions

  • 1987-2001
    • Universität Witten/Herdecke
      • Chair of Pathology
      Witten, North Rhine-Westphalia, Germany
  • 1993
    • Al-Azhar University
      • Department of Urology
      Al Qāhirah, Muḩāfaz̧at al Qāhirah, Egypt