ABSTRACT
Introduction: Patients presenting with bladder lesions identified during cystoscopy require histological diagnosis, routinely obtained by biopsy under general anaesthetic (GA). GA biopsies are resource intensive as they require the use of an operating theatre and surgical staff. Local anaesthetic cystodiathermy (LAC) is an alternative method for obtaining biopsies, suitable for bladder lesions <5mm in size. LAC can be performed in the outpatient setting thus reducing the need for theatre resources. The aim of our audit was to assess the safety and feasibility LAC bladder biopsies for indeterminate bladder lesions. Method(s): LAC were carried out at our peripheral London outpatient clinic. The main inclusion criteria was the presence of sub 5mm indeterminate lesions identified during routine and surveillance flexible cystoscopy. Patients notes were reviewed for follow up 2 months after their procedure. Result(s): 10 patients underwent LAC between July and September 2021, with an age range of 36-83 years old and ASA grade between 1 and 3. 6 patients were invited following positive findings at routine surveillance cystoscopy, 3 following cystoscopy for new haematuria, and 1 was investigated for routine UTIs. Only one patient had a malignant histology, with 90% reporting a benign biopsy. No patient required admission or subsequent GA biopsy, and no complications were reported. Conclusion(s): LAC is a resource-effective procedure eliminates the exposure of patient to GA. It avoids the need for preassessment and inpatient admission, thus freeing up theatre resources for other patients. This project supports the use of LAC for small indeterminate bladder lesions.
ABSTRACT
Cancer is a global challenge and the second leading cause of death worldwide as reported by the World Health Organization. With the current global pandemic caused by the novel coronavirus, cancer patients are identified as having increased risk of mortality. With the growing number of cancer patients every year, the need for a continuous and round the clock observation system has become quite imperative. An Internet of Things (IoT) based system for monitoring cancer patients has the potential to timely detect cancer related symptoms in its early stages, to continuously monitor cancer diagnosed patients and to monitor those that got cured for post-treatment measures. This paper proposes a multi-layered architecture of an IoT-based cancer observation system that can be utilized as a platform to remotely diagnose and monitor cancer patients. An implementation framework of the proposed system is also presented is this work, along with a prototype design of a Patient Side Unit (PSU) represented by a wearable wrist band. The proposed system has the potential to be applied as a solution for reducing expensive and exhausting hospital visits, while gaining similar quality of medical services when residing at home. © 2020 ACM.