Urologists
11 years of experience
Video profile
Accepting new patients
Abington
Urology Health Specialists
1235 Old York Rd
Ste 210
Abington, PA 19001
215-517-1100
Locations and availability (2)

Education ?

Medical School Score
State University of New York Downstate (1999)
  • Currently 2 of 4 apples

Awards & Distinctions ?

Associations
American Urological Association
American Board of Urology

Affiliations ?

Dr. Schachter is affiliated with 3 hospitals.

Hospital Affilations

Score

Rankings

  • Warminster Hospital
    225 Newtown Rd, Warminster, PA 18974
    • Currently 2 of 4 crosses
  • Abington Memorial Hospital
    1200 Old York Rd, Abington, PA 19001
    • Currently 2 of 4 crosses
  • Fox Chase Cancer Center
    333 Cottman Ave, Philadelphia, PA 19111
  • Publications & Research

    Dr. Schachter has contributed to 6 publications.
    Title A Sealed Bladder Cuff Technique During Laparoscopic Nephroureterectomy Utilizing the Ligasure Electrosurgical Device: Laboratory and Clinical Experience.
    Date June 2010
    Journal Journal of Endourology / Endourological Society
    Excerpt

    Laparoscopic nephroureterectomy (LNU) is a safe, minimally invasive approach for management of upper tract urothelial tumors. Controversy exists over the optimal technique for the distal ureter and bladder cuff (DUBC) excision. We examined the novel technique of using the LigaSure bipolar electrosurgical device in laboratory investigations and during clinical LNU to manage the DUBC.

    Title Second Prize: Frequency of Benign Renal Cortical Tumors and Histologic Subtypes Based on Size in a Contemporary Series: What to Tell Our Patients.
    Date December 2007
    Journal Journal of Endourology / Endourological Society
    Excerpt

    BACKGROUND AND PURPOSE: Historically, 85% to 90% of renal masses have been malignant, with the majority being renal-cell carcinoma. However, with the increasing frequency of incidentally discovered renal masses, only 70% to 85% of lesions are found to be malignant. Furthermore, the pathologic breakdown of these lesions on the basis of size is not well described. This study sought to determine the incidence of the various histologic subtypes of renal cortical tumors according to size in a contemporary series of surgically treated patients. MATERIALS AND METHODS: Our prospectively collected database of all 482 patients who underwent partial or radical nephrectomy for a unilateral, unifocal, suspicious renal cortical tumor between January 2001 and October 2005 was reviewed. The frequency of benign and malignant lesions was determined according to size, as was the incidence of the various histologic subtypes. RESULTS: Of the lesions, 228 were <or=4 cm, and 254 were >4 cm. Of all lesions <or=4 cm, 26.3% were benign, whereas only 8.3% of the lesions >4 cm were benign. For larger lesions, 10.9% of those between 4 and 7 cm and only 5.6% of those >7 cm were benign (P < 0.001). A significant difference between histologic subtypes according to size also was found (P = 0.01). Smaller lesions (<or=4 cm) that proved to be malignant were less likely than larger lesions to be of clear-cell histology (50.0% v 72.8%) and more likely to be papillary (15.8% v 9.4%). CONCLUSIONS: This study examined the largest contemporary database evaluating the histologic type of renal lesions according to size. Approximately one fourth (26.3%) of lesions <or=4 cm and 16.8% of lesions overall were benign, percentages higher than those reported in older series. Importantly, there was a higher incidence of benign and papillary lesions and a lower incidence of clear-cell histology in smaller lesions. Given the differences in the biological behavior of the various histologic subtypes of these tumors, these data are important when counseling patients about the treated and untreated natural history of small renal masses.

    Title The Impact of Tumour Location on the Histological Subtype of Renal Cortical Tumours.
    Date July 2006
    Journal Bju International
    Excerpt

    OBJECTIVE: To determine whether the location of renal cortical tumours (RCTs) is a possible factor affecting tumour behaviour, by investigating whether exophytic vs a central location is associated with a difference in histological subtype distribution, as recognized prognostic factors for RCTs include size, stage, grade, and histological subtype. PATIENTS AND METHODS: Between 1 January 1996 and 1 June 2003, we evaluated 485 consecutive RCTs in 469 patients who had renal imaging studies and underwent either partial or radical nephrectomy at our institution. A radiologist and a urologist independently reviewed the imaging studies of all patients to determine exophytic vs central location. An exophytic lesion was defined as one that clearly both pushed out the renal contour and did not extend into the collecting system, hilum, or renal sinus. A lesion that did not meet these criteria was defined as a central lesion. Logistic regression analysis was used to determine if either type of lesion had a greater representation of any histological subtype. A two-tailed P < or = 0.05 was considered to indicate significance. RESULTS: Of the 485 RCTs, 171 (35%) were exophytic and 314 (65%) were central, while 308 (64%) were clear cell and 177 (36%) were non-clear cell tumour histology. Of the exophytic lesions, 52.0% were clear cell, while 69.7% of central lesions were clear cell (P < 0.001). Conversely, 71.1% of clear cell tumours were central, while 53.7% of non-clear cell tumours were central (P = 0.003). After controlling for size and stage, tumour location remained associated with histological subtype (P = 0.003). CONCLUSIONS: Exophytic lesions are significantly more likely than central lesions to be non-clear cell tumours, and clear cell tumours are significantly more likely than non-clear cell tumours to be central. As studies indicate that the clear cell histological subtype portends a worse prognosis than the non-clear cell subtype, our results imply that tumour location affects the prognosis in RCTs, with exophytic lesions having a better prognosis than central lesions. This result may have important implications for physicians and patients when planning partial vs radical nephrectomy by either open or minimally invasive techniques.

    Title Comparison of Outcomes in Elective Partial Vs Radical Nephrectomy for Clear Cell Renal Cell Carcinoma of 4-7 Cm.
    Date June 2006
    Journal Bju International
    Excerpt

    OBJECTIVE: To compare the outcomes of patients who had a elective partial nephrectomy (PN) or radical nephrectomy (RN) for clear cell renal cell carcinoma (RCC) of 4-7 cm. PATIENTS AND METHODS: From March 1998 to July 2004, 45 and 151 patients underwent PN and RN, respectively, for clear cell RCC. A multivariate Cox model was constructed for disease-free survival with adjustment for markers of disease severity, and a propensity-score approach used as a confirmatory analysis. RESULTS: In the PN and RN cohorts the treatment failed in one and 20 patients, respectively; the median follow-up was 21 months. The hazard ratio (95% confidence interval) for PN after adjusting for disease severity was 0.36 (0.05-2.82; P = 0.3). Using planned PN as a predictor (intent-to-treat analysis) the hazard ratio was 1.06 (0.32-3.53; P = 0.9). In the propensity-score model, planned PN was associated with a hazard ratio of 1.75 (0.50-6.14; P = 0.4). The serum creatinine level 3 months after surgery was significantly lower in patients who had PN, with a difference between the means of 0.36 (0.23-0.48; P < 0.001). CONCLUSIONS: Renal function was preserved after PN for 4-7 cm clear cell RCC tumours. When comparing the outcomes of PN and RN it is important to consider the intended operation as an independent variable. There was no clear evidence that PN was associated with worse cancer control, although a continued follow-up of this and other cohorts is warranted.

    Title Umbilical Endometriosis.
    Date February 2004
    Journal The Journal of Urology
    Title A Surgeon in New York: a View of the American Internship.
    Date October 2000
    Journal Hospital Medicine (london, England : 1998)
    Excerpt

    A young surgeon describes life as an intern in New York. Well-supervised hands-on operative experience and an assured place on a training programme for most residents compensate for low pay and gruelling hours of work.


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