摘要:

&NA;In a series of 242 patients who underwent additional intra‐abdominal surgery at the time of colectomy, there were two deaths (0.8 per cent) and five (2 per cent) complications. This experience suggests that selected patients who have had adequate bowel preparation have minimal risks associated with additional intra‐abdominal surgery performed at the time of colectomy.

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;Based on data from many clinical studies and programs, guidelines are presented for application of the flexible fiberoptic sigmoidoscope in the management of the surgical patient. The flexible fiberoptic sigmoidoscope has proved to be an instrument of extraordinary capability in detecting colorectal neoplasms with yields being two or three times greater than those of the rigid sigmoidoscope in the symptom‐resolution, polyp and cancer surveillance patient categories. In addition, the practical advantages of the narrow diameter, flexibility, and length of the fiberoptic sigmoidoscope are readily appreciated when the surgeon finds that he can satisfactorily examine patients with rectal or sigmoid strictures, marked angulations, or contracted lumens in whom a rigid scope would be unsuitable. Data from the authors' comparative study of more than 3000 patients have permitted the development of not only guidelines for the application of the flexible fiberoptic sigmoidoscope but an appreciation of the modified role of the rigid sigmoidoscope and the proper relationship between the flexible fiberoptic sigmoidoscope and the flexible fiberoptic colonoscope. A most important consideration is based on data regarding the site distribution of 400 benign premalignant neoplasms detected in the comparative study. The even distribution of these lesions throughout the terminal 50 cm of colorectum underscores the need to examine as much of the colorectum as possible.

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;Of 340 patients with histologically proven colorectal carcinoma, hepatic metastases were diagnosed in 90 (26 per cent), in 50 at the time of initial surgery (synchronously) and in 40 during the postoperative follow‐up (metachronously). At the time of initial surgery, plasma carcinoembryonic antigen (CEA) levels were markedly elevated in patients with synchronous metastases and normal or only moderately elevated in those with metachronous metastases. During follow‐up, CEA levels in the entire group of patients with metastases remained normal in 8 per cent and rose in the remainder: very quickly in 85 per cent and slowly in 15 per cent. Hepatic metatases were diagnosed by strict scintigraphic criteria in 70 per cent of patients and were suggested by liberal criteria in the remainder. During follow‐up, hepatic metastases progressed in the scintigraphic image from those defined by liberal to those diagnosed by strict criteria. In two‐thirds of the patients, liver scintigraphy proved to be superior to the CEA test in diagnosing hepatic metastases by strict criteria; in the majority of the remainder of patients, the CEA test, particularly in cases with a pattern of fast increase of CEA in plasma, suggested metastases before a definite diagnosis could be made by liver scintigraphy. In only 3 per cent of the patients neither liver scintigraphy nor the CEA test were indicative of metastases. Thus, the two diagnostic modalities, when combined, could attain a sensitivity of 97 per cent, when patients with persistently rising CEA levels and concomitant liver lesions defined by the liberal criteria were grouped with those for whom scintigraphy was unequivocal.

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;Resting anal canal pressure was measured in 15 patients with anal fissure before and after lateral internal sphincterotomy. This pressure was found to be significantly higher in these subjects (mean 95±23.08 mm HG) than in the control group (mean 66.10±14.28 mm Hg) before surgery (P<0.005). After surgery, a normal anal canal pressure was produced. The authors maintain that anal canal spasm is responsible for chronicity of anal fissures.

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;Records of 230 patients who underwent abdominoperineal resection between 1963 and 1976 were reviewed. The median age of the patients was 62 years. The mortality rate was 1.7 per cent, and the morbidity rate was 61 per cent. One hundred eighty patients were followed for five to 13 years to identify patterns of recurence. Ten‐year survival for Dukes' A, B, and C lesions was 83 per cent, 57 per cent, and 31 per cent, respectively. Seventy‐eight patients (43 per cent) had recurrent cancer; 10 per cent had local lesions, and 33 per cent had distant lesions. Dukes' B lesions had a greater latency for local recurrence than Dukes' C lesions. Dukes' A lesions with distant recurrence had a greater latency than Dukes' B or C lesions. Once recurrence was established, the survival rate was not significantly different, regardless of Dukes' stage or local or distant site. Radiation therapy for established local recurrence or chemotherapy for established distant recurrence did not seem to alter survival rates.

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;The mean incidence of colorectal carcinoma in persons under age 40 in Sweden is 1.74/100,000/year. Over a 30‐year period, 1950 through 1979, 1061 patients with colorectal carcinoma were seen, 48 of whom were under age 40 (21 to 39 years) and in this study were compared with older patients. Carcinoma was superimposed upon ulcerative colitis in 18 patients. All patients treated for palliation died within two years. Curability rate, 67 per cent, and the proportion of Dukes' A lesions were the same as in older patients, whereas young patients had fewer B and more C lesions. Five‐year survival was 33 per cent overall and 50 per cent in curable cases, not different from the rates in older patients (33 and 47 per cent). Five‐year survival was 100 per cent in stage A, 50 per cent in stage B, and 33 per cent in stage C. The age factor had no impact upon survival, and colitic origin of a carcinoma did not decrease survival more than did carcinoma itself. It is concluded that colorectal carcinoma in patients under age 40 differs in no respect from the disease in older patients.

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;Electrocoagulation is an effective treatment modality for localized cancer of the distal rectum. Proper selection remains the key to successful treatment. Of potentially curable patients with cancer of the rectum followed up for a median of five years, 69 per cent had no evidence of cancer at the end of the study period. Gross tumor morphology defined two distinct groups with regard to outcome after electrocoagulation. Ninety‐two per cent of patients with polypoid/exophytic tumors as compared to 33 per cent of patients with ulcerative lesions had successful treatment. Based on these results, the authors believe that lesions that are exophytic represent early cancers with a low incidence of nodal spread and, as such, can be treated by electrocoagulation with confidence. As a palliative measure, the authors found electrocoagulation to yield equivocal results.

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID