摘要:

&NA;The charts of all patients with the acquired immune deficiency syndrome (AIDS) who underwent emergency intra‐abdominal surgery between January 1981 and July 1987 were reviewed. Eleven AIDS patients underwent 13 emergency laparotomies. Seven of these patients (64 percent) had cytomegalovirus (CMV) ileocolitis as the pathologic process requiring emergent surgical intervention. Four patients had hemorrhagic CMV proctocolitis and three had perforations of CMV ulcers of the ileum or rectosigmoid. The operations performed included three subtotal colectomies, two segmental resections, and two diverting stomas. The postoperative mortality rate in the CMV group was 28 percent at one day, 71 percent at one month, and 86 percent at six months. Furthermore, CMV ileocolonic pathology was directly responsible for 70 percent of the deaths in AIDS patients who underwent emergent exploratory laparotomy.

ISSN:0012-3706    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

&NA;Anorectal function was evaluated in eight patients who had low anterior resection of the rectum with a low anastomotic line, using an EEA™stapler, with determination of function based on periodic manometric studies and clinical symptoms. Immediately following surgery all patients suffered from frequent bowel actions and soiling. These symptoms improved with time and most patients could enjoy almost normal daily life by the sixth postoperative month. One month after surgery, anal canal resting pressure and maximum squeeze pressure were significantly reduced and rectoanal inhibitory reflex was absent; neither showed a distinct tendency to improve thereafter. Rectal sensation and reservoir capacity, which also were seriously impaired, recovered satisfactorily by the time of the six‐month examination. This suggests that an improvement of clinical symptoms following this operation is dependent upon the recovery of reservoir capacity and sensation of the neorectum, and that this operative procedure is a functionally acceptable option for low rectal cancer.

ISSN:0012-3706    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

&NA;Six cases of gracilis muscle transplant for fecal incontinence are reported. The causes of fecal incontinence included previous anal operation, idiopathic incontinence, and rectal prolapse. All patients had had a previous operation for fecal incontinence. Postoperative sepsis developed at the operative site in five patients despite a defunctioning colostomy in two. Functional results of the operation were poor in all patients and a colostomy has now been raised in all cases. The operation was not associated with any objective improvement in resting or voluntary component pressure.

ISSN:0012-3706    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

&NA;The findings of a partly prospective case control study of chronic fissue‐in‐ano conducted in two Danish outpatient clinics are reported. One hundred seventy‐four patients with chronic fissure‐in‐ano were matched by age and sex to outpatients from the same community suffering from benign skin tumors. All subjects were interviewed regarding diet, beverage consumption, occupational exposures, and medical and surgical history. Significantly decreased risks were associated with frequent consumption of raw fruits, vegetables, and whole‐grain bread, and significantly increased risks were associated with frequent consumption of white bread, sauces thickened with roux, and bacon or sausages. Risk ratios for consumption of coffee, tea, and alcohol were not significantly different. No statistical associations were found with particular occupational exposures. However, a history of previous anal surgery was reported significantly more often for cases than for controls. Current evidence indicates that anal fissure is likely to result at least partly from an inappropriate diet and that dietary manipulations might reduce the incidence of fissure‐in‐ano.

ISSN:0012-3706    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

&NA;In a multicenter study the prophylactic efficacy of two antibiotic regimens was tested against postoperative septic complications following elective colorectal surgery. The study was conducted in a prospective block‐randomized design. Patients were preoperatively allocated to either ampicillin, 1 gm, four times daily, and metronidazole, 0.5 gm, three times daily, for 72 hours, or to cefoxitin, 2 gm, given three times in a period of 10 hours. Both regimens were initiated immediately before surgery. Forty‐five patients were withdrawn from the study after randomization. Three hundred fifty two patients (175 receiving ampicillin and metronidazole and 177 receiving cefoxitin) completed the study and were followed for one month postoperatively. The frequency of septic and nonseptic complications was not statistically significant different between the two regimens. About one third of all septic complications appeared more than two weeks after surgery. It is concluded that short‐term treatment with cefoxitin is at least as efficient as a three‐day treatment with ampicillin and metronidazole.

ISSN:0012-3706    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

&NA;Interstitial collagen is a major constituent of the tumor matrix. The quantity of this protein may influence the prognosis. The collagen content of 54 colorectal tumors, measured as the hydroxyproline concentration in relation to clinicopathologic stage and histologic grade, was investigated and no support for either a negative or positive influence on the prognosis.

ISSN:0012-3706    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

&NA;A monoclonal antibody against carcinoembryonic antigen (CEA), MAbC27, and its F(ab′)2fragments were prepared and labeled with131I. They effectively suppressed the growth of a human colorectal carcinoma cell line, LS174T, both in culture medium and in inoculated nude mice, whereas131I‐labeled normal mouse immunoglobulin or131I itself did not have similar effects. Intravenous injection of131I‐MAbC27 or131I‐MAbF(ab′)2following inoculation of carcinoma cells suppressed their growthin vivo. The suppression effect was even more effective when intact antibody rather than its F(ab′)2fragments was used, especially when the treatment was repeated. This study indicates that radiolabeled MAbC27 may be used as a therapeutic agent in CEA‐secreting human colorectal carcinomas.

ISSN:0012-3706    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

&NA;The management of patients with metastatic disease from primary carcinoma of the colon and rectum is still controversial. To evaluate the results of resection of pulmonary metastases from patients with colorectal primaries, a retrospective study of all patients who underwent such resection was carried out at the teaching hospitals of McGill University and Université de Montréal. A total of 345 patients admitted with pulmonary metastases; 27 of them underwent pulmonary resection with the extent of the resection varying from wedge excision of the metastatic nodule to pneumonectomy. In 25 of the 27 patients the resection was considered curative. Eight of the 27 patients had resection of two metastatic lesions while the remaining 19 patients had resection of solitary lesions. The interval between resection of the primary colorectal malignancy and the resection of the metastatic lesion (disease‐free interval) varied from 2 to 77 months with a median interval of 35 months. The five‐year survival following resection of pulmonary metastases was 21 percent. A prolonged interval between treatment of the primary and resection of the pulmonary metastasis was associated with a longer survival. This retrospective study demonstrates that prolonged survival can be achieved following resection of pulmonary metastases from colorectal carcinoma.

ISSN:0012-3706    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

&NA;A case control study of 150 individuals with colonic symptoms and diverticular disease diagnosed by total colonoscopy was performed to ascertain whether adenomas and carcinomas are detected with a higher frequency in these patients than in matched controls with symptoms but not diverticular disease. Adenomas and carcinomas were seen in 36 percent of the patients and in 17 percent of the controls (P<.001); the overall odds ratio was calculated to be 3.0 (95 percent confidence interval ±1.8). When examined separately, adenomas maintained their significantly higher frequency (27vs.10 percent,P<.001), while no difference was observed as regards carcinomas (9vs.7 percent). The odds ratios for adenomas and carcinomas were calculated to be 3.5±2.5 and 1.4±1.4, respectively. From the fifth to eighth decades there was a fourfold increase in premalignant and malignant lesions in the patient group and a twofold increase in controls. With relation to sex, a statistically significant difference was reached in men but not in women in the sample examined. These data show that symptomatic patients with colonic diverticula have more frequent adenomas, but not carcinomas than symptomatic control matched by sex and age.

ISSN:0012-3706    

出版商:OVID    

年代:1988

数据来源: OVID