摘要:

&NA;Twenty mongrel dogs underwent preoperative radiation therapy to the colon and rectum using the Nominal Standard Dose Equation to simulate treatment with 2000 rads. Each dog then underwent anterior resection of the rectosigmoid, and reconstruction was randomized into two groups consisting of either handsewn or EEA‐stapled anastomoses. Anastomoses were examined digitally and radiographically on the day of surgery and on the seventh postoperative day. There were three radiographic leaks among the ten dogs having the handsewn anastomoses and one radiographic leak among the ten dogs having the EEA‐stapled anastomoses. There was one clinically significant leak which occurred in a dog having an EEA‐stapled anastomosis and was associated with peritonitis and death. The overall leak rate was 30 per cent among dogs having handsewn anastomoses and 20 per cent among dogs with stapled anastomoses. The data suggest that an anterior resection in low colorectal anastomosis can be done safely after low‐dose radiation using either handsewn or stapling techniques.

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;Twenty mongrel dogs underwent preoperative irradiation to the colon and rectum, receiving 4000 rads according to the Nominal Standard Dose Equation. Each dog then underwent anterior resection of the rectosigmoid, and reconstructive technique was randomized into two groups consisting of either handsewn or EEA‐stapled anastomoses. Anastomoses were examined digitally and radiographically at the time of surgery and on the seventh postoperative day. There were four radiographic leaks among the handsewn anastomoses, but only one was clinically significant and associated with peritonitis. There were no leaks among the ten EEA‐stapled anastomoses. The data suggest that low anterior resection and anastomosis can be done safely after 4000 rad irradiation and that the EEA‐stapled anastomosis may be preferable.

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;During a six‐year period, six patients were treated for invasive necrotizing infection secondary to anorectal abscess. The delay in definitive diagnosis and treatment ranged from three to 14 days. All patients had significant concomitant diseases. The number of operative procedures for each patient ranged from one to nine. Antibiotics, as well as nutritional supplementation by the parenteral or enteral route, were used on all patients. Each patient had three or more complications attributable to this infection. Hospital stay ranged from 30 to 76 days. All patients survived. Factors contributing to the development of this condition are delay in diagnosis, inadequate and inappropriate treatment, and concomitant disease. Factors associated with a satisfactory outcome are examination under general or conduction anesthesia by an experienced examiner, prompt and definitive operative therapy (including drainage and removal of all necrotic tissue), antibiotics, frequent reexamination under general anesthesia, nutritional support, and close attention to concomitant disease.

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;A randomized, controlled study on occult blood in stool was conducted in 48,000 asymptomatic participants, ages 50 to 80 years. Those with positive hemoccult test results underwent a complete colonic workup including colonoscopy and, in some cases, an air‐contrast barium‐enema examination when total colonoscopy could not be accomplished. From April 1976 to December 1980, 113 patients (62 men and 51 women), with an average age of 66 years, were found to have invasive carcinomas of the large bowel: right colon−25 per cent, transverse colon (included both flexures)−9 per cent, descending colon−10 per cent, sigmoid and rectosigmoid−42 per cent, rectum−12 per cent, anal canal−2 per cent. The stages of the cancers were: Dukes' A−57 per cent, Dukes' B−21 per cent, Dukes' C−19 per cent, Dukes' D−3 per cent. The findings suggest that a complete colonic workup is required for the detection and diagnosis of large‐bowel cancers in asymptomatic patients.

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;This study reviews 86 colostomy closures with 61.6 per cent of the cases resulting from trauma. The overall complication rate was 17.4 per cent which included 7 per cent wound infection, 3.5 per cent anastomotic leak with fecal fistula, 2.3 per cent partial bowel obstruction, and 1 per cent each of deep stitch abscess, wound dehiscence, incisional hernia, and death due to intra‐abdominal sepsis. Age, sex, and underlying disease had no demonstrable influence on the outcome of the operation. Closure of colostomy after three months of construction, mechanical and antibiotic bowel preparation, intraperitoneal closure, end‐to‐end anastomosis, and seconary skin closure were factors that appeared to influence the morbidity of the operation.

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;The purpose of this study was to investigate whether the distribution of malignant polyps of the colon is the same as the distribution of all polyps in general. A consecutive and unselected series of 1226 endoscopically removed polyps was analyzed; the analysis indicated a strong preponderance of malignant polyps to be located in the left side of the colon. Ninety‐five per cent of the malignant polyps were taken distal to the splenic flexure, whereas that segment of the colon produced only 72 per cent of all of the polyps in general. It is not possible to determine the reason for this from the present study, but the importance of removing these polypoid lesions continues to be emphasized by these data.

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;Prostaglandin F2&agr;applied directly in quantities up to 400 &mgr; g had no clinical effect on the emptying time of the colon in patients undergoing colostomy irrigation.

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;The experience of Karolinska Hospital with colorectal carcinoma over a 30‐year period, 1950 through 1979, was reviewed and analyzed. Altogether, 1061 patients were seen; 69 per cent were resected with the intention of cure. The proportion of curative resections did not change with time. Operative mortality decreased from 12 to slightly over 1 per cent. Five‐year survival rates were 34 per cent overall and 47 per cent in curable cases. After correction for operative mortality, the latter rate increased from 47 to 58 per cent over the study period (no significance). Sex and age were not correlated with survival. Of tumors resected for cure, 28 per cent were Dukes' A, 39 per cent Dukes' B, and 33 per cent Dukes' C. Corresponding five‐year survival rates were 82, 44, and 21 per cent. Though the proportion of Dukes' A tumors increased from 23 to 33 per cent over the 30‐year interval, the impact on overall prognosis was insignificant. A possible overdiagnosis of Dukes' A is discussed. The proportion of sphinctersaving procedures for rectal carcinoma increased moderately; excisional and restorative procedures were equal with respect to mortality and survival. Some patients underwent local excisions for Dukes' A rectal carcinomas with a close to 90 per cent five‐year survival.

ISSN:0012-3706    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

&NA;In 1969, the concept of “blind” subtotal colectomy was introduced for the treatment of patients with colonic diverticulosis and massive lower gastrointestinal (LGI) bleeding. This “policy” was soon extended to include all patients with LGI bleeding from obscure bleeding sources. In a nine‐year period, ten patients presented with massive LGI bleeding, had evidence of colonic diverticula on barium‐enema examination, and were explored for unrelenting bleeding. In four patients, careful exploration revealed another source for bleeding and three did well after appropriate surgery. One patient died during surgery. Six patients had blind subtotal colectomy, continued to bleed postoperatively, and three of these patients died. With the advent of selective mesenteric angiography and other preoperative diagnostic techniques, all efforts should be made to identify the exact source of bleeding and proceed with the appropriate surgery rather than subject the patient to blind subtotal colectomy.

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