摘要:

&NA;In a prospective, randomized, comparative study, patients undergoing elective major colorectal surgery received four six‐hour doses of either sulbactam (a &bgr;‐lactamase inhibitor) with ampicillin (1 gm with 1 gm), or cefoxitin (2 gm) commencing at induction of anesthesia. The groups were well matched for age, sex, diagnosis, and surgical procedures. Three patients in the sulbactam group (N=44), and four in the cefoxitin group (N=48) developed significant would sepsis. Minor wound sepsis occurred in an additional four sulbactam patients, and in five cefoxitin patients. There was no difference between the groups in deep sepsis or anastomotic leak rates (sulbactam, four patients; cefoxitin, seven patients). No serious side effects were recorded in either group. These results suggest that sulbactam combined with ampicillin provides a safe, effective alternative to cefoxitin for prophylaxis in colorectal surgery.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;A series of 122 patients with colorectal carcinoma belonging to 22 verified Finnish cancer family syndrome kindreds was examined retrospectively. The identification of this hereditary syndrome and the best lines of management were the main concerns of this study. Early presentation (mean, 41 years), the proximal location of the colonic tumors (54 percent in the right colon) and the high frequency of multiplicity (24 percent) were demonstrated clearly. In only 40 percent of patients, however, was a positive family history demonstrable with certainty at the time of diagnosis of the colorectal tumor. A high tendency of second and third colorectal carcinomas to occur was observed with mean annual cumulative rates of 3.2 and 5.4 percent, respectively. It was concluded that identification of the cancer family syndrome remains problematic; for example, with regard to the planning of screening procedures for asymptomatic relatives; until the family history has been clarified carefully. A verified case of colorectal cancer in a cancer family syndrome kindred requires lifelong follow‐up examinations of the remaining colon and rectum. Abdominal colectomy is the operation of choice.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;A prospective randomized trial was performed to determine the value of tetracycline lavage in addition to systemic antibiotic prophylaxis in 159 patients undergoing elective and emergency intestinal operations. Tetracycline lavage was associated with a significant overall reduction in postoperative infection rates in 25 of 74 patients (34 percent) receiving saline lavage compared with 15 of 85 patients (18 percent) having tetracycline lavage (P<0.05). Tetracycline lavage was associated with a significant reduction in the counts of aerobic and anaerobic bacteria in the peritoneal fluid at the end of the operation (P<0.05 andP<0.01, respectively) and with a significant reduction of aerobes 24 hours postoperatively (P<0.02). Tetracycline lavage would appear to confer clinical benefit in preventing postoperative infection.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Sine the turn of the century, the elderly population, particularly those over the age of 80, has been increasing steadily. Consequently, the surgeon will be confronted frequently with the diagnostic challenge of acute appendicitis in this population. Over the past ten years, 13 patients over the age of 80 were treated for acute appendicitis at the St. Lukes‐Roosevelt Hospital Center. The mean duration of symptoms was 2.4 days; all patients complained of abdominal pain, with 72 percent of patients having right lower quadrant involvement. Ninetytwo percent had perforated prior to surgery, and 23 percent did not survive the disease. This high mortality rate is atributed to both a delay in presentation to the physician and a further delay in proper treatment due to misdiagnosis. This is a disease with which every physician must be familiar and be continually vigilant, as correct diagnosis and prompt treatment are the keys to averting high morbidity and mortality rates.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;The results of elective surgery for diverticulitis in 100 consecutive patients were reviewed. Follow‐up was possible in 82 individuals. Seventy‐seven (94 percent) were improved. There was no inflammatory change apparent on histologic examination of the resected specimens in 24 percent of patients. These individuals were less likely to have favorable results. There are a number of preoperative factors which may predict the likelihood of a successful surgical outcome

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;An experimental model has been developed to produce colonic mucosal destruction followed by regeneration. The canine model consists of a defunctioned portion of the large intestine which has been subjected to water at a temperature of 125°F for 7 hours. Colonic specimens were harvested at different periods of up to six weeks and studied macro‐ and microscopically. It has been shown that it is possible to achieve significant mucosal destruction and regeneration. Possible adaptation to clinical states is presented and discussed.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;A retrospective study was made of 190 patients who had anterior resections of the rectum for carcinoma at Concord Hospital between 1971 and 1981. Urinary tract infection occurred in 25 percent of patients. Bladder dysfunction occurred in 22 percent of patients, and was more frequent in those in whom the tumor was less than 10 cm from the anal verge. The patients were compared with 122 patients who had undergone abdominoperineal excisions of the rectum for carcinoma. Although the overall incidence of bladder dysfunction was the same in both groups, there was a significantly higher incidence of permanent bladder dysfunction in patients undergoing abdominoperineal excision (P=0.00034).

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Flow cytometry DNA measurements were carried out on colorectal carcinomas from a series of 33 patients who have since been followed for three to four years. The tumors could be subclassified by this technique into 15 that had near‐diploid DNA and 18 that were aneuploid. Prior reports had suggested that the near‐diploid tumors carry a better prognosis than aneuploid tumors, but in this study the distribution by Dukes' stage and survival were the same in both groups.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID