ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;The therapeutic effect of sucralfate on ulcerated gastric and duodenal mucosa is well known. There is, however, almost no information about its activity in colitis. Experimental colitis was produced in rats by rectal instillation of 1 ml of 10 percent acetic acid, and 1.5 ml of a 20 percent suspension of sucralfate was then administered every 12 hours for various lengths of time. Study animals and appropriate controls were killed after 3, 7, 10, or 14 days. The distal colons were studied macroscopically and histologically. Colonic prostaglandin E2levels were measured in animals killed after 3, 7, 10, or 14 days. The macroscopic score was significantly improved 10 and 14 days after induction of colitis, although the histologic appearence was unchanged. Acetic acid administration increased and sucralfate treatment reduced prosta‐glandin E2levels in colitic animals on days 3 and 7, but not later. The present study supports a role for sucralfate in the treatment of colitis, but further studies on the mechanism of its effect and on its clinical activity are indicated.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Employing the monoclonal antibody CAM5.2, the sensitivity of immunohistologic staining was compared with conventional hematoxylin and eosin staining for detection of lymph‐node metastases from large‐bowel cancer. Ten patients who died unexpectedly early from recurrent disease were selected; 86 lymph nodes were examined. Where metastases were located they were readily identified by both methods but when the original lymph‐node sections were reviewed, attention was drawn to two metastatic deposits that had been overlooked previously. These results suggest that immunohistologic techniques offer no advantage in the identification of lymph‐node metastases in largebowel cancer.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Resection and peranal suture is now an accepted technique for low rectal carcinoma; however, long‐term results of large numbers are not known. Eighty‐four patients who had this procedure at a specialist institution between 1972 and 1985 are reviewed. There was a low operative mortality (2.4 percent), but a high complication rate with pelvic sepsis in 34 (40.5 percent) and anastomotic dehiscence (either partial or complete) in 40 (47.6 percent). The crude five‐year survival rate was 56 percent. Isolated local recurrence occurred in seven patients (9.2 percent) and in a further seven patients it was associated with systemic recurrence. The functional results were satisfactory with 92 percent of assessed patients having three or less bowel actions per day. Subsequent incontinence occurred in 8 of the 60 patients assessed and 5 of these needed proximal diversion. For patients in whom the only alternative is abdominoperineal excision of the rectum, these results confirm that there is no disadvantage in terms of potential cure and that the functional results are acceptable.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;A retrospective review of 922 colorectal cancer patients was undertaken to determine whether the nonuniform anatomic distribution of colorectal cancer was influenced by age and/or sex. The mean age of patients with right colon lesions (71.2 years) was significantly higher than for either patients with left colon lesions (68.2 years) or rectal lesions (65.6 years). Further analysis disclosed that patients with proximal tumors were older than patients with distal tumors primarily because of the later presentation of females with cecal or ascending colon cancers. Comparison of the anatomic distribution of tumors in patient groups above and below the age of 70 revealed that right colon cancers accounted for a greater percentage of colorectal tumors in the older patient group than in the younger patient group. These findings support the roles played by both age and sex in influencing colorectal cancer location. Furthermore, these data provide a plausible explanation for the increasing incidence of proximal colonic lesions

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Anal manometry and anal electromyography (EMG) were performed in 45 patients to evaluate the external anal sphincter. Their symptoms were soiling (N=6), incontinence (N=10), and obstipation (N=10). Clinical diagnoses were previous anal surgery (N=16), rectal prolapse—partial, total, intussusception (N=16), puborectalis syndrome (N=4), neurologic disorders (N=3), and others (N=6). The relationship between the maximum squeeze pressure (MSP) measured with anal manometry and the maximum (voluntary) contraction pattern (MCP) and signs of denervation (DEN) measured with anal EMG were examined. The correlation coefficient between MSP and MCP was 0.55 (P<.001) and between MSP, and DEN 0.13 (NS). A normal MSP always showed a normal MCP, a normal MCP showed an abnormal MSP in 43 percent only. In conclusion, the clinical value of anal EMG seems limited. Assessment of an additional anal EMG seems indicated in incontinent patients with previous anal surgery with a low MSP to estimate muscle function, whenever anal surgery is considered. Anal EMG during straining can easily confirm the clinical diagnosis of puborectalis syndrome.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Four hundred eighty‐six patients who have had resections for Crohn's disease at the Cleveland Clinic were reviewed. The patients were categorized by indication for surgery into three groups: perforating (P) (135 patients), nonperforating (NP) (278 patients), and miscellaneous (M) (77) patients. One hundred ninety‐four patients had two or more resections and 56 underwent a third resection. Patients were no more likely to have the same indication for surgery at the time of the second resection (P=25 percent; NP=44 percent; M=57 percent) or the third resection (P=11 percent; NP=65 percent; M=55 percent). There was also no difference in the interval between resections for the P and NP groups. The lack of agreement between resections suggests that the categorization of patients into P and NP groups does not facilitate prediction of the nature of recurrent disease. The concept of aggressive perforating and indolent nonperforating Crohn's is not substantiated by this study.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;This multicenter, prospective, randomized trial of short‐term antimicrobial prophylaxis in colorectal surgery was designed to compare the efficacy of a single dose of cefotetan vs. multiple doses of cefoxitin. Of the 403 evaluable patients, 206 received cefoxitin (1 gm intravenously at the beginning of surgery and after 3, 6, and 12 hours, group A) and 197 cefotetan (2 gm intravenously at the beginning of surgery, group B). The two groups of patients were similar in respect to age, sex, obesity, preoperative weight loss, diabetes, type of disease, type, and mean duration of surgery. The abdominal wound infection rate was 11.2 percent in group A and 9.1 percent in group B (difference not significant). The number of patients with infections at nonsurgical sites (respiratory and urinary tract, phlebitis, and septicemia) was significantly greater in group A than in group B (17 vs. 9.1 percent, P<.05). The mean postoperative hospital stay was similar in both the cefoxitin and cefotetan groups (15.1 vs. 15.9 days). Both regimens were inadequate in preventing infections in the presence of severe contamination of the operative field.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Records of four hundred thirty‐seven patients with lower and middle rectal cancer who underwent resection for cure at National Cancer Center Hospital from 1969 to 1983 were reviewed. There were significantly lower recurrence rates in the extended excision group compared with the conventional excision group. The recurrence rates between these two groups with Dukes' A were 0 percent (0 of 23)vs.5.2 percent (5 of 96), those with Dukes' B were 6.3 percent (5 of 80)vs.21.9 percent (14 of 64), Dukes' C were 23.6 percent (20 of 89)vs.32.8 percent (28 of 85). The differences between the two groups with Dukes' B and C were statistically significant (P<.05). The cumulative five‐year survival rates in the extended excision group were 94 percent with Dukes' A stage, 88 percent with Dukes' B stage, and 61 percent with Dukes' C stage, compared with 91 percent (Dukes' A), 74 percent (Dukes' B), and 43 percent (Dukes' C) in the conventional excision group. There were also statistically significant differences between the two groups with Dukes' B and C stages (P<.05). Although wide iliopelvic lymphadenectomy was successful as far as decreasing the incidence of local recurrence and also in prolonging survival, there were increased incidences of urine‐voiding failure (loss of sense of bladder being full of urine detected in 39.4 percent of the extended excision groupvs.8.8 percent of the conventional excision group) and sexual impotency (76 percentvs.37.5 percent).

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID