摘要:

&NA;A prospective evaluation of 149 patients with Dukes' B2or C colorectal carcinoma, including periodic history, physical examination, chest radiograph, liver function tests, complete blood count, carcinoembryonic antigen (CEA) radioimmunoassay, barium enema, and endoscopic studies, has been underway since 1976. Thirty‐four patients have had recurrence. This study suggests that the history and CEA are the most sensitive noninvasive methods with which to detect recurrent tumors but are unlikely to indicate recurrence at a therapeutically advantageous stage.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Intragastric infusion of 9000 cc of body temperatue normal saline solution over a three‐hour period cleaned the colon equally as well as cleasing for three days with clear liquid diet, purges and enemas. When appropriate antibiotics were added to the solution, suppression of intestinal bacteria was similar to that method using the three‐day prep.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Whole‐gut irrigation was compared with conventional mechanical bowel preparation in a prospective, randomized study. All 100 patients had a combination of ampicillin and metronidazole during and after colorectal surgery. Patients' complaints were equally frequent during the two preparations and were severe in 15 per cent. Gastric position of the tube for irrigation resulted in severe complaints in 3 of 26 patients and in the duodenal position, in severe complaints in five of 24. The time for irrigation was shorter than that for conventional preparation.Deep wound infections were equally frequent after irrigation (3/46) and conventional preparation (4/47). Seven patients were excluded, since no bowel resection had been performed. Collapse of the small and large intestine, as evaluated blindly during surgery, was more frequent after irrigation (P<0.05). Anastomotic leaks after left side resections were less frequent in patients with collapse of the small (P<0.001) and large (P<0.05) intestine.Five leakages among 29 patients after conventional preparation in contrast to one among 22 after whole‐gut irrigation favor the latter, even if this difference did not reach statistical significance (0.05<P<0.10), since anastomotic leakage is lethal in a high number of patients.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;The authors have investigated the frequency with which the rectum contains feces by recording the presence or absence of fecal contamination of the membrane or of discoloration by feces of the contents of dialysis bags placed in the unprepared rectum for one hour. Feces were present in the rectum in 31 per cent of 32 studies in normal control subjects, in 49 per cent of 80 studies in obese subjects (P<0.05 from controls), in 36 per cent of 28 studies in patients with the irritable bowel syndrome, and in 31 per cent of 103 studies in patients with ulcerative proctocolitis, whether or not they had diarrhea. Fecal staining of the bag and its content occurred much more frequently in 27 studies in subjects with various other diarrheal diseases (67 per cent,P<0.02 from controls), including eight with stearorrhea (87 per cent,P<0.02 from controls). The frequency with which feces were present was unaffected by age, sex, or time of day of the study. These results provide quantitative support for the assertion that in subjects without diarrhea the rectum is usually empty. In patients with diarrhea or steatorrhea and no distal large intestinal inflammation, however the rectum usually does contain fecal material.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;The authors measured the length of the surgical anal canal (anorectal ring to anal verge) in 108 men and 103 women; the age ranged from 18 to 90 years (average 59 years). The average length of the surgical anal canal was 4.2 cm (range 3.0‐5.3 cm). In men the average length was 4.4 cm (range 3.2‐5.3 cm) compared with the average length of 4.0 cm (range 3.0‐5.0 cm) in women (P<0.001). The average length of the anatomic anal canal (dentate line to anal verge) was 2.2 cm (range 1.0‐3.8 cm). In men, the average length was 2.2 cm (range 1.4‐3.8 cm), whereas in women the average length was 2.0 cm (range 1.0‐3.2 cm) (P<.01). The length of the anatomic and cnal has no relationship to the length of the surgical anal canal orvice versa(P<0.1). There was no statistically significant difference in the length of the surgical anal canal or the anatomic anal canal in persons below 60 years old versus those above in either sex (P>0.1).

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Many methods, which have effectively reduced the number of patients requiring hospital admisssion, have been described for the outpatient treatment of hemorrhoids. However, complications have been reported, and the methods are often associated with unpleasant side effects. In 1977 Neigeret al.described a new method that used infrared coagulation, which plroduced minimal side effects.The authors have conducted a prospective, randomized trial to evaluate infrared coagulatioin compared with more traditional methods of treatment. The authors' results show that it may be more effective than injection selerotherapy in treating nonprolapsing hemorrhoids and that it compares favorably with rubber band ligation in most prolapsing hemorrhoids. No complications occurred, and significantly fewer pattents experience pain after infrared coagulation (P=<0.001).

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;The results of palliative operative management of 338 patients with rectal carcinoma managed by one of the authors are presented. Postoperative mortality was higher for patients undergoing palliative resection (11.7 per cent) than colostomy bypass (5.3 per cent) or diagnostic laparatomy (6.8 per cent). Cancer specific survival following palliative resection was significantly (P<0.001) longer than that following colostomy bypass or diagnostic laparotomy for tumor Stages D1(local visceral involvement) and D2(distant metastases). However, in patients with liver or peritoneal metastases alone, cancer specific survival did not differ significantly after the operations of resection or colostomy bypass. The failure to demonstrate improved survival after resection of the primary tumor in these latter two groups with distant metastases indicates the dominant role of volume of tumor tissue present in these situations. The results suggest that longer survival following pallitative resection reflects a bias of patient selection towards more favorable cases.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;A controlled, prospective, randomized study of 457 patients undergoing colonic surgery was done to compare systemic cefamandole therapy to neomycin‐erythromycin in reducing postoperative septic complications. Parenteral cefamandole and cephalothin were given before, during, and after surgery to achieve maximal antimicrobial coverage in the blood, tissues, peritoneum, and urine. Such protection is not obtained with oral antibiotic preparation. Major surgical indications were carcinoma in 216 patients and diverticulitis in 107 patients. More than half the patients had colonic perforations, obstruction, or fistulas. All patients were operated upon by a single surgeon during 1975‐1980. Cephalothin (151 patients), combined with neomycin‐erythromycin, resulted in an 11.3 per cent rate of post‐operative septic complications. Cefamandole treatment in 112 patients resulted in an 8.9 per cent postoperative infection rate compared with 16.3 per cent in 141 matched control patients.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;One thousand cryohemorrhoidectomies were performed during the past seven years with the result that one‐third of our patients were relatively pain‐free while two‐thirds complained of severe to minimal pain. The recurrence rate was about 11 per cent but the true incidence was 6.3 per cent. Unpleasant anal discharge, occurring in patients with prolapsed hemorrhoids, can be prevented by ligation prior to freezing. Overall, 90 per cent of our patients were satisfied with the procedure while 6.6 per cent underwent repeated surgery. Comparative analyses were made with other studies and it is fair to say that cryosurgery has definite advantages for selected cases of nemorrhoids, but it is not a panacea for all hemorrhoidal disease.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;In the past five years, routine CEA determinations have been carried out on all patients after curative operation for colorectal carcinoma. These patients also underwent a clinical follow‐up examination in the Oncology Outpatient Department. In 86 patients, recurrence of a tumor was confirmed. In 31 cases, a second‐look operation was carried out. The CEA determinations were retrospectively analyzed in these patients and correlated with the time the recurrence of the tumor was diagnosed. These results show that of 86 patients only 15 (17.4 per cent) had pathologic CEA values before clinical symptoms of tumor recurrence. In the patient group with local recurrence only 11 (23.9 per cent) of 46 patients had previously pathologically raised CEA values. Of 31 patients, 15 (48.4 per cent) underwent curative resection after the second‐look operation. At this time, 12 patients (38.7 per cent) still had normal CEA values, whereas only three patients (9.7 per cent) had pathologically raised CEA values. From these results, it was established that early diagnosis of tumor recurrence was very low. Therefore, one should not rely more on postoperative routine CEA determinations in the post‐operative monitoring of patients following curative operations for colorectal carcinoma than on regular comprehensive follow‐up examinations of these patients.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID