ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Continuous chemotherapy for hepatic metastases secondary to carcinoma of the colon and/or rectum was delivered via implantable pump in 20 patients. This is a follow‐up to a preliminary report published in January 1985. Pumps were placed by a single surgeon in a community hospital; there was no mortality and minimal morbidity. Follow‐up of these patients revealed a significant long‐term complication rate secondary to effects of chemotherapy. Nine patients were alive at the cutoff date of this report; mean follow‐up was 16 months. Eleven patients have died following implantation, with a mean survival of 14 months.Statistical analyses demonstrated increased survival rates for those patients whose tumors were poorly differentiated when compared with those with moderately differentiated or well‐differential tumors. The objective response of liver metastases was overwhelmingly positive, as judged by CT scan and serial CEA levels. The significant rehospitalization rate for complications and the marginal increase in survival, however, have discouraged implantation of the pump at our institution.

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;From 1976 to 1984, 43 patients with psoas abscess were seen at the Mayo Clinic. Intestinal disease, including Crohn's disease, diverticulitis, and carcinoma, was the most frequent cause (14 patients). Eleven patients had osteomyelitis, five had postoperative complications, four had a foreign‐body reaction, and three had a primary staphylococcal abscess. Two patients each had extension of a primary pancreatic and perinephric abscess. One patient had tuberculosis of the spine, and in the remaining patient, an exact cause was not determined. Definied treatment of psoas abscess includes adequate debridement, drainage of the abscess cavity, and resection of involved bowel.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Polyethylene glycol electrolyte lavage solution was compared with a 10 percent mannitol solution for preoperative colonic cleansing. Eighty patients were prepared randomly with one of these solutions on the afternoon prior to surgery. Colonic cleansing was better with polyethylene glycol electrolyte lavage (90 percent optimal cleansingvs.75 percent). Analysis of hematologic, biochemical, and weight changes before and after the bowel preparation, demonstrated a mild subclinical dehydration with the use of mannitol. Evaluation of patient tolerance demonstrated more nausea, cramps, and abdominal pain with mannitol. Other symptoms were similar with both preparations. Colonic hydrogen gas was sampled during surgery, and two patients in the mannitol group had combustible levels. This study confirms that both 10 percent mannitol and polyethylene glycol electrolyte lavage are safe, effective methods of preoperative bowel cleansing. Better cleansing, patient tolerance, and lower hydrogen gas level make polyethylene glycol electrolyte lavage the preferred method.

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;In a randomized prospective clinical trial in 128 patients undergoing radical surgical resection of primary colorectal cancer, 63 patients received intravenous fluorouracil (5‐FU) in two courses, four and eight weeks after surgery; 65 controls received no chemotherapy. The duration of follow‐up exceeded five years in all cases, and 28 patients have died in each group. Recurrent disease was present in 26 5‐FU patients (41.2 percent) and in 22 controls (33.9 percent). There is no evidence that short‐term 5‐FU therapy was of significant value in the chemoprophylaxis of colorectal cancer.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Rectocele is a condition that can be repaired transrectally with an obliterative suture technique. The obliterative suture is essentially a tightly drawn continuous lock‐stitch suture that strangulates the tissues contained in the suture line, and causes them to slough, yet approximates the tissues at the base of the suture line, the submucosa, and muscularis layers and allows them to heal rapidly. This technique is bloodless, easy to perform, and effective as far as cure and relief of symptoms. The time required for repair of the rectocele is approximately 6 minutes. The presence of a rectocele should be sought for routinely in every proctologic examination in the female. If anorectal surgery is to be performed, the rectocele should be repaired coincidentally, even if the rectocele is asymptomatic. If the rectocele is symptomatic, it should be repaired even if no other anorectal procedure is contemplated. The transrectal obliterative suture technique appears to have advantages over the vaginal or other transrectal techniques and is the method of choice for the repair of rectocele.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;A double‐blind and randomized clinical trial, which included 48 patients with postoperative intestinal paralysis on the third day after laparotomy, demonstrated no difference between treatment with ceruletide (0.3 &mgr;g/kg body weight) and neostigmine (5.0 &mgr;g/kg body weight) in restoring normal intestinal function.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Radiation therapy is being used alone or in combination with surgery with increasing frequency in the treatment of colorectal malignancies. Preoperative or postoperative irradiation may be offered to patients with marginally resectable lesions who are at high risk for local recurrence. Dose levels required for cure, however, may be such that the complications are unaceeptable.The use of intraoperative radiation therapy (IORT) has increased the possibility of a higher local control rate and possible cure. The ability to increase the therapeutic ratio between local control and complications using IORT is achieved only with close interaction between the surgeon and radiation oncologist. Furthermore, intraoperative radiation therapy may be offered for patients with recurrent rectal tumors.The technique of intraoperative radiation therapy will be described briefly and recent results regarding colorectal cancers from larger centers will be reviewed. It apperas from many reports that the three‐to‐five‐year results for marginally resectable disease are approximately 50 percent and for recurrent disease, approximately 40 percent.The incidence of complications following intraoperative radiation therapy does not appear to increase as a result of this aggressive treatment modality. The number of centers offering this modality is increasing rapidly.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID