ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;Recognition of the different shapes of the buttocks will help surgeons to appropriately select patients for anorectal surgery. Basically, there are three types of buttocks. In Type A, the mounds of the buttock make a low and gentle slope with the anal verge. In Type B, the mounds of the buttock are high and rise almost straight up from the anal verge. In Type C, the anus is located more anteriorly than normally. Patients with Type A buttocks are ideal candidates to use local anesthesia for hemorrhoidectomy and lateral internal sphincterotomy because it is easy to infiltrate the anesthetic agent into the anal canal. With Type C, this is somewhat more difficult, but no significant problem exists. For Type B buttocks, general or spinal anesthesia is recommended. For Types A and C buttocks, a lithotomy position will give an excellent exposure of the anorectal lumen for stripping the mucosa and submucosa. For Type B buttocks, a prone jack‐knife position gives the best exposure.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;The need for protective transverse colostomy in low anterior resection using the EEA stapler was tested in a randomized series of 50 patients, half of whom received peroperative protective colostomy. Gastrografin®enema, on the tenth postoperative day showed a leakage frequency of 30 per cent in both groups. Clinical leakage was noted in 4 per cent (one patient) in the colostomy group and 12 per cent (three patients) in the noncolostomy group. Protective colostomy was followed by stenosis in nine instances, compared with only two in the noncolostomy group (2&agr;=0.05). Routine protective colostomy should not be used in low anterior resection when the EEA stapling instrument is used. The occasional clinical leakage, which may appear in the postoperative period, can be revealed by close observation and successfully treated by an emergency colostomy. The majority of patients with anterior resection of the rectum, therefore, can be spared the inconvenience and cost of temporary colostomy.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;In 337 cases of primary advanced large intestinal cancer in patients without familial polyposis coli, the risk factor for cancer was discussed chiefly from the background mucosa surrounding and apart from the cancers. The following findings were obtained: (1) in the mucosa surrounding cancers, adenoma was seen in 23 cases (6.8 per cent), adenomatous changes of the basal cells in 211 cases (62.6 per cent), and hyperplastic glands in 167 cases (49.6 per cent), (2) in the mucosa at least 10 mm from the cancers, adenoma, adenomatous changes of the basal cells, and hyperplastic glands were seen in 42 cases (12.5 per cent), 129 cases (38.3 per cent), and 40 cases (11.9 per cent), respectively. Therefore, it is suggested that microscopic adenoma and adenomatous changes of the basal cells might be a sign of premalignancy in patients without familial polyposis coli.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;Twenty‐five patients with second‐ or third‐degree hemorrhoids were treated on an outpatient basis using a modified form of pile suture of Farag. There were no postoperative complications such as acute urinary retention, hemorrhage, infection, or anal stenosis. After follow‐up for 12 to 18 months, the method has relieved bleeding in all patients and anal prolapse in 96 per cent of them. The modified pile suture is useful in a tropical setting where excisional hemorrhoidectomy is a costly operation.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;One hundred ninety‐three patients had curative resections for carcinoma of the rectum between January 1971 and December 1979. Nineteen patients developed local recurrence (9.8 per cent): 5/95 after abdominoperineal excision (5.2 per cent) and 14/98 after anterior resection (14.3 per cent). There was no difference in the overall survival rate between the two operations, but there was a trend toward decreased survival for patients who developed local recurrence. Metastatic spread to the lymph nodes increased the risk of local recurrence.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;The right transverse colostomy is the one traditionally performed for distal colonic obstructive tumors, perforated sigmoid diverticulitis, distal colonic injuries, or for the protection of precarious low colonic anastomoses. However, the right transverse colostomy has a tendency to prolapse; its effluent is frequently liquid; it cannot be performed without producing adhesions in the right upper quadrant; and it obligates the surgeon generally to three operations when done as the first part of a staged colonic resection. The left transverse colostomy has the advantages of a reduced incidence of prolapse, an increased length of absorptive surface, absence of adhesions in the right upper quadrant, and the possibility of a two‐stage resection. Fifteen instances in which left transverse colostomies were performed with diverse indications formed the basis for this report.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID