ISSN:0007-1323    

DOI:10.1002/bjs.1800710802

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractA prospective, randomized, controlled trial was performed to study truncal vagotomy and drainage (TV), selective vagotomy and drainage (SV) and parietal cell vagotomy (PCV) as elective treatment for duodenal ulcer. Five years postoperatively, 233 patients were available for study: 73 TV, 81 SV and 79 PCV. The ulcer recurrence rates were 13.6, 19.8 and 30.4 per cent respectively. The incidence of severe dumping was 4.9, 10.9 and 1.9 per cent; of severe diarrhoea 4.9, 6.3 and 1.9 per cent; of severe pain/dyspepsia 3.3, 6.3 and 3.8 per cent and of severe nausea/vomiting 0, 1.6 and 0 per cent respectively. Women suffered more postvagotomy symptoms than men. After treatment of recurrences and postvagotomy symptoms, more patients after PCV achieved excellent results than after TV and SV, as recurrences were easier to treat than severe postvagotomy symptoms. The only factor found contributing to the high ulcer recurrence following PCV was the large number of surgical trainees operating in the trial.

ISSN:0007-1323    

DOI:10.1002/bjs.1800710803

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractNine cases of perforation whilst patients received cimetidine therapy were identified and followed prospectively. There was a high correlation with the other major complications of duodenal ulceration: pyloric stenosis and haemorrhage. Initially, three of the nine patients had simple suture of the perforation, but eventually all required truncal vagotomy and a drainage procedure. The follow‐up ranges from 6 months to 2.5 years and the results in the surviving patients are good. The pre‐operative identification of this group, being established medical failures with the high probability of requiring necessary definitive surgery, will aid the surgical management of this condit

ISSN:0007-1323    

DOI:10.1002/bjs.1800710804

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710805

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractEighty‐one patients who underwent subtotal thyroidectomy for thyrotoxicosis had a 10 per cent incidence of symptomatic hypocalcaemia (corrected calcium<2.0mmol/l) but only a 1.2 per cent incidence of prolonged hypocalcaemia. In the same patients only one had a transient right sided recurrent laryngeal nerve palsy. These results would seem to confirm the wisdom of lateral ligation of the inferior thyroid arteries to protect the recurrent laryngeal nerve. They lend no support to the suggestion that in order to protect parathyroid function this teaching be abandoned in favour of a policy of ligation of the arteries on the surface of the gland. Nevertheless, injury, devascularization or inadvertent removal of parathyroid tissue must still be the first practical consideratio

ISSN:0007-1323    

DOI:10.1002/bjs.1800710806

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710807

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractIn the period 1970–1983, 27 patients with end stage renal failure underwent neck exploration for hyperparathyroidism. In 1977 the operative policy changed from subtotal parathyroidectomy to total parathyroidectomy and autotransplantation. Eight patients underwent subtotal parathyroidectomy while fifteen patients underwent total parathyroidectomy and autotransplantation. All were cured of their symptoms and hypercalcaemia was resolved. There was no significant difference in the requirement for postoperative calcium and vitamin D supplements between the two groups. Recurrent hypercalcaemia developed in one patient who had undergone total parathyroidectomy and autotransplantation. Resolution followed removal of approximately half the transplant. There were four deviations from the operative polic

ISSN:0007-1323    

DOI:10.1002/bjs.1800710808

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractThe accuracy of clinical examination, mammography and fine needle aspiration cytology in identifying malignancy has been assessed in 1655 breast masses from two time periods. Clinical examination and mammography remained consistent at identifying malignancy but 9 per cent of all breast carcinomas were considered benign by both techniques (sensitivity 91 per cent). Fine needle aspiration cytology, when performed by multiple aspirators in the first study period, had a sensitivity of only 66 per cent for malignancy. During the second period of study, when all aspirates were performed by a single aspirator, sensitivity rose to 99 per cent. The two patients with false negative cytology in this latter period had both clinical and mammographic evidence of malignancy. No patient with malignant cytology was subsequently shown to have benign disease. It is concluded that a combination of clinical examination and mammography, with fine needle aspiration cytology performed by committed individuals with aptitude for the technique and interpreted by experienced pathologists, can identify all patients with breast cancer before surgery.

ISSN:0007-1323    

DOI:10.1002/bjs.1800710809

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractForty‐eight patients who presented to St. Mark's Hospital, London between 1948 and 1979 with smooth muscle neoplasms of the rectum or anal canal have been reviewed. Twenty‐six tumours arose from the muscularis mucosae of the rectum. These lesions were small, asymptomatic and did not recur after local removal. Eighteen tumours arose from the muscularis externa of the rectum. Local excision of these resulted in a high local recurrence rate regardless of the degree of differentiation of the tumour but long‐term survival figures were similar whether the tumours were treated by local or radical techniques. However, the prognosis did relate to the degree of tumour differentiation, being worst in the poorly differentiated group. In four cases the smooth muscle tumour arose from the internal sphincter of the anal

ISSN:0007-1323    

DOI:10.1002/bjs.1800710810

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractLarge bowel cancer induced in rats by dimethylhydrazine (DMH) closely resembles human disease both histologically and clinically. In this study it has been used to assess the antimitotic drug razoxane (ICRF‐159). Dimethylhydrazine induced benign colorectal tumours after 20 weeks and adenocarcinomas from 30 weeks. Razoxane was given from week 25 until the end of experiment (week 35) to see if this drug could inhibit the development of tumours. Animals were randomly allocated to four groups: DMH + razoxane (26), DMH + control (26), control + razoxane (25), control + control (25). There were fewer malignant colorectal tumours in rats receiving razoxane than in the controls (10 vs. 24; P = 0.04). Some animals developed malignant tumours of the small intestine as well as the large bowel and the number of malignant tumours for the whole intestinal tract was also reduced in animals receiving razoxane (15 vs. 32; P = 0.025). This study demonstrates inhibition of the development of malignant tumours in rats by razoxane. This finding may have relevance to colorectal cancer in man where razoxane has been used in disseminated disease and as an adjuvant to surger

ISSN:0007-1323    

DOI:10.1002/bjs.1800710811

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY