ISSN:0007-1323    

DOI:10.1002/bjs.1800760802

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

摘要:

AbstractMethods used to improve the accuracy of diagnosis of acute appendicitis are reviewed. Laparoscopy, barium enema, ultrasonography and computer assistance have all been shown to improve accuracy, but no one method is of proven superiority. Such diagnostic aids or intensive in‐hospital observation must be used to reduce the 15–30 per cent negative laparotomy rate when acute appendicitis is suspected, without increasing the incidence of appendiceal perforat

ISSN:0007-1323    

DOI:10.1002/bjs.1800760803

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

摘要:

AbstractNine postoperative colonic and rectal strictures were treated using dilatation balloons passed over a guide‐wire introduced endoscopically. Six strictures resolved after a single dilatation. The method is simple, safe, effective and avoids further surger

ISSN:0007-1323    

DOI:10.1002/bjs.1800760804

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

摘要:

AbstractMinor difficulties with continence may occur after low anterior resection. Intraoperative injury to the internal anal sphincter or its nerve supply may contribute to this. To study the effect of low anterior resection on the anal sphincter mechanism, anal manometry was performed on 20 patients before and 10 days after resection. Fifteen patients were studied again 6 months after operation. Resting, maximum squeeze and squeeze increment pressures were recorded. Intraoperative manometry (n = 11) and presacral nerve stimulation (n = 6) were performed to determine whether peroperative injury to the internal anal sphincter had occurred. Resting and maximum squeeze anal canal pressures were reduced by low anterior resection, and did not recover. The squeeze pressure increment did not change. Division of the inferior mesenteric artery, full mobilization of the rectum and mesorectum, and rectal transection did not affect resting anal pressure, which was reduced after EEA® anastomosis (mean (s.e.m.) before, 40(5) mmHg; after, 27(4) mmHg; P<0.05, n = 5). Presacral nerve stimulation produced relaxation of the internal sphincter. Anal sphincter pressures are reduced after low anterior resection. The external anal sphincter and the nerve supply to the internal anal sphincter appear intact. A direct injury to the internal sphincter is postulated

ISSN:0007-1323    

DOI:10.1002/bjs.1800760805

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800760806

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

摘要:

AbstractThe adaptive response of the large bowel to surgical defunction in man is essentially unknown, although in the rat there is progressive hypoplasia and a reduced propensity to experimental carcinogenesis. Mucosal biopsies were taken from the upper rectum completely defunctioned by a proximal stoma from 2 months to 5 years earlier in 11 patients and from 14 controls without abdominal operations or disease. Samples were established in organ culture and, after 16 h, crypt cell production rate (CCPR) was determined by a stathmokinetic technique. Crypt morphometry was also undertaken. CCPR in defunctioned large bowel was less than half that of controls: (mean (s.d.) 1.96 (0.68) versus 4.65 (0.54) cells crypt−1h−1, P<0.0001). Likewise, crypt length was 24 per cent lower (0.34 (0.05) versus 0.44 (0.04) mm, P<0.0001) and crypt width was 38 per cent lower (0.04 (0.01) versus 0.07 (0.01) mm, P<0.0001). Rectal defunction causes profound and persistent hypoplasia in

ISSN:0007-1323    

DOI:10.1002/bjs.1800760807

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

摘要:

AbstractRats with colonic cancer were given a palatable liquid diet which enabled them to gain weight while those fed on stock diet, either ad libitum or in restricted amounts, lost weight. Protein synthesis was measured in vivo using a flooding dose technique. Increased nutrient intake caused increases in the rate of protein synthesis in muscle, liver and non‐diseased parts of the colon, but had no effect on protein synthesis in the tumours. These data suggest that enteral hyperalimentation may be safely employed in the preoperative management of patients with cancer, as it is likely to stimulate nitrogen retention in the host tissues without increasing the growth rate of the tumou

ISSN:0007-1323    

DOI:10.1002/bjs.1800760808

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

摘要:

AbstractThirteen cases of benign fatty tumours of the colon have been reviewed. There were ten instances of submucosal lipoma, two of which were multiple, and three of lipohyperplasia of the ileocaecal valve. Abdominal pain and gastrointestinal bleeding were the commonest symptoms. Barium enema and angiography were misleading, the former in confusing polypoid lipomas and protruberant ileocaecal valves with carcinoma, the latter in misinterpreting fatty tissue vasculature as angiodysplasia in three patients. Most lesions were in the right side of the colon, and many were treated by limited colectomy as if for carcinoma or angiodysplasia. No patient has died as a result of their disease. Awareness of the possibility of colonic lipomas and knowledge of the normal ileocaecal valve anatomy are of importance to radiologists and endoscopists, particularly now that angiography is localizing the smaller fatty lesions.

ISSN:0007-1323    

DOI:10.1002/bjs.1800760809

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800760810

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY

摘要:

AbstractThe changes in collagen, measured as hydroxyproline, concentration around both ileal and colonic anastomoses in germ‐free and control rats have been investigated and compared with each other. The germ‐free rats were raised, operated on and maintained under completely pyrogen‐free conditions. Animals were killed 2, 3 or 7 days after operation. There was a significant reduction in the lowering of hydroxyproline concentrations around the colonic anastomosis of germ‐free rats compared with control rats both in the anastomosis at days 2 and 3 (P = 0.04 and P = 0.006 respectively) and in the proximal segment at day 3 (P = 0.03). In ileal anastomoses, significant differences between control and germ‐free rats were only found at 7 days. Here the increase in hydroxyproline concentration observed in control rats was significantly reduced in germ‐free rats. These data are taken to support the hypothesis that bacteria affect colonic anastomotic healing by contributing to postoperative collagen

ISSN:0007-1323    

DOI:10.1002/bjs.1800760811

出版商:John Wiley&Sons, Ltd.    

年代:1989

数据来源: WILEY