ISSN:0007-1323    

DOI:10.1002/bjs.1800750602

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800750603

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractThis review examines the evidence linking dietary fibre to gastrointestinal disease. Fibre increases stool weight, decreases whole gut transit time and lowers colonic intraluminal pressure. While it may be of benefit in the treatment of constipation, the irritable bowel syndrome and diverticular disease, its role in the prevention or treatment of other gastrointestinal disease has yet to be established.

ISSN:0007-1323    

DOI:10.1002/bjs.1800750604

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractThis review evaluates the available evidence dealing with the natural history of hepatic metastases in patients with colorectal cancer. Methods of detection of such metastases are discussed and the factors influencing survival after surgical resection are reviewed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800750605

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractThis retrospective study analyses the fate and associated risk factors of 99 patients who underwent laparotomy for hepatic trauma from 1977 to 1986. Blunt trauma (88 patients) and stab wounds (7 patients) had mortality rates of 36 and 14 per cent respectively. The overall death rate was 35 per cent. Multiple trauma patients had a significantly higher mortality for each additional system that was seriously injured. Pre‐operative shock raised the mortality from 20 to 58 per cent (P<0.001). For patients over 50 years of age, the mortality rate increased from 30 (younger patients) to 63 per cent (P = 0.028). Minor hepatic wounds required relatively simple surgical measures in 60 patients, yet 13 died (22 per cent) of other causes. More sophisticated surgical management was applied to 27 major hepatic lesions, with 10 deaths (37 per cent). Twelve patients (seven with minor and five with major hepatic wounds) died before surgical treatment of the liver injury could be undertaken. The overall mortality rate of major hepatic wounds was 47 per cent and for minor wounds 30 per cent. However, the difference was not significant (P = 0.152). Resection was resorted to in 15 patients, 5 of whom subsequently died (33 per cent). Classical hepatic lobectomy led to 4 deaths (50 per cent). Among the 35 deaths, 6 were due to the hepatic trauma itself (5 exsanguinations and 1 intra‐abdominal sepsis). Isolated hepatic injury was fatal in three patients. We believe that conservative surgical measures should be used whenever possible in patients with hepatic trauma, especially when risk factors are encounte

ISSN:0007-1323    

DOI:10.1002/bjs.1800750606

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractA novel method of repeated hepatic de‐arterialization is presented. A vascular occluder is placed around the hepatic artery and connected to an injection port. The hepatic artery can thereafter be occluded repeatedly. Patients with irresectable liver metastases from colorectal cancers were treated with occlusions of the hepatic artery for 1 h twice daily, in combination with intraperitoneal cyclic administration of 5‐fluorouracil. The first three patients treated are presented. They all exhibited massive tumour calcifications in the liver reflecting tumour necrosis and resorption. This therapeutic principle must undergo further clinical tri

ISSN:0007-1323    

DOI:10.1002/bjs.1800750607

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe postoperative pulmonary complications in 25 patients undergoing subtotal oesophagectomy for intrathoracic oesophageal carcinoma during the 3‐year period 1981–1983 were compared with those of 25 patients undergoing surgery from 1984 to 1986. Although more extensive lymphadenectomies were performed from 1984, the mortality rate caused by the postoperative pulmonary complications was zero in the later period (1984–1986) compared with a rate of 16 per cent in the earlier period (1981–1983). The incidence of postoperative pulmonary complications was lower in the later series but the difference was not statistically significant. Factors which may have contributed to the decrease in critical pulmonary complications after surgery during the later period were the selection of the posterior mediastinal route for reconstruction, the introduction of selective endobronchial intubation by a double lumen tube with combined epidural anaesthesia, fluid restriction during and after surgery, postoperative mobilization and the administration of an expe

ISSN:0007-1323    

DOI:10.1002/bjs.1800750608

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractDetailed histopathological examination of serial blocks and subserial sections of the entire resected oesophagus in 63 patients operated upon for oesophageal cancer revealed 11 associated minute superficial cancers, independent and apart from the main tumours, in 10 patients (15.9 per cent). Only one of these eleven lesions was diagnosed pre‐operatively, and only three of the eleven lesions were detected macroscopically on the resected specimens. The high incidence of such coexisting independent lesions may indicate a possible increased multicentric carcinogenic potential in the non‐cancerous epithelium of patients who have had an antecedent oesophageal cancer. These results emphasize the need for careful attention to the choice of margins during surgical resection of the oesopha

ISSN:0007-1323    

DOI:10.1002/bjs.1800750609

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractIn a series of 74 children undergoing Nissen fundoplication for persistent gastro‐oesophageal reflux unresponsive to intensive medical treatment, there was an unexpectedly high incidence (54 per cent, n = 40) of intestinal malrotation. The series was not homogeneous, 25 of the children having reflux as a complication of a serious congenital abnormality (48 per cent incidence of intestinal malrotation), and 49 presenting with ‘idiopathic’ reflux (57 per cent incidence of intestinal malrotation). Intestinal malrotation is best detected pre‐operatively by careful barium radiology, requiring clinicians to be aware of the association. In our experience, in children over the age of 3 months, both an antireflux operation and Ladd's procedure are often necessary to stop gastro‐oesophageal reflux when an intestinal malrotation i

ISSN:0007-1323    

DOI:10.1002/bjs.1800750610

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractGastric secretory studies are subject to considerable error owing to incomplete collections and to contamination by reflux of alkaline duodenal contents. Corrections for these sources of error have been defined, and they have been extensively applied in a research setting. In order to assess their utility in the performance of routine gastric secretory studies? the value of such corrections was assessed in 56 studies in patients with duodenal ulceration (10), previous surgical vagotomy (8), reflux oesophagitis (30) and primary oesophageal motility disorders (8). The effect of such corrections was small, and there were close correlations between uncorrected and corrected acid outputs in all four groups. The status of the vagal efferent gastric fibres was assessed by comparing the acid output after insulin hypoglycaemia with the maximal acid output after pentagastrin (insulin: pentagastrin ratio). The application of the corrections did not alter the conclusion regarding the assessment of vagal status in 55 of the 56 studies performed. It is concluded that such corrections are not necessary in the routine performance of gastric secretory studies.

ISSN:0007-1323    

DOI:10.1002/bjs.1800750611

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY