ISSN:0007-1323    

DOI:10.1002/bjs.1800830102

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800830103

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

摘要:

AbstractInvestigation and treatment of malignant ascites are often in the hands of the general surgeon and can be difficult. This article considers the aetiology and pathophysiology of malignant ascites and explores the best form of management. Established treatment modalities and new therapeutic options are reviewed and a new management regimen based on a knowledge of the tumour of origin is proposed, which aims to balance potential benefit against morbidity.

ISSN:0007-1323    

DOI:10.1002/bjs.1800830104

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

摘要:

AbstractApart from the occasional tumour which is suitable for local excision, most low rectal cancers are best treated by anterior resection with complete removal of the rectum; the construction of a coloanal reservoir should allow routine sphincter saving. This surgery may be carried out independently of adjuvant radiotherapy which, if given, should be administered before operation.

ISSN:0007-1323    

DOI:10.1002/bjs.1800830105

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

摘要:

AbstractPhlegmasia caerulea dolens and venous gangrene are rare conditions that tend to occur in association with malignancy. They are characterized by total or near‐total occlusion of the venous drainage of the limb, including the microvascular collaterals. Associated mortality and morbidity rates are high, especially when progression to venous gangrene has occurred. Treatment options are limited; elevation and anticoagulation are recommended as first‐line management. Experience with thrombolysis has been disappointing although intra‐arterial administration of thrombolytic agents may improve results. Thrombectomy cannot be advocated routinely. Little advance in management, or in life and limb salvage, has been made in the past 30

ISSN:0007-1323    

DOI:10.1002/bjs.1800830106

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

摘要:

AbstractThe effect of fibroblasts on the growth of HT29 human colorectal cancer cells was used to study stromal modulation of tumour growth dynamics. Fibroblasts were isolated from rat livers 1, 2.5 and 4 days after two‐thirds partial hepatectomy and from normal livers. Cells harvested 2.5 and 4 days after hepatectomy (‘fast’ fibroblasts) had a significantly faster growth ratein vitrothan those harvested on day 1 or those from normal livers (P<0.02). The fibroblasts were inoculated with HT29 colorectal cancer cells into nude mice: Controls received cancer cells with or without a fibroblast cell line (C3H10T 1/2). At 3 weeks both tumour take and growth (size) were significantly greater in the group inoculated with cancer cells and ‘fast’ fibroblasts than in the other groups (tumour take 100 versus 42–75 per cent, P<0.03; median tumour size 3.5 versus 0.3–0.4 g, P<0.02). In conclusion, tumour growth is enhanced by fibroblasts, especially by those derived from actively regenerating liver. It is suggested that the stimulation is not only mechanical but may also involve a humo

ISSN:0007-1323    

DOI:10.1002/bjs.1800830107

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

摘要:

AbstractA total of 370 patients underwent colorectal resection: 320 had a primary single‐layer seromucosal anastomosis without a protective colostomy, 22 had Hartmann's procedure and 28 abdominoperineal resection. There were 260 elective procedures and 110 patients had peritonitis and/or bowel obstruction at the time of surgery. Overall the mortality rate was 2.7 per cent, the morbidity rate was 18.3 per cent and clinical anastomotic leak rate 3.4 per cent. After elective operation, the leak rate for intraperitoneal anastomosis was 0.6 per cent and for low extraperitoneal anastomosis 7 per cent. The mortality rate was 1.2 per cent and morbidity rate 11.9 per cent. Patients with peritonitis had a significant increase in morbidity rate (46 per cent) in comparison with those having elective surgery (χ2= 31.5, 1 d.f.,P<0.0001). Patients who had bowel obstruction and no bowel preparation had a significantly higher morbidity rate of 26 per cent and mortality rate of 7 per cent, compared with those having an elective procedure (χ2= 11.2, 1 d.f.,P<0.001; χ2= 8.7, 1 d.f.,P<0.005 respectively). Patients having palliative surgery had the highest mortality rate (19 per cent), compared with those operated on with curative intent (1.5 per cent) (χ2= 28.7, 1 d.f.,P<0.0001). Cost‐saving hand‐sutured anastomosis is effective and, in experienced hands, technically feasible after all kinds of colorectal resection and should remain the standard in colorecta

ISSN:0007-1323    

DOI:10.1002/bjs.1800830108

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

摘要:

AbstractTwenty‐six patients who underwent total pelvic exenteration for locally advanced colorectal cancer were studied retrospectively. The operative mortality rate was 8 per cent (two deaths). In patients with stage II primary disease the recurrence rate after curative surgery was three of seven, although the mean survival time was 58 months and the 5‐year survival rate 71 per cent. Patients with stage III primary disease had a shorter mean survival time regardless of supposed curability (curative 14 months versus non‐curative 9 months). Patients with stage IV disease had a mean survival time of 5 months. In patients who underwent curative surgery for recurrent disease the mean survival time was 33 months and 5‐year survival rate 25 per cent, although in those receiving non‐curative surgery the survival time was significantly shorter at 10 months (P<0.05). Total pelvic exenteration is warranted for patients with stage II locally advanced colorectal carcinoma and is an option for those with recurrent carcinoma when performed with curvati

ISSN:0007-1323    

DOI:10.1002/bjs.1800830109

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

摘要:

AbstractThe transitional mucosa adjacent to colorectal carcinoma shows characteristic morphological and histochemical abnormalities that may be indicative of premalignant changes. Sixteen colorectal carcinomas were studied to analyse the proliferative activity and its distribution pattern in tissue samples from transitional mucosa located within 2 cm of the cancer and from uninvolved mucosa 10 cm from the cancer. Proliferative activity was assessed using a monoclonal antibody to proliferating cell nuclear antigen (PCNA). The total labelling index (percentage of labelled cells in a column) of transitional mucosa was not significantly different from that of uninvolved mucosa and normal control mucosa but it was significantly higher in cancer tissue (P<0.001). An upward shift of the compartment of proliferating epithelial cells towards the bowel lumen was seen in transitional mucosa. The labelling index of the middle compartment (compartment 3) of the crypt in transitional mucosa was significantly higher than that in uninvolved mucosa and control mucosa (P<0.001). Unstable cytokinetic change may already have started in apparently normal transitional mucosa. Assessment of cell proliferation kinetics by PCNA immunostaining may be useful in screening for heightened risk of the development of colorectal cancer.

ISSN:0007-1323    

DOI:10.1002/bjs.1800830110

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800830111

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY