ISSN:0007-1323    

DOI:10.1002/bjs.1800720902

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800720903

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800720904

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractThis study was designed to investigate the long‐term effects of early pancreatic resection for acute necrotizing pancreatitis. During 1973–1978 40 resections were performed in our clinic. Eleven patients died initially (28 per cent). None of the four further deaths was due to pancreatitis or associated disorders. Twenty‐four patients were reexamined 5–11 years after resection ‐ one patient refused to participate. Five had not been able to return to work because of severe polyneuropathy; one more had retired because of chronic pancreatitis in the pancreatic remnant. Polyneuropathy was found in five further patients. The reason for this high incidence of polyneuropathy (42 per cent) remains unknown. Eight patients still drank excessive alcohol; three of them had had recurrent pancreatitis and dyspepsia, and insulin requiring diabetes. All but 2(92 per cent) had diabetes, 14 needing insulin ‐ half of them at 6 months to 6 years after the resection. Moreover, 11 patients (46 per cent) suffered from dyspeptic symptoms. The results suggest that because of the high frequency of late complications, in addition to the early complications, early resection of pancreas should be critically re‐evaluated as the treatment for acute necrotizing pancreatitis. If resection is used in patients with extreme pancreatic necrosis, careful and continuous postoperative follow‐up

ISSN:0007-1323    

DOI:10.1002/bjs.1800720905

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractThe effect of chronic progressive distal large bowel obstruction on colonic motility was studied in six mini‐pigs. Motility was detected in vivo during the development of obstruction with chronically implanted Ag/AgCl electrodes using an impedance technique. When the obstruction was complete the segments of bowel were resected and spontaneous contractile activity and response to cholinergic stimulation were studied in an organ bath. Any hypermotility resulting from obstruction was shortlived and a gradual state of hypomotility supervened proximal to the obstruction. Decompression of the bowel did not result in the immediate return of motility and the resected bowel was unresponsive to carbachol. These results suggest that spontaneous resolution of large bowel obstruction is unlikely and that motility disturbances are unlikely to be a cause of anastomotic dehiscenc

ISSN:0007-1323    

DOI:10.1002/bjs.1800720906

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800720907

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractSelection of patients with ulcerating rectal cancer for treatment by local excision has been governed by a policy based on clinical and histological criteria; if these criteria are not fulfilled, major resection is recommended. This policy was re‐examined in three groups of patients treated by local excision: Group 1 for cure (27 patients), Group 2 due to unfitness for major surgery (13 patients), Group 3 for local tumour control in the presence of metastatic disease (6 patients). When the policy was fulfilled, there was a cancer‐specific death rate of 8.3 per cent in Group 1 (two patients with poorly differentiated tumours) and 0 per cent in Group 2. Unavoidable policy breaches occurred when patients refused major surgery or were too unfit: in the latter elderly group, this did not have the adverse effect expected. It is concluded that pre‐operative clinical digital assessment and histological grading are a satisfactory means of identifying a small group of tumours appropriate for local treatment and that the results justify local excision where the policy is obs

ISSN:0007-1323    

DOI:10.1002/bjs.1800720908

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractData on 709 patients who had a resection for colorectal carcinoma at Concord Hospital between 1971 and 1980 were studied to determine the independent effects on survival of several patient characteristics and pathological variables using the Cox regression model. Clinicopathological stage had the strongest association. Other variables ranked according to their relative importance independent of stage were: histological grade, level of direct spread, the presence of venous invasion, age and sex of the patient and the presence of obstruction.

ISSN:0007-1323    

DOI:10.1002/bjs.1800720909

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractIn a consecutive series of 153 emergency admissions with large bowel disease during a 7 year period, 49 per cent were for colonic obstruction, 46 per cent for peritonitis and 5 per cent for miscellaneous conditions. Urgent operation was performed on 104 (68 per cent) patients. Of those operated upon, 82 (79 per cent) had a primary resection with a mortality rate of 12·2 per cent, intraperitoneal sepsis rate of 2·4 per cent and wound sepsis rate of 7·3 per cent. The median postoperative hospital stay was 21 days. An immediate anastomosis was performed in 46 (56 per cent) patients with a mortality rate of 8·7 per cent, anastomotic leak rate of 2·2 per cent, and wound sepsis rate of 8·7 per cent. The median postoperative hospital stay was 19

ISSN:0007-1323    

DOI:10.1002/bjs.1800720910

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractIn a consecutive series of 93 patients who required emergency surgery for distal colonic lesions, 61 had primary bowel resection with immediate anastomosis after intra‐operative antegrade colonic irrigation. The operative mortality was 8 per cent, anastomotic leakage rate 7 per cent and superficial wound infection occurred in 3 per cent of patients. The mean hospital stay was 13 days. Of the remaining 32 patients, 3 did not have a resection and 29 had a primary resection and end colostomy without anastomosis: bowel continuity was later restored in 17 of 28 survivors (61 per cent) but 11 (39 per cent) were left with a permanent colostomy. The hospital mortality in this group was 6 per cent, superficial wound infection rate 14 per cent and the mean hospital stay 26 days. The results of this study suggest that intra‐operative colonic irrigation is an effective method enabling the surgeon to perform a primary anastomosis with reasonable safety after emergency resection of selected distal colonic lesi

ISSN:0007-1323    

DOI:10.1002/bjs.1800720911

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY