ISSN:0007-1323    

DOI:10.1002/bjs.1800740602

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractBenign oesophageal stricture remains a common problem. Following accurate diagnosis, early treatment allows dilatation in the great majority of patients. Resection can frequently be avoided and in fit patients dilatation should be combined with an anti‐reflux operation plus gastroplasty where necessary. Frail elderly patients may be managed by continued dilatation and medical means to reduce and combat the effects of reflux. Resection should now be necessary in only about 5 per cent of patients and colonic interposition offers good long‐term results. It must be remembered that adenocarcinoma is a small but real risk in patients with reflux strict

ISSN:0007-1323    

DOI:10.1002/bjs.1800740603

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractSeveral trials have demonstrated that pre‐operative irradiation for rectal cancer decreases significantly the incidence of pelvic recurrence. However, this method is far from being generally accepted. It is now possible to enhance the effectiveness of external beam irradiation and to use it to extend the field of sphincter‐saving and conservative procedures. Our protocol consists of a split‐course regimen with a short course of cobalt‐60 arc rotation (3000 cGy in 12 days). After 2 months rest, the second stage of treatment depends upon the pressure of residual disease and the site of the tumour. It consists of either radical surgery (82 cases) or conservative treatment by intracavitary irradiation in the event of a favourable initial response or in the case of poor risk patients (73 cases). In the radiotherapy‐surgical group, the subsequent operative specimens were tumour free in 17 per cent of cases and assigned to Dukes' A category in 32 per cent of cases. Of 91 patients with T2or T3tumour involving the lower third of the rectum (followed up for more than 3 years) 72 (84 per cent) had no recurrence. Thirty‐three of these patients (46 per cent) underwent a colostomy while 39 (54 per cent) had normal anal function. These results demonstrate the major place that a properly planned external beam irradiation can have in the curative management of cancers of the

ISSN:0007-1323    

DOI:10.1002/bjs.1800740604

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800740605

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractA series of 243 patients with adenocarcinoma of the rectum treated with radiotherapy is presented. In the early part of the study radiotherapy was combined with 5‐fluorouracil (5FU). Later, radiotherapy was given alone. Seventy‐four patients were treated with radical external beam radiotherapy for recurrent or inoperable rectal adenocarcinoma. One hundred and forty‐five patients with advanced pelvic tumours or with metastases were treated with palliative pelvic radiotherapy. Twenty‐four patients who had small‐volume residual pelvic tumour or who were felt to be at high risk of pelvic recurrence following radical resection received postoperative radiotherapy. Complete tumour regression was seen in 38 per cent of radically treated patients, and 24 per cent of palliatively treated patients. Partial regression was observed in 56 per cent of radically treated patients, and 58 per cent of palliatively treated patients. Long‐term local tumour control was more commonly observed for small tumours (<5 cm diameter). Fifty‐eight per cent of patients treated with postoperative radiotherapy remained free of local recurrence. Survival was significantly better in patients with small tumours. The addition of 5FU did not appear to improve survival or tumour control. The value of radiotherapy in the relief of distressing symptoms related to the presence of pelvic tumour has b

ISSN:0007-1323    

DOI:10.1002/bjs.1800740606

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe biofunctional activity of the plasminogen activators urokinase and tissue plasminogen activator has been measured in extracts from 50 colorectal carcinomas and 21 adenomas using a bioimmunoassay. Compared with control mucosa urokinase activity was significantly‐elevated in adenomas (P<0.001) and carcinomas, levels being significantly higher in carcinomas (P<0.05). In contrast tissue plasminogen activator activity was reduced in adenomas (P<0.01) and carcinomas, levels being significantly lower in carcinomas (P<0.01). Although enzyme activity did not relate to Dukes' stage or histological grade urokinase activity was higher in carcinomas with venous invasion (n = 17,P<0.05), in those with moderate or extensive local spread (n = 27,P<0.05) and in cases where a palliative resection only was feasible because of advanced disease (n = 8,P<0.05). Urokinase has been implicated in tissue degradation as well as fibrinolysis and may play a role in tumour invasion and metastasis in human colorectal neoplasi

ISSN:0007-1323    

DOI:10.1002/bjs.1800740607

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800740609

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800740610

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractForty women presenting with mammillary fistulas over a 6 year period have been reviewed. The events preceding the fistula were incision of a periareolar breast abscess (n = 24), breast biopsy (n = 13) and spontaneous discharge of an inflammatory mass (n = 3). Only two of the women with abscesses were lactating. Two patients had granulomatous mastitis. The remaining 36 patients were all considered to have periductal mastitis/mammary duct ectasia as the cause of their fistulas. The two mammillary fistulas associated with lactation healed spontaneously. Nine patients had the fistula excised and the wound packed; this resulted in satisfactory healing in all but one patient. Twenty‐one patients had excision of the fistula and primary closure, without antibiotic cover, but only ten healed without complications and six patients required further surgical procedures for a recurrent fistula. Six patients had primary excision and closure under antibiotic cover with a penicillin and metronidazole; all healed. Mammillary fistulas are complications of the periductal mastitis/duct ectasia syndrome. They should be treated by excision and primary closure under appropriate antibiotic cover or alternatively excised and left open to granulat

ISSN:0007-1323    

DOI:10.1002/bjs.1800740611

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800740612

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY