ISSN:0007-1323    

DOI:10.1002/bjs.1800840702

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800840703

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800840704

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

摘要:

AbstractBackgroundRectal prolapse is a condition that has fascinated surgeons for a long time. To date, no single ideal surgical treatment has been identified. The aetiology of rectal prolapse remains highly controversial, but it is recognized that associated functional problems, such as incontinence and constipation, are common. The pathophysiology, and controversies surrounding continence and constipation, remain topics of debate.MethodAll relevant papers derived from Medline and manual searching on rectal prolapse and associated functional problems were reviewed.Results and ConclusionThe surgical management of rectal prolapse has evolved from historical encirclement procedures to current minimally invasive ones. Successful management must include adequate attention to the associated functional problems in order to eradicate the basic abnormality.

ISSN:0007-1323    

DOI:10.1002/bjs.1800840705

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

摘要:

AbstractBackgroundThe development of duplex ultrasonography and colour flow imaging has greatly extended the scope of non‐invasive assessment of lower limb arterial disease. This review questions whether recent advances might allow colour duplex imaging to displace arteriography as the primary imaging modality for native vessel occlusive disease.MethodsA literature review was carried out based predominantly on a Medline database search of English language publications from 1985 to 1996.ResultsIn creasing evidence indicates that colour duplex ultrasonography can accurately image the lower limb native arterial tree, and that colour duplex imaging can replace diagnostic arteriography in a large proportion of patients.ConclusionArteriography should no longer be considered the gold standard of imaging of peripheral arterial occlusive disease. Future studies should concentrate on the efficacy of colour duplex sonography in guiding clinical decision makin

ISSN:0007-1323    

DOI:10.1002/bjs.1800840706

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

摘要:

AbstractBackgroundLocalized inflammation is a physiological protective response which is generally tightly controlled by the body at the site of injury. Loss of this local control or an overly activated response results in an exaggerated systemic response which is clinically identified as systemic inflammatory response syndrome (SIRS). Compensatory mechanisms are initiated in concert with SIRS and outcome (resolution, multiple organ dysfunction syndrome or death) is dependent on the balance of SIRS and such compensatory mechanisms. No directed therapies have been successful to date in influencing outcome.MethodThis review examines the current spectrum and pathophysiology of SIRS.Results and conclusionFurther clinical and basic scientific research is required to develop the global picture of SIRS, its associated family of syndromes and their natural histories.

ISSN:0007-1323    

DOI:10.1002/bjs.1800840707

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

摘要:

AbstractFor this quarter's digest, Dr Denis Castaing, Editor ofAnnales de Chirurgie, chooses the best from issues nine and ten of 1996 and issue one of 1997. A reciprocal digest written by our European Editor, Mr Colin Johnson, appears in the French journal.

ISSN:0007-1323    

DOI:10.1002/bjs.1800840708

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

摘要:

AbstractFor this quarter's digest, Professor Christian Herfarth and Dr Thomas Lehnert have selected the best from the October to December 1996 issues ofDer Chirurg. A digest for theBJSfor the same period, written by Mr Colin Johnson, appears in the German journal.

ISSN:0007-1323    

DOI:10.1002/bjs.1800840709

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

摘要:

AbstractBackgroundThere is an increased incidence of postoperative renal failure in patients with obstructive jaundice. The purpose of this study was to investigate the role of endotoxaemia and nitric oxide in this association.MethodsIn bile duct‐ligated, sham‐operated and control rats, plasma total bilirubin levels, creatinine clearance and plasma endotoxin were determined. Endothelium‐dependent vasodilatation to acetylcholine, and endothelium‐independent vasodilatation to nitroglycerine and forskolin were evaluated in isolated perfused rat kidney.ResultsTwenty‐one of 27 bile‐duct ligated rats had endotoxaemia. Plasma bilirubin levels were higher and creatinine clearance was significantly reduced in the bile duct‐ligated endotoxin‐positive group compared with values in the other groups. Furthermore, in the isolated perfused rat kidney from rats with endotoxaemia, basal perfusion pressure and renal vascular relaxation to acetylcholine and nitroglycerine which is mediated by guanosine cyclic 3′, 5′‐cyclic monophosphate (cGMP) were significantly reduced, but relaxation to forskolin mediated by adenosine cyclic 3′, 5′‐cyclic monophosphate did not change.ConclusionEndotoxaemia in obstructive jaundice may induce overproduction of nitric oxide that may lead to impairment of cGMP‐associated vasodilatation and disrupt autoregulation of the renal vascular bed. This may contribute to renal fa

ISSN:0007-1323    

DOI:10.1002/bjs.1800840710

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY

摘要:

AbstractBackgroundTreatment of ampullary adenoma is complicated by difficult preoperative staging, malignant potential and a high recurrence rate. This study was designed to assess the accuracy of diagnosis and staging by endoscopic biopsy and endosonography, and to compare the results of local resection and pancreaticoduodenectomy (Whipple procedure).MethodsAll 23 patients, diagnosed by endoscopic biopsy and surgically treated by local resection (n= 12) or pancreaticoduodenectomy (n =11) between 1984 and 1994, were analysed retrospectively.ResultsPancreaticoduodenectomy was associated with more complications (seven of 11 patientsversusthree of 12) and a longer hospital stay (36versus18 days) than local resection. After local resection tumour excision was incomplete in half of the patients. One patient died after a Whipple procedure. Endoscopic biopsy did not identify infiltrating carcinoma in seven of the 23 patients. Endoscopic ultrasonography had a 44 per cent accuracy rate for tumour invasion and was false positive for lymph node metastases in five of 16 patients. After local resection one recurrence was observed during follow‐up and one possibly died from turnour recurrence.ConclusionDiagnosis and staging of ampullary adenomas by endoscopic biopsy and endosonography ws unreliable. Local resection seems a viable alternative for patients whose general condition does not allow a Whipple procedur

ISSN:0007-1323    

DOI:10.1002/bjs.1800840711

出版商:John Wiley&Sons, Ltd.    

年代:1997

数据来源: WILEY