ISSN:0007-1323    

DOI:10.1002/bjs.1800820702

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820703

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820704

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractSepsis is an intriguing pathological condition associated with many complex metabolic and physiological alterations. In this review a novel hypothesis in the pathophysiology of oxygen metabolism during sepsis is explored. It is proposed that the hypermetabolic response to sepsis results from enhanced reactive oxygen generation by phagocytes. Reactive oxygen detoxification by host enzyme systems subsequently leads to alterations in oxidative metabolism. The similarities between the metabolic consequences of reactive oxygen metabolism and the metabolic changes observed during sepsis are outlined. A unified concept is presented to help explain the pathophysiological changes in oxygen metabolism during sepsis.

ISSN:0007-1323    

DOI:10.1002/bjs.1800820705

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820706

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractThe association between renal dysfunction and obstructive jaundice is well established. Despite a substantial number of clinical reviews and prospective studies, the exact incidence and extent of the problem has not been determined accurately. Various pathogenic mechanisms and therapeutic strategies have been proposed but renal dysfunction remains a persistent problem in hepatobiliary practice. The intention of this review is to determine the current extent of the problem, outline the proposed pathophysiological mechanisms and assess the current therapeutic options.

ISSN:0007-1323    

DOI:10.1002/bjs.1800820707

出版商:John Wiley&Sons, Ltd.    

年代:1995

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 January to March 1995 issues ofDer Chirurg.A digest of theBJSfor the same period, written by Professor John Farndon, appears in the German journal.

ISSN:0007-1323    

DOI:10.1002/bjs.1800820708

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractA prospective audit of all large bowel cancer resections is being conducted in the adjacent Health Boards of Lothian and Borders. The results of surgery in 750 consecutive patients recruited during the first 2 years are presented. In this time, 249 (33.2 per cent) patients presented as an emergency, 490 (65.3 per cent) had resection of a colonic cancer, and 36 (4.8 per cent) patients died within 30 days. Abdominal resection was performed in patients and intestinal continuity was restored in 646 (87.2 per cent). Of all anastomoses performed, 31 (4.8 per cent) leaked (15 of 467 (3.2 per cent) and 16 of 179 (8.9 per cent) after resection of colonic and rectal cancers, respectively). Of the patients presenting with a rectal cancer, 251 (96.5 per cent) underwent abdominal resection and intestinal continuity was restored in 179 (71.3 per cent). Five of 28 consultants were responsible for half of these patients. Patients treated by these five consultants were no more likely to undergo anastomosis, but when an anastomosis was performed it was less likely to leak (four of 95 (4.2 per cent)versus12 of 84 (14.3 per cent) (χ2= 4.63,P<0.05)). The overall outcome of surgery appears to be improved when compared to previous similar audits. Considerable intersurgeon variation remains in the results of resection of rectal cancer

ISSN:0007-1323    

DOI:10.1002/bjs.1800820709

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractIn patients infected with human immunodeficiency virus (HIV) no effective surgical procedure has been described for anorectal ulceration that is resistant to medical thearpy. This study was designed to determine the effectiveness of surgical excision of anorectal ulcers, with or without mucosal advancement. The medical records of patients with HIV and anorectal pathology diagnosed between 1984 and 1994 were reviewed. Patients with anorectal ulcers were divided into group A which was treated only with excision and group B in which excision was combined with mucosal advancement. Surgical treatment was considered successful if relief of symptoms was achieved within 4 weeks of the operation. Excision of anorectal ulcers was successful in seven of 16 patients (44 per cent) in group A. Relief of symptoms was achieved in 12 of 13 patients (92 per cent) in group B when surgical excision was combined with mucosal advancement, which is significantly better than the results in group A (P= 0.02). This non‐randomized study indicates that after unsuccessful medical treatment persistent symptomatic ulcers should be treated operatively by excision with mucosal advancemen

ISSN:0007-1323    

DOI:10.1002/bjs.1800820710

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractStaged fistulotomy with a seton is considered to decrease the high incidence of continence disorders after surgical incision of a fistula. This retrospective study reports the results of the two‐stage procedure with special emphasis on faecal continence. Thirty‐four patients (aged between 20 and 57 years) were treated between 1981 and 1990 with a two‐stage seton procedure for anal fistula (16 extrasphincteric and 18 trans‐sphincteric) with a high anal or rectal internal opening. Thirty‐one patients had normal preoperative continence. There were two recurrences. All trans‐sphincteric fistulas healed. Twenty‐nine patients with preoperative normal faecal control were available for follow‐up. Postoperative continence was normal in 12 patients (category A according to Browning and Parks classification2): five patients had no control over flatus (B), 11 were incontinent for liquid stool or flatus (C) and one had continued faecal leakage (D). The two‐stage seton technique is not recommended for fistulas with high anal o

ISSN:0007-1323    

DOI:10.1002/bjs.1800820711

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY