摘要:

AbstractThe viability of tumour cells shed into the intestinal lumen was determined in 49 patients with carcinoma of the large bowel. Preoperative colorectal lavage was performed in 19 patients and irrigation of the cut ends of the operative specimen in 30 patients. The resulting cell suspensions were centrifuged on a Nycodenz® linear density gradient column so that tumour cells, being larger, were concentrated in a band at the top. In 14 of 19 colorectal lavage cases viable tumour cells were recovered, as assessed by their characteristic morphology and ability to exclude trypan blue. A median of 0·78 × 106viable tumour cells was recovered. The median percentage cell viability in the suspension was 92, i.e. 8 per cent of the tumour cells were dead (stained with trypan blue). In eight specimens viability was confirmed by the ability of tumour cells to hydrolyse fluorescein diacetate. In 17 of 30 proximal resection margin irrigations a median of 0·55 × 105viable tumour cells was recovered, with a median percentage viability of 92·5. In 15 specimens the neoplastic cells showed fluorescence. In 21 of 25 distal resection margin irrigations a median of 1·92 × 105viable tumour cells was recovered with a median percentage cell viability of 79·3, and fluorescence was observed in all specimens. The number of viable tumour cells did not correlate with the stage, differentiation, diameter or fixity of the tumour. However, the number of tumour cells recovered from the distal resection margin was inversely related to the distance of the tumour from that margin (Rank Difference Coefficient R = −0·6). Thus viable exfoliated tumour cells were demonstrated in 52 of 74 specimens (70 per cent). Their presence in large numbers at the site of intestinal anastomoses supports a potential role in the aetiology of suture‐li

ISSN:0007-1323    

DOI:10.1002/bjs.1800710902

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710904

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710905

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractPatients who had undergone proctocolectomy and ileostomy for ulcerative colitis have been studied. One group (contrast group) had undergone resection of only small amounts of terminal ileum (median = 4 cm), the other group of patients (study group) had undergone resection of greater lengths of small bowel (median = 60 cm). Gastric emptying and transit of a standard meal through the small bowel were estimated, whilst the amounts of fat, nitrogen, glucose, sodium and potassium excreted by the ileostomy were simultaneously determined. Significantly greater amounts of fat, nitrogen, sodium, potassium and water were excreted by patients who had undergone resection compared with contrast patients (P<0·01). The rate of gastric emptying was not increased in patients who had undergone ileal resection compared with contrast patients but small bowel transit within 4 hours of ingestion of the meal was significantly faster. A significant correlation between transit times and excretion of fat was also noted in patients (P<0·02). Thus, quite modest ileal resection in addition to proctocolectomy leads to rapid small bowel transit and marked malabsorption of nutrients as well as water and electrolyte

ISSN:0007-1323    

DOI:10.1002/bjs.1800710906

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710907

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710908

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractEighty‐four patients with advanced gastric cancer treated in four centres in Scotland between June 1980 and December 1982 were reviewed following treatment with 5‐fluorouracil, adriamycin and mitomycin‐C (FAM). Eighty‐one patients were evaluable. Twenty‐eight patients (35 per cent) responded (four complete) with a median duration of response of 10·5 months and median survival of 17 months. Ten are still alive. Response was associated with an improvement in performance status. Eight patients (10 per cent) had stable disease with a median survival of 10 months. Forty‐five (55 per cent) had progressive disease with a median survival of 4·5 months; one patient remains alive. Analysis of prognostic variables indicated that the presence of hepatic metastases had a negative influence on response to FAM (P<0·001). Treatment was well tolerated on an outpatient basis. FAM offers good palliative therapy in a proportion of patients with this disease, especially those without overt li

ISSN:0007-1323    

DOI:10.1002/bjs.1800710909

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

Abstract13175 patients with gastric carcinomas have been staged with reference to the TNM staging system. This has confirmed the poor overall prognosis (5·5 per cent and 3·8 per cent age‐adjusted survival rates at 5 and 10 years respectively). However, it has demonstrated the significant survival associated with the treatment of Stage I disease (70·0 per cent at 5 years and 63·2 per cent at 10 years). This study demonstrates that 72·9 per cent of cases are unresected and that interpretation of resectability rates must be related to the population base of the

ISSN:0007-1323    

DOI:10.1002/bjs.1800710910

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractFifty‐two patients with reflux oesophagitis resistant to medical treatment were randomized at operation to receive either the Angelchik prosthesis or a fundoplication. All patients were assessed postoperatively by a physician unaware of the nature of the operation. Forty‐two patients have been followed up for 1–2 years; ten patients for 3–9 months. Ninety‐six per cent of the Angelchik patients had satisfactory or excellent results compared with 81 per cent with a fundoplication. There were no failures to control reflux with the Angelchik prosthesis whereas 6 patients (23 per cent) of the fundoplication group have persisting reflux. Operating times for insertion of the prosthesis averaged a little over half that recorded for fundoplication. Complication rates were similar. The results of the trial encourage the use of the prosthesis in patients with gastro‐oesophageal reflux, where medical treatment has failed. The prosthesis should not be used if the gut is opened during operation either inadvertently or deliberately, as in making a suture line or anastomosis, because of the ris

ISSN:0007-1323    

DOI:10.1002/bjs.1800710911

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710912

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY