ISSN:0007-1323    

DOI:10.1002/bjs.1800700602

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800700603

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractThe reactive changes in the axillary lymph nodes of 50 breast cancer patients treated by mastectomy immediately following frozen section diagnosis have been compared with the changes in the nodes of 50 patients whose biopsy preceded mastectomy by between 2 and 5 days. The frequency of sinus histiocytosis was significantly greater in those patients who had been subjected to previous biopsy. This finding suggests that prior breast biopsy may negate the prognostic significance of sinus histiocytosis in breast cancer.

ISSN:0007-1323    

DOI:10.1002/bjs.1800700604

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractThe relationship of serum blocking activity and susceptibility to tumour recurrence using E‐rosette inhibition by normal allogenic lymphocytes was evaluated before and after operation in 20 patients with early breast cancer. Preoperative serum inhibition levels did not predict recurrent tumour. The mean postoperative inhibition in patients with recurrence was significantly greater than in those without recurrence. Postoperative testing only in a group of 124 patients showed that the development of local tumour recurrence was preceded by significantly greater inhibition of E‐rosetting than occurred in patients without recurrence. The application of a threshold level of serum inhibition of 15 per cent distinguishes patients who are unlikely to develop tumour recurrence over a 4‐year follow‐up period. Serial measurements of serum inhibition at 6‐monthly intervals over 2 years did not add to the predictive value of

ISSN:0007-1323    

DOI:10.1002/bjs.1800700605

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractBillroth II resection was carried out in 1000 duodenal ulcer patients in the period 1948–1956. Twenty‐two to thirty years later, gastroscopy and biopsy was performed in 196 of 423 survivors. Chronic atrophic gastritis appeared in 93 per cent of the cases, 47 per cent showed slight and 46 per cent severe changes. Seven per cent had normal mucosa. The microscopic grade of gastritis proved to be independent of age, alcohol and tobacco consumption and serum gastrin. No correlation between clinical status, such as dumping, diarrhoea, vomiting and pain, haematological parameters and the microscopic grade of gastritis, could be found. It is suggested that gastritis might be caused by reflux of bile, pancreatic and intestinal juices, and that postgastrectomy symptoms and anaemia do not depend on the microscopic grade of gastri

ISSN:0007-1323    

DOI:10.1002/bjs.1800700606

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractOver a 6‐year period 64 axillofemoral bypass and femorofemoral crossover grafts have been performed in 58 patients, most of whom were considered unfit for intra‐abdominal surgery. Indications were peripheral ischaemia in 78 per cent and disabling claudication in 22 per cent. The limb salvage rate at 3 years was 75 per cent. No claudicants lost limbs, but only one‐third of patients presenting with forefoot gangrene or ulceration avoided amputation. Most patients presenting with ischaemic symptoms at rest had associated femoropopliteal and distal disease, confirmed by the ankle pressure index measurements, and this influenced graft patency. Although the cumulative patency at 3 years for all grafts combined was 57 per cent with similar patencies for both the axillofemoral and femorofemoral grafts, early occlusion was more common in axillofemoral grafts and this may be reduced in bifemoral grafts by the increased flow rate in the vertical limbs. Peroperative electromagnetic flowmeter measurements were made after reconstruction on 55 femoral arteries in 46 of the patients and graft flow velocities were derived from these measurements. Comparison between velocities from those grafts remaining patent and those subsequently occluding showed a high incidence of occlusion in grafts with a maximal velocity after distal vasodilatation of<8 cm/s. Graft occlusion after the first postoperative month was more commonly associated with other factors such as continued smoking, severity of distal disease and perigraft infe

ISSN:0007-1323    

DOI:10.1002/bjs.1800700607

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractThirty‐one oesophageal rings from patients undergoing transection for varices were examined histologically for oesophagitis. Four cases showed neutrophil infiltration but all had recent oesophageal intubation. Fifteen patients had significant morphological epithelial changes of oesophagitis assessed by two sets of criteria. Only 4 of these patients (13 per cent) had no other likely causative factor such as recent sclerotherapy or recent insertion of a Sengstaken tube. Therefore there appears little evidence for oesophagitis as a major aetiological factor in bleeding oesophageal varice

ISSN:0007-1323    

DOI:10.1002/bjs.1800700608

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractThe optimum method of restoring the ability to swallow in patients with oesophageal carcinoma remains controversial. This prospective randomized study evaluates the palliative potential of pulsion intubation v. retrosternal gastric bypass of the excluded oesophagus in 106 patients with unresectable carcinoma; 55 patients were intubated and 51 patients treated by gastric bypass. The operative mortality and morbidity, palliation of dysphagia and postoperative nutritional status were compared in the 2 groups. Intubation resulted in 3 deaths (5·5 per cent) and gastric bypass in 4 deaths (7·8 per cent). Intubation was complicated by chest infection in 13 patients (24 per cent) but complications related to the procedure occurred in only 5 patients and included tube migration (2), respiratory obstruction (1), bleeding (2) and oesophageal perforation (1). Gastric bypass was complicated by chest infection in 14 patients (27 per cent), but procedure‐related complications were common and included pneumothorax (3), wound infection (6), subphrenic abscess (2), anastomotic leak (5) and purulent neck discharge (3). Palliation of dysphagia was achieved in 93 per cent of patients following intubation and 92 per cent of patients following bypass. Nutritional status improved more rapidly following intubation. Pulsion intubation is the preferred palliative procedure because of fewer complications and a lesser degree of postoperative catabol

ISSN:0007-1323    

DOI:10.1002/bjs.1800700609

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractA nutritional and immunological assessment was prospectively performed in 75 patients with squamous cell carcinoma of the oesophagus. Abnormal nutritional and/or immunological values were present in 37 patients (50 per cent) and absent in 38. The tumour was resectable in 27 patients (71 per cent) with normal values and only in 11 among the 37 (29 per cent) with abnormal values (P<0·001). Complications after resection including death, pneumonia and anastomotic failure were not significantly different in the two groups of patients except for anastomotic failure. This observation suggests that reduction of surgical complications by preoperative nutritional therapy might be expected only in few patients with oesophageal carcinoma

ISSN:0007-1323    

DOI:10.1002/bjs.1800700610

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractA total of 153 patients (124 male and 29 female) with uncomplicated chronic duodenal ulceration were studied in a prospective, randomized trial of proximal gastric vagotomy (PGV) and truncal vagotomy and pyloroplasty (TVP), conducted in four Manchester hospitals. Of these, 137 patients have now been followed up for 2·5 to 5·5 (mean 4·1) yr. There have been 15 (21 per cent) recurrent ulcers following PGV compared with 5 (7·5 per cent) after TVP (P<0·05). A satisfactory functional result was obtained in 82 per cent of patients after TVP compared with 73 per cent following PGV and there was little difference between the groups with regard to the incidence of dumping, heartburn and vomiting. There was significantly more diarrhoea following TVP (13 per cent) compared to PGV (1·4 per cent) but this represented only a minor clinical pr

ISSN:0007-1323    

DOI:10.1002/bjs.1800700611

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY