ISSN:0007-1323    

DOI:10.1046/j.1365-2168.1996.02476.x

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1046/j.1365-2168.1996.02495.x

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800830904

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

摘要:

AbstractCancer of the oesophagus has great diversity in geographical distribution and incidence. The rate of oesophageal cancer has been increasing in some areas and the reasons for this are not clear. This review outlines fascinating epidemiological aspects and the risk factors for squamous cell carcinoma of the oesophagus. While in the Western world the effects of alcohol and tobacco are substantial preconditions, worldwide other factors, such as diet, nutritional deficiencies, environmental exposure and infectious agents (especially papillomavirus and fungi), play a significant role. Chronic irritation of the oesophagus appears to participate in the process of carcinogenesis, particularly in patients with thermal and/or mechanical injury, achalasia, oesophageal diverticulum, chronic lye stricture, radiation therapy, injection sclerotherapy and gastric resection before the appearance of oesophageal tumour. The association of Plummer–Vinson syndrome, coeliac disease, tylosis and scleroderma with oesophageal cancer has also been reviewe

ISSN:0007-1323    

DOI:10.1046/j.1365-2168.1996.02421.x

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

摘要:

AbstractSepsis is a common surgical problem which can induce profound changes in the plasma concentrations of cytokines and hormones, leading to a catabolic state. Hypertriglyceridaemia and increased fat oxidation are the main features of altered fat metabolism encountered in this state. The endogenous catabolism of sepsis can be reduced by administering exogenous lipid emulsions as a source of metabolic fuel, although the changes in lipid metabolism associated with sepsis may affect the handling of these exogenous lipids. An exciting area for future research is an examination of the ability of lipid emulsions to reduce the morbidity and mortality associated with sepsis by altering immune responses, in addition to limiting catabolism.

ISSN:0007-1323    

DOI:10.1046/j.1365-2168.1996.02445.x

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

摘要:

AbstractLaparoscopic inguinal hernia repair may cause a revolution in general surgery if it proves to be the best treatment for inguinal hernia. Today there are several laparoscopic techniques that have been shown to be feasible. However, no information concerning long‐term recurrence rates and cost–effectiveness is available. This review summarizes current knowledge, including all randomized studies that have appeared hitherto, and concludes that it is still premature to advocate a transition from the preferred individualized conventional technique to a laparoscopic technique on a large scale. However, a definite statement on the place of laparoscopic repair may be given in the near future in the light of larger randomized stud

ISSN:0007-1323    

DOI:10.1046/j.1365-2168.1996.02496.x

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800830908

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

摘要:

AbstractIncreasing evidence suggests that motility disorders of the sphincter of Oddi may lead to episodes of recurrent pancreatitis in a small proportion of patients with the diagnosis of idiopathic recurrent pancreatitis. Over 10 years, 35 patients have been identified and treated for this condition. The aim of the study was to assess symptomatic outcome in these patients. Following the exclusion of common causes of pancreatitis the patients underwent sphincter of Oddi manometry. Patients with manometric abnormalities and three with normal manometric findings underwent treatment. Twenty‐six patients with persistent symptoms underwent total division of the sphincter via open sphincteroplasty and septectomy. Patients were followed up according to symptoms and classed as having a cure, mild symptoms or no change. At a median follow‐up of 24 (range 9–105) months, 15 of the 26 patients were cured, eight had only mild symptoms and three remained unchanged. In the majority of patients with a good clinical outcome, manometry had demonstrated sphincter of Oddi stenosis. Total division of the sphincter of Oddi is associated with good symptomatic outcome in patients with recurrent episodes of pancreatitis and documented sphincter of Oddi ste

ISSN:0007-1323    

DOI:10.1046/j.1365-2168.1996.02467.x

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1046/j.1365-2168.1996.02309.x

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY

摘要:

AbstractThe spleen may be removed by a laparoscopic technique, although the benefits and associated morbidity of this approach are unknown. This study reports a series of 28 consecutive patients (15 women; median age 39 (range 17–84) years) considered for laparoscopic splenectomy, because of idiopathic thrombocytopenia in 14, human immunodeficiency virus‐related thrombocytopenia in seven, autoimmune haemolytic anaemia in four, lymphoma in two and chronic lymphocytic leukaemia in one. In 23 cases dissection was completed laparo‐scopically, with the patient in the right lateral position, using a four‐cannula technique. Vascular isolation was achieved with an Endo‐GIA (powered vascular linear stapler). The spleen was removed by morselation within a retrieval bag (18 patients) or via either a Pfannenstiel or subcostal incision (five). The last 14 procedures have all been completed successfully in a mean operating time of 105 min with discharge from hospital within a median of 3 days. One patient developed a clinically apparent deep venous thrombosis 23 days after operation, for which he required readmission. Elective laparoscopic splenectomy is a feasible although technically demanding operation which may be performed safely and without associated mortality by surgeons experienced in laparoscopic t

ISSN:0007-1323    

DOI:10.1046/j.1365-2168.1996.02487.x

出版商:John Wiley&Sons, Ltd.    

年代:1996

数据来源: WILEY