摘要:

Abstract1. A series of 87 patients operated on because of subfrontal fractures is reported. In 73 of these a fistulous lesion (connecting the brain with the nose or the accessory air sinuses) was displayed and was repaired. Almost always a bifrontal exploration has been made, because the lesions were bifrontal in 43 per cent of cases. The mean follow‐up period was 4 years; to date no instances of postoperative meningitis or rhinorrhoea have occurred.2. Our experience suggests that cerebrospinal rhinorrhoea accompanying fractures of the facial bones (without fractures of the skull vault) can safely be treated conservatively.3. Damaged brain adheres to the lips of the torn dura andpermanentlyprevents natural healing, thereby creating a continuing threat to life. Consequently it is recommended that all frontal fractures lying below the hairline and all comminuted anterior temporal fractures should be referred for expert neurosurgical/neuroradiological assessment. This is because 42 per cent of the patients requiring operative repair were selected after tomographic studies of the anterior fossa; they had not presented with the classic criteria of cerebrospinal rhinorrhoea, intracranial air, or meningiti

ISSN:0007-1323    

DOI:10.1002/bjs.1800590802

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractVesico‐intestinal fistulae carry a serious prognosis by the nature of the underlying pathology. The inflammatory lesions offer the best hope for surgery and the necessity for early radical surgery in this group is stressed. The clinical details of 74 cases of vesico‐intestinal fistulae are given together with their investigations, treatment, and results. The improved results over the past 10 years appear to bear out the necessity for early treatm

ISSN:0007-1323    

DOI:10.1002/bjs.1800590803

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractTwelve cases of abdominal tuberculosis are presented. They illustrate the great variability in the clinical features of this condition, making diagnosis extremely difficult. In particular, we draw attention to the problem of tuberculosis of the reticuloendothelial system in the abdomen. Biopsy and culture are essential at laparotomy if a correct diagnosis is to be made.

ISSN:0007-1323    

DOI:10.1002/bjs.1800590804

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractOut of 415 patients with duodenal ulcer under‐going vagotomy in the past 6 years, 198 truncal vagotomies (T.V.) and 217 selective vagotomies (S.V.) were performed. Of the 217 S. V. s, 134 cases had a total selective vagotomy of the stomach (preserving the pyloroduodenal nervous peduncle), and in 83 cases a proximal selective vagotomy was performed (preserving also the antral branches of the two principal nerves of the gastric lesser curve or Latarjet nerves). The authors prefer the name ‘acid‐fundic selective vagotomy (A.F.S.V.) of the stomach’ for the latter procedure.In 89 of the patients having S.V. no gastric drainage procedure was performed; in 27 of these a total S.V. had been performed and in 62 cases an A.F.S.V.In patients undergoing S.V. without gastric drainage the clinical results and gastric emptying were fairly good in the cases with a total S.V. (follow‐up time, 12 months), and very good in the cases with an A.F.S.V. (follow‐up time, 6 months). Basal acid output (B.A.O.) and maximal (pentagastrin‐stimulated) acid output (M.A.O.) were evaluated in those patients undergoing A.F.S.V. before and 10 days after operation. B.A.O. was reduced by 80.5 per cent and M.A.O. by 68.5 per cent. An insulin test performed 3 months after operation was negative in 80 per cent of cases (complete vagotomy); in the other cases the vagotomy was adequate.Clinical results, although after only a short follow‐up, suggest that the procedure can be considered as the treatment of choice in most patients with an uncomplicated duodenal ulcer (76 per cent in our series). Gastric drainage is required only in cases of stenosing duodenal ulcer with delayed gastric emptying. Pyloroplasty is also mandatory in the treatment of bleeding ulcer and of perforated ulcer (if the sutur

ISSN:0007-1323    

DOI:10.1002/bjs.1800590805

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractOne hundred and thirty‐two patients who were about to undergo vagotomy and drainage were randomly allocated nasogastric tubes, gastrostomy tubes, or no decompression postoperatively. Significantly fewer patients with no decompression developed respiratory infections postoperatively. The role of smoking in the production of post‐operative chest complications was again confirmed. Neither the choice of decompression nor its absence appeared to affect postoperative electrolyte control. Postoperative dysphagia was more common in the group with a nasogastric tube. Wound infections were commoner in the gastrostomy group. While most patients with gastrostomies expressed a preference for this type of decompression a proportion of those with nasogastric tubes expressed a preference for a gastrost

ISSN:0007-1323    

DOI:10.1002/bjs.1800590806

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractTwo hundred and seventeen patients presenting with abdominal aneurysms in the Department of Surgery at the Manchester Royal Infirmary between the years 1958–69 were surveyed retrospectively.One hundred and eighty‐seven of the patients underwent operation for resection of their aneurysms; of these, 19 (10 per cent) showed excessive thickening of the aneurysm walls and perianeurysmal adhesions at operation.Subsequent histological examination of the walls of these unusual aaneurysms showed extensive active chronic inflammatory changes, including plasma‐cell infiltration.This group of patients whose aneurysms we describe as ‘inflammatory’ presented with different clinical features in comparison with the atherosclerotic group.Retrospective investigation has not yet revealed any aetiological factors. We feel that ‘inflammatory’ aneurysms are a discrete entity with significant differences from atherosclerotic aneurysms and previously descri

ISSN:0007-1323    

DOI:10.1002/bjs.1800590807

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractFemoral aneurysms are a relative ratity in clinical practice. A series of 15 such aneurysms treated in a variety of ways is presented. The method of treatment did not appear to affect the outcome. Where the aneurysm was found to be infected at operation treatment was not successful. An alternative method of arterial reconstruction by endo‐aneurysmorrhaphy is presente

ISSN:0007-1323    

DOI:10.1002/bjs.1800590808

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

Abstract1. The histopathological findings following microvascular repair of 105 arteries and 89 veins in Englishstrain rabbits are reported.2. The importance of (a) the accurate apposition of the vessel walls and (b) the avoidance of excesive medial necrosis is stressed.3. The process of subintimal hyperplasia is described and the importance of its role in the repair of small vessels is discussed. Previously, the new formation of elastin tissue has been considered pathognomonic of vascular disease.4. The appreciably slower rate of repair in veins is also reported.5. From these observations suggestions have been made with regard to improved technique of surgical repair.

ISSN:0007-1323    

DOI:10.1002/bjs.1800590809

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractA retrospective study of 549 patients who had undergone repair of an inguinal hernia is presented. It is noted that appendicectomy does not predispose to the development of a right inguinal hernia.

ISSN:0007-1323    

DOI:10.1002/bjs.1800590810

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractThe left hemithoraxes of 150 SPF rats were transformed into stable skin‐lined gas cavities which were opened to the exterior. Fifty‐nine of 75 rats so exposed survived with the natural, unilateral lung receiving air from the trachea, and the skin‐lined hemithorax (an artificially produced gas cavity) receiving air independently from a thoracostomy.In the test rats the mean arterialpH, Po2, and Pco2, were 7.355 ± 0.17, 77.03 ± 2.56 mm. Hg, and 38.41 ± 2.41 mm. Hg respectively. The values were similar to those obtained for unoperated rats (7.349 ± 0.015, 80.18 ± 2.77 mm. Hg, and 38.24 ± 0.94 mm. Hg). Although the skin‐lined hemithorax was functionally an open‐ventilated gas cavity, its mean tidal volume (0.93 ± 0.07 ml.) and its mean minute‐ventilation (271.6 ± 24.4 ml. per kg. per minute) were about half of normal.In the test the mean rate of respiration and the mean tidal volume were 98.5 ± 4.3 per minute and 1.68 ± 0.04 ml. as compared with 76.1 ± 5.3 per minute and 1.94 ± 0.12 ml. in the unoperated rats. The differences were significant. However, the difference between the mean minute‐ventilation (tidal volume X rate of respiration) in the two groups was not significant. The values obtained were 506.1 ± 36.2 ml. per kg. per minute (test rats) and 407.0 ± 50.4 ml. per kg. per minute (unoperated rats). This suggested further that under basal conditions the test rats achieved adequate ventilation by means of a compensatory rise

ISSN:0007-1323    

DOI:10.1002/bjs.1800590811

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY