摘要:

AbstractTwo hundred cases of male breast carcinoma were treated at the Christie Hospital, Manchester, between 1942 and 1971. The survival rate of the group following curative treatment is presented; the response to palliative treatment is also discussed. The survival rate was particularly good for stage I cases, with 79 per cent surviving for 5 years and 56·3 per cent surviving for 10 years. However, the later stages did less well, particularly when compared with female patients of the same age and stage. With such a rare disease it would be of help to centralize the treatment of these patients as much as possible

ISSN:0007-1323    

DOI:10.1002/bjs.1800640602

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractTo the authors' knowledge, an intensive investigation of pulmonary function during the first 2 postoperative days has not previously been reported. Consequently, in this study the effect of regional surgery on respiratory function, monitored every 4 h during the first 2 postoperative days, was analysed. Hypoxaemia was a constant finding in all patients undergoing general anaesthesia. The degree and duration of hypoxaemia and spirometry changes were related to the site of surgical incision. Clinical signs of atelectasis were commonly observed during the first postoperative day and occurred after the change in Po2and spirometry. Atelectasis was more common in patients having upper abdominal surgery. The current investigation reveals that the earliest postoperative change indicative of atelectasis is the fall in Po2; that auscultatory changes do not always occur in the presence of postoperative hypoxaemia; that auscultatory signs are not indicative of the extent of the Po2fall; and that radiology represents a crude method of assessing postoperative atelectasis.

ISSN:0007-1323    

DOI:10.1002/bjs.1800640603

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractTo observe the duration of hypoxaemia 8 patients were monitored every day for the first 7 days following upper abdominal surgery. Three of these patients who had failed to regain their preoperative Po2value by the seventh postoperative day were further monitored on alternate days until the fourteenth postoperative day. A further 3 patients were similarly monitored on alternate days for 14 days. In another group of 10 patients blood gases were monitored every 4 h for the first 48 h following major abdominal surgery, during which time the patients were given 35 per cent oxygen for the first 24 h after operation. (All patients in this group had a diminished respiratory reserve preoperatively to a sufficient degree to warrant admission to the intensive therapy unit postoperatively, and these patients were treated with oxygen for 24 h, as is the practice in our unit and in other surgical units).Oxygen was administered using a Ventimask at 8 l/min (British Medical Journal, 1972). Nine of the 10 patients did not show postoperative hypoxaemia while being treated with 35 per cent oxygen, although the Po2values attained were lower than expected. On withdrawal of oxygen after 24 h, the Po2decreased below preoperative levels in all patients. The Po2of 7 patients in this group decreased below 8 kPa during the second 24 postoperative hours, in 4 of whom the level fell below 6·7 kPa. Some recommendations to improve the respiratory care of the surgical patient are presented

ISSN:0007-1323    

DOI:10.1002/bjs.1800640604

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractA series of 368 patients with hand lacerations which required suturing were randomly allocated to one of three treatment groups. The incidence of infected and of imperfectly healed wounds was noted 7 days after suturing. As well as the influence of antibiotics on healing, sixteen other factors which it was considered might affect healing were analysed.The overall infection rate was 9·8 per cent, and there was no significant difference between the three groups. The imperfect healing rate (which includes the infected cases) was 24·6 per cent. There was a lower rate (P<0·05) of imperfect healing in the Triplopen group (15 per cent) than in either the flucloxacillin group (29·5 per cent) or the group who received no antibiotics (29·0 per cent).Other factors associated with imperfect healing found to be significant at the 1 per cent level, were wound contamination, pain and the presence of a wet or changed dressing at the second examina

ISSN:0007-1323    

DOI:10.1002/bjs.1800640605

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe crush syndrome was first defined as a clinical entity in 1941. This paper reports 2 patients suffering from the syndrome as a result of being trapped for several hours during the Moorgate tube train disaster. An account of the initial course, management and complications is presented and discussed with reference to the available literature on the subject.

ISSN:0007-1323    

DOI:10.1002/bjs.1800640606

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800640607

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractPhytobezoars are plant fibre concretions occurring in the stomach as a complication following some types of gastric surgery. Symptoms include distension, pain and vomiting. Ulceration, gastric bleeding and even perforation can occur. If untreated, they result in a significant mortality.Dissolution of the phytobezoar can be achieved with‐out operative intervention. Enzymes and especially cellulase help to break up the mass and it can then be aspirated or allowed to pass on. Five patients with phytobezoars were thus treated and the cellulase method was confirmed to be simple, safe and effectiv

ISSN:0007-1323    

DOI:10.1002/bjs.1800640608

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractSigmoid volvulus is a well‐recognized clinical entity, occurring more commonly in the male in middle or old age. In younger age groups the diagnosis is therefore often delayed. We report here 11 patients of an average age of 31 years (range 12–57 years), with a preponderance of females (7 : 4), who have presented to us in the past 2 years with intermittent sigmoid volvulus. The average age at onset of initial symptoms was 26 years. All had the diagnosis confirmed radiologically by colonoscopy or at operation. The diagnostic features of the condition are descri

ISSN:0007-1323    

DOI:10.1002/bjs.1800640609

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe presence or absence of starch granulomas on the peritoneal surface or within peritoneal adhesions is reported in 20 patients subjected to a second laparotomy. Evidence is presented to show that starch granuloma formation is common in the early months following operation and that adhesions associated with starch granulomas cause intestinal obstruction. It is suggested that although starch is usually absorbed within 2 years, associated band adhesions may persist. Glove powder contamination of the peritoneal cavity may thus be a common cause of band adhesion obstruction.

ISSN:0007-1323    

DOI:10.1002/bjs.1800640610

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractWide excision of the rectum in inflammatory bowel disease is both unnecessary and undesirable as the healthy pelvic floor is damaged and the pelvic nerves put at risk. An operative technique is described which includes dissection of the anal canal and rectum in the intersphincteric plane, i.e. the plane of fusion between the visceral rectum and anal canal and the somatic pelvic musculature, which minimizes these undesirable elements.Fifty–three cases are presented. Perineal wound healing rates are comparable with those of other methods of resection and only 1 of 14 men reported partial sexual dysfunction following this operatio

ISSN:0007-1323    

DOI:10.1002/bjs.1800640611

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY