ISSN:0007-1323    

DOI:10.1002/bjs.1800780702

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractIn this review of English language publications from 1970, operative mortality following surgery for gastric cancer has been analysed. Operative mortality has declined in series reporting operations in successive decades to 1970, 1980 and 1990. Series reporting patients having surgery for gastric cancer in the decade to 1990 show a mean operative mortality rate of 7·8 per cent (median 4·6 per cent). This improvement may have contributed to the declining mortality rates for gastric cancer in the face of unchanging surgical workload. Results of operations for gastric cancer should be reported in a standard manne

ISSN:0007-1323    

DOI:10.1002/bjs.1800780703

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractMany reports in the medical literature are flawed through poor presentation of numerical results, or, more seriously, by the use of inadequate or inappropriate statistical methodology. This article expands on the more complex methodological issues. The main emphasis is on discussing key aspects of experimental design, and the idea of reporting results in terms of confidence intervals rather than P values.

ISSN:0007-1323    

DOI:10.1002/bjs.1800780704

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800780705

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractA set of statistical guidelines is presented which should be followed by authors preparing manuscripts for submission to The British Journal of Surgery. Simple points relating to presentation are explained in full, and more complex issues are highlighted and discussed in an accompanying review article.

ISSN:0007-1323    

DOI:10.1002/bjs.1800780706

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractEndosonography is the best available method for the pretherapeutic staging of rectal cancer. The present prospective study was to determine the influence of previous radiotherapy, widely used in the management of this tumour, on the accuracy of endosonography. A complete endosonographic examination was performed just before surgery in 40 patients with rectal cancer. Endosonographic and pathological staging were compared in group A, 21 patients without previous radiotherapy, and group B, 19 patients with preoperative radiotherapy. While the endosonographic accuracy for lymph node involvement was similar in the two groups (85 per cent compared with 84 per cent), wall invasion was correctly ascertained in 86 per cent in group A but in only 47 per cent in group B (P<0·05). After irradiation, the thickening of the rectal wall and the poor visualization of the hyperechoic layers hampered interpretation. Post‐radiotherapy inflammation and/or fibrosis probably explained the echographic changes. Radiotherapy therefore altered endosonographic staging of rectal cancer. New interpretation criteria are needed for evaluation and follow‐up of rectal cancer treated by radiothe

ISSN:0007-1323    

DOI:10.1002/bjs.1800780707

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractRestorative proctocolectomy with an ileal reservoir (RPC) should prevent colorectal cancer in patients with familial adenomatous polyposis. Until this is confirmed its role compared with total colectomy and ileorectal anastomosis (IRA) will depend on the relative morbidity and postoperative bowel function after the two procedures. This was analysed in 99 patients (37 RPC, 62 IRA) operated on between 1977 and 1989. Morbidity was greater after RPC with subsequent ileostomy closure (median hospital stay, 24 versus 11 days; complications, 60 versus 21 per cent; reoperation, 29 versus 3 per cent; return to normal activity, 31 versus 14 weeks). There was little difference in bowel function; after IRA median frequency was 3/24 h and urgency (unable to wait 15 min) occurred in 50 per cent, compared with 4·5/24 h and 17 per cent after RPC. Night evacuation occurred in 10 and 43 per cent respectively. IRA was performed in younger patients (median 19 versus 31 years) who had fewer bowel motions before operation (2 versus 5/24 h). The greater morbidity of RPC suggests that it should be restricted to patients at higher risk of developing later rectal cancer, including those unavailable for follow‐up and those with large or confluent rectal polyps or with curable colon cancer at the initial colecto

ISSN:0007-1323    

DOI:10.1002/bjs.1800780708

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractUse of the ultrathin choledochoscope (2 mm) was evaluated in 80 patients undergoing routine cholecystectomy. It was used successfully in 67 (84 per cent) patients. There were eight (12 per cent) explorations of the common bile duct and no negative explorations. The instrument was helpful in determining the nature of an equivocal on‐table cholangiogram. The ultrathin choledochoscope may be useful in reducing the rate of negativecommon bile duct exploratio

ISSN:0007-1323    

DOI:10.1002/bjs.1800780709

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractThe usefulness of the rebound tenderness test in indicating peritonitis was prospectively assessed in 142 unselected patients admitted as emergencies with abdominal pain and tenderness. It was found to be of no predictive value.

ISSN:0007-1323    

DOI:10.1002/bjs.1800780710

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractOne hundred patients with hepatic metastases from colorectal cancer underwent ‘radical’ liver resection from 1980 to 1989. At least 1 cm of normal parenchyma surrounded the tumour and no microscopic invasion of resection margins was evident. The disease was staged according to our own staging system. Lobectomy was performed in 50 patients and non‐anatomical resection in the remainder. The postoperative mortality rate was 5 per cent and the major morbidity rate was 11 per cent. The actuarial 5‐year survival rate for patients in stages I, II and III was 42 per cent, 34 per cent and 15 per cent respectively (P<0·001). The overall actuarial 5‐year survival rate was 30 per cent. The prognostic importance of various patient and tumour variables was evaluated by univariate analysis and then by multivariate analysis. Age of patient, site of primary, disease‐free interval between treatment of primary and of hepatic metastases, preoperative carcinoembryonic antigen levels, and number of metastases, did not relate to prognosis, while sex (P = 0·024), stage of primary (P = 0·026), extent of liver involvement (P<0·001), distribution of metastases (P = 0·01) and type of surgery (P = 0·028) significantly affected prognosis as single factors. Multivariate analysis revealed that only the extent of liver involvement and stage of the primary tumour were independent predictors of survival. We conclude that liver resection is effective in selected patients with hepatic metastases from colorectal cancer. In resectable patients it is not yet possible to formulate a clear prognosis based on clinical factors. The extent of liver involvement and the staging system used may be significant, although not absolute, indi

ISSN:0007-1323    

DOI:10.1002/bjs.1800780711

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY