ISSN:0007-1323    

DOI:10.1002/bjs.1800820202

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820203

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820204

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractLaparoscopic surgical techniques have recently entered the field of colorectal surgery. Because the laparoscopic approach has revolutionized biliary surgery, it is hoped that similar advances will be possible in the more elderly population with colorectal disease. Early experience suggests that such advances have not been achieved and there is concern about developing minimal access surgical techniques in the face of potentially curable cancer. This article reviews the current state of knowledge based on published series; however, the current lack of controlled data in patients with extended follow‐up makes this area highly controversial. Suggestions regarding the future of laparoscopic surgery are made and include the establishment of a national register and the development of controlled randomized trial

ISSN:0007-1323    

DOI:10.1002/bjs.1800820205

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractCurrent controversies surrounding restoration of gastrointestinal continuity after pancreaticoduodenectomy are reviewed. The optimum method of reconstruction following this procedure remains debatable, particularly with regard to the pancreatic anastomosis. Pylorus‐preserving pancreaticoduodenectomy is increasing in popularity. Pancreaticogastrostomy is associated with at least as low a morbidity rate as pancreaticojejunostomy and is a safe alternativ

ISSN:0007-1323    

DOI:10.1002/bjs.1800820206

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractIn a prospective controlled study the effect of antibiotics as the only treatment in acute appendicitis was evaluated. Of 40 patients admitted with a duration of abdominal pain of less than 72 h, 20 received antibiotics intravenously for 2 days followed by oral treatment for 8 days and 20 considered as controls were randomized to surgery. All patients treated conservatively were discharged within 2 days, except one who required surgery after 12 h because of peritonitis secondary to perforated appendicitis. Seven patients were readmitted within 1 year as a result of recurrent appendicitis and underwent surgery, when appendicitis was confirmed. The diagnostic accuracy within the operated group was 85 per cent. One patient had perforated appendicitis at operation. Antibiotic treatment hi patients with acute appendicitis was as effective as surgery. The patients had less pain and required less analgesia, but the recurrence rate was high.

ISSN:0007-1323    

DOI:10.1002/bjs.1800820207

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractHartmann's procedure remains the favoured option in patients with acute left colonic and sigmoid disease, despite the well documented morbidity and mortality associated with reversal. In 40 patients with left colonic pathology, primary anastomosis was performed; 32 had a covering transverse colostomy. There were six hospital deaths, five in the transverse colostomy group. Closure was not attempted in seven of the 27 patients surviving with a colostomy (three refused, four had disseminated malignancy). In the 20 undergoing closure, there was no morbidity or mortality. With advances in intensive care, antibiotic therapy and anaesthesia, it is reasonable to consider alternatives to Hartmann's procedure, particularly when subsequent reconstruction is envisaged.

ISSN:0007-1323    

DOI:10.1002/bjs.1800820208

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820209

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractAnorectal manometry, balloon proctometrography, measurement of anorectal angles and videourodynamics were used to investigate 45 asymptomatic women and 13 with faecal incontinence and urinary symptoms, nine of whom also had stress urinary incontinence. The anorectal angle was measured and videourodynamics performed on 17 constipated women with urinary symptoms. Mean (s.e.m.) values obtained with anorectal manometry were lower in women with faecal incontinence and urinary symptoms than in controls (maximum resting pressure 42·5(8·1)versus82·5(9·3) cmH2O,P= 0·001; maximum attained pressure 80·5(13·7)versus216·2(11·2) cmH2O,P= 0·001; maximum squeeze increment 35·3(7·5)versus141·6(100) cmH2O,P= 0·001), indicating a weakened puborectalis and external anal sphincter. Mean(s.e.m.) anorectal angles at rest, squeeze and strain were all significantly greater in the doubly incontinent women than in those with constipation (114(3·8)versus93(5·9)°,P= 0·01; 103(2·5)versus78(3·5)°,P<0·001; 120(2·9)versus104(4·2)°,P= 0·01). Urinary incontinence was worse in the doubly incontinent than in the constipated women (eight of nineversusone of eight with grade 2a or higher,P= 0·002). These results suggest that doubly incontinent women have a significantly weakened pelvic floor and that this should be taken into account before any planned surger

ISSN:0007-1323    

DOI:10.1002/bjs.1800820210

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820211

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY