ISSN:0007-1323    

DOI:10.1002/bjs.1800671102

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractExcision of the recto‐sigmoid and rectum for cancer or inflammatory disease frequently damages the autonomic nerve supply. The anatomy and function of the autonomic nervous system in the pelvis is reviewed.Thirty‐two patients who underwent excision of the rectum have been studied: 28 operations were for carcinoma, 4 for ulcerative colitis. A detailed history of sexual function was obtained preoperatively together with a neurological examination of the genitalia and perineum. Biopsies were taken from the surgical specimens and examined for the presence of nerve tissue. A further sexual history was taken 3 months postoperatively.Ten sexually active men (ages 46–74) who had anterior resections or abdominoperineal excisions for carcinoma tended to show impaired sexual activity if there was excessive nerve tissue in the specimen. Two out of 3 sexually active women (ages 53–68) who had cancer operations had satisfactory sexual function postoperatively.Four patients (ages 28–66) all had satisfactory sexual function after panproctocolectomy for ulcerative colitis.The advantages of avoiding damage to the pelvic autonomic nerves at operation are

ISSN:0007-1323    

DOI:10.1002/bjs.1800671103

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractThe survival prospects for carcinoma of the rectum in a series of 1320 patients managed between 1950 and 1978 by one surgeon have been analysed by computer. Survival curve analysis showed a worsened survival after curative resection during 1970–8 in comparison with previous decades (P = 0·001). The 5‐year cancer‐specific survival after curative resection (832 patients) decreased from 73 per cent (1950–9) to 50 per cent (1970–3) (P = 0·001). An increase in the incidence of Dukes' stage C tumours from 22 per cent (1960–9) to 32 per cent (1970–8) (P = 0·003) explains, at least in part, the worsened survival prospects. Paradoxically the deterioration was paralleled by earlier presentation (P = 0·001).The worsened survival prospects were not explained by alterations in sex or age distribution, tumour site, or increase in the percentage of sphincter‐saving resections. The alternative hypotheses that earlier presentation has resulted in a larger proportion of aggressive tumours coming to curative resection or that worsened survival prospects represent a real change in the behaviour of carcinoma of the rectum in the Australian comm

ISSN:0007-1323    

DOI:10.1002/bjs.1800671104

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractWe have recorded the latency of the anal reflex, using a simple electrophysiological method, in 22 patients with anorectal incontinence and in 33 control subjects without anorectal disease. The mean latency in the control subjects was 8·3 ms (range 5–11·3 ms). In the patients with faecal incontinence the mean latency of the anal reflex was 13·0 ms (range 6·5–22·0 ms). The reflex latency was within the normal range in only three incontinent patients. These findings support our concept, based on histological examination of the external anal sphincter musculature, that a major cause of this syndrome is denervation of these muscles due to damage to the innervation of the external anal sphincter and puborectalis

ISSN:0007-1323    

DOI:10.1002/bjs.1800671105

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractSolitary rectal ulcer is a curious and uncommon condition of contentious aetiology. Six patients seen at Gloucestershire Royal Hospital during 5 years have been studied. In 4 self‐interference was certain and likely in one other; no information was available concerning the sixth. Our evidence suggests that the disease is self‐indu

ISSN:0007-1323    

DOI:10.1002/bjs.1800671106

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800671107

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractOne hundred patients with second‐ or third‐degree haemorrhoids were randomly allocated to haemorrhoidectomy (50) or rubber band ligation (50). Forty‐two in each group presented with rectal bleeding; haemorrhoidectomy relieved 36 and rubber band ligation relieved 31 of this symptom. All patients had prolapsing haemorrhoids at presentation. One year after treatment 45 haemorrhoidectomy and 43 rubber band ligation patients were assessed. Haemorrhoidectomy relieved 44 of 45 patients and rubber band ligation relieved 34 of 43 (P<0·05). Haemorrhoidectomy caused pain in all cases, lasting for more than 48 h in 35. Rubber band ligation was painless in 5 and produced pain for more than 48 h in 15. Mean time off work was 32 days for haemorrhoidectomy and 3 days for rubber band ligation (P<0·001).Rubber band ligation as an outpatient procedure is an effective treatment for second‐ and third‐degree haemorrhoids and should be considered before recourse

ISSN:0007-1323    

DOI:10.1002/bjs.1800671108

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractA study of 7000 women attending a diagnostic breast clinic and the Breast Screening Clinic in Edinburgh has failed to show a significant relationship between the occurrence of previous symptomatic breast disease and a risk of cancer.

ISSN:0007-1323    

DOI:10.1002/bjs.1800671109

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800671110

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractAn analysis of the biology of cancer of the oesophagus suggests that significant dissemination may not have taken place at the time of diagnosis in approximately one‐third of cases. Positive nodal histology in the mediastinum or abdomen is the best available evidence of disseminated disease. Patients without such nodal involvement there‐fore represent a group in whom the disease is most likely to be localized. It is suggested that only these patients be subjected to aggressive local therapy. The effects of no treatment, ortho‐ and megavoltage radiotherapy, surgery and combinations of surgery and radiotherapy are reviewed. The need for cooperative randomized clinical trials to test the biological hypothesis outlined is discussed. Megavoltage radiotherapy as a primary treatment for oesophageal cancer followed by radical surgery in those patients without evidence of dissemination from nodal histology is proposed as a basis for such clinical t

ISSN:0007-1323    

DOI:10.1002/bjs.1800671111

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY