ISSN:0007-1323    

DOI:10.1002/bjs.1800820502

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820503

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820504

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractEvidence suggests that perioperative allogeneic blood transfusion increases the risk of infectious complications after major surgery and of cancer recurrence after curative operation. This has been attributed to immuno‐suppression. Several authors have suggested that filtered whole blood and/or red cell concentrate, or leucocyte‐and buffy coat‐reduced red cells in artificial medium or their own plasma, may reduce postoperative immuno‐suppression. It was also anticipated that the use of autologous blood might minimize the risk of perioperative transfusion, but studies have unexpectedly shown similar postoperative infectious complications and cancer recurrence and/or survival rates in patients receiving autologous blood donated before operation and those receiving allogeneic blood. Future studies should identify common risk factors associated with blood

ISSN:0007-1323    

DOI:10.1002/bjs.1800820505

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractIndium‐111 labelled platelet scintigraphy permits simple, accurate evaluation of platelet kinetics and sites of deposition. The most meaningful results are obtained from serial scans, although these are clinically useful in only a few of the many applications that have been suggested, principally in studies of acute thrombosis, prosthetic graft thrombogenicity and antiplatelet medication. Key pitfalls are associated with selection of regions and patient variatio

ISSN:0007-1323    

DOI:10.1002/bjs.1800820506

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractThe effect of haemorrhoidectomy on rectal and anal physiological abnormalities was studied in 24 consecutive patients (12 men and 12 women of mean(s.e.m.) age 39.1(2.4) years) and compared with results in 13 sex‐ and age‐matched controls. Before operation those with haemorrhoids had significantly higher resting anal pressures (P<0.005), lower rectal compliance (P<0.05) and more perineal descent (P<0.05). Following haemorrhoidectomy there were significant decreases in the maximum resting (P<0.05) and maximum squeeze anal (P<0.001) pressures to within normal values 3 months after operation. Rectal compliance also increased significantly (P<0.05), to that of normal controls. The abnormalities found in patients with prolapsed piles reverted to the normal range within 3 months of haemorrhoidectomy. These physiological changes are therefore more likely to be an effect, rather than the cause, of enlarged anal cushi

ISSN:0007-1323    

DOI:10.1002/bjs.1800820507

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractThe effect of microacinar growth patterns on survival after radical surgery for rectal cancer was assessed in 138 consecutive patients. All had Dukes and Jass staging and a median follow‐up of 95 (range 11–180) months. Tumour acini were classified according to size (microacinar, 28; macroacinar, 110). Patients with microacinar tumours had a significantly reduced 5‐year survival rate compared with those with macroacinar lesions (43 and 68 per cent respectively,P= 0.004). When examined in the presence of other histological factors, acinar size had independent prognostic value (relative risk 2.37,P= 0.006). This was true even when the Dukes and Jass classifications were included in the model (relative risk 2.08,P= 0.02 and 1.95,P= 0.03 respectively). Histological classification of rectal tumours into microacinar and macroacinar types adds prognostic value to the Dukes and Jass classifications and may be a more objective criterion than conventional histological gr

ISSN:0007-1323    

DOI:10.1002/bjs.1800820508

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractA total of 36 rectal advancement flap repairs were performed in 32 patients with perianal Crohn's disease. There were 12 anovaginal and 20 trans‐sphincteric fistulas. Patients were followed prospectively for a mean of 19‐5 months to evaluate postoperative recurrence rate. The prognostic influence of fistula type, rectal disease, intestinal disease and faecal diversion on recurrence was assessed. Four of 36 repairs showed primary failure, the operated fistula recurred in 11 patients after a median of 7 months, and a new fistula developed in six patients. The fistula recurrence rate was higher in patients with anovaginal fistula or Crohn's colitis but did not correlate with disease activity. Transitory mild incontinence of stool was observed in one patient only. Although rectal advancement flap repair does not cure perianal fistulas in most patients with Crohn's disease, those without Crohn's colitis may have long‐term benefit. Short‐term improvement of symptoms justifies this simple procedure even in patients with anovaginal

ISSN:0007-1323    

DOI:10.1002/bjs.1800820509

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractThe high volume output of a defunctioning loop ileostomy after rectal excision and anastomosis may lead to severe dehydration and electrolyte imbalance if not properly managed. Although chronic losses may be seen, the early postoperative period remains the most hazardous with regard to acute fluid and electrolyte losses for the patient with a defunctioning ileostomy1–3. A prospective study was therefore conducted to determine the period and severity of excessive ileostomy los

ISSN:0007-1323    

DOI:10.1002/bjs.1800820510

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractTwenty patients (13 men) with low rectal cancer, median (range) age 64.5 (38–83) years were prospectively randomized to undergo ultra‐low anterior resection with a J colonic pouch‐anal anastomosis (median (range) distance of anastomosis from the anal verge 3 (1–4) cm). Another 20 patients (15 men), median (range) age 62.5 (44–86) years) with low rectal cancer were randomized to a straight coloanal anastomosis (median (range) distance of anastomosis from the anal verge 3.25 (2–5) cm). There were no significant differences in operative time or complications between the two groups. There was significantly better postoperative anal function in patients who underwent pouch‐anal anastomosis at 1, 6 and 12 months after ileostomy closure. At 12 months all patients (19 of 19) with a pouch reconstruction had regained normal continence compared with 14 of 20 of those who had a straight coloanal anastomosis. No patient complained of severe constipation requiring enema or intubatio

ISSN:0007-1323    

DOI:10.1002/bjs.1800820511

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY