ISSN:0007-1323    

DOI:10.1002/bjs.1800770202

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

摘要:

AbstractManagement of pilonidal sinus is frequently unsatisfactory. No method satisfies all requirements for the ideal treatment ‐ quick healing, no hospital admission, minimal patient inconvenience, and low recurrence ‐but greater awareness of the strengths and weaknesses of existing methods would lead to improved management. Early excision of the pilonidal pit at the time of treatment of pilonidal abscess reduces the high (40 per cent) risk of subsequent sinus. Treatments for pilonidal sinus that flatten the natal cleft halve the risk of recurrence. En bloc excision of pilonidal sinus with secondary healing should be abandoned and emphasis given to development of treatments, such as primary asymmetric closure, which have more potential. Some treatments are operator‐dependent and, to achieve the best results, junior surgeons must be correctly trained and supervised. Future treatment studies must be prospective and randomized, and should compare healing time, recurrence rates beyond 3 years, nurse and hospital visits, patient inconvenience and loss of i

ISSN:0007-1323    

DOI:10.1002/bjs.1800770203

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800770204

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

摘要:

AbstractEndoscopic transanal resection (ETAR) of rectal tumours is a simple and inexpensive procedure, well tolerated in elderly patients or those undergoing palliation. We have performed 137 ETARs in 81 patients with a 30‐day mortality rate of 11·1 per cent and a postoperative complication rate of 15·3 per cent. Thirty‐one patients (38 per cent) had ETAR for palliation: in this group rectal bleeding was abolished or improved in 66 per cent of patients, altered bowel habit (diarrhoea) corrected in 77 per cent of patients, faecal incontinence improved in 50 per cent of patients and rectal pain (including tenesmus) improved in 50 per cent of patients. Twenty‐three patients (28 per cent) were treated for large benign rectal polyps: in this group symptoms were universally abolished. The technique is particularly suited to the management of these patients. Twenty‐seven elderly patients with theoretically ‘curable’ rectal cancer underwent ETAR with a 78 per cent crude survival rate at 1 year. While long‐term results remain to be assessed, ETAR appears a useful technique for treating selected patients with

ISSN:0007-1323    

DOI:10.1002/bjs.1800770205

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800770206

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800770207

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

摘要:

AbstractD. F. KerridgetBlood transfusion in the perioperative period has been reported to have a detrimental effect on survival in many types of cancer. Other studies have failed to confirm this. We have examined retrospectively the records of 246 patients with prostatic carcinoma who underwent transurethral resection of the prostate (TURP) in Aberdeen Royal Infirmary between 1977 and 1982. Bilateral orchiectomy (BLO) was performed in 193 patients. Of these patients, 71 of 246 (29 per cent) received perioperative blood transfusion. After controlling for differences due to a number of variables, transfusion of non‐autologous blood was shown to be associated with a significant negative effect on survival. Perioperative transfusion of non‐autologous blood should be avoided in patients with malignancy, unless there are clear overriding clinical indications. Prospective trials are needed urgen

ISSN:0007-1323    

DOI:10.1002/bjs.1800770208

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

摘要:

AbstractTwo treatment policies for rectal prolapse were prospectively assessed between April 1986 and January 1989. Sixteen patients had a Marlex® mesh posterior rectopexy alone and 13 underwent a sigmoidectomy combined with a sutured posterior rectopexy. Preoperative and post‐operative assessment included manometry, a saline infusion test and video‐proctography. Hospital stay, control of prolapse and complications were comparable in both groups. Restoration of continence occurred in nine of the 12 incontinent patients after Marlex rectopexy, compared with six of nine after sutured rectopexy and sigmoidectomy. Constipation persisted in three patients who were constipated before operation and in four of 13 who had previously normal bowel habits became constipated after Marlex rectopexy; constipation persisted in one of five previously constipated patients while none with previously normal bowel habits became constipated after sutured rectopexy and sigmoidectomy. Sigmoidectomy combined with sutured rectopexy was safe and as efficient as Marlex rectopexy in prolapse control and improvement of continence; significantly fewer patients were constipated (one of 13) after sigmoidectomy than following rectopexy alone (seven of 16). A randomized trial now seems justi

ISSN:0007-1323    

DOI:10.1002/bjs.1800770209

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

摘要:

AbstractIn 6 years, 74 neonates were treated for necrotizing enterocolitis, 40 (54 per cent) of whom underwent operation. The early postoperative mortality rate was 23 per cent and there was one late death. Of the 30 postoperative survivors, two have short bowel syndrome, two have chronic respiratory disease, two are partially sighted, and five (17 per cent) have severe developmental delay. Only 15 (50 per cent) survivors enjoy good health.

ISSN:0007-1323    

DOI:10.1002/bjs.1800770210

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY

摘要:

AbstractSome authorities believe that patients with conventional ileostomies are chronically water and salt depleted but there are no data on the metabolism of body water and electrolytes after ileoanal J pouch. To clarify the situation we studied the body composition of 14 patients with well functioning ileostomies and 20 patients with well functioning J pouches. Both groups were compared with two closely matched control groups. Body weight, total body fat, fat‐free mass, total body water and extracellular water were measured by neutron activation analysis, tritiated water and bromide dilution respectively; 24‐h collections of urine and stool were analysed for volume and electrolyte content. The results show that the body content of water and extracellular fluid in ileostomy patients and J pouch patients is normal. The faecal volume and chemistry is similar in both groups resulting in a similar and significant degree of urinary sodium retent

ISSN:0007-1323    

DOI:10.1002/bjs.1800770211

出版商:John Wiley&Sons, Ltd.    

年代:1990

数据来源: WILEY