ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb05455.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The International Committee of the Red Cross (ICRC) is at the forefront in the provision of surgical care to the victims of war. In 1990 twenty‐two surgical teams were deployed in 14 hospitals in eight countries and 18 450 patients were treated. This article reviews the contribution made by ICRC, and the experience that can be gained by New Zealand and Australian surgeons and anaesthetist

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb05456.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb05457.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb05458.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A consecutive series of 220 laparoscopic cholecystectomies (June 1990 to May 1991) is presented. These were the author's initial experience of the technique. Procedures were elective (205) and acute (15). including 3 gangrenous cholecystitis and 4 empyema. There were 166 females and 34 males, 12–75 years, weighing 44–115 kg. Forty‐eight patients had prior abdominal surgery. Two hundred and eleven patients had successful laparoscopic cholecystectomies, 6 open cholecystectomies and 3 mini laparotomies to remove spilt stones. None of the last 120 cases were opened. Operating time ranged from 20min to 3h 20min. There were 4 serious complications: 2 bile leaks from the gall‐bladder bed and 2 jejunal injuries (Veres needle and 5 mm trocar). Sixty‐one patients were discharged the next day, 29 on day 2, 5 on day 3, 4 on day 4, 1 on day 5, I on day 22 and I on day 27. At two weeks follow‐up all but 2 patients had full

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb05459.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The indications, contraindications and complications of percutaneous laparoscopic cholecystectomy (PLC) were established from a group of 308 patients referred for cholecystectomy. Of the 308 patients 86% underwent PLC, 5% were commenced laparoscopically, but converted to open cholecystectomy and 9% were performed as open cholecystectomy from the outset.Complications included two bile leaks from the gall‐bladder bed, one cystic duct stump leak and three retained stones. Pre‐operative rather than intra‐operative duct imaging was used so that common duct stones could be removed before operation. PLC is a safe procedure that has now become the standard technique for cholecyste

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb05460.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb05461.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

During a 6 year period, 31 consecutive patients under the care of one surgeon had emergency colectomies for complicated colitis. A selective policy of closing the rectum intraperitoneally to minimize the length of retained diseased bowel and to avoid a mucus fistula was used during the study period. One patient underwent proctocolectomy, 7 subtotal colectomy with mucus fistula and 23 total colectomies with intraperitoneal closure of the rectum. Two patients (8.9%) developed pelvic sepsis. Both had intraperitoneal closure of the rectal stump and were readily managed by drainage into the stump. Subsequent surgery in the 18 patients having rectal excision has been uncomplicated. Intraperitoneal closure of the rectal stump in emergency surgery for complicated colitis can be performed safely in most of these patients.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb05462.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A review of the Hartmann's operation for patients with rectal and sigmoid cancer over an 18 year period is presented. There were 1063 patients who had a resection for carcinoma of the rectum or sigmoid colon and 4.4% of these had a Hartmann's procedure. This operation was particularly useful in the management of patients who presented with a proximal obstruction or perforation at the tumour site. It was also effective in the elective treatment of elderly unfit patients who had locally advanced tumors or those with distant metastases. Re‐anastomosis is recommended in those patients who are relatively fit and have had a potentially curative resectio

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb05463.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

This study was carried out to evaluate the predictive power of a mathematical model called TRISS in identifying avoidable trauma deaths when compared with peer review (PR).The subjects studied comprised the 24 deaths that occurred among 81 severely injured patients (Injury Severity Score ≥ 16) admitted to a trauma unit over a 1 year period.Sixteen patients who had a>50% probability of survival (Ps) calculated by TRISS died. Peer review concluded that five of those were potentially avoidable deaths. Eight deaths occurred in patients with a Ps less than 50%. Peer review regarded those eight as inevitable deaths.The data. when analysed, showed TRISS to have a 100% sensitivity, 42% specificity, 31% positive predictive value and a negative predictive value of 100% when compared with peer review.It is concluded that TRISS tends to over‐estimate potentially avoidable death, especially in patients with severe head injury. However it is a good audit filter as it reliably excludes inevitable de

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb05464.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY