ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05921.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Cancer specific survival analysis in a series of 2204 patients managed by one of the authors for large‐intestinal cancer shows a worsened outcome for patients treated operatively for rectal cancer from 1970 to 1979 in comparison with the two previous decades (p>0.05). Cancer specific survival after curative resection has also worsened (p>0.001). These changes are partly explained by an increase in Dukes' stage C tumours (p = 0.01). Paradoxically, the deterioration has been paralleled by earlier diagnosis (p>0.01). The worsened outcome cannot be accounted for by changes in sex or age distribution, tumour site, patient referral pattern or by an increase in sphincter‐saving operations. The hypothesis advanced that a real change has occurred in the behaviour of rectal cancer in the Australian community requires further testing. There has been no significant change in survival prospects between the last two decades for colonic cancer patients treated operatively. A national cancer registry should be established to monitor changes in the epidemiology and survival prospects of large‐intestinal cancer and of her maligna

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05922.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

A review of 532 patients undergoing elective resection for colorectal carcinoma between January 1971 and December 1978 showed no significant trend in the proportion of right colon carcinomas resected during this time. There was a higher proportion of advanced‐stage tumours in the right colon than in the rectum. Patients with carcinoma of the right colon had a significantly poorer survival than did patients with rectal carcinom

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05923.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

The biological vagaries of anal malignant melanoma are illustrated by four cases in Chinese patients. All four died within five years. Their poor prognosis emphasizes the value of preoperative studies to detect clinically occult metastases and obviate futile radical surgery. Many patients already have disseminated disease at the time of diagnosis, and local excision of the tumour provides acceptable palliation. For localized disease, abdominoperineal resection prevents local recurrence and removes the mesenteric nodes which are frequently involved. Palpable inguinal nodes necessitate therapeutic groin dissection, but we perform elective resection only when affected nodes are found at laparotomy. Pelvic lymphadenectomy should be performed in conjunction with abdominoperineal resection. The efficacy of chemotherapy for anorectal melanoma remains uncertain.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05924.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

The extent to which new information on colorectal cancer (C.C.) is being transmitted to medical undergraduates was assessed in a repeated survey of new interns' knowledge of and attitudes on C.C. A probability sample of 214 graduates of the two Sydney medical schools was drawn as they commenced their internships in 1978. A comparable sample of 186 was drawn in 1980. Interns in each sub‐sample completed a questionnaire of 54 pre‐coded items of knowledge of C.C. epidemiology, early diagnosis, and followup, and on their attitudes towards C.C. On most topics knowledge was not well developed, and 1980 graduates were not significantly better informed than those of 1978. Almost three‐quarters of 1980 interns intend using faecal occult blood te

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05925.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Over a period of 30 years a total of 27 patients have been subjected to partial or complete colectomy and anastomosis for constipation. Patients fall into four groups: (i) functional constipation; (ii) adult megacolon; (iii) megasigmoid and (iv) persistent Hirschsprung's disease. The first two groups comprised 17 patients with resistant constipation, with or without megacolon or dolichocolon. Seven (41%) of these patients subsequently required operation for acute small‐bowel obstruction due to adhesions. In two patients a permanent ileostomy was necessary for persistent rectal inertia after colectomy. The functional results in these first two groups were good. The third and fourth groups had similar presenting features; five had megasigmoid, and in these resection of the sigmoid colon gave good results. The remaining five patients with proven Hirschsprung's disease responded well to a pull‐through resection (4) and to colectomy and anastomosis

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05926.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Eighty‐five patients who developed pelvic recurrence after abdominoperineal resection for carcinoma of the rectum have been reviewed. The average period of latency was 16 months, with increasing incidence of recurrence in the more advanced stages of the disease. Eighty per cent of recurrences occurred within two years of surgical treatment and a further 20% between two and five years after operation. The prominent manifestations were pelvic pain (100%) and mass (54%), which responded to palliative radiotherapy in 92% and 80% of the cases respectively. The mean duration of palliation was 6.5 months. Patients with pelvic recurrence secondary to rectal carcinoma benefit from palliative radiation therapy, and this should be given whenever possibl

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05927.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

A comparative study of the accumulative five‐year survival rates was made between patients with symptomatic peripheral vascular disease and patients with operable colorectal carcinoma. There was no significant difference between the two groups, but both had a significantly lower longevity than the normal population of the same average age (p>0.01). The patients' age at the time of treatment and their sex influenced survival in a similar manner in both colorectal cancer and peripheral vascular disease, there being no significant difference in the five‐year survival curves in this comparison. A subset of individuals with colorectal cancer, those with Stage A lesions, were distinguished from the remainder. Their survival was significantly better than that of those patients with peripheral vascular disease (p>0.05) and was almost identical to that of the normal age‐matched popul

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05928.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

A cross‐sectional survey was carried out in the Bangalow Valley on the far north coast of New South Wales to determine the prevalence of lower limb ischaemia. A study was made of 80.2% of the population aged thirty years and over. The presence or absence of peripheral vascular disease was determined by clinical history, clinical examination, and measurement of peripheral arterial pressures with a Doppler ultrasonic velocity detector. Twelve out of 232 (5.2%) males and seven out of 282 (2.5%) females had symptomatic lower limb ischaemia. From these data the predicted incidence of lower limb ischaemia in the sixth and seventh decades in New South Wales is 40/10,000/year in males and 14.5/10,000/year in females. These N.S.W. data are compared with studies in the United Kingdom, the United States of America, and Switzerland, and similarities are noted indicating the universal nature of lower limb atherosclerosis in developed countrie

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05929.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Thomas shunts have been utilized 24 times in 20 patients to provide secondary vascular access in an often poor‐risk group of patients, including children. Twenty of the shunts were on the iliac vessels. Five shunts are in current use, the longest having beenin situfor 83 months. Another 13 shunts provided access until renal transplantation or death of the patient. Six shunts developed deep infection which usually extended to the Dacron‐arterial anastomosis; the management of these infected iliac shunts was difficult and hazardous. No definite advantage for the iliac placement of shunts has been established, and its use at this site cannot be recommended. Although the Thomas shunt can provide good long‐term access, our experience suggests that its use should be limited to that of a “shunt of last

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05930.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY