ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01408.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01409.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01410.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Classical radical neck dissection (rnd) remains the primary treatment for clinically positive lymph nodes among patients with squamous carcinoma of the upper aerodigestive tract. Recurrence rates following rnd range from 20 to 70% depending on the number of nodes involved and the extent of extracapsular spread. Modified radical neck dissection (mrnd) is associated with less cosmetic and functional morbidity than rnd but, used alone, mrnd is only appropriate when clinical neck disease is absent or minimal. Both rnd and mrnd should be combined with adjuvant postoperative radiotherapy when more than one node is positive or extracapsular spread is present. This approach will significantly decrease regional failure, but may not improve survival because of an increased incidence of distant metastases. Mrnd is especially useful as an elective procedure to stage the clinically negative neck. A survival benefit from elective neck dissection, however, remains to be demonstrated.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01411.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

There is new evidence from experiments in conscious animals that when acute blood loss exceeds about 30% of blood volume, reflex vasoconstriction is abruptly replaced by widespread vasodilatation, and there is a precipitous fall in arterial blood pressure. This vasodilatation is associated with a decline in sympathetic vasoconstrictor drive. It is likely that the signal which causes the switch from vasoconstriction to vasodilatation reaches the brain via afferent nerves from the heart. There is also circumstantial evidence that endogenous opiate mechanisms are involved in the translation of the cardiac afferent signal into failure of reflex sympathetic vasoconstrictor drive. These mechanisms may explain the ‘vaso‐vagal’ reaction that can occur in man during or following acute, severe, blood

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01412.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

The craniofacial resection operation was developed for the treatment of advanced nasal, paranasal and orbital malignancies. It has been refined in recent years, giving increased cure rates and better palliation when cure is not possible. When used to treat extensive benign lesions involving the anterior skull base, this procedure allows more complete and safer resection with better access for repair and avoidance of major complications of brain damage, cerebrospinal fluid leak and haemorrhage. Presented here is a technique for craniofacial resection. The study demonstrates its effectiveness and low morbidity in treating 10 patients with extensive benign disease.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01413.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

In a series of 253 excisions of cancer of the floor of the mouth, 57 marginal resections of the mandible retaining mandibular continuity were performed. Tumour recurred at the primary site in six of the 47 patients available for review at three years; three within the mandible itself. Three patients died with uncontrolled primary disease, but the other three survived after additional surgery and/or radiation therapy. Although this recurrence rate might appear high, the outcome of the total series is comparable with other reported series. The results do not finally demonstrate that marginal resection can be used freely, but the low morbidity and good functional results make the technique attractive. Further prospective study is needed to refine the indications for both conservation and ablation of the mandible.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01414.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Seventy patients with squamous cell cancer of the oral cavity or oropharynx, because of advanced disease, or excision of residual or recurrent disease after radiotherapy required pedicle flap reconstruction. All were treated before 1 january 1976. Analysis of the outcome of these patients, some of whom were elderly, and most heavy smokers, showed that 17 (24.3%) survived 10 years or more. Age, metastatic neck nodes, and prior failure of radiation therapy to control the cancer did not seem to influence the prognosis significantly. It is concluded that, if patients are fit, and a reasonable quality of life can be assured with either a pedicle or vascularized free flap reconstruction, major resection is justified when technically feasible.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01415.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

The efficacy of low pressure, high pressure and passive drainage systems have been compared after cholecys‐tectomy. Symptoms of pain, discomfort and nausea were compared using linear analogue scales and spirometry was used to examine pre‐operative and postoperative respiratory function. The low pressure suction drain removed an intraperitoneal marker, gentamicin, more effectively than the high pressure suction drain, but not more effectively than the passive drain. There were no differences in postoperative respiratory function nor in the amount of pain or discomfort between the groups. The passive drain group reported less nausea than the suction drain groups. If a negative pressure drainage system is to be used, a low pressure suction drain should be used in preference to a high pressure sys

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01416.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

The treatment of severe pancreatitis remains a challenge. Eighty‐six cases were retrospectively reviewed after treatment in intensive care units at two major brisbane hospitals between january 1980 and may 1986. Thirty‐three patients died. Sixty‐one patients had 97 operations, with 40% mortality. The severity of biliary and postoperative pancreatitis is highlighted. After early detection and aggressive resuscitation of severe cases, repeated debridement of necrotic pancreas and retroperitoneal slough may offer the best treatment. Marsupialization is an effective method of controlling sepsis after necrosectomy and abscess dra

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01417.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY