ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07062.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Delivered at the Gcncral Scientific Meeting of the Royal Australasian College of Surgeons, Wellington. New Zealand, May 1990.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07063.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.tb07064.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The incidence and outcome of metastatic squamous cell carcinoma of the skin is poorly documented. This study, undertaken in a population accessible to long‐term follow‐up, documents the metastatic aspects of squamous cell carcinoma of the skin of the trunk and limbs. In a review of 695 cases, metastases occurred in 34 cases, with a metastatic rate of 4.9%, an overall mortality of 3.4%, and a 70.6% mortality in the metastatic group. Forty‐six per cent of overall mortality was associated with inoperable or recurrent regional disease without evidence of distant metastases.The risk factors associated with the development of metastatic disease were; delayed presentation: large neglected lesions: misdiagnosis; and multiple treatments to the primary lesions. In this series no correlation was found between the histological degree of differentiation of the primary tumour and the development of metastases. The mean latent period between treatment of the primary and the diagnosis of metastases was 11 months. Histopathological review of the regional lymph nodes in the operable group showed that adverse pathology such as multiple nodes, extracapsular spread, vascular and perineural invasion. were associated with regional recurrence and short survival.Twenty‐one patients with operable metastases had a mean survival of 53.8 months. This was compared with 13 patients with inoperable disease, in whom the mean survival was 12.2 months (

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07065.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

This paper reviews two of the newer concepts—multiple daily fractions of radiotherapy, and concomitant chemotherapy and radiotherapy—in improving the treatment of squamous cell carcinoma of the head and n

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07066.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Between 1970 and 1990, 104 patients with squamous cell carcinoma (SCC) of the tonsil were treated. The median age was 58 years and 80% of patients were males. Distribution among clinical stages was: stage I, 19 patients; stage II, 12 patients; stage III, 23 patients; and stage IV, 48 patients. More than 70% of patients had initial radiotherapy as definitive treatment irrespective of stage, reflecting the treatment philosophy over much of this period. The overall survival rate was 26% at 5 years, with survival being significantly affected by T stage, clinical stage and age. Clinical node status did not significantly affect survival rates. Good local control of T1N0cancers was achieved with radiotherapy alone, but patients with more advanced cancers did poorly. We have now moved away from a non‐selective policy and use initial surgery combined with postoperative radiotherapy in most patients, reserving radiotherapy alone for mainly early tonsil cancer

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07067.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Five approaches to postal faecal occult blood test (FOBT) were compared in a population sample of 966 subjects collected from three general practitioner patient lists in Southern Sydney. The highest compliance rate (59.8%) was achieved by a method using a general practitioner letter, with no dietary restrictions with FOBT. This was also the least expensive method. Compliance rates can be affected by incorrect address information and screenees not considering themselves to be current patients. An explanation from the family doctor addressed personally to the patient with an enclosed FOBT kit can achieve high compliance rates.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07068.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A retrospective study was performed on 160 patients admitted to the University Surgical Unit between July 1975 and November 1989 with haemorrhoidal disease. Patients' records were analysed with respect to predisposing factors, inpatient management, postoperative analgesia, hospital stay and post‐management complications.One hundred and nineteen patients had haemorrhoidectomy (low ligation combined with an anal stretch). Of these, 1.6% developed urinary retention and 4.2% bled postoperatively but did not require surgical intervention. Ten patients were found to have tight anal canals post surgery and required outpatient anal dilatation. In no case was dilatation necessary for more than 3 months. Three patients required a therapeutic course of antibiotics. Of the 119 patients, 60 required narcotic analgesia for less than 24 hours. Hospital stay was 1–4 nig

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07069.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We report the results of a prospective study of all patients undergoing highly selective vagotomy (HSV) for bleeding duodenal ulceration (BDU) at Concord Hospital between 1979 and 1989. Highly selective vagotomy was undertaken in 63 patients (58 male, 5 female) with a median age of 69 years (range: 16–89). Fifty‐five patients were reviewed, 7 patients having died in the peri‐operative period and one being lost to follow‐up. The mean period to review was 50 months (range: 1–120). Thirty‐six patients have been followed‐up for more than 24 months.Thirty‐day postoperative mortality was 11% (7 patients). Combined major and minor morbidity was 41%. Postoperative rebleeding occurred in four patients (6.3%), three of whom died. Ulceration had recurred in two of 55 patients (4%). Symptoms have been evaluated in 55 patients since operation and 93% have been graded as Visick I or II.We conclude that HSV is effective in the emergency treatment of BDU and has few lon

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07070.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Since 1944 there has been a dramatic change in the pattern of admissions for perforated peptic ulcer (PPU) to the Royal Newcastle Hospital, the main teaching hospital of the Hunter Region, Australia, Between 1944 and 1950, females accounted for 6% of all perforations; since then the proportion of females admitted with this complication has risen to 32%. Simultaneously, the modal age for PPU has shifted from the fifth to the seventh decade and the ratio of gastric to pyloroduodenal perforations has fallen from 1.1:1 to 0.6:1. No good explanation for this change in the natural history of PPU, also noted elsewhere, is evident.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1992.tb07071.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY