ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01356.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.tb01357.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.tb01358.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Parathyroid surgery was performed on 50 patients following thallium‐technetium subtraction scanning. Parathyroid adenomata were correctly localized in 34 (83%). Of eight patients with hyperplastic glands, 15 (75%) of these glands were correctly localized. There were seven (17%) false negative scans and one (2%) false positive result. Thallium‐technetium subtraction scanning is a valuable technique in the pre‐operative assessment of patients with clinical evidence of hyperparathyro

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01359.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Thirty‐five patients requiring tracheostomy or endotracheal intubation, following thyroidectomy are reviewed. Conditions included 30 patients with multinodular goitre, three patients with graves's disease and two patients with carcinoma of the thyroid. Early in the series, emergency tracheostomy was performed in three patients with airway obstruction following thyroidectomy. Ten patients were deemed at extremely high risk of developing airway obstruction and underwent prophylactic tracheostomy. Endotracheal intubation has been used in preference to tracheostomy in the latter part of the series. Emergency endoctracheal intubation was performed on one patient and prophylactic intubation was carried out in 20 patients. The morbidity and length of hospital stay in this latter group was considerably less than those requiring tracheostomy. It is concluded that patients with potential airway obstruction following thyroidectomy should have prophylactic endotracheal intubation, in preference to tracheostom

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01360.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Forty‐six patients with smooth muscle tumours of the stomach and small intestine were treated surgically at the princess alexandra hospital between 1970 and 1986. Leiomyomas were three times more common than leiomyosarcomas, but malignant tumours occurred more frequently in the small intestine than in the stomach. Gastric tumours tended to present with gastrointestinal bleeding, in contrast to intestinal lesions which presented predominantly with abdominal pain. Although leiomyomas tend to be smaller at operation than leiomyosarcomas, the size of a smooth muscle tumour is not reliable in discriminating between benign and malignant lesions. Therefore all smooth muscle tumours of the upper gastrointestinal tract should be excised as widely as possible, including local lymphatics in the dissection where practicable, so as to maximize the likelihood of radical extirpation of malignant lesions. Approximately one‐third of patients with leiomyosarcomas have metastases at the time of surgery; the 5 year survival rate after surgical treatment of leiomyosarcomas of the upper gastrointestinal tract is less than

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01361.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

A simple microcomputer based surgical audit system, written by one of the authors and implemented on a tandy model iv microcomputer, is described. The system allows data from 2000 patients to be stored on a single disc. Data stored can be easily analysed and used to audit clinical activity.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01362.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Transluminal (balloon) angioplasty of iliac or superficial femoral stenoses in 18 diabetic patients resulted in a significant improvement in ankle/brachial systolic pressure index with marked symptomatic improvement in 16, little change in one and deterioration requiring arterial bypass surgery in one patient. Follow‐up for 12 months or more showed that the initial good results were sustained despite a downward drift in ankle pressures. These findings indicate that transluminal angioplasty has a useful place in the management of proximal atherosclerotic stenotic lesions in diabetic patients with symptomatic peripheral vascular diseas

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01363.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

A restrospective study was undertaken to assess the influence of known ischaemic heart disease on the operative and the long‐term survival of patients undergoing elective repair of an abdominal aortic aneurysm. One hundred and seventy‐one patients underwent elective surgery between june 1977 and december 1983. The patients were divided on routine clinical grounds into cardiac and noncardiac groups. Ninety‐five patients had a history of heart disease and/or an abnormal resting pre‐operative ecg. Seventy‐six patients had no history of heart disease and a normal pre‐operative resting ecg.Two of the seven operative deaths were due to myocardial infarction with one each from the cardiac and noncardiac groups. Eight patients suffered an acute myocardial infarction with five from the cardiac and three from the noncardiac group and this was not significantly different. The overall survival of 95% at 1 year and 76% at 5 years closely follows the age/sex matched australian population. The survival at 1 year in the cardiac group was 97% and 95% in the noncardiac group. The 5 year survival was 72% and 79% respectively. During follow‐up to december 1984, 11 patients died from ischaemic heart disease with six from the cardiac and five from the noncardiac group. No significant difference was found between the two groups in the incidence of myocardial infarction or the short‐and long‐term survival.This study does not support a more aggressive approach to coronary artery disease in the pre‐operative management of patients with abdomi

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01364.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Thirty consecutive patients with angina pectoris undergoing coronary artcry bypass grafting using the proximally attached right gastro‐epiploic artery are described.Posterior coronary arteries were grafted using the right gastro‐epiploic artery, and grafts to the left coronary artery were done using predominantly internal mammary artery grafts. The right gastro‐epiploic artery graft is mobilized along the greater curvature of the stomach, and transected distally. With cardiopulmonary bypass and blood cardioplegic arrest for myocardial preservation during cross‐clamping of the aorta, the distal end of the artery is anastomosed end‐to‐side to the posterior descending artery or a postero‐lateral branch, or to both, using a sequential technique. Twenty‐five of the patients complained of symptoms suggestive of angina early postoperatively but are currently symptom‐free with normal excercise tolerance.Thirteen patients had postoperative exercise tests: eight were normal, two were inconclusive, and three were abnormal. Nine grafted coronary arteries were re‐angiogrammed, and seven were judged to be patent. It is concluded that, as an alternative resource, the right gastro‐epiploic artery can be used to bypass coronary obstructions expeditiously and with results comparable to those obtained with the saphenous vein or in

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01365.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY