摘要:

In the four years between the beginning of 1979 and the end of 1982, 23 hepatic resections have been carried out for tumours, trauma, biliary access, cystic disease of the liver and spontaneous rupture. There have been four deaths amongst these 23 patients. The 23 resections were performed on 68 patients referred for possible surgery on their hepatic lesions. Right‐sided hepatic resections and resections carried out under emergency circumstances were found to carry a significantly higher risk than all other resections. Of the various organ imaging methods available for assessment of hepatic tumours, CT scanning seems to be the most powerful. Liver surgery is probably best done in a limited number of units prepared to implement appropriate protocols of investigation and surgical managemen

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02449.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Fine needle aspiration cytology (FNAC) of thyroid nodules is a useful diagnostic technique. The cases of 107 patients with pathological changes in the thyroid are reviewed. Nine carcinomata were found – seven of which showed abnormal cytology. There was one false negative but no false positive result. The role of FNAC in pre‐operative evaluation of thyroid nodules is discus

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02450.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

The high incidence (50–60%) of deep venous thrombosis of the legs (DVT) after major thoracic surgery is reduced only by about half with routine low‐dose heparin prophylaxis. The present study compared the efficacy of a higher dose of heparin (7500 U twice daily) with the commonly used dose of 5000 U twice daily in preventing scan‐detected DVT in 100 consecutive patients having thoracotomy for carcinoma of the lung or oesophagus. After the higher dose of heparin, postoperative DVT was not significantly less frequent (22% compared with 33% for total DVT) but was significantly less extensive (8% and 14%, respectively, for bilateral calf DVT, and 0% and 4% for popliteal DVT). Despite prophylaxis, DVT was especially common after oesophagogastrectomy (41% total DVT, 30% extensive DVT). No excessive postoperative bleeding was noted in either group. It is concluded that an increased dose of heparin safely offers increased prophylaxis against DVT in patients undergoing major thoracic surgery for c

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02451.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

During the period 1968–1982, six patients with tracheobronchial ruptures following chest injury were treated in the Royal Newcastle Hospital Intensive Care Unit. In one there was associated oesophageal rupture. The management of these patients is described and recommendations regarding management are mad

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02452.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Three patients with idiopathic Budd‐Chiari syndrome with occlusion of the hepatic veins and significant obstruction of the hepatic segment of the inferior vena cava are presented. The inferior vena caval obstruction precluded the use of conventional side‐to‐side portacaval or mesocaval shunts. Dramatic regression in liver size and resolution of ascites occurred in all three patients following the construction of meso‐atrial shunts using wide‐lumen woven Dacron grafts. Shunt patency was confirmed by angiography in two patients and Doppler studies in one. One patient died five months after surgery and another after 16 months. The shunts were widely patent at autopsy and the full length of the grafts were lined by neo‐intima. The third patient is asymptomatic 20 months after surgery and is free of ascites. Our experience in these three cases suggests that patency can be expected in long synthetic grafts between the portal and systemic venous system provided the shunt is of adequate diameter and there is a pressure gradient between t

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02453.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

This paper describes two cases of true atheromatous aneurysm formation within reversed autogenous saphenous vein used for femoropopliteal bypass graft. We note the rarity of this complication and review the literature for true aneurysm formation within vein grafts used for this and other bypass procedures.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02454.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

The physical and psychosocial consequences of gastric bypass surgery were observed in 30 morbidly obese patients. Twenty‐seven of these patients were satisfied with the results of surgery. Satisfaction was associated with improved health, a better self‐image, and greater social activity. Dissatisfaction occurred when an appreciable amount of weight was not lost, or when the patient's expectations about the results of surgery were unrealis

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02455.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Two family groups with familial carcinoid tumours with metastases are presented. These are the fourth and fifth family groups to be reported which do not occur within the setting of the multiple endocrine neoplasia (MEN) syndrome. Relatives of patients with carcinoid tumours having persistent vague abdominal pain or gastrointestinal symptoms should be investigated.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02456.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Sixty‐one (3.0 %) of 2029 patients managed operatively for carcinoma of the large intestine had synchronous carcinomas. In 47 (77.0%) of the 61 patients the carcinomas were in the same or adjacent segment(s) of large intestine. Adenomatous polyps were present in 18 (30%) patients compared to 269 (14%) of 1968 patients with a single cancer. A curative resection was performed in 40 of 61 patients, palliative resection in 16 and a non‐resection palliative operation in five. Two patients required proctocolectomy and eight subtotal colectomy with ileorectal anastomosis. Cancer specific survival for the entire group and for those treated by curative resection did not differ significantly from that of patients with a single carcinoma. It is concluded that: (1) the presence of a second carcinoma does not significantly alter the survival prospects; (2) both pre‐operative large intestinal examination and careful operative palpation of the entire large intestine should be performed, and (3) the significantly higher incidence of adenomatous polyps in patients with synchronous carcinomas is consistent with the polyp/cancer sequence hypot

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02457.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Cis‐platinum (120 mg/m2) was given to 14 patients with locally inoperable or metastatic transitional cell carcinoma of the bladder. Five patients (35%) showed a response, two complete (14%), and three partial (21%). Nine patients (65%) had no response. The median duration of survival was 3.5 months for non‐responders; 6.5 months for partial responders; and 25 months for complete responders. The side effects and implications of treatment using this agent are discus

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02458.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY