ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;From 1968 to 1975, 201 women had prophylactic oophorectomy at the time of definitive large‐bowel resection, while in 134 patients oophorectomy was not performed. Oophorectomy was performed more commonly in women with cancer of the rectum and rectosigmoid. More patients undergoing oophorectomy had Dukes' C primary carcinoma. Four patients undergoing synchronous oophorectomy (2.0 per cent) had ovarian involvement or metastases from large‐bowel cancer. Three patients (2.2 per cent) developed subsequent ovarian disease: two cases of ovarian carcinoma and one case of ovarian metastases from primary breast cancer. No late ovarian recurrences of large‐bowel cancer were seen during this study. No patient with ovarian involvement or metastases from large‐bowel cancer survive five years nor was the overall survival of the group of women undergoing oophorectomy materially affected. While stage and site significantly influenced survival, oophorectomy, menopausal status, preoperative irradiation, tumor size, and degree of differentiation had no influence. The prevention of primary ovarian cancer in postmenopausal women is considered to be the main benefit of bilateral prophylactic oophorectomy. Selective recommendations for oophorectomy under other circumstances are discussed.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;Conventionally, acquired diverticular disease of the colon has been regarded as a single entity, so far as complications go. Experience at St. Vincent's Hospital, Melbourne, suggests that there are two kinds of diverticular disease, one with the classic muscle abnormality, chiefly confined to the left colon and characterized by inflammatory and perforative complications and the other without muscle abnormality, but with diverticula throughout the colon, in which bleeding is common, perhaps due to a connective‐tissue abnormality which, on the one hand, allows development of diverticula in the absence of abnormal intraluminal pressure and, on the other, provides inadequate support for vessels in the diverticular wall or for vascular malformations, which are therefore likely to bleed. Clinical evidence from admissions to St. vincent's Hospital suggests that both acute and chronic pain may be either inflammatory or associated with muscle spasm and hypertrophy. Finally, there is some evidence to suggest that perforation may be due often, or usually, to abnormal intraluminal pressures rather than to diverticular inflammation.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;Experience with 66 penetrating injuries of the retroperitoneal colon and rectum is reviewed. These injuries usually affect the intraperitoneal anterior and the retroperitoneal posterior walls. The bare areas of the colon have to be inspected when only one intraperitoneal hole is found or whenever the wound is in the flank or back. There is an increasing tendency toward primary suture rather than exteriorization unless there are multiple severe intra‐abodominal injuries, gross contamination, or poor general condition of the patient. Rectal injuries require careful repair, diverting colostomy, irrigation of the excluded rectum and presacral drainage. For suspected bowel injuries, antibiotics should be started preoperatively

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;In an effort to elucidate whether bacteremia occurs during endoscopic examination of the lower gastrointestinal tract, two prospective spective studies were undertaken involving patients undergoing colonoscopy and proctosigmoidoscopy. The former group has been presented earlier, and the second study, which includes the proctosigmoidoscopy group, is the basis for this study. Fiftyseven patients undergoing proctosigmoidoscopy were studied. Excluded from the study were patients with fever, diarrhea, inflammatory bowel disease, valvular heart disease, vascular prosthesis, chemotherapy, and immunosuppression. Aerobic and anaerobic blood cultures were taken before, during, and after proctosigmoidoscopy. Additional cultures were taken after a biopsy or polypectomy. Skin cultures were taken from the venipuncture site prior to venipuncture. No bacteremia was demonstrated. Three blood cultures were positive, but all were considered contaminants on the basis of the nature of organisms. No correlates could be drawn as to the depth of insertion, length of time, or position of patient during the procedure. It is concluded that no significant bacteremia occurs during proctosigmoidoscopy. Further studies are warranted in the excluded high‐risk group.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;Early surgical complications following colostomy closure in 65 cancer patients operated on at the Istituto Nazionale Tumori of Milan were evaluated retrospectively. The overall complication rate was 24.6 per cent, including infections (13.8 per cent), fistulas (6.1 per cent), wound dehiscence (3.0 per cent), and distal stenosis (1.5 per cent). Type and rate of complications were analyzed to find a correlation with type, site, and location of colostomy, technique of closure, presence or absence of drains, or time interval between construction and closure of colostomy. No statistically significant association between the aforementioned factors and occurrence and rate of complications was found. The authors think, therefore, that surgical attention, including meticulous manipulation of the stoma, avoidance of contamination of the wound, tension of sutures, dead spaces, and collection of blood in the wound, and use of antibiotics and antiseptics are the most important principles to minimize postoperative complications.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;External beam megavoltage radiation therapy was used as primary treatment for 123 patients with rectal adenocarcinoma. Surgery was undertaken for some patients who had residual tumor. The overall five‐year survival rate was 21 per cent. When patients were separated into those who presented with clinically mobile and those with clinically fixed rectal tumor masses, the survival rates were 38 per cent and 2 per cent, respectively. The primary tumor was controlled by radiation alone in 21 of 56 (38 per cent) patients who had mobile tumors but in only six of 67 (9 per cent) patients who had fixed tumors. Further investigation of high‐dose primary radiation, with surgery reserved for patients with residual rectal carcinoma, may allow reduction of the number of patients who require abdominoperineal resection.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID