摘要:

&NA;The results after gracilis muscle transposition were studied in ten patients with a follow‐up of six months to 17 years. Nine patients were continent for formed feces and the condition of one patient worsened after operation. Anorectal manometry was performed in eight of the ten patients. Evaluation of pressure recordings showed a normal image, both at rest and at maximal squeeze, in five patients. Low‐pressure recordings at rest and at maximal squeeze were seen in two continent patients, in whom the tissue scarring resulted in narrowing of the anal canal. One patient with low‐pressure recordings was completely incontinent. An attempt was made to explain the continence and low‐pressure recordings. The results suggest gracilis muscle transposition to be a method of choice in patients with total incontinence who have no functional anal sphincter.

ISSN:0012-3706    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

&NA;A modification of the technique suggested by Hopkinson for the repair of rectal prolapse via the perineal route is described. This technique involves the use of an Angelchik Anti‐Reflux ProsthesisTMand is particularly suitable for elderly patients in whom abdominal rectopexy would be hazardous because of general health.

ISSN:0012-3706    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

&NA;The purpose of this paper is to show whether there is a keyhole deformity, its surgical significance, and how often it occurred following surgery for ulcer‐in‐ano. To do this, a retrospective study, over a 16‐year period, of all patients admitted to the Ferguson Clinic with chief complaints of anal incontinence was undertaken. Of this group of patients, seven were identified as having questionable keyhole deformities, three of whom probably had classic defects. There were six females and one male. Only two of the deformities were associated with surgery for ulcer‐in‐ano. One of these was easily repaired and the other patient had a full rectal prolapse. In addition, of 186 patients undergoing fistula surgery, 77 who had posterior midline transsphincteric fistulas were studied and ten of these patients went on to complete recovery without any permanent problems resulting from severance of the sphincter. It can generally be concluded that, although there is such a defect as the keyhole deformity, it occurs only rarely, especially after surgery for ulcer‐in‐ano, and that many times it is not associated with anal incontinence.

ISSN:0012-3706    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

&NA;Staining of 326 rectal mucosal biopsies from ulcerative colitis patients with peanut agglutinin (PNA), which binds to the T‐blood group antigen and has been claimed to reflect a cancer‐associated mucin alteration, showed highly significant direct associations with mucosal dysplasia (P<0.001), disease activity (P<0.001), and subsequent development of rectal cancer in a smaller series of patients (P=0.005). Staining for normal colonic mucin by theDolichos biflorus(DBA) lectin related significantly and inversely to dysplasia. Intense normal colon mucin staining by DBA related significantly (P<0.025) to long disease duration and to subsequent development of cancer (P=0.02). The latter association is based on a small number of patients only and is not considered conclusive evidence, but may provide a link with goblet‐cell hyperplasia. The authors conclude that although T‐antigen expression relates to dysplasia, the findings of “false” positive and negative rates of 22 and 33 percent respectively, make it unlikely that staining of biopsy sections for the T‐antigen by peanut agglutinin will contribute materially to routine assessment for dysplasia and cancer risk prediction in patients with ulcerative colitis.

ISSN:0012-3706    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

&NA;Final evaluation of the Infusaid Pump system (Infusaid Corporation, Sharon, MA) for administration of regional chemotherapy must await completion of trials prospectively comparing survival of matched patients treated in this manner and patients treated by traditional systemic chemotherapy. A review of the current medical literature confirms our personal experience that response rates within the liver are high. Survival reports appear encouraging but this may represent an artifact in patient selection. An algorithm is presented to offer surgeons a reasonable and conservative means for selection of those colorectal cancer patients with metastatic involvement of the liver who are most likely to benefit from this system of drug delivery.

ISSN:0012-3706    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

&NA;The delivery of chemotherapy through the implantable hepatic infusion pump in the management of patients with hepatic metastases secondary to carcinoma of the colon and rectum is evaluated in this preliminary prospective study. Patients were selected according to hepatic lobar distribution and magnitude, age, and general systemic evaluation. Infusion pumps were implanted in a total of 14 patients who were judged to be unsuitable for hepatic resection. After pump implantation all patients were alive and well and receiving regional perfusion chemotherapy. For the nine patients in this study who have been monitored for a full six months, the median decrease in CEA levels was 49 percent. On computerized axial tomography (CT) and/or liver‐spleen scan, five patients showed greater than 50 percent reduction in tumor size. All patients have demonstrated minimal systemic toxicity and have maintained a good quality of life. The results encourage further evaluation of perfusion chemotherapy.

ISSN:0012-3706    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

&NA;The relationship between cholecystectomy and large‐bowel cancer development was investigated in animal models. Female ICR mice underwent cholecystectomy, and received 15 weekly intragastric administrations (Experiment 1) or 10 weekly subcutaneous injections (Experiment 2) of 15 mg/kg body weight of large‐bowel carcinogen 1,2‐dimethylhydrazine (DMH). Autopsy at 28 weeks after surgery showed that cholecystectomized mice had a nonsignificantly increased incidence of large‐bowel carcinomas, compared to sham‐operated and/or unoperated control mice (85 vs. 64 percent in Experiment 1; 31 vs. 16 and 20 percent in Experiment 2). Cholecystectomy alone without DMH treatment did not produce any cancer. Cholecystectomized mice excreted a significantly increased level of primary bile acids but an unchanged level of secondary bile acids in the feces, compared with unoperated control mice. It is obvious that cholecystectomy enhanced the development of DMH‐induced, large‐bowel carcinomas along with the change of fecal bile acid composition, suggesting that changes of bile acid metabolism after cholecystectomy may enhance or promote large‐bowel carcinogenesis in man as well. This association of cholecystectomy and large‐bowel cancer is not a strong one however, as presented in epidemiologic as well as experimental studies.

ISSN:0012-3706    

出版商:OVID    

年代:1985

数据来源: OVID