ISSN:0007-1323    

DOI:10.1002/bjs.1800780102

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800780103

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800780104

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractTransabdominal exposure is the most widely used surgical approach to the infrarenal aorta. Over the last 30 years a number of surgeons have championed the retroperitoneal approach for repair of abdominal aortic aneurysms and aortoiliac occlusive disease using a variety of incisions. Several studies attest to the clinical superiority of this approach over the transabdominal route and recent evidence demonstrates reduced physiological disturbance with this technique. The retroperitoneal approach is suitable for all elective operations on the abdominal aorta, particularly in patients with high‐risk aneurysms and in selected patients with symptomatic and ruptured aneurysm

ISSN:0007-1323    

DOI:10.1002/bjs.1800780105

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractRecurrent Crohn's disease develops in most patients after surgical resection if the patient is followed for sufficient time. This review examines various aspects of recurrent Crohn's disease. It is concluded that Crohn's disease is a diffuse condition of the gastrointestinal tract and that radical resection of Crohn's disease does not prevent recurrence. Assorted factors thought to be associated with recurrence are examined and the relevance of these factors to the surgeon treating Crohn's disease is discussed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800780106

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractFrom August 1969 to December 1989, 600 patients had elective proximal gastric vagotomy for duodenal ulceration with an operative mortality of 0·2 per cent. Of these, 372 patients had surgery over 10 years ago. Three hundred and forty‐two patients survived for more than 10 years and, in a prospective study, 305 were reviewed, forming the basis of this 10–20‐year follow‐up report. Forty‐six (15 per cent) have had recurrent ulceration; 80 per cent of these developed symptoms within 5 years and no patient has had recurrence after 13 years. Although 29 patients required reoperation for recurrent ulceration, the current patient satisfaction rate for Visick grades I and II is 92 per cent. Only two patients required reoperation because of gastric stasis. It is concluded that proximal gastric vagotomy is a safe and satisfactory first choice operation for duodenal

ISSN:0007-1323    

DOI:10.1002/bjs.1800780107

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800780108

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractGastric adaptive relaxation is reported to be impaired after vagotomy. This abnormality has been implicated in the pathogenesis of postvagotomy symptoms, but no association has previously been demonstrated between the two. Gastric adaptive relaxation was measured in 15 healthy volunteers and 33 patients more than 1 year after highly selective vagotomy or truncal vagotomy and drainage. Seventeen patients were asymptomatic. The remainder were symptomatic including seven patients with persistent diarrhoea. Fasted subjects were intubated with a Ryle's tube containing a pressure microtransducer within a flaccid (800 ml) plastic bag. Gastric corpus‐fundus pressure was recorded during distension of the bag with air (15 ml/s) over 30 s. Pressure indices were derived from the areas under the pressure curves. Median (range) pressure indices were: healthy volunteers 12·7 (7·5–17·1) cmH2O, highly selective vagotomy 14·0 (9·8–15·9) cmH2O (n.s.), truncal vagotomy and drainage 14·5 (8·6–26·8) cmH2O (P = 0·04). All patients with diarrhoea had abnormally high pressure indices (P<0·001). Pressure indices in all other patient groups were within the normal range. We conclude that gastric adaptive relaxation remains abnormal in patients with postvagotomy diarrhoea but not in those who are asymptomatic or who h

ISSN:0007-1323    

DOI:10.1002/bjs.1800780109

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractTo evaluate the effects of improvements in medical therapy on the incidence of, indications for and operative methods used in peptic ulcer surgery, all cases of primary peptic ulcer surgery among adults in the city of Helsinki in the years 1972, 1977, 1982 and 1987 were analysed. There was a total of 565 such cases in a population which consisted of 5·2 × 105individuals in 1972 and 4·8 × 105individuals in 1987. The introduction of H2‐receptor antagonists in 1979 was associated with a fall in the annual incidence of elective duodenal ulcer operations, from 15·5 to 6·7 per 105individuals, and a fall in the annual incidence of elective gastric ulcer operations, from 9·4 to 3·1 per 105individuals (P<0·05). The decrease was greatest among males with duodenal ulcer. In contrast, the annual incidence of emergency surgery for ulcer haemorrhage and perforation (all types of ulcers) remained relatively stable, varying from 7·2 to 10·2 per 105inhabitants over the observation period (n.s.). The mean age of patients undergoing elective surgery remained essentially unchanged. The mean age of patients undergoing emergency surgery increased. The decrease in the annual incidence of elective duodenal ulcer surgery occurred mainly in relation to proximal gastric vagotomy. There was a concomitant relative increase in the incidence of gastric resection. The types of operative procedures used in cases of pyloric, prepyloric and gastric ulcer remained unchanged over the years

ISSN:0007-1323    

DOI:10.1002/bjs.1800780110

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY

摘要:

AbstractThe ability to belch was evaluated by a novel test, after gaseous stomach distension to standard volume, in 16 patients after antireflux surgery and nine healthy volunteers. A structured assessment of dyspeptic symptoms was also carried out in both groups. Repeat studies in volunteers showed acceptable reproducibility for the new test of belching capacity (within‐subject coefficient of variance 4·5 per cent). After antireflux surgery, patients had lower volume individual belches (median(range) 27·5(0–104) ml in patients versus 76(15–165) ml in volunteers; P<0·02) and belched less gas within 1 h of the stimulus than volunteers (median(range) 205(0–1363) ml in patients versus 456(45–818) ml in volunteers; P<0·05). Belching frequency was similar in both groups. The incidence and severity of symptoms were unrelated to belche

ISSN:0007-1323    

DOI:10.1002/bjs.1800780111

出版商:John Wiley&Sons, Ltd.    

年代:1991

数据来源: WILEY