摘要:

AbstractA survey is presented of 293 cases of lung cancer operated on by one surgeon over a period of 35 years. Lobectomy was done in 86 cases with a mortality of 3.5 per cent. Simple pneumonectomy was done in 89 cases with a mortality of 20 per cent, and radical pneumonectomy in 118 cases with a mortality of 15.25 per cent.The survival rate after 5 or more years for lobectomy was 41 per cent (34 patients). After simple pneumonectomy 21 patients (30 per cent) lived 5 years or more, and after radical pneumonectomy 39 patients (39 per cent) lived 5 years or more. The survival of the patients in whom the excised lymph nodes were involved by growth is presented. It is pointed out that at least 1 in 3 patients with cancer of the lung treated by operation was alive 5 years later.The very good long term results are presented including the 10‐year and 20‐year survival rates. Two patients are still alive after 30 and 34 years respectively. One patient is alive 29 years after a lobectomy and 13 years after a contralateral lobectomy for a new primary cancer. A second new cancer occurred in 9 patients. Continuance of smoking is shown to be harmful.The factors affecting the long term freedom from recurrence are discussed. The cell type of the cancer is shown to be important. Squamous‐celled growths have the best results and oat‐celled and small‐celled the worst, although long term survival can follow operation for both these. The occurrence of a pleural infection after operation may be favourable to long term freedom from recurrence and this was probably so in 2 patients who lived 25 and 27 years respectively and 1 patient who is still alive after 34 years.On the whole the evidence is unconvincing that much benefit may follow radiotherapy combined with

ISSN:0007-1323    

DOI:10.1002/bjs.1800620102

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractA fatal cardiac tamponade caused by an intact polyethylene central venous catheter perforating the wall of the right ventricle is reported. A retrospective review of 105 central venous catheters used in an intensive care unit revealed a high incidence of catheter malposition and a 20 per cent mechanical complication rate. The possible causes of these malpositions and complications are discussed. Guidelines for the safer use of central venous catheters are presented.

ISSN:0007-1323    

DOI:10.1002/bjs.1800620103

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractMeasurements of the lower oesophageal sphincter pressure and gastric secretion were made in patients with dyspepsia but no reflux and in patients with a hiatus hernia and reflux in response to a near maximal dose of pentagastrin. Patients with hiatus hernia had lower resting sphincter pressures than those with dyspepsia. The magnitude of the pressure rise following pentagastrin was related to the resting tone of the sphincter. However, in terms of percentage increase over resting sphincteric pressure, patients with dyspepsia and patients with a hiatus hernia had similar responses.

ISSN:0007-1323    

DOI:10.1002/bjs.1800620104

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractChanges in plasma gastrin and lower oesophageal sphincter pressure were measured in 20 subjects after a standard protein meal. Significant increases in both gastrin and sphincter pressure were seen. Peak gastrin response occurred an average of 19‐5 minutes and peak lower oesophageal sphincter response 43‐0 minutes after the meal. Both gastrin and sphincter pressure showed a wide spectrum of response. In 5 subjects there was no appreciable rise (<5 pg/ml) in plasma gastrin after the meal, and 3 of these had symptoms of oesophageal reflux. In this group there was only a small but nevertheless significant rise in lower oesophageal sphincter pressure (mean pressure rise 18‐0 per cent of fasting value, P<0.05). Greater increases in sphincter pressure (mean rise 54‐2 per cent, P50 pg/ml) showed the greatest rise in pressure (mean rise 80‐3 per cent, P<0.0025).These results suggest that endogenous plasma gastrin is the main stimulus to the rise in lower oesophageal sphincter pressure after food. Subjects with a poor gastrin response to the meal have only a small increase in sphincter pressure and as a result may be more liable to develop gastro‐oesopha

ISSN:0007-1323    

DOI:10.1002/bjs.1800620105

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractThe results obtained by using the Boerema anterior gastropexy for symptomatic hiatus hernia over a 4‐year period are reviewed. All 68 patients were operated upon by the same surgeon. The success rate as judged by relief of the patients' symptoms was 90 per cent.It is felt that the operation has advantages such as to justify its wider us

ISSN:0007-1323    

DOI:10.1002/bjs.1800620106

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractExamination of gastrectomy specimens has shown that atrophic gastritis and intestinal metaplasia are widespread and have the same distribution in cancer of the stomach as in gastric ulcer affecting the body. Their distribution is restricted to the distal part of the stomach in pyloric ulcer. After gastrojejunostomy the distribution is also like that seen in cancer. There is a close association of widespread atrophic gastritis and intestinal metaplasia with the development of cancer and a high cancer rate after stomach operation for benign conditions. The similarity of distribution of atrophic gastritis and intestinal metaplasia in the stomach with body ulcer to that in cancer and after gastrojejunostomy points to a higher cancer risk in the stomach containing a body ulcer.

ISSN:0007-1323    

DOI:10.1002/bjs.1800620107

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractA clinical and pathological review of 68 patients with a primary carcinoma of the gallbladder was undertaken. A prolonged preceding history of biliary disease was noted. Preoperative radiological and biochemical investigations were not helpful, but an isolated elevation in serum alkaline phosphatase level in the absence of any biliary obstruction or hepatic dysfunction was noticed in some patients. The significance of stones in relation to pathogenesis is discussed. A more radical surgical approach involving a partial hepatectomy appears to be the only possible treatment in view of the mode of spread of this tumour and the bad overall prognosis.

ISSN:0007-1323    

DOI:10.1002/bjs.1800620108

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractThe clinical and pathological features of 100 consecutive cases of primary carcinoma of the gallbladder, treated by a single surgical unit, are described. Females outnumbered males by 2 to 1. The maximum incidence was seen in the fifth decade. Pain and the presence of a mass were the two most common clinical features. Gallstones coexisted in 45 per cent of cases. Ancillary investigations were of little value in preoperative diagnosis. At laparotomy biopsy alone was possible in a large number of cases owing to the advanced disease process. Two patients were alive 5 years after surgery. Prophylactic cholecystectomy for all diseased gallbladders, whether symptomatic or not, is advocated.

ISSN:0007-1323    

DOI:10.1002/bjs.1800620109

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractExperience with 131 pseudocysts of the pancreas in 112 patients has been analysed with a view to answering specific questions. Spontaneous regression was documented in 8 per cent. Complications occurred in 33·5 per cent of the pseudocysts, including obstruction of adjacent organs, rupture, haemorrhage and pancreatic ascites. In 14 pseudocysts, rupture into the gastrointestinal tract, the peritoneal cavity or the pleural cavity, when unassociated with haemorrhage, had a mortality rate of 14 per cent. Sixteen patients with significant haemorrhage associated with a pseudocyst had a mortality rate of 61 per cent; early direct surgical control is advocated. Pancreatic ascites was associated with 14·5 per cent of the pseudocysts and had a 40 per cent recurrence rate, which can be greatly diminished when operative procedures are guided by pancreatography. The mortality rate for the surgical treatment of 97 uncomplicated pseudocysts was 6 per cent and the recurrence rate was 11 per cent. The prime cause of death was haemorrhage. Seven of the 131 pseudocysts were synchronous and 12 were metachronous. The actual figure is probably higher. Small cysts of the head of the pancreas, impalpable at operation but demonstrable by pancreatography, may be the cause of severe, continuing or recurrent symptom

ISSN:0007-1323    

DOI:10.1002/bjs.1800620110

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractCharacteristic radio‐opaque lesions were detected in the mandibular bone, most clearly on the panoramic X‐ray, in 27 or 93·2 per cent out of 29 cases in 15 families with familial polyposis coli, including 21 cases without Gardner's stigmata, 7 cases with the incomplete syndrome and 1 with the complete syndrome.Only 3 out of 19 members of these families who were free from polyposis had radio‐opaque jaw lesions. The cases with polyposis of other types also showed a negative result.The radiological diagnosis suggested that the lesions were of the character of endosteoma. Our observation is considered to be significant evidence in the understanding of the pathogenesis of Gardner's syndrome as well as a useful method for the early detection of carriers in the polyposis

ISSN:0007-1323    

DOI:10.1002/bjs.1800620111

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY