ISSN:0007-1323    

DOI:10.1002/bjs.1800740102

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe Birmingham liver transplant programme started in 1982. Forty‐six patients have been transplanted with a follow‐up of 3 months or longer. Twenty‐seven patients are still alive, of whom sixteen have lived for more than one year. The 30 day hospital mortality was 30·4 per cent and the actuarial predicted one year survival 55·5 per cent. Four patients have been regrafted for chronic rejection and graft failure. Thirteen patients have required surgery in the postoperative period for: bleeding (two), removal of abdominal packs (four), biliary leaks and obstruction (five), duodenal perforation (one) and small bowel obstruction (one). Acute rejection was common, occurring in 30 patients and progressing to chronic rejection in 4. Ten patients developed renal failure with an 80 per cent mortality and eleven patients developed grand mal fits. Severe bleeding (>70 units) was associated with previous abdominal surgery and a high mortality (88·9 per cent). Opportunistic fungal infection carried a 100 per cent mortality. Although more than half of all transplanted patients will survive for more than one year, the postoperative period is still one of high morbidity and m

ISSN:0007-1323    

DOI:10.1002/bjs.1800740103

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800740104

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractAll 197 patients admitted to the Bristol Royal Infirmary during the 16 year period 1970‐‐1985, and diagnosed as having Dukes' A colorectal cancers, were studied. The numbers diagnosed per year by 1985 were 20, compared with 9·4 per year for the period 1970–1979. This represented an increase in the percentage of Dukes' A cancers of all the colorectal cancers diagnosed from 8·3 to 15 per cent. The increase was largely due to better quality double contrast barium enemas and increased use of flexible sigmoidoscopy and colonoscopy. The operative mortality dropped from 17 to 3 per cent in the last 6 year period. The recurrence rate was 9·6 per cent of which 1 per cent were locally resected and crude 5 year survival was 90·4 per cent u

ISSN:0007-1323    

DOI:10.1002/bjs.1800740105

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractColonoscopic biopsies were performed on 38 patients, 10–13 years after jejuno‐ileal bypass. No significant dysplasia or premalignant change was seen in 371 biopsies. In one patient two tubulovillous adenomata were found in an otherwise normal colon, which is likely to be a chance finding. Although it will take another 10–20 years to establish whether jejuno‐ileal bypass is associated with an increased risk of large bowel cancer in humans, there is at present no indication for regular colonoscopic surve

ISSN:0007-1323    

DOI:10.1002/bjs.1800740106

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800740107

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe proliferative activity of the colonic crypts of patients who are at high risk of developing colonic tumours has been assessed. Cells from the upper parts of the colonic crypts were collected at colonoscopy, and were stained for DNA by the Feulgen technique. Using a microdensitometer the DNA content of the cells was measured and a proliferative index calculated. Patients with single neoplasms had a proliferative index similar to controls although individual patients with hyperplastic mucosa could be identified. Patients with multiple neoplasms had an elevated proliferative index. These results may form the basis of a screening programme for colonic tumours.

ISSN:0007-1323    

DOI:10.1002/bjs.1800740108

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800740109

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractClinical and experimental studies indicate that transfusion of allogeneic blood has immunomodulating properties, and that the behaviour of some tumours may be influenced by the immune system of the host. Eighty‐seven patients who had undergone ‘curative’ resection of cancer of the colon or rectum were studied retrospectively to determine whether blood transfusion adversely affected the rate of cancer recurrence. Fifty‐three patients (61 per cent) were transfused and 34 were not. The transfused and non‐transfused groups were comparable in terms of age, sex, duration of follow‐up, mode of presentation, stage of disease and haemoglobin level at discharge from hospital, and differed in admission haemoglobin and distribution of tumour locations (right‐ or left‐sided colonic or rectal tumours). Recurrent malignancy was detected in 36 per cent of transfused patients and 26 per cent of non‐transfused patients (P>0·1). There was no association between the number of transfusions and recurrence for any tumour site or stage. The incidence of recurrence was significantly higher in those patients who received transfusions during surgery than in those who received transfusion either before or after surgery (χ2= 7·01, d.f. = 1, P>0·01) or no transfusions (χ2= 4·23, d.f. = 1, P>0·05). The study indicates that factors influencing the need for blood transfusion during operation had a greater bearing on prognosis than receipt of a blood transfusion per se and that future prospective studies investigating the association between transfusion and cancer recurrence need to determine accurately the ind

ISSN:0007-1323    

DOI:10.1002/bjs.1800740110

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY

摘要:

AbstractTen patients with severe chronic irradiation injury to the rectum were treated by mucosal proctectomy and colo‐anal sleeve anastomosis. The indications were: recurrent rectal bleeding (five), stricture (three), fistula (one) and intractable pain (one). Overall follow‐up has ranged from 8 to 77 months (mean 40 months). In the present survivors (n = 7) the follow‐up ranges from 18 to 77 months (mean 52 months). Six patients have been followed up for more than 3 years and four for more than 5 years. There was no operative mortality. Three anastomotic strictures occurred but the protecting stoma could be closed in all but one patient. Continence was acceptable although urgency and frequency of defaecation were troublesome symptoms. The operation is recommended for life‐threatening, haemorrhagic chronic irradiation injury to the

ISSN:0007-1323    

DOI:10.1002/bjs.1800740111

出版商:John Wiley&Sons, Ltd.    

年代:1987

数据来源: WILEY