bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metachronous colorectal carcinoma
Authors: Bülow S , Svendsen L B , Mellemgaard A 
Published: March 2007

Abstract
During the period 1943–67, 903 Danish patients aged &lt;40 years had colorectal carcinoma. The patients were followed up for up to 41 years and during this period 44 of 501 (9 per cent) operated on for cure developed a metachronous colorectal carcinoma. The cumulative risk of a metachronous colorectal carcinoma was 30 per cent after up to 41 years of observation. The occurrence of a metachronous colorectal carcinoma was evenly distributed in the observation period. The cumulative survival rate after operation for a metachronous colorectal carcinoma was 41 per cent after 20 years of observation. We propose a lifelong follow-up programme after resection of colorectal carcinoma for cure in this age group, including annual Hemoccult® test and colonoscopy at 3-year intervals.
Incidence of dysplasia in the anorectal mucosa in patients having restorative proctocolectomy
Authors: Tsunoda A , Talbot I C , Nicholls R J 
Published: March 2007

Abstract
The incidence of dysplasia in the mucosal strippings from the anorectal stump was studied in 132 patients treated by restorative proctocolectomy with Heal reservoir for ulcer at ive colitis and familial adenomatosis. The anorectal mucosa was stripped from the level of division of the gut tube to the dentate line. Of 118 patients with ulcerative colitis, 12 (10–2 per cent) had dysplasia in some part of the large bowel. Mucosal strippings were examined histologically in 118 cases, of which only three (2–5 per cent) showed dysplasia. There was a correlation between dysplasia and the presence of carcinoma and the duration of the disease in the operative specimen of colon and rectum and also in the anorectal mucosal specimen although the number of patients with carcinoma (eight cases) in this analysis was small. All 14 patients with familial adenomatous polyposis showed large bowel mucosal dysplasia in the operative specimen which was severe in six cases. Anorectal mucosal strippings were examined in these patients and 12 showed dysplasia which was severe in three.
‘Close shave’ in anterior resection
Authors: Karanjia N D , Schache D J , North W R S , Heald R J 
Published: March 2007

Abstract
Of 192 anterior resections for rectal cancer performed over 10 years by one author (R.J.H.), 169 (88 per cent) included total mesorectal excision and all included lavage of the clamped distal rectum. Of this series, 152 (79 per cent) were classed as curative, 110 with a resection margin &gt; 1 cm and 42 with a resection margin ≤ 1 cm. The group with a &gt; 1 cm margin had a significantly lower Dukes' A to B ratio than the group with a margin ≤1 cm, although the proportion with Dukes' C lesions was similar in both groups (X2 = 6·712; P = 0·035). There were no local recurrences in the latter group (95 per cent confidence interval (CI) is 0–5·9 per cent) while there were four (3·6 per cent) in the former group (95 per cent CI is 0·8–7·4 per cent). There were no significant differences in recurrence rates, local and distant, between the two groups (Fisher's exact test, P = 0·2). Reduction of resection margin, provided total mesorectal excision and washout is properly performed, does not increase local recurrence or compromise survival.
Comparison of one dose versus three doses of prophylactic antibiotics, and the influence of blood transfusion, on infectious complications in acute and elective colorectal surgery
Authors: Jensen L S , Andersen A , Fristrup S C , Holme J B , Hvid H M , Kraglund K , Rasmussen P C , Toftgaard C 
Published: March 2007

Abstract
In a randomized prospective controlled trial involving 311 patients undergoing acute or elective colorectal surgery, the efficacy and safety of two different single dose and one triple dose regimen of antibiotic prophylaxis, as well as the influence of blood transfusion on postoperative infectious complications, were studied. Postoperative infectious complications occurred in a total of 59 patients (19-0 per cent). There were no major differences between the three treatment groups. Thirty-four patients (10·9 per cent) developed abdominal wound infection, 17 patients (5·5 per cent) intra-abdominal abscess and 16 patients (5·1 per cent) anastomotic leakage. Of 202 patients (65·0 per cent) requiring blood transfusion during hospitalization 57 (28·2 per cent; 95 per cent confidence limits of 23·36 per cent) developed infectious complications, whereas two non-transfused patients (1·8per cent; 95per cent confidence limits of 0·2 to 6per cent; P&lt;0·001) developed infectious complications. It is concluded that one single dose of antibiotic prophylaxis in acute and elective colorectal surgery is as protective as a triple dose regimen. The development of infectious complications despite antibiotic prophylaxis is strongly related to blood transfusion.
Faecal occult blood testing in symptomatic patients: Comparison of three tests
Authors: Tate J J T , Northway J , Royle G T , Taylor I 
Published: March 2007

Abstract
This study examines three faecal occult blood tests, Haemoccult®, Fecatwin® and E-Z Detect®, each with different sensitivities, to determine which is best suited for use in symptomatic patients - both for the detection of cancer and of non-malignant mucosal disease of the large bowel. A test was completed by 1025 patients before double-contrast barium enema and the performance of each test was determined from the result of this investigation. The study was completed by 969 patients. There were 49 patients with colorectal cancer, 92 patients with a cancer or a polyp &gt;5 mm, and 130 with some mucosal abnormality. The test most sensitive for blood, Fecatwin, detected 14 of 15 (93 per cent) cancers and 29 (69 per cent) of 42 patients with mucosal disease (including inflammatory bowel disease) but gave three times as many false positive results as the Haemoccult test, which is less sensitive for blood. The chance of a patient with a positive Haemoccult result having mucosal disease on barium enema was 24 of 47 patients (51 per cent) (two-thirds of these having colorectal cancer). A negative Haemoccult result, however, was unreliable and should not influence patient management. A test less sensitive for blood than Haemoccult was found to be of little value in symptomatic patients.
Whole gut irrigation and Prepacol® laxative preparation for colonoscopy: A comparison
Authors: Köhler L , Vestweber K H , Mennigen R , Sommer H , Troidl H 
Published: March 2007

Abstract
Two techniques for preparation of the colon for colonoscopy were compared in a controlled trial. Fifty patients given a low residue diet and the laxative Prepacol® were compared with 50 patients given whole gut irrigation. Significantly more patients suffered from vomiting (P = 0·0005), shivering (P = 0·0062) and nausea (P = 0·031) following irrigation; in two cases the procedure had to be abandoned because of profuse vomiting. Irrigation was less well tolerated by the patients (P = 0·00002) than preparation with Prepacol®. On the other hand, the quality of bowel preparation was found to be better (P = 0·0005) after irrigation. On two occasions colonoscopy was not possible following Prepacol® preparation because of faecal residue. Patients with a previous colorectal resection showed a similar quality of cleansing to those patients prepared with irrigation. We conclude that Prepacol® is as efficient as irrigation for patients who have had a previous colorectal resection because the quality of bowel preparation is as good and the associated patient discomfort is small.
Percutaneous transhepatic cholangioscopic lithotripsy
Authors: Chen M F , Jan Y Y 
Published: March 2007

Abstract
Since 1983, 14 patients with intrahepatic and common bile duct stones have undergone percutaneous transhepatic cholangioscopic lithotripsy because the stones were too large to be removed using ordinary percutaneous transhepatic cholangioscopy. Stones were completely fragmented in seven cases (six with intrahepatic stones and one with common bile duct stone) and partially disrupted in five cases with intrahepatic stones. Intrahepatic duct angulation and stricture was the factor most often responsible for failure. All the disintegrated stones were removed by subsequent transhepatic cholangioscopy. Amongst the seven patients with complete stone fragmentation, six stones were found with electrohydraulic shock-wave lithotripsy and one with NdYAG laser lithotripsy. Complications of percutaneous transhepatic cholangioscopic lithotripsy using electrohydraulic shock waves were found in three cases, two had transient haemobilia and one had fever and chills after the procedures. They all recovered by conservative treatment. NdYAG laser treatment was expensive, time consuming and inconvenient to use. Percutaneous transhepatic cholangioscopic lithotripsy by using electrohydraulic shock wave is an effective and safe method to fragment biliary stones and to facilitate their removal.
Management of the stump of the pancreas after distal pancreatic resection
Authors: Shankar S , Theis B , Russell R C G 
Published: March 2007

Abstract
The optimal management of the stump of the pancreas following distal resection remains controversial. To determine whether there was an advantage in draining the stump of the pancreas into a Roux-en-Y loop of jejunum, a retrospective survey of 113 patients who had a distal pancreatectomy for chronic pancreatitis or complications of acute pancreatitis in the non-acute phase was undertaken. The decision to perform a drainage procedure was determined on the basis of the pancreatogram, the size of the pancreatic duct and technical factors at the time of the operation. Sixty-seven patients had no drainage procedure and 46 patients had a drainage procedure. The two groups were comparable in all respects before surgery. The postoperative outcome in the short- and long-term was similar in both groups. It is concluded that caudal pancreatic drainage confers no benefit following distal pancreatic resection.
Outcome of revisional gastric surgery using a Roux-en-Y biliary diversion
Authors: Ferguson G H , Maclennan I , Taylor T V , Torrance H B 
Published: March 2007

Abstract
One hundred and seven patients with postoperative reflux gastritis treated by Roux-en- Y biliary diversion were reviewed. Three patients died in the postoperative period, and 16 others have since died; cardiorespiratory disease was the most frequent cause of death. Seventy-nine patients were interviewed at a median of 5·5 years (range 0·5–26 years) following Roux-en-Y diversion. At review, a satisfactory result by modified Visick grading was present in 47 per cent of patients. Bilious vomiting (P&lt;0·001), food vomiting (P&lt;0·01), the severity of upper abdominal pain (P&lt;0·001) and heartburn (P&lt;0·025) were significantly improved by Roux-en- Y diversion. Weight, haemoglobin levels and employment status were not significantly altered by the procedure. Outcome was related to the surgery preceding Roux-en- Y diversion with significantly better results after partial gastrectomy compared with truncal vagotomy and drainage (P&lt;0·01), cholecys-tectomy (P&lt;0·05), or combinations of these procedures (P&lt;0·01). Outcome was not predicted by sex, preoperative symptoms, smoking status, consultant surgeon, length of Roux-en-Y or 99Tc-Sn-2,6-di-ethylacetanilidoiminodiacetate (HIDA) scanning results.
First rib resection for vascular complications of thoracic outlet syndrome
Authors: Thompson J F , Webster J H H 
Published: March 2007

Abstract
The surgical approach to vascular complications of the thoracic outlet syndrome remains controversial. When present, removal of a cervical rib alone has produced disappointing results. Our experience of 29 consecutive first rib excisions over a 5-year period is presented. Of 20 cases with uncomplicated subclavian artery compression 19 were cured, and of six cases with aneurysm or thrombosis five were improved. Of 12 cases with neurological symptoms nine were cured and two were improved. It is suggested that first rib excision is the essential primary treatment for patients with arterial symptoms due to thoracic outlet syndrome.
Vacuum drainage of groin wounds after vascular surgery: A controlled trial
Authors: Dunlop M G , Fox J N , Stonebridge P A , Clason A E , Ruckley C V 
Published: March 2007

Abstract
A pilot study of 100 consecutive groin wounds after vascular surgery demonstrated lymph leaks in 12 per cent. Lymph leak was significantly associated with wound infection and with prolongation of in-patient stay. A controlled trial was therefore instituted to assess the influence of vacuum drainage in groin wound healing. One hundred and twenty-seven wounds were randomized to drainage (n = 65) or no drainage (n = 62) and the wounds were examined ‘blind’ by independent observers. No difference in the incidence of lymph leakage or wound infection was noted between the two groups. The routine use of suction drainage for groin wounds in vascular surgery is unnecessary.
Flow cytometric and histological analysis of ductal carcinoma in situ of the breast
Authors: Locker A P , Horrocks C , Gilmour A S , Ellis I O , Dowle C S , Elston C W , Blarney R W 
Published: March 2007

Abstract
Using archival paraffin wax embedded tumour we have investigated histological grade, DNA ploidy, S phase fraction and prolifera live index in 74 patients with symptomatic ductal carcinoma in situ (DCIS) of the breast. Nine patients developed local recurrence, six invasive in character. No patients with the cribriform subtype of DCIS developed local recurrence. The cribriform subtype showed a significantly lower rate of DNA aneuploidy and a lower proliferative index than the other subtypes. Cribriform tumours were almost exclusively well differentiated in contrast with the comedo and solid variants. Our results suggest the cribriform variant is less aggressive than other subtypes of DCIS. This has possible implications for management of these lesions.
Intestinal permeability is increased in burn patients shortly after injury
Authors: Deitch Edwin A 
Published: March 2007

Abstract
There is increasing direct experimental and indirect clinical evidence to indicate that under certain conditions intestinal barrier function may be lost in trauma victims. No direct measurements, however, have been performed in patients to determine whether intestinal permeability is increased shortly after a major thermal injury in the absence of infection. Fifteen hemodynamically stable burn patients with burns on more than 20% of their body surface (39% ± 12%) had their intestinal permeability measured within 24 hours of injury with use of the two nonmetabolizable sugars lactulose and manmtol as permeability markers. Lactulose absorption was fourfold higher in the patients (223 ± 54 μmol) than in the controls (58 ± 77 μmole;p &lt; 0.02), whereas the lactulose/manmtol ratio was threefold higher (5.2 vs 1.7; p &lt; 0.05). Thus intestinal permeability was increased in patients with moderate to major burn injuries shortly after injury. (Surgery 1990;107:411-6).
Relationship between age and survival in cancer of the colon and rectum with special reference to patients less than 40 years of age
Authors: Enblad G , Enblad P , Adami H-O , Glimelius B , Krusemo U , Påhlman L 
Published: March 2007

Abstract
The relative survival of all patients (n = 61 769) in the entire Swedish population reported to have a malignant tumour of the colon and rectum between 1960 and 1981 was analysed with special reference to patients under 40 years of age. The 5-year relative survival rate of patients with a tumour of the colon, irrespective of histopathological diagnosis, was 62·0 per cent below the age of 40 years and 44·4 per cent in those 40 years of age or older (P &lt; 0·05). The corresponding figures for patients with a tumour of the rectum were 46·6 per cent and 39·1 per cent, respectively. When the relative survival was analysed separately for patients with a histopathologically demonstrated adenocarcinoma, the 5-year survival rate among patients with a cancer of the colon was 50·9 per cent in patients below 40 years of age and 48-6 per cent in those 40 years of age or older. In patients with adenocarcinoma of the rectum, the 5-year relative survival rate was 41·1 per cent in patients younger than 40 years of age and 40·7 per cent in patients 40 years of age or older. Thus, patients below the age of 40 years with an adenocarcinoma of the colon and rectum as a group appear to have the same or even a better prognosis than older patients if all tumours are considered, irrespective of histopathological diagnosis.
High versus low ligation of the inferior mesenteric artery in rectal cancer
Authors: Surtees P , Ritchie J K , Phillips R K S 
Published: March 2007

Abstract
The argument for and against high ligation of the inferior mesenteric artery in rectal cancer has yet to be resolved. Between 1948 and 1983, 4250 patients underwent surgery for rectal carcinoma at St. Mark's Hospital, London. From these, 250 patients were selected who had undergone curative anterior resection of a Dukes' C adenocarcinoma and their records were examined. In 150 (60 per cent) the inferior mesenteric artery was ligated above the origin of the left colic artery. The outcome was analysed using the Dukes', Gastrointestinal Tumour Study Group and Astler-Coller classifications, either alone or in combination. Tumour differentiation and extent of local invasion were also considered. Despite this detailed analysis, no improved survival was seen in patients when the inferior mesenteric artery was ligated above the origin of the left colic artery.
Comparison of coloscreen self-test® and Haemoccult® faecal occult blood tests in the detection of colorectal cancer in symptomatic patients
Authors: Pye G , Jackson J , Thomas W M , Hardcastle J D 
Published: March 2007

Abstract
The usefulness of faecal occcult blood tests is limited by their acceptability to patients. Standard tests require the collection of a stool sample which may inhibit compliance. Self-read tests which avoid this step have therefore been devised. Coloscreen Self-Test® (CST) and Haemoccult®, which may be regarded as the standard slide test, were offered to 450 consecutive patients attending surgical outpatient clinics with symptoms suggestive of lower gastrointestinal disease. Both tests were successfully completed by 383 patients. Although 262 (68 per cent) patients indicated that they preferred CST this was not reflected in the overall compliance to the two tests (CST 86 per cent, Haemoccult 90 per cent). CST gave a positive result in only eight out of 24 patients with a colorectal cancer (sensitivity = 33 per cent) compared with 13 out of 24 for Haemoccult (sensitivity = 54 per cent). CST had no advantage from increased compliance to outweigh its lower sensitivity.
Rectopexy for internal rectal intussusception
Authors: McCue J L , Thomson J P S 
Published: March 2007

Abstract
Twelve patients presented with symptomatic internal intussusception of the rectum between 1979 and 1987. All were women with a mean age of 55·5 years. Ten patients had symptoms of obstructed defaecation and only three were completely continent. Polyvinyl alcohol sponge abdominal rectopexy was performed in each patient. Over a mean follow-up period of 26·9 months there was no recurrence of internal intussusception. The functional results, however, were mixed but only one patient remained incontinent for solid stool. Rectal discomfort and defaecatory difficulties persisted; six patients continued to strain at stool and in three this was worsened by the operation. Abdominal rectopexy can be recommended for those with associated incontinence, significant rectal bleeding or solitary rectal ulcer but may not benefit those who have obstructed defaecation.
Perineal, vulval and vaginoperineal reconstruction using the rectus abdominis myocutaneous flap
Authors: Skene A I , Gault D T , Woodhouse C R J , Breach N M , Thomas J M 
Published: March 2007

Abstract
Poor perineal healing is a major complication of total or partial pelvic exenteration especially when the pelvis and perineum have previously been irradiated. Perineal, vulval or vaginoperineal reconstruction was performed in five women using the inferiorly based rectus abdominis myocutaneous flap. Primary perineal wound healing occurred in all patients and no flap-related complications developed. Primary healing of abdominal wall wounds occurred in all patients without incisional hernia. Three of the patients had an anterior or total pelvic exenteration with continent urinary diversion by the Mitrofanoff technique. Two of the patients had complete vaginal reconstruction and one patient had after-loading catheters inserted for postoperative interstitial irradiation. The patients were in hospital for 42, 28, 21, 17 and 15 days respectively. The longest stays were associated with training for self-catheterization of the continent urinary diversion. Median follow-up was 9 months. One patient developed two perineal recurrences at 16 months which were resected, and she remains disease-free 6 months later.
Epidural analgesia in colonic surgery: Results of a randomized prospective study
Authors: Bredtmann R D , Herden H N , Teichmann W , Moecke H P , Kniesel B , Baetgen R , Tecklenburg A 
Published: March 2007

AbstractColonic surgery patients were studied to measure: the influence of continuous thoracic epidural analgesia (TEA) on a postoperative pain score, the time till onset of defaecation, blood loss, postoperative temperature elevations, rate of bacterial contamination of wounds and urine, and general surgical complications. Group I patients (n = 57) received general anaesthesia and TEA for the operation, followed by continuous TEA (0·25 per cent bupivacaine) for 72 h. Group IIpatients (n = 59) received general anaesthesia for the operation, followed by systemic analgesia on request. Significant beneficial effects of TEA in group I were demonstrated by lower pain scores in the first 24 h after surgery and earlier defaecation. However, there were fewer temperature elevations in group II. There was no significant difference between the groups in terms of positive bacteriological cultures, blood loss, need for postoperative mechanical ventilation and complications. However, there was a trend toward a higher rate of rectal anastomotic breakdown, increased blood replacement and intensive care therapy, and longer hospitalization in group I. These results do not suggest any significant beneficial therapeutic effect of continuous TEA in colonic surgery compared with a conventional systemic analgesic regimen. In selected patients (i.e. those with severe pain or those prone to develop postoperative ileus) continuous TEA may be beneficial.
Single layer anastomosis in the upper gastrointestinal tract
Authors: Irwin S T , Krukowski Z H , Matheson N A 
Published: March 2007

Abstract
A total of 466 single layer upper gastrointestinal anastomoses were made in 349 patients during an 11-year period. Six (1·3 per cent) anastomoses leaked. Radiological leakage was seen in one of 24 (4·2 per cent) oesophagogastricljejunal anastomoses. There were no leaks after 66 gastrojejunal anastomoses; one of 84 (1·2 per cent) gastroduodenal anastomoses leaked and was converted to a gastrojejunal anastomosis. Two of 121 (1·7 per cent) biliary-enteric anastomoses leaked and both were successfully managed without reoperation. Two of 171 (1·2 per cent) enteroenteric anastomoses leaked, both in patients with established intraperitoneal sepsis which proved fatal. Of the 349 patients, 13 (3·7 per cent) died in hospital or within 30 days of operation but in only two was anastomotic leakage implicated. Single layer appositional upper gastrointestinal anastomoses are simple, safe and economic.