bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lothian and borders large bowel cancer project: Immediate outcome after surgery. The consultant surgeons and pathologists of the lothian and borders health boards
Authors: Carter D C 
Published: March 2007

Abstract
A prospective audit of all large bowel cancer resections is being conducted in the adjacent Health Boards of Lothian and Borders. The results of surgery in 750 consecutive patients recruited during the first 2 years are presented. In this time, 249 (33.2 per cent) patients presented as an emergency, 490 (65.3 per cent) had resection of a colonic cancer, and 36 (4.8 per cent) patients died within 30 days. Abdominal resection was performed in patients and intestinal continuity was restored in 646 (87.2 per cent). Of all anastomoses performed, 31 (4.8 per cent) leaked (15 of 467 (3.2 per cent) and 16 of 179 (8.9 per cent) after resection of colonic and rectal cancers, respectively). Of the patients presenting with a rectal cancer, 251 (96.5 per cent) underwent abdominal resection and intestinal continuity was restored in 179 (71.3 per cent). Five of 28 consultants were responsible for half of these patients. Patients treated by these five consultants were no more likely to undergo anastomosis, but when an anastomosis was performed it was less likely to leak (four of 95 (4.2 per cent) versus 12 of 84 (14.3 per cent) (χ2 = 4.63, P&lt;0.05)). The overall outcome of surgery appears to be improved when compared to previous similar audits. Considerable intersurgeon variation remains in the results of resection of rectal cancer.
Colectomy as treatment for constipation in selected patients
Authors: Piccirillo M F , Reissman P , Wexner S D 
Published: March 2007

Abstract
The aim of this study was to conduct a prospective assessment of the results of total abdominal colectomy and ileorectal anastomosis (TAC) in patients with colonic inertia. Overall, 416 patients were evaluated for chronic constipation. Of the patients, 54 (13 per cent) had colonic inertia, defined as diffuse marker delay during transit study without paradoxical puborectalis contraction on cinedefaecography or electromyography. All 54 patients (42 women and 12 men), with a mean age of 49 (range 17–78) years, underwent TAC. Preoperative bowel frequency was a mean of one every 8 days, requiring large doses of laxatives, enemas or both. There was no major postoperative morbidity; five patients were readmitted due to bowel obstruction, three for successful conservative management while the other two required enterolysis. After a mean follow-up of 27 (range 2–51) months these 54 patients reported a mean frequency of spontaneous bowel movements of 3.7 (range 1–10) per day. ‘Excellent’ or ‘good’ outcome was reported by 51 patients (94 per cent). TAC can be performed with acceptable morbidity and 94 per cent of patients will have satisfactory improvement in bowel habit.
Assessment of feasibility for endovascular prosthetic tube correction of aortic aneurysm
Authors: Andrews S M , Cuming R , Macsweeney S T , Barrett N K , Greenhalgh R M , Nott D M 
Published: March 2007

Abstract
Abdominal aortic aneurysm (AAA) can now be corrected by perfemoral introduction of a prosthetic tube graft with fixation using expandable metal stents. This technique requires a satisfactory iliac system, through which the graft can reach its destination, and suitable lengths of non-aneurysmal aorta below the renal arteries and above the aortic bifurcation for stent attachment. The feasibility for placement of endovascular grafts was assessed in 44 consecutive patients admitted for transabdominal AAA repair. The proximal and distal aneurysmal necks and the iliac arteries were assessed before operation by colour flow Doppler ultrasonography (duplex scanning), computed tomography and intravenous digital subtraction angiography, using intraoperative measurements as the ‘gold standard’. At operation 32 of 44 patients had a suitable proximal neck and five of 44 a suitable distal neck for endovascular grafting. Duplex scanning was the most accurate modality for preoperative assessment of the aneurysm necks. According to this technique 32 of 44 patients had a satisfactory iliac system for introduction of an endovascular graft. Overall only four of 44 patients were considered suitable for endovascular correction of AAA using a tube graft-stent combination.
Prospective randomized trial of high versus low vacuum drainage after axillary lymphadenectomy
Authors: Van Heurn L W E , Brink P R G 
Published: March 2007

Abstract
A randomized prospective trial was performed to assess the effect of low versus high vacuum drainage after axillary lymphadenectomy. The mean(s.e.m.) volume of seroma evacuated with a low vacuum system was 386(26) ml (n = 38) compared with 537(43) ml with a high vacuum system (n = 40) (P&lt; 0.005). Low vacuum drains were removed earlier than high vacuum drains (P = 0.02). Seroma production after removal of the drains was not significantly different. The use of low vacuum drains after axillary dissection can reduce hospital stay.
Yield pressure, anatomy of the cardia and gastro-oesophageal reflux
Authors: Ismail T , Bancewicz J , Barlow J 
Published: March 2007

Abstract
The yield pressure at which the cardia opens in response to gastric distension was measured in 155 subjects with and without gastro-oesophageal reflux (GOR) and after Nissen fundoplication. Yield pressure was measured by endoscopy or during oesophageal manometry. The median pressure was significantly lower in subjects with GOR than in those without (P &lt; 0.0001). After successful Nissen fundoplication this pressure increased to supranormal values (P &lt; 0.0001). There was a close relationship between yield pressure and the presence and size of hiatus hernia and also between yield pressure and the valvular appearance of the cardia at endoscopy. There was a significant correlation between yield pressure and oesophageal acid exposure. However, no relationship was observed between yield pressure and lower oesophageal sphincter pressure or intra-abdominal length. These results suggest that yield pressure is useful for assessment of the competence of the cardia, particularly after antireflux surgery. The competence of the cardia is greatly influenced by its anatomical structure.
Early gastric cancer: Prognostic factors in 223 patients
Authors: Folli S , Dente M , Dell'Amore D , Gaudio M , Nanni O , Saragoni L , Vio A 
Published: March 2007

Abstract
A retrospective study of 223 patients treated for early gastric cancer (EGC) is reported, representing 21.2 per cent of the 1051 patients with gastric cancer treated over the same period. Two main types of surgical procedure were used: subtotal resection of the stomach for EGC of the two lower thirds and total gastrectomy for lesions of the upper third. A lymphadenectomy of groups 1 and 2, according to the procedure of the Japanese Research Society for Gastric Cancer (R2 resection), was performed in all patients. The mean duration of follow-up was 7.5 years. Univariate analysis showed a significant difference in survival rates only between patients with and without involved nodes (log rank = 6.05, P = 0.0139). Other prognostic factors were not identified. A bivariate analysis was performed to evaluate the joint effect of node status and the Kodama classification: survival rates for patients with EGC of the penetrating (Pen) A type and node positive falls to around 57 per cent within 6 years. This group of patients has a tumour that should probably be considered as a ‘non-early’ lesion. To improve the survival of patients with a Pen A, node positive lesion, adjuvant chemotherapy may be appropriate.
Laparoscopic Heller's cardiomyotomy without an antireflux procedure
Authors: Robertson G S M , Lloyd D M , Wicks A C B , De Caestecker J , Veitch P S 
Published: March 2007

Abstract
The treatment of achalasia by laparoscopic Heller's cardiomyotomy may combine the minimally invasive advantages of pneumatic dilatation with the success rate and low risk of perforation of conventional surgery. The requirement for an antireflux procedure remains a contentious issue, as in conventional surgery. Nine patients underwent laparoscopic cardiomyotomy; excellent symptomatic relief was obtained in eight at follow-up between 12 and 21 months after operation. Four of these patients agreed to 24-h pH monitoring and showed no evidence of acid reflux. One patient, however, developed recurrent symptoms associated with significant acidityi on monitoring. Laparoscopic Heller's cardiomyotomy without an antireflux procedure produced effective symptomatic relief in this small group of patients.
Introduction of laparoscopic cholecystectomy in a large teaching hospital: Independent audit of the first 3 years
Authors: Steele R J C , Marshall K , Lang M , Doran J 
Published: March 2007

Abstract
Commencing with the introduction of laparoscopic cholecystectomy, a detailed independent prospective audit of all cholecystectomies attributable to 12 general consultant surgeons has been carried out over a period of 3 years. Of 650 operations 502 were intended laparoscopic cholecystectomies. In the first year 58 per cent were intended laparoscopic cholecystectomies; this rose to 80 per cent in the second year and to 90 per cent in the third. The conversion rate was 21 per cent in the first year, 21 per cent in the second and 15 per cent in the third. The mean operating time for laparoscopic cholecystectomy was 133 min for year 1, 123 min for year 2 and 115 min for year 3, compared with 92, 101 and 95 min respectively for open cholecystectomy. The overall complication rate was 10 per cent for laparoscopic and 21 per cent for open cholecystectomy. This included six bile duct injuries (1.2 per cent) in the patients undergoing the laparoscopic procedure and one (0.7 per cent) in those having open cholecystectomy. This unselected audit of a group of general surgeons introducing laparoscopic cholecystectomy into their practice has revealed complication and conversion rates that are higher than those reported in most of the published literature, but may be representative of practice throughout the UK.
Comparison between pylorus-preserving and Whipple pancreatoduodenectomy
Authors: Zerbi A , Balzano G , Patuzzo R , Calori G , Braga M , Di Carlo V 
Published: March 2007

Abstract
Between 1989 and 1993, 62 patients underwent Whipple pancreatoduodenectomy and 75 pylorus-preserving pancreatoduodenectomy (PPPD); 35 patients in the first group and 37 in the second had pancreatic adenocarcinoma while 17 and 21 patients respectively had periampullary adenocarcinoma. The aim of this retrospective study was the comparison of operative outcome, nutritional recovery and survival of patients who underwent these two operations. No significant differences were found between the two groups in operative mortality or morbidity, duration of gastric aspiration and time to start of solid meals. Patients who underwent PPPD had a better nutritional recovery: the increase of both body-weight and serum albumin level at 6 months after discharge was significantly higher for those who had preservation of the whole stomach (P &lt; 0.001 and P &lt; 0.05 respectively). No significant difference in survival was found between the two procedures when patients with pancreatic or periampullary adenocarcinoma were analysed separately.
Budd-Chiari syndrome
Authors: Tilanus H W 
Published: March 2007

Abstract
Budd-Chiari syndrome is the generic term for different forms of hepatic venous outflow obstruction resulting in a clinical picture of portal hypertension and hepatomegaly. Three levels of venous outflow obstruction may be recognized, affecting respectively the small intrahepatic venules, the large hepatic veins and the inferior vena cava (IVC). Each level of obstruction is related to a different aetiology. Clinical manifestations range from mild symptoms to acute or chronic end-stage liver disease. Treatment is surgical in the great majority of patient Occlusion of the IVC may be treated by removal of the caval obstruction in selected patients. Hepatic outflo obstruction may be circumvented by different forms of shunting from the portal or upper mesenteric vein to the IVC or right atrium, depending on the level of obstruction and the difference in venous pressure. For the rare patient presenting with acute or chronic end-stage liver failure hepatic transplantation may be a life-saving procedure.
Exercise capacity in patients undergoing proctocolectomy and small bowel resection for Crohn's disease
Authors: Brevinge H , Berglund B , Bosaeus I , Tölli J , Nordgren S , Lundholm K 
Published: March 2007

Abstract
The effect of proctocolectomy and small bowel resection on working capacity has not been assessed objectively in previous research. Twenty-nine patients with Crohn's disease were investigated with cycle ergometry and a questionnaire, following proctocolectomy with and without small bowel resection. Maximal exercise load is known to correspond well with working capacity, particularly when account is taken of body composition and metabolic variables. Maximal exercise load was reduced marginally (by 9 per cent) in patients without small bowel resection and by 22 per cent in patients with moderate small bowel resection (15–30 per cent resection). Patients with extensive bowel resection (more than 50 per cent) had a 40 per cent reduction in the maximal exercise load. This reduction in maximal exercise load was greater than predicted when accounting for reduction in muscle mass. All patients had a normal oxygen uptake including resting energy expenditure. Urinary sodium and magnesium excretion was low in the group with moderate bowel resection, whereas the extensively resected patients were malnourished and had a reduced body cell mass. The authors conclude that the significantly reduced working capacity was of multifactorial origin secondary to malabsorption. However, the patients seemed unaware of the degree of their diminished working capacity. This reduced capacity makes it unlikely that they would be able to perform any labour involving high energy consumption at the level of 500-700 W, and this inability was reflected by a high rate of unemployment among the patients.
Value of oral antibiotic prophylaxis in colorectal surgery
Authors: McArdle C S , Morran C G , Pettit L , Gemmell C G , Sleigh J D , Tillotson G S 
Published: March 2007

Abstract
A total of 169 patients undergoing colorectal surgery were randomly allocated to receive either gentamicin plus metronidazole or oral ciprofloxacin plus metronidazole as prophylaxis; they were also allocated to receive cover for 1 or 3 days. Twenty-eight patients (17 per cent) developed postoperative wound infections. The proportion of patients with wound infections and other infective complications was significantly less (P &lt; 0·02) in those receiving oral ciprofloxacin. Cover for 3 days was no better than that for only 1 day. Oral ciprofloxacin for prophylaxis may offer advantages in efficacy and ease of administration compared with parenteral antibiotics.
Prediction of local recurrence and survival of carcinoma of the rectum by surgical and histopathological assessment of local clearance
Authors: Goldberg P A , Nicholls R J 
Published: March 2007

Abstract
The surgeon and histopathologist were asked to assess whether clearance of the resected primary rectal tumour was complete or not. The results of each assessment were related to survival and recurrence rates. Of 478 patients entered, full information was available for 396 who were followed to death or for at least 5 years. The surgeon and pathologist agreed on the clearance in 341 of the 396 patients. The 5-year local recurrence rate was 15 per cent in the 331 patients with complete local clearance and 62 per cent in those with incomplete clearance. There was disagreement regarding 55 patients (14 per cent) (39 pathologist ‘incomplete’/surgeon ‘complete’ 16 surgeon ‘incomplete’/pathologist ‘complete’). Local recurrence occurred later where the pathologist assessed resection to be incomplete (log rank X2 = 11·0, 1 d.f., P = 0·001). Of 321 patients without metastatic disease, the surgeon and pathologist agreed in 290 that 284 had complete and six incomplete clearance. The 5-year survival rates were 53 and 0 per cent respectively. There was disagreement regarding 31 patients (10 per cent) (11 surgeon ‘incomplete’/pathologist ‘complete’; 20 pathologist ‘incomplete’/surgeon ‘complete’). The 5-year survival rates were 18 and 10 per cent respectively (log rank X2 = 1·5, 1 d.f., P = 0·2). Surgical and histopathological assessments of local clearance are important in determining local recurrence and survival.
Ilioinguinal block dissection for malignant melanoma
Authors: Sterne G D , Murray D S , Grimley R P 
Published: March 2007

Abstract
A retrospective analysis of 41 patients treated for metastatic inguinal lymph node malignant melanoma is presented: 16 underwent inguinal node excision and 25 ilioinguinal node excision. The two groups were well matched for age, sex and other characteristics. The mean time in hospital (inguinal 20 days, ilioinguinal 18 days) and the complication rates (inguinal, ten of 16 patients, ilioinguinal, 13 of 25) were similar in each group. The incidence of groin relapse, defined as the development of symptomatic melanoma in the region of the inguinal or iliac node basins following block dissection, was lower after ilioinguinal block dissection (inguinal, three patients; ilioinguinal, none). Histological examination demonstrated a high proportion of iliac node involvement (13 of 25 patients), even in those with a single mobile inguinal lymph node clinically and no clinical or computed tomographic evidence of iliac node involvement. This supports the value of ilioinguinal block dissection and suggests that the associated morbidity need not be greater than that associated with inguinal clearance alone.
Exposure of the peritoneal cavity to air regulates early inflammatory responses to surgery in a murine model
Authors: Watson R W G , Redmond H P , McCarthy J , Burke P E , Bouchier-Hayes D 
Published: March 2007

Abstract
Factors in circulating air may play a role in immune responses after surgery through induction of gut-derived lipopolysaccharide (LPS) translocation across the gut. CD-1 mice were randomized to one of four treatment groups: controls, laparoscopy with carbon dioxide inflation, laparoscopy with air inflation and laparotomy. The peritoneal and systemic immune response was assessed by evaluating peritoneal macrophage, blood monocyte and neutrophil activity. In a second study, the effect of each of the treatments on fluorescein isothiocyanate (FITC)-LPS translocation across the gut was assessed. There were significant (P &lt; 0·05) increases in peritoneal tissue macrophage release of superoxide and tumour necrosis factor after laparoscopy with air and laparotomy compared with control procedures and carbon dioxide laparoscopy. However, peritoneal macrophage FITC-Candida albicans ingestion was significantly decreased after air laparoscopy and laparotomy compared with controls and carbon dioxide laparoscopy (P &lt; 0·05). These findings correlated with a significant (P &lt; 0·05) decrease in CD11b expression. Significant translocation into the peritoneal cavity and systemic circulation occurred after air laparoscopy and laparotomy only. Factors in circulating air can induce LPS translocation and subsequent stimulation of postoperative immune responses. The beneficial effects of laparoscopic surgery may be explained by the minimal air contamination of the peritoneal cavity.
Importance of hepatovenous back-perfusion for maintenance of liver viability during the Pringle manoeuvre
Authors: Tatsuma T , Kim Y I , Kai T , Ishii T , Akizuki S , Takayama F , Egashira T , Kobayashi M 
Published: March 2007

Abstract
The role of hepatovenous back-perfusion in maintaining hepatic viability was investigated during inflow occlusion (Pringle manoeuvre) of the pig liver. The study compared two ischaemia procedures of 60 min duration: hepatic inflow occlusion and inflow plus outflow occlusion (vascular exclusion). Each procedure was carried out in six pigs and liver tissue perfusion, energy metabolism, lipid peroxidation and 7-day survival were assessed. Although all pigs survived after inflow occlusion, five of six died after vascular exclusion (P &lt; 0·01). Exclusion induced a significant decrease in perfusion to 15·3 per cent of the value before ischaemia compared with 32·4 per cent after hepatic inflow occlusion alone (P &lt; 0·01). Although cellular adenosine 5′-triphosphate levels were significantly decreased by ischaemia in both groups, the fall was less in pigs with inflow occlusion alone (to 55 per cent of the preclamp value) than in those with exclusion (to 24 per cent of the preclamp value) (P &lt; 0·01). The plasma phosphatidylcholine hydroperoxide level rose immediately after reperfusion in pigs with exclusion, while the level remained constant after inflow occlusion alone. There is a fundamental difference between the two ischaemia procedures: back-perfusion from the vena cava contributes to the maintenance of liver function during inflow occlusion.
Hereditary breast cancer and linkage analysis to BRCA1
Authors: McKinley A G , Russell S E H , Spence R A J , Odling-Smee W , Nevin N C 
Published: March 2007

Abstract
In this study, over 1000 women with breast cancer were contacted by questionnaire and 164 families with a strong history of breast cancer were identified. Home visits to obtain full pedigree details took place for 123 women, and members of 24 families gave venous blood samples. The extracted DNA was typed by polymerase chain reaction amplification and the derived haplotypes submitted to linkage analysis which confirmed that in 12 families breast cancer susceptibility could be traced to BRCA1. The study demonstrates the number of women at risk of breast cancer in the population, illustrates the complexity of genetic analysis for hereditary breast cancer and demonstrates the problems of predictive analysis in clinical management.
Multivariate analysis of histopathological features as prognostic factors in patients with papillary thyroid carcinoma
Authors: Moreno-Egea A , Rodriguez-Gonzalez J M , Sola-Perez J , Soria-Cogollos T , Parrilla-Paricio P 
Published: March 2007

Abstract
A retrospective analysis of 121 papillary thyroid carcinomas was made to assess prognostic factors including histological variants which might be related to survival. The mean follow-up period was 10 years and clinical, surgical and histopathological data were studied. The survival curves were analysed by the Kaplan-Meier method and the multivariate analysis used Cox's regression model. Eighty-seven patients had well differentiated papillary cancers. The survival rate for papillary thyroid cancer was 86 per cent at 5 years and 72 per cent at 10 years. Factors showing prognostic significance for survival were tumour size, extrathyroid extension and histological type. Disease-free survival was influenced by sex, existence of a capsule and nodal metastases. Factors showing a favourable prognosis were: age under 45 years, size less than 4 cm, no extrathyroid extension and well differentiated histological type (P &lt; 0·001). Histological subtype was one of the most important prognostic factors.