bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of subclinical malnutrition and refeeding on the healing of experimental colonic anastomoses
Authors: Ward M W N , Danzi M , Lewin M R , Rennie M J , Clark C G 
Published: March 2007

Abstract
The effects of dietary protein deprivation on the healing of colonic anastomosis in the rat have been investigated. Nutritional status was assessed both before and after operation using body weight, nitrogen balance studies and serum albumin estimations. Healing of colonic anastomosis was assessed by bursting pressure measurements. Rats fed a protein-depleted diet throughout the study were compared both with rats restored to a full diet after surgery and rats receiving a full diet throughout. Although protein depletion caused a 12·5 per cent weight loss and a negative nitrogen balance, serum albumin remained normal in all rats at the time of operation. After operation, all rats were in negative nitrogen balance, although this was greater in the protein-depleted group. Similarly, in comparison to control animals, the protein-depleted group had significantly lower colonic bursting pressures and significantly lower serum albumin concentrations. Rats returned to a full diet after operation had smaller losses of nitrogen and normal colonic bursting pressures. The results indicate that a commonly encountered degree of malnutrition, insufficient to affect nutritional indices used in clinical assessment, may interfere with colonic healing. Early re-introduction of nutrition in the postoperative period may be able to reverse this effect.
Splenectomy and vasoligation for patients with haematemesis secondary to bilharzial hepatic fibrosis
Authors: El Masri Shawgi H , Hassan Mohamed A 
Published: March 2007

Abstract
One hundred and thirteen patients with haematemesis secondary to bilharzial hepatic fibrosis had splenectomy and vasoligation. There were 6 deaths in the immediate and 28 in the late postoperative period. The commonest cause of death was recurrent haematemesis followed by hepatic failure. Transient jaundice, ascites and infection were common in the postoperative period. The operation improved the cellular elements of the blood but the 20 per cent incidence of recurrent bleeding is unacceptable.
Cimetidine and perforated peptic ulcer
Authors: McKay Alan J , McArdle C S 
Published: March 2007

Abstract
Cimetidine is thought to have accelerated the reduction in elective peptic ulcer surgery but its effect on the incidence of perforated peptic ulcer has not been reported. A 15-year (1966–1980) review of peptic ulcer surgery in a district general hospital is presented. Since cimetidine became available (November 1976), the mean annual number of elective operations has fallen from 91·4 to 50·5 (45 per cent reduction). The number of perforations has fallen from 40·6 to 36·5 (10 per cent reduction).
One hundred and five patients treated for perforation (97 duodenal, 8 gastric) from 1978 to 1980 were reviewed in detail. Of the 64 patients with a chronic ulcer, 8 were taking cimetidine when their ulcers perforated and a further 8 had been on the drug previously. Cimetidine has substantially reduced elective peptic ulcer surgery. There appears to have been no equivalent reduction in the incidence of perforation.
Do women do worse after proximal gastric vagotomy?
Authors: Linhardt G E , Stoddard C J , Johnson A G 
Published: March 2007

Abstract
The view that woman fare worse than men following gastric surgery led us to examine the results of proximal gastric vagotomy (PGV) performed in 25 women with chronic duodenal ulcer. Follow-up was from 6 months to 8 years, with an average of 45 months. These were compared with men undergoing PGV for the same condition over the same period. The age, duration of symptoms and complication and recurrence rates were similar. Modified Visick grading rated the result as good in more than 90 per cent of both men and women. Flatulence and postprandial fullness were the most common complaints but were usually mild. The results of PGV in women are just as good as those in men.
Skin closure of inguinal herniorrhaphy wounds in short-stay patients
Authors: Ralphs D N L , Cannon S R , Bolton J P 
Published: March 2007

Abstract
One hundred and twenty-two inguinal hernias were repaired in a consecutive series of 104 patients. The patients were randomly divided into two groups. In one, 66 wounds were closed by the traditional method of using interrupted non-absorbable skin sutures. In the second group, 56 wounds were closed with subcuticular Dexon sutures. The results of the two methods of skin closure were compared in the immediate postoperative period, at 2 weeks, 3 months and at more than 18 months after surgery. The final appearance of the wounds was similar in the two groups. Dexon has the advantage for short-stay patients of not requiring removal.
Abdominal wall resection and reconstruction with the aid of Marlex mesh
Authors: Blom W F , Koops H Schraffordt , Vermey A , Oldhoff J 
Published: March 2007

Abstract
Treatment of malignant tumours of the abdominal wall is primarily surgical and should consist of ample excision with a margin of 4–6 cm into the adjacent healthy tissue. When primary closure of the defect in the abdominal wall is not feasible, it can be repaired with the aid of Marlex mesh, combined if necessary with a pedicled omentum flap and free skin grafts. Major resections of the abdominal wall are thus made possible.
Bile diversion after total gastrectomy
Authors: Donovan I A , Fielding J W L , Bradby H , Sorgi M , Harding L K 
Published: March 2007

Abstract
A method for studying bile reflux into the oesophagus after total gastrectomy is described using 99Tcm-HIDA and an external imaging system. Two reconstructions were studied: oesophagojejunostomy with a diverting entero-anastomosis (omega reconstruction, 6 studies) and Roux-en-Y reconstruction (20 studies). The incidence of reflux on scanning correlated well with the incidence of oesophagitis, and the finding of reflux was almost always associated with severe symptoms. The omega procedure was unsuccessful in diverting bile in 5 patients despite an entero-anastomosis as wide as 12 cm. The Roux-en-Y reconstruction was unsuccessful in diverting bile in 5 patients all of whom had a diverting limb 35 cm in length; none of the 9 patients with a diverting limb longer than 35 cm refluxed (range 40–50 cm).
Anorectal sepsis: Microbiology in relation to fistula-in-ano
Authors: Grace R H , Harper I A , Thompson R G 
Published: March 2007

Abstract
One hundred and sixty-five patients presented in a 4-year period; 68 (41·2 per cent) had had previous anorectal sepsis and in 56 of these patients (82·3 per cent) the presenting sepsis was at the site of the previous abscess. The abscesses were drained and pus was sent for culture; any fistula, if found, was laid open. A second examination under anaesthesia was performed within 7–10 days if no fistula had been found. The pus from 114 patients grew bowel-derived organisms; 62 (54·4 per cent) fistulas were found. The pus from 34 patients grew skin-derived organisms but no fistula was demonstrated in this group. It is suggested that a second examination need only be performed if culture of the pus grows bowel-derived organisms; anorectal abscesses which grow skin-derived organisms are not associated with a fistula.
The clinical syndrome of mammary duct ectasia
Authors: Thomas W G , Williamson R C N , Davies J D , Webb A J 
Published: March 2007

Abstract
Over an 11-year period in one surgeon's practice, mammary duct ectasia constituted 5·5 per cent of all breast diseases treated by operation. A total of 78 patients undergoing major duct excision for mammary duct ectasia has been studied to determine the success of the standard operative treatment. Good results were obtained when the indications for operation were nipple retraction, nipple discharge or a sub-areolar mass. By contrast, generally poor results were obtained in 9 patients in whom the indication for operation was recurrent para-areolar sepsis; two of these ultimately came to simple mastectomy.
Treatment of well-differentiated carcinoma of the thyroid based on initial staging
Authors: Duffield R G M , Lowe D , Burnand K G 
Published: March 2007

Abstract
Sixty-six patients with well-differentiated thyroid carcinomas have been followed up for a minimum of 10 years. A conservative surgical approach was adopted for unsuspected intrathyroid tumours. Twenty-three out of 29 patients (80 per cent) with papillary carcinomas and 18 out of 37 (50 per cent) with follicular carcinomas were alive at the time of review. Although patients with follicular carcinoma have only a moderate overall prognosis, patients with node-negative intrathyroid tumours (unsuspected) treated by conservative resection have a 79 per cent 10-year survival. These survival figures compare favourably with other reported series where all the patients were treated by radical surgery. Early conversion of a conservative resection to a total thyroidectomy for an unexpected tumour does not appear to be warranted since an increased risk of complications is not balanced by an improved outcome. Two patients, with intrathyroid papillary carcinomas who developed tumours in the residual gland more than 5 years after initial lobectomy, successfully underwent further resections of the thyroid remnants, and are disease free more than 9 years later.
The use of a rigid choledochoscope in exploration of the common bile duct
Authors: Ernst D , Windsor C W O 
Published: March 2007

Abstract
In 62 consecutive explorations of the common bile duct during a 2-year period, a Storz rigid choledochoscope was used to visualize the lumen of the duct before its closure over a T tube. All patients had radiological abnormalities on cholangiography; 45 had stones and 17 apparent strictures. In those with stones, the instrument was introduced after apparent removal of the stones to confirm the completeness of the manoeuvre. This examination showed that 11 patients (25 per cent) still had stones present and needed further manipulation. When the duct was seen to be clear, a T tube was inserted and the validity of the choledochoscopic findings checked by postoperative T-tube cholangiography. This confirmed the visual accuracy in all but one patient, an accuracy of 98 per cent. Of the 17 patients explored for other radiological abnormalities, choledochoscopy correctly determined the aetiology or excluded abnormalities in all cases. No complications of the procedure were encountered.
The pelvic ileal reservoir: An experimental assessment of its function compared with that of normal rectum
Authors: Cranley B , McKelvey S T D 
Published: March 2007

Abstract
The function of the 3-loop pelvic ileal reservoir as an alternative to total proctocolectomy and ileostomy is assessed experimentally in dogs and compared with normal rectum under identical conditions. No difference was found between the pelvic ileal reservoir and normal rectum in their ability to maintain continence. The efficiency of evacuation, however, is significantly better in normal rectum (P &lt; 0·01). Observations made over a prolonged period of time suggest that frequency of defecation, tenesmus and incomplete evacuation are persistent problems with an ileal reservoir. The results of the experiments concur with clinical findings that satisfactory continence may be achieved by using the ileal reservoir but that it does not possess the ability of normal rectum to evacuate completely. Hence the frequent need for self-catheterization.
Cerebrospinal fluid rhinorrhoea and its management
Authors: Westmore G A , Whittam D E 
Published: March 2007

Abstract
A series of 100 cases of cerebrospinal fluid rhinorrhoea has been analysed with reference to the incidence and pattern of meningitis in order to formulate a rationale for the future management of such cases. Most cases are best managed conservatively for the first 14 days during which the majority resolve spontaneously. Of those requiring surgery, the trans-ethmoid/sphenoidal route of repair is preferred except in certain specified circumstances. The high incidence of meningitis in cerebrospinal fluid rhinorrhoea following nasal or trans-sphenoidal surgery probably demands early operation by craniotomy.
Prospective study of dialysis fistulas: Problem patients and their treatment
Authors: Reilly D T , Wood R F M , Bell P R F 
Published: March 2007

Abstract
A 5½-year prospective study of the fate of arteriovenous fistulas for haemodialysis is reported with particular reference to the prevention and treatment of complications. A total of 157 consecutive patients was accepted for chronic haemodialysis: 148 patients had a first attempt at a wrist fistula construction, 2 patients had a failed exploration of the wrist, 1 patient had a primary brachial fistula due to absent forearm veins and 6 patients were excluded from analysis because vascular access operations had already been performed elsewhere. Including early failures, 80 per cent of the fistulas remained patent 1 year after construction and 65 per cent remained patent at 4 years. When early thrombosis and technical failures were excluded, the 1-year patency rate was 90 per cent.
Of the study group of 150 patients with attempts at wrist fistula construction, 94 had no problems with their fistulas. Five were lost to follow-up and complications developed in 51 patients, including poor flow, thrombosis, venous hypertension and false aneurysm. These patients constituted a problem group and 107 further procedures were required to re-establish satisfactory access. Analysis of variables including age, sex, smoking habit, pre-dialysis time and operative factors showed only vein size to exert a significant effect on fistula survival. Discriminant analysis failed to separate the two groups. There were 42 salvage operations and 65 new access procedures. The latter included 49 wrist or brachial fistulas, 9 ankle shunts and only 4 loop grafts.
It is suggested that with careful management of wrist fistulas and their complications, the place of autogenous or artificial grafts is strictly limited.
A study of the quality and duration of survival following resection, endoscopic intubation and surgical intubation in oesophageal carcinoma
Authors: Watson A 
Published: March 2007

Abstract
A series of 130 cases of oesophageal carcinoma managed by one surgeon in a unit with a major interest in oesophageal disorders is reviewed. The management policy has been an active one of resection in suitably selected cases, less favourable ones being treated by operative intubation before 1979 and by endoscopic intubation since 1979. Operative mortality and morbidity have been compared between the three groups, together with duration of survival and quality of swallowing as measured by a modified Visick grading. In the intubated groups, endoscopic intubation carried a hospital mortality of 15·6 per cent compared with 40·8 per cent in the operative group. It was associated with less morbidity and a better quality of survival, although survival times were comparable and did not exceed 18 months in either group. In the resection group, hospital mortality was 12·2 per cent, and both the mean survival and quality of swallowing were greater than in either endoscopic group.
It is concluded that in suitably selected cases, resection can be performed with a mortality considered acceptable for palliative intubation whilst conferring greater survival and restoration of normal swallowing. In less favourable cases, endoscopic intubation is superior to operative intubation in terms of reduced mortality and better restoration of swallowing.
Psoas abscess in Crohn's disease
Authors: Van Dongen L M , Lubbers E J C 
Published: March 2007

Abstract
In a series of 161 patients treated surgically for Crohn's disease, 7 patients were seen with a psoas abscess as a complication of the bowel disease. Drainage only was not sufficient to check the rapid downhill course in these patients. Resection of the underlying bowel disease was performed in all patients. There was one death from pulmonary embolism and 3 patients required drainage on more than one occasion.
Surgical treatment of pancreatic pseudocysts
Authors: Schattenkerk M Eeftinck , De Vries J E , Bruining H A , Eggink W F , Obertop H 
Published: March 2007

Abstract
Twenty-five patients with pancreatic pseudocysts were treated surgically. The operative mortality was 4 per cent. Morbidity after external drainage was higher (86 per cent) than after internal drainage (36 per cent), mainly due to the presence of chronic postoperative pancreatic fistulas. A standard procedure based on our own results and published data for management of pancreatic pseudocysts is proposed.
The control of human pancreatic adenocarcinoma xenografts in nude mice by hormone therapy
Authors: Greenway B , Duke D , Pym Barbara , Iqbal M J , Johnson P J , Williams R 
Published: March 2007

Abstract
The effect of hormone therapy on the growth of human non-endocrine pancreatic adenocarcinoma xenografts in nude mice was evaluated. The androgen testosterone stimulated tumour growth rate, whereas the anti-androgen cyproterone acetate significantly inhibited tumour growth rate compared with untreated controls. These findings provide further support for the suggestion that the growth and metabolism of pancreatic carcinoma may be dependent on the sex steroid hormones.
The value of routine peroperative cholangiography—a report of 4000 cholecystectomies
Authors: Doyle P J , Ward-McQuaid J N , Smith A Mcewen 
Published: March 2007

Abstract
A total of 4000 consecutive cholecystectomies performed over a period of 25 years has been analysed to determine whether routine peroperative cholangiography (PC) has influenced overall mortality. The patients have been divided into four cohorts of 1000, the first cohort before the introduction of PC, two covering the period of introduction of PC and the final cohort when PC was an established routine. A significant fall in overall mortality has been demonstrated, but when the patients are divided into simple cholecystectomy and the group undergoing additional choledochotomy there is no significant fall in the mortality rate. The mortality rate for the latter group is three or four times greater than that for the cholecystectomy alone group. The main contribution to the lower mortality is the reduced duct exploration rate following the introduction of PC. The stone recovery rate has improved from 34 to 71 per cent. The use of routine PC during cholecystectomy is recommended.
Combined antrectomy and Rouxen-Y anastomosis in the surgical treatment of recurrent peptic ulceration
Authors: Cooper G , Bell G 
Published: March 2007

Abstract
The results of antrectomy performed for recurrent peptic ulceration after vagotomy and drainage are frequently marred by bilious vomiting. Consequently, there has been interest in combining antrectomy with Roux-en-Y drainage to prevent this complication. The experience of one surgeon in revisional gastric surgery has been studied retrospectively. Thirty-six patients have been reviewed in detail, 24 of whom had a combined antrectomy and Roux-en-Y anastomosis: 16 for recurrent peptic ulceration, 2 for non-ulcer dyspepsia and 6 for bile reflux gastritis. None of these has required reoperation, and 12 of the 16 with recurrent ulcers have had a good result. Four of 12 who underwent antrectomy alone subsequently required biliary diversion. Combining antrectomy with a Roux-en-Y anastomosis prevents postoperative bile reflux gastritis and thereby the need for further revision on this account. The results of this approach compare well with those of other procedures used in the treatment of recurrent peptic ulceration.
Long term results of truncal vagotomy and pyloroplasty for gastric ulcer
Authors: Madsen P , Schousen P 
Published: March 2007

Abstract
The results of truncal vagotomy and pyloroplasty for gastric, prepyloric and combined ulcers in 215 patients were evaluated 9–15 years after operation. The operative mortality was 1·9 per cent, and the recurrence rates in gastric, prepyloric and combined ulcer patients were 8, 13 and 0 per cent respectively. Recurrent ulceration was significantly related to acid serretion. The functional results were not different in patients with gastric and prepyloric ulcers, but significantly better in the small group with combined ulcer than in the group with prepyloric ulcer. No long term weight changes were seen. Gastric cancer was the cause of death in 2 men and 1 woman treated for gastric ulcer.
Measurement of gastric emptying after gastric bypass surgery using radionuclides
Authors: Horowitz M , Cook D J , Collins P J , Harding P E , Hooper M J , Walsh J F , Shearman D J C 
Published: March 2007

Abstract
The pattern of gastric emptying has been assessed after gastric bypass surgery using a double isotope technique for measuring solid and liquid emptying with a scintillation camera. Eleven control subjects and 12 patients, 12 months post-gastric bypass, were studied. Stomal and gastric pouch size were assessed at endoscopy. Solid emptying was slower and liquid emptying was more rapid after gastric bypass surgery. Initial rapid emptying of solid occurred in the 4 patients with the smallest pouch diameters. There was no correlation between stomal size and rates of solid or liquid emptying nor between the weight loss produced by the operation and the rates of solid or liquid emptying, stoma or pouch size.
Staples or sutures for colonic anastomoses—a controlled clinical trial
Authors: Brennan S S , Pickford I R , Evans Mary , Pollock A V 
Published: March 2007

Abstract
We randomly allocated 100 patients undergoing colonic or rectal resections to have their anastomoses made either by a single layer of braided polyester interrupted sutures, or by the SPTU circular stapling instrument. Twelve anastomoses leaked, 4 being detected only by contrast enema. There was no difference in leak rate between the two anastomotic methods, but patients in the stapled group had a significantly higher incidence of minor wound infection, and spent significantly more days in hospital after operation. The stapling instrument is no safer than sutures for colonic and rectal anastomoses, but considerably facilitates the performance of a low anterior resection.
Cough dynamics in oesophageal cancer: Prevention of postoperative pulmonary complications
Authors: Sugimachi K , Ueo H , Natsuda Y , Kai H , Inokuchi K , Zaitsu A 
Published: March 2007

Abstract
The value of the cough reflex and its pressure and flow in the immediate postoperative period was measured in patients who underwent subtotal oesophagectomy and reconstruction for oesophageal cancer and other thoracic surgery. Twenty-two patients with subtotal oesophagectomy and reconstruction were found to have an extensive reduction in cough reflex and force, compared with those who had undergone pulmonary lobectomy. Damage to the vagal nerve caused by dissection of the paratracheal lymph nodes, and injury to the diaphragm during operation for oesophageal cancer appeared to be responsible for the inability to cough. It was of interest that the patients who showed a high value of cough reflex and force in the immediate postoperative period had few pulmonary complications. The postoperative measurement of cough ability may be a useful indicator for safe extubation of the intratracheal tube, as a means of preventing pulmonary complications after thoracic surgery. Continuous mechanical ventilation and frequent suction to remove retained secretions are strongly recommended for the patients who are unable to cough properly.