European Journal of Surgery最新文献

{"title":"Small bowel volvulus: a common cause of mechanical intestinal obstruction in our region","authors":"Emin Gürleyik,&nbsp;Günay Gürleyik","doi":"10.1080/110241598750004959","DOIUrl":"10.1080/110241598750004959","url":null,"abstract":"<div>\u0000 \u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective:</h3>\u0000 \u0000 <p>To find out the incidence and causes of small bowel volvulus in our region, and to analyse the results of our management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design:</h3>\u0000 \u0000 <p>Retrospective study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting:</h3>\u0000 \u0000 <p>Teaching hospital, Turkey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects:</h3>\u0000 \u0000 <p>38 Patients who had had no previous abdominal operations who were operated on for mechanical intestinal obstruction caused by small bowel volvulus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures:</h3>\u0000 \u0000 <p>Incidence of small bowel volvulus, details of patients, treatments, complications, and outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results:</h3>\u0000 \u0000 <p>Small bowel volvulus constituted 8%(38/466) of all cases of mechanical intestinal obstruction and 13%(38/292) of small bowel obstruction. Volvulus was primary in 18 (47%), and secondary in 20 (53%) patients. 33 Patients (87%) were male. The mean age of the whole group was 30 years, 42 and 19 in patients with primary and secondary volvulus, respectively (<i>p</i> = 0.0005). The incidence of small bowel volvulus was 19%(27/143) in patients under 40 years, and 7%(11/149) in those over 40 years of age (<i>p</i> = 0.005). Sixty percent of patients with secondary volvulus (12/20) were under 20 years of age compared with 17% of those with primary volvulus (3/18; <i>p</i> = 0.009). The causes of secondary volvulus were Meckel's diverticulum in 14 patients (70%), and malrotation and ileosigmoid knotting in 3 patients each (15%). Segments of bowel were gangrenous in 12 patients (32%). Treatment was by simple untwisting in patients with viable segments of gut, or with resection of gangrenous segments and primary small bowel anastomosis. One patient died postoperatively of septic shock.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions:</h3>\u0000 \u0000 <p>Small bowel volvulus is a common form of intestinal obstruction in our region. It carries a high risk of gangrene of twisted segments of bowel. Fortunately perforation of small bowel is uncommon, and resection and primary anastomosis is a safe procedure in cases of necrosis. Today the outcome of such patients is satisfactory. Early and proper management is essential for a good outcome. Copyright © 1998 Taylor and Francis Ltd.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 1","pages":"51-55"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004959","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20459724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concentrations of parathyroid hormone in functioning and non-functioning parathyroid cysts","authors":"Jonas S. A. Röjdmark,&nbsp;John M. Monchik","doi":"10.1080/110241598750004977","DOIUrl":"10.1080/110241598750004977","url":null,"abstract":"","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 1","pages":"65-67"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004977","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20459726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Graft reconstruction using an intraluminal balloon catheter in ruptured abdominal aortic aneurysms","authors":"Marco Lorenzi,&nbsp;Stefano Mancini,&nbsp;Sergio Mancini","doi":"10.1080/110241598750004814","DOIUrl":"10.1080/110241598750004814","url":null,"abstract":"","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 2","pages":"147-148"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004814","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20460233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of gastric mucosal pH and clinical judgement in critically ill patients","authors":"Joseph T. Santoso,&nbsp;David H. Wisner,&nbsp;Felix D. Battistella,&nbsp;John T. Owings","doi":"10.1080/110241598750005877","DOIUrl":"10.1080/110241598750005877","url":null,"abstract":"<div>\u0000 \u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives:</h3>\u0000 \u0000 <p>To compare gastric tonometry (pHi) with estimates of pHi in ill injured patients, and to correlate pHi with haemodynamic variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design:</h3>\u0000 \u0000 <p>Prospective, non-interventional study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting:</h3>\u0000 \u0000 <p>ICU of Level I trauma centre, USA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures:</h3>\u0000 \u0000 <p>154 gastric tonometry measurements were compared with physicians' estimates of adequacy of resuscitation. Resuscitation was categorised as inadequate (pHi &lt; 7.35) or adequate (pHi ≥ 7.35). Measured and estimated pHi were also compared with oxygen delivery, oxygen consumption, cardiac index, mixed venous O₂ saturation, and critical illness scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results:</h3>\u0000 \u0000 <p>Estimated pHi was often higher than measured pHi in the judgement of all four surgical intensive care physicians. Measured pHi correlated positively with mixed venous O₂ tension (<i>r</i> = 0.21). There were significant negative correlations between measured pHi and both oxygen delivery (<i>r</i> = −0.25) and oxygen consumption (<i>r</i> = −0.28). Estimated pHi correlated positively with mean arterial pressure (<i>r</i> = 0.21) and hospital day (<i>r</i> = 0.26); it correlated negatively with pulmonary arterial elastance (<i>r</i> = −0.35).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion:</h3>\u0000 \u0000 <p>Experienced intensive care physicians tended to overestimate visceral perfusion, which suggests that gastric tonometry adds useful information over and above routine haemodynamic indices. Arterial blood pressure and mixed venous oxygen saturation correlated better with measured pHi than with other indices of perfusion. Copyright © 1998 Taylor and Francis Ltd.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 7","pages":"521-526"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750005877","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20612868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic cholecystectomy for acute cholecystitis and the consequences of gallbladder perforation, bile spillage, and “loss” of stones","authors":"Yaron Assaff,&nbsp;Ibrahim Matter,&nbsp;Edmond Sabo,&nbsp;Jorge G. Mogilner,&nbsp;Ernest Nash,&nbsp;Jack Abrahamson,&nbsp;Samuel Eldar","doi":"10.1080/110241598750004238","DOIUrl":"10.1080/110241598750004238","url":null,"abstract":"<div>\u0000 \u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective:</h3>\u0000 \u0000 <p>To study the factors associated with accidental perforation of the gallbladder and spillage of bile and stones and to assess the consequences of these mishaps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design:</h3>\u0000 \u0000 <p>Prospective study with retrospective bacteriological evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting:</h3>\u0000 \u0000 <p>Teaching hospital, Israel.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects:</h3>\u0000 \u0000 <p>189 Patients who were treated for clinical acute cholecystitis between January 1994 and August 1996.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions:</h3>\u0000 \u0000 <p>Emergency laparoscopic cholecystectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures:</h3>\u0000 \u0000 <p>Incidence of accidental perforation of gallbladder and spillage of bile and stones and of conversion and complications in relation to preoperative and operative findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results:</h3>\u0000 \u0000 <p>Bile was spilt in 65 (34%) and gall-stones were “lost” in 27 (14%), 44 (23%) required conversion to an open approach and 36 (19%) developed complications. Preoperative duration of symptoms &gt;96 hours and a palpable gallbladder were associated with accidental perforation of the gallbladder and spillage of bile. A palpable gallbladder, gangrenous cholecystitis, and WBC &gt; 15 × 10⁹/L were associated with stones “lost” in the peritoneum. A history of biliary disease was inversely related to “lost” stones. Conversion of laparoscopic to open cholecystectomy was associated with male sex, age &gt;60 years, a non-palpable gallbladder, WBC &gt; 15 × 10⁹/L, and a gangrenous gallbladder. Complications of surgery were more common among men and associated with fever of &gt;38°C. Neither the conversion nor the complications were associated with perforation of the gallbladder or “lost” stones.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion:</h3>\u0000 \u0000 <p>Perforation of the gallbladder and intraperitoneal spillage of bile or stones during laparoscopic cholecystectomy for acute cholecystitis are not associated with undesirable events, are not indications for conversion, and are not associated with further complications. When patients are given appropriate antibiotics perioperatively and the spilt bile is properly aspirated and the peritoneum irrigated, the operative and postoperative courses are similar to those of pat","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 6","pages":"425-431"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004238","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20613693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Michael Lavelle-Jones (Editor). Surgery 1. Churchill Livingstone. Edinburgh, 1997. (220 pages). ISBN 0-443-05172-0","authors":"Gudrun Lindmark","doi":"10.1080/110241598750005011","DOIUrl":"10.1080/110241598750005011","url":null,"abstract":"","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 1","pages":"78"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750005011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80376911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shearman D. J. C., Finlayson N. D. C. and Camilleri M. (Eds). D. C. Carter (Surgical Ed): Diseases of the gastrointestinal tract and liver, 3rd ed. Edinburgh: Churchill Livingstone, 1997. (1500 pages). ISBN: 044305147X","authors":"Gunnar Järnerot","doi":"10.1080/110241598750004328","DOIUrl":"10.1080/110241598750004328","url":null,"abstract":"","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 6","pages":"477"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004328","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"93392456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editors: Hiatt JR, Phillips EH, Morgenstern L: Surgical disease of the spleen. Springer Verlag, Berlin, 1997 (113 figures, many in colour, and 24 tables. 285 pages). ISBN 3-54061-781-7","authors":"Lars Lundell","doi":"10.1080/110241598750004850","DOIUrl":"https://doi.org/10.1080/110241598750004850","url":null,"abstract":"","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 2","pages":"157"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004850","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109229990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute mesenteric vascular occlusion: analysis of 39 patients","authors":"Hiroshi Urayama,&nbsp;Hiroshi Ohtake,&nbsp;Takuhisa Kawakami,&nbsp;Yoshio Tsunezuka,&nbsp;Kenji Yokoi,&nbsp;Yoh Watanabe","doi":"10.1080/110241598750004643","DOIUrl":"10.1080/110241598750004643","url":null,"abstract":"<div>\u0000 \u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective:</h3>\u0000 \u0000 <p>To study the factors that influence mortality and long term outcome of patients with acute mesenteric vascular occlusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design:</h3>\u0000 \u0000 <p>Retrospective study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting:</h3>\u0000 \u0000 <p>University hospital, Kanazawa, Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients:</h3>\u0000 \u0000 <p>Thirty-nine patients treated between 1978 and 1995 for acute mesenteric vascular occlusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions:</h3>\u0000 \u0000 <p>34 patients underwent laparotomy. Bowel was resected in 29 patients, and primary anastomosis was done in 20. The occluded vessel was revascularised in 5 patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures:</h3>\u0000 \u0000 <p>mortality, short bowel syndrome and long term survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results:</h3>\u0000 \u0000 <p>25 patients had arterial occlusions, and 8 venous. In the remaining 6, the occluded vessel was not identified. 11 Patients developed renal failure, 11 respiratory failure, and 10 disseminated intravascular coagulation (DIC). Twelve patients died within 30 days. The factors associated with early death were acidosis and high serum amylase activity. 9 Patients developed the short bowel syndrome. Survival was 49% at 1 year, and 34% at 5 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion:</h3>\u0000 \u0000 <p>Mortality was higher in patients with advanced peritonitis. Mesenteric revascularisation should be attempted to avoid the short bowel syndrome. Copyright © 1998 Taylor and Francis Ltd.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 3","pages":"195-200"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004643","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20483043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long term follow up of patients who underwent jejunoileal bypass for morbid obesity","authors":"Jens Frandsen,&nbsp;Steen B. Pedersen,&nbsp;Bjørn Richelsen","doi":"10.1080/110241598750004517","DOIUrl":"10.1080/110241598750004517","url":null,"abstract":"<div>\u0000 \u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective:</h3>\u0000 \u0000 <p>To describe our long term results after jejunoileal (JI) bypass for morbid obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design:</h3>\u0000 \u0000 <p>Retrospective study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting:</h3>\u0000 \u0000 <p>Teaching hospital, Denmark</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects:</h3>\u0000 \u0000 <p>All 57 patients who underwent JI bypass for mobid obesity between January 1973 and December 1988.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions:</h3>\u0000 \u0000 <p>Type A and type B JI bypass.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures:</h3>\u0000 \u0000 <p>Weight loss, operative morbidity and mortality, and subjective evaluation of the results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results:</h3>\u0000 \u0000 <p>Mean duration of follow up was 15.9 years (range 8–22). There were no operative or early postoperative deaths, but there were 7 late deaths (12%). 5 patients developed postoperative complications (9%), and 11 patients (19%) required reoperation for side effects or complications. The mean body mass index (BMI, kg/m²) was reduced from 47.5 (range 40–60) to 32 (range 22–49) during the follow up period which corresponded to a weight loss of about 42 kg. Of the 39 patients who still had a JI bypass in 1994, nearly two thirds said that they were satisfied with the operation, though they nearly all had some side effects such as diarrhoea or intermittent abdominal pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion:</h3>\u0000 \u0000 <p>As complications of JI bypass can develop at any time, we suggest that all patients who have had the operation should be regularly followed up at special clinics so that complications can be diagnosed and treated as soon as possible. Copyright © 1998 Taylor and Francis Ltd.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 4","pages":"281-286"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004517","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20559650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}