Journal of the Royal College of Surgeons of Edinburgh最新文献_第6页

Ivor-Lewis oesophagectomy for middle and lower third oesophageal lesions--how we do it. Ivor-Lewis食道切除术治疗中下三分之一食道病变——我们是怎么做的。

Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-10-01

T J Crofts

引用次数: 0

Rapidly enlarging lump in the neck: is it a tumour? 颈部迅速增大的肿块:是肿瘤吗?

Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-10-01

A A Maheshwar, A G Douglas-Jones, P J Cuddihy

引用次数: 0

Superior mesenteric artery bypass for chronic mesenteric ischaemia: a DGH experience. 肠系膜上动脉旁路治疗慢性肠系膜缺血:DGH经验。

Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-10-01

B Patel, J Widdowson, R C Smith

{"title":"Superior mesenteric artery bypass for chronic mesenteric ischaemia: a DGH experience.","authors":"B Patel, J Widdowson, R C Smith","doi":"","DOIUrl":"","url":null,"abstract":"This article evaluates the results of single vessel bypass surgery for symptomatic chronic mesenteric ischaemia (CMI) in 6 patients undergoing a total of 8 superior mesenteric artery (SMA) bypass operations, all with good post-operative symptom relief. Post-prandial pain and weight loss was present in 5 out of 6 patients. Epigastric bruit was present in only two patients and 4 out of 6 patients had diarrhoea. The patients had varying degrees of peripheral vascular disease, ischaemic heart disease and hypertension. All patients had occlusion of the SMA on angiography and bypassing the occluded segment resulted in disappearance of the symptoms and weight gain. The vascular graft was sutured end to side to the front of the infra-renal aorta and end to side to the SMA, distal to the origin of the middle colic artery. Two patients had recurrence of symptoms due to graft occlusion at 3 and 4 years, respectively; they were successfully treated with repeat SMA bypass. There were no major complications or deaths related to the procedure in this study; one patient developed an incisional hernia requiring elective repair. Thus, early restoration of SMA circulation by bypass grafting in patients with CMI is sufficient to alleviate symptoms and prevent intestinal infarction with its high mortality rate.","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 5","pages":"285-7"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21904711","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}

引用次数: 0

Renal cell carcinoma: incidental detection and pathological staging. 肾细胞癌:偶然发现及病理分期。

Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-10-01

W Y Siow, S K Yip, L G Ng, P H Tan, W S Cheng, K T Foo

{"title":"Renal cell carcinoma: incidental detection and pathological staging.","authors":"W Y Siow, S K Yip, L G Ng, P H Tan, W S Cheng, K T Foo","doi":"","DOIUrl":"","url":null,"abstract":"In developed countries, there has been increased incidental detection of renal cell carcinoma (RCC). The incidence, pathological stage and survival of incidentally detected carcinoma in a developing country in Asia where, from 1990 to 1998, 165 renal cell carcinomas were identified. The clinical presentation, diagnostic-imaging modality employed, pathological staging and patient survival was reviewed. Incidental renal cancers included those that were diagnosed through health screening or detected incidentally through imaging studies for other conditions. The survival between these incidentally detected lesions and their symptomatic counterparts (suspected group) was compared. Sixty-four patients (39%) had their tumours detected incidentally, including 39 who were entirely asymptomatic and 25 who presented with non-specific symptoms, not initially suggestive of RCC. For the entire group, computed tomography provided the definitive diagnosis in 81% of cases. The incidental detection group had significantly smaller size of tumour (5.9 cm c.f. 7.6 cm), lower stage and lower histological grading. In particular, 78% of patients with incidental RCC had stage I or II diseases (TNM stage classification), compared with 57% of patients with suspected tumour (p < 0.05; Chi-square test). The disease free survival was significantly better for those with incidental detection (86% c.f. 66% at last follow up; p < 0.05; log-rank test) over a mean follow up period of 33 months (range 1-91). Regression analysis showed that stage of disease was the only independent variable predictive of clinical outcome. In conclusion, that significant numbers of RCC were detected incidentally. These tumours were of a lower clinical pathological stage and had a better prognosis.","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 5","pages":"291-5"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21904713","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}

引用次数: 0

Agenesis of the gallbladder. 胆囊发育不全

Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-09-01 DOI: 10.1097/00007611-200009000-00016

U. Baltazar, Julie E. Dunn, Sergio Gonzalez-Diaz, William Browder

引用次数: 10

Why is the patient still hypoxic despite being ventilated? 为什么病人在通气后仍然缺氧?

Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-08-01

P Townsend, N R Webster

引用次数: 0

A case of sacro-coccygeal chordoma masquerading as pilonidal sinus. 伪装成毛髓窦的骶尾骨脊索瘤1例。

Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-08-01

G C Beattie, L Millar, I M Nawroz, G G Browning

引用次数: 0

Pancreatic trauma in Scottish children. 苏格兰儿童的胰腺创伤。

Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-08-01

C A Graham, S J O'Toole, A J Watson, F D Munro, G Haddock

{"title":"Pancreatic trauma in Scottish children.","authors":"C A Graham, S J O'Toole, A J Watson, F D Munro, G Haddock","doi":"","DOIUrl":"","url":null,"abstract":"Background: Trauma is the leading cause of death in children. Abdominal trauma is common, but there is little information on pancreatic injuries in UK children. The aim of this study was to investigate the clinical course of children suffering pancreatic trauma in Scotland.Methods: All children admitted to the three major Scottish paediatric surgery centres with evidence of pancreatic injury were identified. A retrospective case note review of these children was performed using a structured proforma.Results: 16 patients (11 males and 5 females), median age 7 years (range 1-11 years) were identified. The commonest mechanism of injury was the typical bicycle handlebar injury (10/16, 62%). Delays in definitive diagnosis were common due to subtle clinical signs. Increased serum amylase levels upon admission were not necessarily diagnostic for pancreatic injury. The diagnosis was confirmed by ultrasound scanning and/or computerised tomography in all patients. Ten patients (62%) developed pseudocysts and, in seven cases, they settled with non-operative management. There were no deaths and no long-term complications.Conclusion: Pancreatic injury in children is rare, and a high index of suspicion is required to make the diagnosis. The commonest mechanism of injury is a direct impact to the epigastrium, typically the bicycle handlebar injury. Presentation and diagnosis are frequently delayed. The incidence of pseudocysts is high, but most can be managed conservatively.","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 4","pages":"223-6"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21951763","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}

引用次数: 0

Efficacy of PSA in the detection of carcinoma of the prostate in patients presenting with acute urinary retention. PSA检测急性尿潴留患者前列腺癌的疗效。

Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-08-01

S A McNeill, T B Hargreave

{"title":"Efficacy of PSA in the detection of carcinoma of the prostate in patients presenting with acute urinary retention.","authors":"S A McNeill, T B Hargreave","doi":"","DOIUrl":"","url":null,"abstract":"Objectives: A temporary elevation in serum-prostate specific antigen (PSA) levels has been reported in association with acute urinary retention. In spite of this, it is not uncommon for clinicians to assay PSA at the time a patient presents with acute urinary retention. We sought to evaluate whether this practice can be justified.Patients and method: Fifty-four patients, aged between 55 and 89 years, who presented to a single institution with acute urinary retention were studied. A PSA assay was performed on admission and a record made of the prostatic size as assessed by digital rectal examination. All patients underwent a trial without catheter, those that failed to void underwent prostatic surgery whilst all others were followed up as outpatients.Results: Five patients were found to have prostatic carcinoma, three following transurethral resection of the prostate (TURP) and two following needle biopsy, performed because of persistent elevation of the PSA. A significant elevation in the PSA was associated with acute urinary retention, with only 15 (28%) patients having a PSA of 4.0 ng/ml or less. This elevation reduced the sensitivity of PSA in detecting carcinoma of the prostate; even with a cut-off of 20 ng/ml, the positive predictive value of the test was only 21%.Conclusions: A PSA assay should not be performed at the time of presentation with acute urinary retention as it may lead to unnecessary investigations and anxiety for the patient. For those in whom a PSA assay is desirable a delay of 2 weeks should be allowed prior to sampling, as the half-life of PSA is known to be 2-3 days.","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 4","pages":"227-30"},"PeriodicalIF":0.0,"publicationDate":"2000-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21951764","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}

引用次数: 0

Senior house officer training: some myths exposed. 1999; 44(5): 324-7. 高级房务官培训:一些神话揭秘。1999;44(5): 324 - 7。

Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-08-01

M J Forshaw, J Henderson, D M Powell

引用次数: 0