Abstract:
:Despite published criteria predicting poor survival after operation for ruptured abdominal aortic aneurysm (RAAA), little is known about the factors which influence surgeons not to operate. Questionnaires were sent to all 404 members of the Vascular Surgical Society of Great Britain and Ireland, posing questions about their practices, and factors influencing the decision not to operate (no influence; may influence; seldom operate; never operate). There were 323 responses (81%) and 97% decided not to operate on selected patients. Age over 80 years influenced 77%, and 54% seldom or never operate over age 85 years. The single most influential factor was severe neurological disease (75% seldom or never operate), while cardiac, pulmonary and renal disease influenced 22%, 28%, and 21%, respectively, to operate seldom or never (74% if two or more of these). Other factors which had some influence for most surgeons were cardiac arrest (85%), loss of consciousness (74%), prolonged hypotension (73%), and long-term nursing care (87%). By contrast, factors which influenced few surgeons were haemoglobin < 9 g/dl (30%), absence of a close relative (33%), and medicolegal considerations (22%). These data help to inform the debate about case selection for repair of RAAA.
journal_name
Ann R Coll Surg Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Hewin DF,Campbell WBsubject
Has Abstractpub_date
1998-05-01 00:00:00pages
221-5issue
3eissn
0035-8843issn
1478-7083journal_volume
80pub_type
杂志文章abstract::Experience with 146 in-situ vein bypass procedures for obliterative arterial disease are reviewed to determine the specific complication of the technique. Vein wall injury with the Hall valvulotome occurred in 6 patients (4%) and vein patching of a stenosed femoral vein was required in 2 patients. Residual arterioveno...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1986-05-01 00:00:00
abstract:INTRODUCTION:Recent studies have shown that women who recall childhood abuse are at increased risk of emotional problems following a breast cancer diagnosis. How services should respond is unclear given the risk of compounding the emotional trauma of cancer with questioning about abuse. Our aim was to present the resea...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588414X13946184901407
更新日期:2014-07-01 00:00:00
abstract::Injuries to the nose can be severe from both a functional and cosmetic perspective. After suffering a dog bite to the central part of the face, an 18-year old woman underwent replantation of the avulsed tissue with the help of microsurgical arterial anastomosis. A venous anastomosis was impossible and venous congestio...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2016.0026
更新日期:2016-02-01 00:00:00
abstract::A term neonate was born with a grossly swollen and discoloured left hand and forearm. He was transferred from the local hospital to the plastic surgical unit, where a diagnosis of compartment syndrome was made and he underwent emergency forearm fasciotomies at six hours of age. Following serial debridements of necroti...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2016.0159
更新日期:2016-09-01 00:00:00
abstract::An Orthopaedic Surgeon's Assistant has been part of the orthopaedic surgical team at Hastings since 1983. Having a suitably trained person in post ensures continuity and stability and enhances the treatment of patients, the performance of the department and the training offered to Higher Surgical Trainees. Discussion ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1996-07-01 00:00:00
abstract::Introduction Venous thromboembolism (VTE) is a potentially fatal complication of hip arthroplasty and knee arthroplasty. The National Institute for Health and Care Excellence recommend rivaroxaban for VTE prevention. Amid concerns over bleeding complications, the modified thromboprophylaxis policy of Chelsea and Westm...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2016.0197
更新日期:2016-09-01 00:00:00
abstract::Massive haemorrhage is an uncommon complication in pancreatitis. Most affected patients suffer from chronic disease with associated pseudocyst. We present five patients (four male) with a mean age of 41 years (range 34-48 years). All patients had alcohol-induced pancreatitis complicated either by haematemesis (3), int...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1998-09-01 00:00:00
abstract::This study investigates incidence and outcome of iatrogenic vascular complications needing surgery in a single vascular unit serving interventional vascular radiology and interventional cardiology. Evolution of diagnostic and interventional cardiovascular radiology, along with the introduction of non-surgical therapie...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::We report a 91% accuracy with fine needle aspiration cytology in 46 patients found to have a mass in the pancreas at laparotomy. Results were compared with conventional biopsy at operation which was accurate in only 56% of an earlier group of 48 patients with a localised mass compared with 97% in 33 patients with diss...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00
abstract::We present a case of a chronic recurrent rectovaginal fistula that initially arose from complications of haemorrhoid surgery and had failed multiple prior surgical repairs. The fistula was successfully managed using viable cryopreserved placental tissue. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2017.0157
更新日期:2017-11-01 00:00:00
abstract::Cystic nephroma is a rare lesion, but there has been an increased number of cases reported in the recent literature. Most cases have been discovered incidentally either on routine examination or during radiological investigations. There are two peaks of incidence, one in childhood and one in middle age and the conditi...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1989-11-01 00:00:00
abstract:INTRODUCTION:An increasing quantity of data is required to guide precision medicine and advance future healthcare practices, but current analytical methods often become overwhelmed. Artificial intelligence (AI) provides a promising solution. Plastic surgery is an innovative surgical specialty expected to implement AI i...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章,评审
doi:10.1308/rcsann.2020.0158
更新日期:2020-10-01 00:00:00
abstract::A patient with phyllodes tumour of the breast is discussed. During follow-up, she presented with intestinal obstruction caused by ileocaecal intussusception. The cause of the intussusception was metastatic phyllodes tumour, which is a unique presentation. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870810X12699662981357
更新日期:2010-09-01 00:00:00
abstract:INTRODUCTION:Acute pancreatitis is a common surgical emergency. Identifying variations in presentation, incidence and management may assist standardisation and optimisation of care. The objective of the study was to document the current incidence management and outcomes of acute pancreatitis against international guide...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2019.0055
更新日期:2019-09-01 00:00:00
abstract::A postoperative radiograph demonstrated a folded radio-opaque structure in the nasopharynx, resembling a retained throat pack, despite her not having any respiratory symptoms. Retention of a throat pack is a never event. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2020.0047
更新日期:2020-07-01 00:00:00
abstract::Massive plexiform neurofibromatosis is an uncommon manifestation of Type 1 neurofibromatosis. These tumours result in functional disability and severe disfigurement. Due to the variable natural history od these lesions, the optimal management is not well defined and surgery is often delayed until significant disfigure...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870807X238230
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Serious complications of laparoscopic fundoplication (LF) have been reported by surgeons new to LF. We investigated whether the reported benefits of LF could be realised by an established consultant, new to LF, without compromising safety, control of reflux or dysphagia rates obtained after open surgery. PA...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:2002-03-01 00:00:00
abstract::A comparative review of changing patterns between 1997 and 2002 of who performs appendicectomy and a snapshot of the surgical approaches in use. It also indicates the stage at which competency in appendicectomy may be achieved by contemporary trainees in surgery and anaesthesia. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588406X114875
更新日期:2006-10-01 00:00:00
abstract:INTRODUCTION:Isolated monocular ischaemic events are thought to be low risk for stroke recurrence. In the presence of carotid stenosis however, the risks should not be treated similarly and surgical intervention should be considered at an early stage. The aim of this study was to determine the vascular risk profile and...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2019.0071
更新日期:2019-11-01 00:00:00
abstract::Mean anaesthetic, surgical and turnover times were used to predict finishing times for elective general surgical operating lists. A predicted early finish was correct in 70 per cent, a predicted on-time finish in 19 per cent, and a predicted late finish in 56 per cent. Overall, predictions of an early or late finish h...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1995-11-01 00:00:00
abstract::The brachial plexus is related intimately to the clavicle such that injury can occur primarily and most commonly at the time of trauma through traction or it can occur secondarily, mainly owing to hypertrophic non-union with exuberant callus formation, causing compression of the plexus. The movement-dependent rearrang...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588413X13511609956174
更新日期:2013-04-01 00:00:00
abstract::Although the operating microscope was introduced more than 50 years ago, its use was at first confined to otolaryngology and, later, to ophthalmology. More recently its use in the development of microvascular techniques has led to spectacular advances in the field of replantation and reconstructive surgery. The organi...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 历史文章,杂志文章
doi:
更新日期:1976-03-01 00:00:00
abstract::To assess and compare the safety and efficiency of a surgical unit at a District General Hospital and a Community Hospital for elective cold surgery. A retrospective survey was made using regional computer Hospital Activity Analysis data and monthly audit meeting records of all inpatients having selected elective gene...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1991-07-01 00:00:00
abstract::A series of 12 femoral herniae in children is presented. Nine were misdiagnosed, eight as inguinal hernia. Nine were reducible. The sex incidence, M:F was 7:5 and nine presented between the ages of 8 and 10 years. One presented as intestinal obstruction due to a Richter's hernia and two had had a previous ipsilateral ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1985-07-01 00:00:00
abstract::Chylothorax is a well-recognised complication of oesophagectomy, occurring in around 3% of cases. If managed conservatively, the mortality rate can be over 50%. We describe our experience of managing a patient with a chylothorax following oesophagectomy, and the use of a blood patch (a novel technique) to overcome per...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870810X12659688852392
更新日期:2010-05-01 00:00:00
abstract:INTRODUCTION:Polypectomy at colonoscopy may be difficult or dangerous. In such instances colonic resection may be indicated. Novel combined laparoscopic-endoscopic procedures have the potential to allow safe extensive extramucosal resection, thus avoiding resection. Laparoscopic colon mobilisation provides a more favou...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588411X565978
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Oral cavity cancers are on the increase in the UK. Understanding site-specific epidemiological trends is important for cancer control measures. This study demonstrates the changing epidemiological trends in lip, intra-oral cavity and tongue base cancers in south-east England from 1987 to 2006. AIM: METHODS...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588414X14055925061676
更新日期:2015-04-01 00:00:00
abstract::Gross enlargement of the male breast with skin redundancy and ptosis cannot be effectively managed by subcutaneous mastectomy alone. A technique is described in which the excess breast tissue and skin are excised along a design which allows the nipple-areolar complex, mounted on a vertical deepithelialised pedicle, to...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:For patients with gastric cancer intraoperative macroscopic serosal change is not always consistent with pathological T stage. We investigated whether macroscopic serosal change is associated with unfavourable prognosis of patients with gastric cancer. METHODS:We reviewed 856 patients with stage T3 gastric ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2018.0217
更新日期:2019-04-01 00:00:00
abstract:INTRODUCTION:The diagnostic performance of ultrasound-fine needle aspiration to identify thyroid nodules harbouring malignancy remains variable. The aim of this study was to determine thyroid nodule size and cytological classification as predictors of malignancy risk. MATERIALS AND METHODS:We conducted a retrospective...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2019.0156
更新日期:2020-01-01 00:00:00