Abstract:
OBJECTIVES:To determine the effects of cuts in surgical beds and operating lists upon the waiting list. To evaluate the effects of the Waiting List Initiative upon the total number of patients on the waiting list, the number of patients waiting for more than one year, and the ratio of patients with low priority, non-life-threatening diagnoses to those with a higher priority, potentially more serious, diagnosis. DESIGN:The study of facilities available and waiting list figures between 1979-1991; a prospective study of a Waiting List Initiative. SETTING:The surgical departments of the Royal Berkshire and Battle Hospitals, Reading and Newbury District Hospital. PATIENTS:Those patients on general surgical waiting lists between 1979 and 1993; those patients who had operations under the Waiting List Initiative. RESULT:Between 1979 and 1989 the number of surgical beds fell from 225 to 153, a reduction of 38 per cent. The number of weekly operating lists fell from 40 to 30, a reduction of 25 per cent. The waiting list remained fairly constant, between 1979-1987, with a median of 420 patients (range 295-688) before 1987, against 983 (range 688-1,253) after 1987. After the Waiting List Initiative the total number of patients on the waiting list fell from 1,114 to 904, a fall of 19 per cent. Patients waiting for more than one year fell from 381 to 176 (54 per cent), whilst those waiting less than one year remained constant at 730. The proportion of patients with low priority varicose veins fell from 65 per cent to 40 per cent, whilst the proportion of patients with potentially more serious inguinal hernias rose from 10 per cent to 15 per cent. CONCLUSION:These results demonstrate the relationship between the increase in the size of the waiting list and the decrease in the facilities available in beds and operating sessions. While the Waiting List Initiative has resulted in a reduction in the number of patients waiting more than one year, there has been no reduction in numbers waiting less than one year. The reduction has been achieved at the expense of those patients with potentially more serious clinical conditions.
journal_name
Ann R Coll Surg Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Umeh HN,Reece-Smith H,Faber RG,Galland RBsubject
Has Abstractpub_date
1994-01-01 00:00:00pages
4-7issue
1 Suppleissn
0035-8843issn
1478-7083journal_volume
76pub_type
杂志文章abstract::Modern stapling equipment makes it possible to perform the vertical banded gastroplasty without major technical difficulties. Follow-up to date confirms its efficacy as a weight reducing procedure in the morbidly obese. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1984-09-01 00:00:00
abstract::Paragangliomas are rare lung tumours; endobronchial localisation is even more rare. This report describes the case of a 59-year-old patient with a symptomatic endobronchial paraganglioma successfully resected by means of pulmonary lobectomy. Recognition of this uncommon tumour can lead to a correct diagnosis and thera...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2016.0284
更新日期:2017-01-01 00:00:00
abstract::Introduction The aim of this study was to identify the proportion of children referred to a paediatric tertiary referral centre who required admission to the paediatric intensive care unit (PICU) following surgery for obstructive sleep apnoea (OSA) and to establish risk factors for these admissions. Methods Retrospect...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2017.0185
更新日期:2018-01-01 00:00:00
abstract::A prospective survey was carried out in West Dorset to determine the incidence of postoperative wound infection. A total of 1242 patients were included in the survey (1086 inpatients and 156 day cases). The overall infection rate was 6.7%. Although the incidence of infection was consistent with that reported by other ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1990-05-01 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::First reported two decades ago, isolated incisional recurrence of hepatocellular carcinoma is an extremely rare clinical entity. We present two cases of recurrence: one recurring over 10 years after initial resection, and the second presenting with a port site recurrence 3.5 years following laparoscopic radiofrequency...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2017.0097
更新日期:2017-07-01 00:00:00
abstract::Erdheim-Chester disease is a rare infiltrative histiocytic disorder with around 800 cases being reported worldwide. Patients most commonly present with skeletal pain, but the condition has been shown to affect multiple other organs. We describe a rare presentation in which the disease infiltrated the sinuses and affec...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2019.0130
更新日期:2020-02-01 00:00:00
abstract::We report the late relapse of a patient following 43 years of surveillance of a germ cell tumour, thought to be a pure seminoma, having undergone yolk sac differentiation. The longest previous recorded time to relapse was 32 years (malignant teratoma with adenocarcinoma de-differentiation).(1) This case report demonst...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870811X580442
更新日期:2011-07-01 00:00:00
abstract::A new definition of the iliotibial tract is made. Its anatomical and physical characteristics are summarised and its known functions discussed. The various postures adopted by standing Man are looked at and one resting posture is closely analysed. Hence a new role is proposed for the iliotibial tract. In the hip bone ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1979-07-01 00:00:00
abstract::Rectus femoris origin injuries in adult athletes are uncommon. In the acute phase, conservative treatment seems to have a favourable outcome, with surgical repair reserved for unsuccessful cases only. However, a group of patients may develop chronic pain and disability after recovery from the acute phase due to heter...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588412X13171221589333
更新日期:2012-04-01 00:00:00
abstract::The recording of medical data has developed from crude non-specific classifications to complex systems tailor-made for individual practices. The development of the Read Clinical Classification has produced a complex classification which is user friendly and covers the whole of medicine. The classification allows uniqu...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
abstract:INTRODUCTION:The aim of this study was to identify whether clinicians are obtaining a valid consent for surgery, and ascertain the parents' perception of parental responsibility when giving consent for their children. PATIENTS AND METHODS:Adults consenting for 100 children were questioned about the possession of paren...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588407X205332
更新日期:2007-09-01 00:00:00
abstract:INTRODUCTION:Accurate written communication is essential in orthopaedic surgery. Incomplete and poorly structured letters can lead to poor knowledge of a patient's diagnosis. MATERIALS AND METHODS:Structured and traditional letter formats were compared for speed of reading and preference by general practitioners (GPs)...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588406X98612
更新日期:2006-05-01 00:00:00
abstract::During a 10-year period (December 1984 to December 1994), 1500 cases of frostbite were treated at a tertiary care medical facility. They were all males with their ages ranging from 17 to 43 years. All the patients sustained the frostbite injury in the northeastern part of Pakistan known as the Karakoram range of mount...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1998-03-01 00:00:00
abstract::From the experience of treating 91 patients with a proven recurrent ulcer we consider that if a proven ulcer is shown to be present and a gastrin-secreting tumour is excluded an appropriate reoperation will almost always produce a successful result (94 per cent). Before subjecting patients to reoperation all attempts ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1975-03-01 00:00:00
abstract:INTRODUCTION:The aim of this study was to determine the efficacy and complications of postoperative endoscopic retrograde cholangiopancreatography (ERCP) in confirming and treating choledocholithiasis found at intraoperative cholangiography during laparoscopic cholecystectomy. METHODS:Patients who had undergone ERCP f...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588414X13824511650290
更新日期:2014-01-01 00:00:00
abstract:INTRODUCTION:Much literature reports on selective nerve root blocks (SNRBs) in cases of lumbosacral radiculopathy. Unfortunately, authors only inconsistently reveal the exact needle tip position relative to the causative pathology at the time of injection. Different injection sites may provide different symptomatic ben...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588413X13629960048073
更新日期:2013-10-01 00:00:00
abstract:AIM:The analgesia provided for children is often less than for adults with the same underlying pathology. This paper attempts to quantify the postoperative analgesic requirements of patients undergoing appendicectomy. METHODS:Patients between 6 and 30 years of age who underwent an unscheduled appendicectomy were prosp...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 临床试验,杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract::INTRODUCTION Central venous catheterisation (CVC) is a commonly performed procedure in a wide variety of hospital settings and is associated with appreciable morbidity. There is a paucity of literature focusing on mechanical complications specifically in the trauma setting. The aim of our study was to determine the sp...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2017.0022
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To examine the current scale of provision of patient information materials by consultant surgeons in UK NHS and private sector hospitals. DESIGN:Secondary analysis of the responses of 12,555 surgical patients to surveys evaluating surgical services provided by specific consultants. SETTING:7 NHS Trusts and ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章,多中心研究
doi:
更新日期:2000-05-01 00:00:00
abstract::In 24 patients where the lower border of a cervical goitre was poorly defined, the value of simple lung function tests in the prediction of the presence of a retrosternal goitre was assessed. At operation there were nine patients with retrosternal extension (Group I) and 15 without (Group II). The preoperative PEF rat...
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:INTRODUCTION:Lymph node metastasis is a poor prognostic indicator and is well established in tongue squamous cell carcinoma. Based on the current staging system, accurate risk stratification is difficult. There is thus a need to evaluate an alternate method for predicting recurrence and survival. The objective of the s...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2020.0173
更新日期:2020-11-01 00:00:00
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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:INTRODUCTION:Breast cancer usually necessitates breast-conserving surgery or mastectomy, which adversely affect appearance and wellbeing. Immediate reconstruction restores the breast mound but its availability and efficacy are uncertain. MATERIALS AND METHODS:Two discrete datasets were used to evaluate mastectomies in...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2019.0101
更新日期:2020-02-01 00:00:00
abstract::The first 50 patients who underwent arthroscopic surgery as a half-day procedure in Doncaster Royal Infirmary were studied: 22 patients underwent an arthroscopic meniscectomy and 6 patients had other procedures. The mean return-to-work time for meniscectomy patients was 23.9 days. The cost improvement per patient, whe...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1988-07-01 00:00:00
abstract::Median arcuate ligament syndrome (MALS) is a rare disorder due to coeliac trunk compression by the median arcuate ligament, resulting in coeliac artery stenosis characterised by chronic, recurrent abdominal pain. Patients with MALS are often middle-aged females presenting with a triad of postprandial epigastric pain, ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章,评审
doi:10.1308/rcsann.2015.0025
更新日期:2015-09-01 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::Congenital cholesteatoma is a rare entity. It arises from aberrant epithelial remnants left at the time of closure of the neural groove, between the 3rd and 5th week of embryonic life. Otoscopy typically shows a pearly white mass, medial to the intact tympanic membrane, primarily in the anterosuperior quadrant, withou...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870807X160425
更新日期:2007-03-01 00:00:00
abstract::We present a case of distal venous embolisation of a peripheral intravenous cannula tip that had lost its structural integrity through repeated failed attempts of insertion of the same cannula, contrary to protocols for intravenous access. Radiological imaging confirmed the presence of a foreign body in the middle fin...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588413X13629960047830
更新日期:2013-10-01 00:00:00
abstract::The technique of regional anaesthesia for hand surgery is described. This has been successfully carried out in a series of 179 patients treated as day cases. The advantages and disadvantages of the technique are discussed. Emphasis is placed on careful patient selection and attention to detail in applying the techniqu...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1983-11-01 00:00:00