Abstract:
:Introduction While surgery is the cornerstone of bowel cancer treatment, it comes with significant risks. Among patients aged over 80 years, 30-day mortality is 13%-15%, and additionally 12% will not return home and go on to live in supportive care. The question for patients and clinicians is whether operative surgery benefits elderly, frail patients. Methods Multidisciplinary team outcomes between October 2010 and April 2012 were searched to conduct a retrospective analysis of patients with known localised colorectal cancer who did not undergo surgery due to being deemed unfit. Results Twenty six patients survived for more than a few weeks following surgery, of whom 20% survived for at least 36 months. The average life expectancy following diagnosis was 1 year and 176 days, with a mean age at diagnosis of 87 years (range 77-93 years). One patient survived for 3 years and 240 days after diagnosis. Conclusions Although surgeons are naturally focused on surgical outcomes, non-operative outcomes are equally as important for patients. Elderly, frail patients benefit less from surgery for bowel cancer and have higher risks than younger cohorts, and this needs to be carefully discussed when jointly making the decision whether or not to operate.
journal_name
Ann R Coll Surg Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Bethune R,Sbaih M,Brosnan C,Arulampalam Tdoi
10.1308/rcsann.2016.0146subject
Has Abstractpub_date
2016-07-01 00:00:00pages
409-12issue
6eissn
0035-8843issn
1478-7083journal_volume
98pub_type
杂志文章abstract::Apposition of skin edges in plastic surgical procedures can be achieved by sutures or stainless steel staples. This retrospective study reviews 45 skin falp operations and finds that 20.6% of sutured flaps are complicated by partial necrosis or slow healing. These complications occur in 62.5% of stapled flaps. It is p...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:INTRODUCTION:Ureteric stenting is a common urological procedure. Forgotten stents have a well-documented morbidity and mortality. Therefore, we asked the question, is a stent register an important factor in reducing the number of lost or overdue stents? PATIENTS AND METHODS:We conducted a retrospective review of 203 p...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588408X242123
更新日期:2008-03-01 00:00:00
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...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1998-05-01 00:00:00
abstract::Objective This study assessed primary urethral reconstruction results in patients with a penile fracture. Materials and methods Between January 2005 and April 2016, patients who underwent primary urethral reconstruction due to penile fracture were called for a follow-up. Epidemiological and clinical presentation data ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2017.0098
更新日期:2018-01-01 00:00:00
abstract::Extensive cephalic spread of solution occurred in three out of seven cases studied during coeliac plexus blockade. Spread on to cardiac nerves and plexus may be a factor in hypotension following this procedure. Incremental dosage and careful screening is recommended. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract:INTRODUCTION:Involvement of regional lymph node is a critical sign in prognosis of gastric cancer. Radiological techniques are commonly used to evaluate the extension of gastric cancer. But their sensitivity and specificity are low especially in the early stage. Our aim was to assess the value of gastric lymphoscintigr...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588406X149200
更新日期:2006-11-01 00:00:00
abstract::While some degree of specialization is essential in surgery there remains a place for the general surgeon. The tendency to regard surgical intensive care as a specialty should be resisted. Similarly the surgery of trauma should remain in the field of the general surgeon in full co-operation with the orthopaedic surgeo...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1975-09-01 00:00:00
abstract::Pharyngocutaneous fistulas following large oncological surgical resection of the upper aerodigestive tract are common and typically heal over a number of weeks. A pharyngostome is a surgically created non-healing opening into the pharynx, which is far less common and often difficult to manage. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588414X13946184902361
更新日期:2014-11-01 00:00:00
abstract::This is a case of a very unusual cause of an acute groin lump in a 71-year-old woman that was presumed initially to either be an incisional or inguinal hernia. However, with subsequent computed tomography it was shown to be thrombophlebitis of collateral vessels secondary to a previous deep vein thrombosis. This case...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588412X13171221499063
更新日期:2012-01-01 00:00:00
abstract::Contact with rat saliva or faeces can lead to infection with Streptobacillus moniliformis and the condition known as 'rat bite fever'. We report a case of septic arthritis of the hip due to this organism following a bite on the finger of a 14-year-old boy from a rat for sale in a pet shop. The case was successfully tr...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:2001-07-01 00:00:00
abstract::We report a fatality due to massive gastrointestinal haemorrhage in a patient receiving prophylactic dabigatran etexilate following a total hip replacement. A 79-year-old woman was commenced on dabigatran for venous thromboembolic prophylaxis following a total hip replacement. She presented again four days after surge...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588414X13824511649779
更新日期:2014-01-01 00:00:00
abstract:INTRODUCTION:Since its first publication in 1997, minimally invasive video-assisted thyroidectomy (MIVAT) has developed into the predominant minimally invasive surgery of the thyroid. A major advantage over conventional thyroid surgery is the superior cosmetic result. However, there are still few data comparing the lon...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2018.0178
更新日期:2019-03-01 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 Pseudoaneurysm formation following ankle arthroscopy is a rare but potentially catastrophic complication. The placement of anterior ankle portals carries inherent risk to the superficial and deep peroneal nerves, as well as to the dorsalis pedis artery. Anatomical variations in the dorsalis pedis and the ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2016.0288
更新日期:2017-04-01 00:00:00
abstract::A 74-year old man underwent a radical cholecystectomy for presumed gallbladder cancer. The histology of the resected specimen in fact revealed the lesion to be metastatic renal cell carcinoma from his resected right nephrectomy performed 14 years previously. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588413X13629960046679
更新日期:2013-11-01 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::A simple, inexpensive method for one-way collection and measurement of secretions is described. This method has been used successfully in surgical practice in Bath for more than 20 years (1). ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract::Childhood achalasia is an uncommon condition characterised by the absence of oesophageal peristalsis together with increased resting pressure and failure of relaxation of the lower oesophageal sphincter. The currently accepted management is a modified Heller's cardiomyotomy with Nissen fundoplication; however, the lon...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1997-11-01 00:00:00
abstract::Superior mesenteric artery (SMA) syndrome, also known as Wilkie syndrome, is a rare condition characterised by compression of the third part of the duodenum against the aorta by the SMA. This can cause symptomatic duodenal obstruction. It is rarely associated with an abdominal aortic aneurysm (AAA). We report the case...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870809X450575
更新日期:2009-10-01 00:00:00
abstract::Failure to provide sufficient information to a patient when seeking consent can result in a claim in negligence. When determining what information to provide, you should be guided by what this particular patient needs to know in order to make an informed decision. Adult patients must be assumed to have capacity to giv...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870811X571127
更新日期:2011-05-01 00:00:00
abstract::The results of selective visceral angiography and colonoscopy were compared in the diagnosis of angiodysplasia of the large bowel. Fifty six patients were diagnosed as having angiodysplasia on angiography and 34 of these patients also underwent colonoscopy. Twenty three of the colonoscopies were positive giving a diag...
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::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:The Improving Outcomes Guidance (IOG) for patients with carcinoma of the penis states that treatment should be provided supraregionally to populations of 4 million or greater who treat over 25 cases of penis cancer each year. This study assesses the impact of this guidance on the management and outcomes of...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588410X12518836439047
更新日期:2010-01-01 00:00:00
abstract::Gastric tube conduit is the method of choice for restoring continuity of the digestive track after a partial or total esophagectomy. Redundant gastric conduit (i.e. an elongated, floppy conduit) is a rare cause of dysphagia in patients with long survival. Gastric tube volvulus is exceedingly rare with only three cases...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2018.0146
更新日期:2019-01-01 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:10.1308/rcsann.2016.0312
更新日期:2017-02-01 00:00:00
abstract::Introduction Short hospital stays and accelerated discharge within 72 hours following colorectal cancer resections have not been widely achieved. Series reporting on accelerated discharge involve heterogeneous patient populations and exclude important groups. Strict adherence to some discharge requirements may lead to...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2017.0149
更新日期:2018-01-01 00:00:00
abstract::Cutaneous manifestations of visceral carcinomas are scarce, occurring in around 0.7-12% of internal malignancies. Lung cancer is one of the most common sources of skin metastasis, particularly in male patients. We present a case of cutaneous metastasis in a man with concurrent lung lesions and a previously treated col...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2016.0088
更新日期:2016-03-01 00:00:00
abstract:INTRODUCTION:Surgical skills courses are an important part of learning during surgical training. The assessments at these courses tend to be subjective and anecdotal. Objective assessment using multiple choice questions (MCQs) quantifies the learning experience for both the organisers and the participants. MATERIALS A...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588408X242097
更新日期:2008-03-01 00:00:00
abstract::The early experience with total prosthetic replacement of the hip from the making up of the first models in 1940 and the actual insertion of a small series in 1951 is described. The introduction of modified designs and the teething troubles experienced with them is dealt with, including the use of acrylic cement as a ...
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:1974-02-01 00:00:00
abstract:INTRODUCTION:Suspected testicular torsion (TT) is a surgical emergency, usually requiring urgent scrotal exploration. Provision of urology on-call cover varies widely between hospitals and often falls under the remit of the general surgical team. The purpose of this study was to investigate whether the management of su...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章,多中心研究
doi:10.1308/003588410X12771863937007
更新日期:2010-11-01 00:00:00