Abstract:
INTRODUCTION:The usual indications for oesophageal replacement in childhood are intractable corrosive strictures and long-gap oesophageal atresia. Generally, paediatric surgeons attempt to preserve the native oesophagus with repeat dilatations. However, when this is not successful, an appropriate conduit must be fashioned to replace the oesophagus. The neo-oesophagus should allow normal oral feeding, not have gastro-oesophageal reflux, and be able to function well for the life-time of the patient. PATIENTS AND METHODS:A Medline search for oesophageal replacement, oesophageal atresia, gastric transposition, colon transposition, gastric tube, caustic stricture was conducted. The commonest conduits including whole stomach, gastric tube, colon and jejunum are all discussed. RESULTS:No randomised controlled studies exist comparing the different types of conduits available for children. The techniques used tend to be based on personal preference and local experience rather than on any discernible objective data. The biggest series with long-term outcome are reported for gastric transposition and colon replacement. Comparison of a number of studies shows no significant difference in early or late complications. Early operative complications include graft necrosis, anastomotic leaks and sepsis. Late problems include strictures, poor feeding, gastro-oesophageal reflux, tortuosity of the graft and the development of Barrett's oesophagus. The biggest series, however, seem to have lower complications than small series probably reflecting the experience, built up over years, in their respective centres. CONCLUSIONS:Long-term follow-up is recommended because of the risks of late strictures, excessive tortuosity of the neo-oesophagus and the development of Barrett's oesophagus.
journal_name
Ann R Coll Surg Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Arul GS,Parikh Ddoi
10.1308/003588408X242222subject
Has Abstractpub_date
2008-01-01 00:00:00pages
7-12issue
1eissn
0035-8843issn
1478-7083journal_volume
90pub_type
杂志文章,评审abstract::The surgical commitment of No. 2 Field Hospital, R.A.M.C., during its stay in Jordan is presented. The majority of patients that were admitted had sustained war wounds, many of which were infected due to the delay in treatment. The difficulties encountered in their subsequent management are discussed. Special referenc...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1971-11-01 00:00:00
abstract::Introduction Procedure specific consent forms (PSCFs) have been shown to improve consenting practice for a standardised list of complications. The aim of this study was to assess the current usage and quality of PSCFs in the National Health Service (NHS) for cholecystectomy, specifically comparing the listed complicat...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2018.0099
更新日期:2018-07-01 00:00:00
abstract:INTRODUCTION:Hip fractures are common injuries in elderly patients presenting to the trauma surgeon. Mortality following such injuries approaches 10% at one month, rising to 30% at one year. Of those who survive, most experience a decrease in mobility and independence. The authors believe that the general public are no...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588411X12851639107034
更新日期:2011-01-01 00:00:00
abstract::Of 50 patients who had scrape cytology of the excision cavity after conservative surgery for breast carcinoma, 10 (20%) had malignant cells remaining in the cavity recognised by cytology. Of these patients, 18 had histological evidence of tumour at the resection margin, giving an accuracy of the cytology of 84%, a sen...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1990-11-01 00:00:00
abstract::INTRODUCTION In our regional spinal injuries unit, complex pressure ulcer reconstruction is facilitated by a monthly multidisciplinary team clinic. This study reviews a series of the more complex of these patients who underwent surgery as a joint case between plastics and other surgical specialties, aiming to provide ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章,评审
doi:10.1308/rcsann.2016.0227
更新日期:2017-02-01 00:00:00
abstract::Long-construct fixations can be complicated by proximal junctional kyphosis. In elderly, high-risk patients with numerous comorbidities, lengthy surgical times and increased blood loss associated with revision osteotomies and extension of fusions are not often tolerated and pose serious life-threatening risks. We pres...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2018.0076
更新日期:2018-07-01 00:00:00
abstract::General anaesthesia is infrequently requested for bronchography in small children. The clinical indications, recommendations for the anaesthetic technique, and problems associated with the investigation are discussed. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1980-05-01 00:00:00
abstract:INTRODUCTION:The use of postoperative drains following total knee replacement (TKR) has recently been modified by the use of re-transfusion drains. The aim of our study was to investigate the optimal time for removal of re-transfusion drains following TKR. PATIENTS AND METHODS:The medical records of 66 patients who ha...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588406X95002
更新日期:2006-03-01 00:00:00
abstract::We have reviewed the results of treatment of 159 consecutive limbs presenting with a clinical diagnosis of venous ulcer in 140 patients (70 male, aged 28-90 years, median 66 years). Of the patients, 61% were referred because of severe pain and 53% of the ulcers had been present > 2 years. Patients were evaluated clini...
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::A 2 mm fibreoptic choledochoscope with a disposable (resterilisable) flexible section was evaluated in 25 cadavers and 13 patients undergoing cholecystectomy. It was possible to pass the instrument via the cystic duct (CD) into the common bile duct (CBD) in 23 out of 25 cadavers and in 12 out of 13 patients. The CD di...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1989-09-01 00:00:00
abstract:INTRODUCTION:There has been a shift away from gross anatomy teaching and hands-on cadaveric dissection. This has been replaced by a variety of teaching modalities including problem-based learning, models and prosections, and computer-assisted learning. We aim to pilot a technique of endoscopic visualisation of upper li...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588411X565040
更新日期:2011-04-01 00:00:00
abstract::Introduction The National Institute for Health and Care Excellence guidance Improving Supportive and Palliative Care for Adults with Cancer (2004) and the Cancer Reform Strategy (2007) support the premise that assessment and discussion of patients' needs for physical, social, psychological, and spiritual wellbeing sho...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2017.0215
更新日期:2018-03-01 00:00:00
abstract::The initial teaching and learning experience of four surgeons performing a laparoscopic Nissen fundoplication is reported. A total of 33 patients underwent the laparoscopic approach for Nissen fundoplication. Two patients also underwent concomitant cholecystectomy. A loose 360 degrees fundoplication secured by three o...
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:1994-07-01 00:00:00
abstract:INTRODUCTION:Safe and effective haemostasis in surgery is clearly essential, and in the neck where risks of airway compromise are also present any new technology that purports to offer advantages must be rigorously evaluated. We describe our experience with the use of the Harmonic Scalpel [Ethicon UK] in thyroidectomy....
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588409X391811
更新日期:2009-04-01 00:00:00
abstract::Infection is an important arbiter of success or failure of surgical practice and the incidence of infection is incorporated into all surgical audit systems. If audit is to be of value the outcome end points of clinical practice must be defined. We have attempted to derive clinical definitions suitable for bedside diag...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 指南,杂志文章,实务指引
doi:
更新日期:1991-11-01 00:00:00
abstract::An observational study was conducted of 105 patients presenting with an open fracture of the tibia or ankle to determine the impact of a dedicated orthoplastic operating list on our management of these injuries over the time period January 2012 to July 2014. There were 51 patients before and 54 after the introduction ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2015.0015
更新日期:2015-09-01 00:00:00
abstract:INTRODUCTION:Faecal incontinence is a prevalent and important condition, with a range of treatment options. Neuromodulation via sacral nerve stimulators is efficacious, but expensive and associated with complications due to device implantation. Peripheral neuromodulation via posterior tibial nerve stimulation (PTNS) ha...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588410X12628812459652
更新日期:2010-07-01 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::Bleeding from the edge of an ileostomy site is a common problem. In those who have undergone a proctocolectomy with ileostomy formation in conjunction with a risk of chronic liver disease (even with normal liver function tests), this may be due to peristomal varices. If this is the case, significant, difficult-to-cont...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870806X129223
更新日期:2006-09-01 00:00:00
abstract:INTRODUCTION:The aim of this study was to evaluate the intra- and inter-observer variation of the Schatzker and AO/OTA classifications in assessing tibial plateau fractures, using plain radiographs. PATIENTS AND METHODS:Fifty tibial plateau fractures were classified independently by six observers as per the Schatzker ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588407X187667
更新日期:2007-05-01 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
abstract:INTRODUCTION:The aim of this study was to determine whether tailoring the extent of resection would allow radical gastric cancer surgery to be performed safely in a UK population. PATIENTS AND METHODS:A total of 180 consecutive patients (median age 70 years; male:female ratio 2:1) undergoing resection for gastric aden...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588408X261546
更新日期:2008-04-01 00:00:00
abstract::Surgical practice must be driven by wise professional judgements, involving complex deliberation, in the interests of ensuring the safe care of patients. Large amounts of energy are now being concentrated in training doctors in skills (competencies) in the belief that this will reduce risk to patients. Little thought ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type:
doi:10.1308/003588405X51164
更新日期:2005-07-01 00:00:00
abstract::Introduction The weekend effect is a perceived difference in outcome between medical care provided at the weekend when compared to that of a weekday. Clearly multifactorial, this effect remains incompletely understood and variable in different clinical contexts. In this study we analyse factors relevant to the weekend...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2017.0116
更新日期:2018-01-01 00:00:00
abstract::The Annual General Meeting of the British Association of Clinical Anatomists for 1983 was held at the Royal College of Surgeons of England on 14th January 1983. The following are abstracts of the papers presented. ...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1983-09-01 00:00:00
abstract:INTRODUCTION:Preliminary studies show that device assisted intravesical therapies appear more effective than passive diffusion intravesical therapy for the treatment of non-muscle invasive bladder cancer (NMIBC) in specific settings, and phase III studies are now being conducted. Consequently, we have undertaken a non-...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章,评审
doi:10.1308/003588414X13946184901001
更新日期:2014-09-01 00:00:00
abstract::Introduction Emergency general surgery services in England are undergoing rapid structural change with the aim of improving care. In our centre, the key issues identified were high numbers of admissions, inappropriate referrals, prolonged waiting times, delayed senior input and poor patient satisfaction. A new model w...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2017.0081
更新日期:2017-09-01 00:00:00
abstract:AIMS:Ultrasound is a non-invasive, non-ionising radiation modality which is highly successful at soft tissue imaging. Groin pain from an occult hernia can be a difficult clinical diagnosis made easier by good imaging. The aim of this study was to demonstrate the accuracy of ultrasound in diagnosing and typing the groin...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588403321661334
更新日期:2003-05-01 00:00:00
abstract::Analysis of the primary fellowship results showed that on average candidates were scoring a significantly higher mark in the MCQ than in the essay or viva. The level of MCQ marking has therefore been reset to the standards of the other parts of the examination. The need for continually monitoring the results of all ex...
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::The 'vascular' aetiology of headache is questioned. An alternative hypothesis based on sensitisation of sensory nerve endings by neurogenic plasma extravasation is discussed. The development of drugs which selectively inhibit the release of vasoactive neuropeptides from perivascular sensory nerves may benefit patients...
journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章,评审
doi:
更新日期:1993-07-01 00:00:00