Abstract：
AIM:Only half of those patients undergoing major lower limb amputations for peripheral vascular disease (PVD) are likely to mobilise on a prosthesis. This study aimed to determine whether a surgeon's experience influenced the quality of the residual limb and thus the likelihood of the stump being suitable for a prosthesis. METHODS:All patients undergoing major lower limb amputations for PVD were recruited prospectively, between August 1992 and July 1996. Following surgery, patients were categorised, by a consultant in rehabilitation medicine, as potentially suitable (group 1) or unsuitable (group II) for rehabilitation. Patients in group I were further assessed by prosthetists for limb fitting. RESULTS:A total of 217 patients underwent 260 amputations for PVD between 1992 and 1996: transfemoral (TFA) 131, trans-tibial (TTA) 127, and through-knee (TKA) in 2. The 30-day mortality was 12% (n = 27). Following surgery, 109 patients were assigned to group I (51%), and 81 patients to group II (37%). The proportion of junior surgeons performing surgery was similar for patients in both groups. Twenty-three amputation stumps (9%) required revision or conversion to a higher level within 30 days. Revisions or conversions were significantly more frequent where the original operation had been performed by an unsupervised junior surgeon rather than a senior surgeon (P = 0.009). The rate of defective amputations compromising limb fitting also reached significance when unsupervised junior and senior surgeons were compared (P = 0.04). CONCLUSIONS:Rehabilitation of the relatively few amputees who reach the stage of limb fitting is hindered by poor surgical technique in a large proportion of cases. Patients operated on by a more experienced surgeon had a better chance of mobilising without revision or conversion surgery.
journal_name
Ann R Coll Surg Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Cosgrove CM,Thornberry DJ,Wilkins DC,Ashley Sdoi
10.1308/003588402760452691subject
Has Abstractpub_date
2002-09-01 00:00:00pages
344-7issue
5eissn
0035-8843issn
1478-7083journal_volume
84pub_type
杂志文章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：INTRODUCTION:Laparoscopic donor nephrectomy (LDN) is now a well established method for kidney procurement from living donors. In our centre, LDN is currently offered only to donors suitable for left nephrectomy. The aim of this study was to investigate the incidence of testicular pain and swelling following LDN. METH...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588412X13171221592177
更新日期：2012-09-01 00:00:00
abstract：:The medical records of 116 patients who had 168 ureteric double J (pigtail) catheters inserted over a 6-year period between 1981 and 1987 were reviewed. Eighty-five patients had pigtails inserted for benign conditions and 31 for malignant disease. The pigtail catheters were inserted cystoscopically in 88 patients, per...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1988-11-01 00:00:00
abstract：INTRODUCTION:Introducing laparoscopic colorectal surgery is a challenge to the whole surgical team. It is usual for an assistant to hold the laparoscope and be responsible for the surgeon's view of the operative field and a lack of expertise in the assistant can add significant difficulties. The EndoAssist is a robotic...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588409X392162
更新日期：2009-07-01 00:00:00
abstract：:As general surgeons, we are regularly referred patients with epigastric pain. There are a huge number of common pathologies which cause this complaint, most of which are gastrointestinal in origin. Although the old adage goes 'common things are common', we must always keep our minds open to the possibility of the unco...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/147870810X12822015504563
更新日期：2010-10-01 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：: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：: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: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 value of nasogastric tube decompression after elective abdominal operations was assessed in a randomised trial in which 97 patients were and 100 were not allocated postoperative nasogastric decompression. Only two patients in the latter group subsequently required decompression. There was no statistically signific...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1991-09-01 00:00:00
abstract：INTRODUCTION:Pulmonary staging in colorectal cancer (CRC) has traditionally been carried out by means of plain chest radiograph (CXR), although computerised tomography (CT) imaging of the chest is increasingly being performed for this purpose. The aim of this study was to assess the value of pre-operative thoracic CT f...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588405X60579
更新日期：2005-09-01 00:00:00
abstract：:One hundred and four patients with second, third degree or thrombosed prolapsed piles, treated by cryotherapy, were studied pre- and postoperatively. A computer analysis was made of all relevant data such as pile mass, freezing time and results of treatment. The method, which is easy to perform and cost effective, is ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1983-07-01 00:00:00
abstract：:A high incidence of complications related to bleeding was observed after open prosthetic inguinal hernia repair. The site of injection of low-dose heparin into the abdominal wall was thought to be a possible causal factor for these complications. The wound complication rate after repair of primary unilateral inguinal ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,多中心研究
doi：
更新日期：1998-01-01 00:00:00
abstract：:We present a rare case of a big oesophageal liposarcoma causing dysphagia and weight loss in a 75-year-old patient. Endoscopically, a pedunculated lesion with subtotal obstruction of the oesophageal lumen had been detected and thoracoabdominal oesophageal resection with gastric sleeve reconstruction was performed. Sur...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2017.0117
更新日期：2017-09-01 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
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：:The effects on pelvic visceral function of radical operations for carcinoma of the lower part of the rectum and of operations for inflammatory bowel disease have been determined by studying bladder, sexual and rectal function. Denervation of the bladder was diagnosed in 15% of patients who had undergone sphincter-savi...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1984-01-01 00:00:00
abstract：:A randomized controlled trial has been conducted into the effects of discharging patients from hospital either at 48 h or 6-7 days after operation for inguinal hernia or varicose veins. There was no statistically significant difference in the frequency of major postoperative complications between the two lengths of st...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1977-05-01 00:00:00
abstract：INTRODUCTION:The Modified Early Warning Score (MEWS) is a simple, physiological score that may allow improvement in the quality and safety of management provided to surgical ward patients. The primary purpose is to prevent delay in intervention or transfer of critically ill patients. PATIENTS AND METHODS:A total of 33...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588406X130615
更新日期：2006-10-01 00:00:00
abstract：INTRODUCTION:Urologists perform retrograde contrast studies of the ureters and pelvicalyceal systems in the operating theatre, both for diagnostic purposes and to guide instrumentation. We describe the development of a set of guidelines that aim to standardise the diagnostic quality of these studies and to reduce radi...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588412X13171221500385
更新日期：2012-07-01 00:00:00
abstract：:The emergency operating patterns in a district general hospital were significantly altered by the introduction of an afternoon emergency theatre list co-ordinated by a consultant anaesthetist. Before the introduction of the list, 88% of emergency operations were carried out after 17.00, with 40% of cases waiting until...
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：INTRODUCTION:The retrojugular approach for carotid endarterectomy (CEA) has been reported to have the advantages of shorter operative time and ease of dissection, especially in high carotid lesions. Controversial opinion exists with regard to its safety and benefits over the conventional antejugular approach. METHODS:...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章,meta分析,评审
doi：10.1308/003588414X13814021679357
更新日期：2014-04-01 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：:In the Royal Navy, after surgery, the time that servicemen spend away from work and the level of duty to which they return are decisions made by the surgeon, not the general practitioner. In a prospective study, we have thus been able to assess the acceptability of return to full duty at decreasing intervals after hig...
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 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：INTRODUCTION:We report our ten-year experience of thyroglossal cyst excision at Queen's Medical Centre, Nottingham, comparing outcomes, practice and technique. METHODS:Retrospective case note analysis was conducted alongside surgical histopathology review for all thyroglossal cyst excisions performed between 2000 and ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588413X13511609958613
更新日期：2013-05-01 00:00:00
abstract：:The history of the technique of promoting dissolution of retained gallstones in the biliary tree is briefly reviewed. Present methods are described in detail and our own experience recorded. We have treated six patients with retained calculi by means of heparinized saline and sodium cholate infusions of the common bil...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1977-03-01 00:00:00
abstract：:The necessity of an outpatient (OP) consultation for patients referred for minor surgery under local anaesthetic (LA) was examined. Two separate prospective studies were performed. The first comprised 107 patients referred for minor surgery, who were assessed in the outpatient department (OPD), before being booked for...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1996-09-01 00:00:00
abstract：OBJECTIVES:To provide guidance about the risks which should be disclosed to patients and documented during the consent process. METHODS:The Delphi Consensus Technique was used to decide what constitutes mandatory risk disclosure for three index procedures. Documentation of risk on consent forms was audited and compare...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/1478708041118
更新日期：2004-11-01 00:00:00
abstract：:This is a report of a 2-year experience with the management of penetrating injury of the cervical trachea. There were 29 cases. The respiratory status of the patient on admission dominated the initial management: 12 patients required emergency intubation and were immediately taken to operation, while 17 patients were ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1997-05-01 00:00:00
