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A review of closure of Hartmann's colostomy was undertaken to establish guidelines for the timing and technique of reversal. Between 1984 and 1990 there were 69 reversals; 48 patients originally had diverticular disease and 21 had carcinoma. One-third underwent reversal before 4 months and two-thirds after this time. The operative mortality rate was 3 per(More)
OBJECTIVES Routine histopathology may understage colorectal cancer by failing to detect involved lymph nodes. This study examined the feasibility of dye staining those lymph nodes most likely to harbour metastases. PATIENTS AND METHODS Patent Blue V dye 2.5% was injected intra-operatively into left-sided colorectal carcinomas prior to resection in 19(More)
This study examined differences in anorectal function, with particular reference to anismus, which might explain why some patients with intractable constipation have slow and others have normal whole gut transit times. Twenty-four patients were studied; 13 with slow transit (all female, median age 32 years, range 16-52 years) and 11 with normal transit(More)
A laparoscopic technique for formation of intestinal stomas is described and reported in four cases. The procedure has a role where difficulties with trephine stoma formation are anticipated, where simultaneous laparoscopic procedures are performed, and where accurate assessment of the extent of intra-abdominal malignancy is indicated.
A new method for staging local invasion in rectal cancer has been assessed. Thirty-eight patients with primary rectal cancers have been examined pre-operatively with endoluminal rectal ultrasound and results compared with histological analysis of resected specimens in 33 cases. Three patients who also underwent laparotomy but not resection had good evidence(More)
To measure the effects of defunction in the anorectum, 12 patients (seven men and five women aged 59 (44-81) years) were studied after the Hartmann operation. The operation was for septic complications of diverticular disease in nine and sigmoid carcinoma in three patients. Physiology studies were undertaken 1 and 3 months after surgery, and diversion(More)
A laparoscopic technique is described, suitable for both full thickness intestinal biopsy and placement of a feeding jejunostomy tube. Its application in three cases is reported. The method is simple, permits full laparoscopic examination of the abdominal contents and being minimally invasive, facilitates early patients recovery.
Digital examination is the most commonly used method of assessing local invasion in rectal cancer, but it is highly subjective and accuracy is related to surgical experience. The use of transrectal ultrasound in the preoperative staging of rectal cancer has been assessed in 51 patients with histologically proven rectal cancers. Results showed a high degree(More)
An unusual case of the cri-du-chat syndrome is described in a 6½ year old boy, who, as well as attacks of stridor and choking, showed disorders of spatial perception and cerebellar signs in the form of nystagmus, clumsiness of the hands, and ataxia. Pyramidal signs were also present. He was only mildly retarded mentally. Psychological testing showed that he(More)
AIM To determine factors associated with perineal wound complications following abdominoperineal excision of the rectum (APER) for rectal adenocarcinoma and their effects on time to healing. PATIENTS AND METHODS We studied all cases of APER performed in our unit by four consultants over 7 years. Seven out of nine factors considered important in wound(More)