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Biomedical subjects

A D Irving

Publications and source records attributed to A D Irving.

33 records · Page 2Linked to original sources
PubMed1983

Percentage malignant involvement: a new concept in staging of breast cancer.

All the recognised systems of clinical staging of breast cancer have failed to provide reliable prognostic estimates of survival since they do not accurately reflect the pathological extent of the disease. In this prospective study of 52 female patients with established primary breast cancer we have measured the percentage neoplastic involvement of the breast at the time of mastectomy. This correlated well with the histological axillary node status, the subsequent development of overt metastatic disease, and survival during a follow-up period of 28-54 months.

Adult↗
PubMed1981

Age at operation and the results of truncal vagotomy and gastroenterostomy for chronic duodenal ulcer.

Truncal vagotomy and posterior, no loop gastrojejunostomy is a safe and expedient procedure for chronic duodenal ulcer. A proved recurrence rate of only 1.5 per cent was noted at a mean of 10.5 years after operation in a 94 per cent follow-up study of 290 surviving patients from a consecutive series. One of the most striking features has been the identification of the relationship between age at operation and outcome. Life does, indeed, appear to begin at 40. If the decennial age groupings at operation are reviewed considering postoperative patients attaining the fifth decade of life. In the surgical treatment of chronic duodenal ulcer, the present operation is advocated for patients older than 40 years of age. It is suggested that other treatment be sought for those less than 40 years of age. If this group cannot continue with medical treatment, then a reasonable choice of operative procedure would seem to be proximal gastric vagotomy.

Adult↗
PubMed1979

Needle aspiration of the breast with immediate reporting of material.

Needle aspiration with immediate cytological reporting has been practised in a breast clinic for one year. Patients benefit by receiving immediately the provisional diagnosis and, when indicated, appointments for metastatic surveys. Close co-operation between surgeon and cytologist has resulted in increased skill in aspiration, better preparation of samples, and greater accuracy in interpretation of reports. Since 5% of clinically benign lesions have proved malignant, even on immediate reporting, we would recommend cytological examination of all breast lumps.

Biopsy, Needle↗
PubMed1978

Laparoscopic assessment of the jaundiced patient: a review of 53 patients.

Laparoscopy in the investigation of patients with jaundice allows visualization of intra-abdominal pathology, target biopsy of intra-abdominal lesions and percutaneous fine-needle cholangiography, all to be carried out at the one procedure. Formal laparotomy can then be planned electively or avoided completely in appropriate cases. In our experience we have found laparoscopy with percutaneous fine-needle cholangiography and biopsy to be a useful procedure in the diagnosis and management of jaundiced patients.

Adolescent↗
PubMed1976

Pleural empyema in association with renal sepsis.

Five cases of pleural empyema in association with perinephric abscess or renal infection are presented. This represents 4 per cent of a series of 122 pleural empyemas, or 30 per cent of empyemas with subdiaphragmatic aetiology. It is suggested that the renal tract should be investigated in all cases of recurrent or non-resolving pleural empyema of uncertain aetiology.

Abscess↗
PubMed1976

Single layer anastomosis in the gastrointestinal tract.

Anastomotic leakage, often followed by serious morbidity or death, is an important complication of resection of the intestine. If surgical technique and judgment are sound, anastomotic leakage seldom occurs. In 205 elective, single layer anastomoses of stomach to duodenum, of small intestine, of colon and of colorectum, clinically apparent leakage did not occur except in one of 52 patients after colorectal anastomosis. After resection of the intestine performed as an emergency procedure, anastomotic leakage occurred but was infrequent and could clearly be attributed to poor judgment or technique. The results are presented to support a conviction that anastomotic leakage need seldom occur if surgical technique and judgment are sound and to draw attention anew to the efficacy and safety of single layer anastomosis.

Adolescent↗
PubMed1975

Single layer anastomosis after rectosigmoid resection.

Anastomosis after resection of the rectosigmoid colon is often followed by leakage at the suture line. When occult leakage discovered on routine contrast study is included incidence rates of over 50 per cent have recently been reported. A single layer interrupted seromuscular inverting technique was used for the anastomosis after elective rectosigmoid resection in 52 consecutive patients. The total incidence of suture line leakage was 6 per cent. Therefore a high incidence of anastomotic dehiscence in the rectum can be avoided and it is concluded that a single layer technique is sound.

Aged↗