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Biomedical subjects

H C Umpleby

Publications and source records attributed to H C Umpleby.

25 records · Page 2Linked to original sources
PubMed1984

Survival in acute obstructing colorectal carcinoma.

Acute intestinal obstruction was the presenting feature in 124 (19 per cent) of 646 patients with colorectal carcinoma seen over a six-year period. Forty-two per cent of tumors were incurable at presentation. Obstruction was complicated by perforation in 22 patients (18 per cent). Only 15 per cent of tumors occurred in the rectum. Although the postoperative mortality rate was higher in patients with coincidental perforation than in those without (52 vs. 26 per cent: P = 0.03), five-year survival rates were the same: 18 per cent overall, rising to 29 to 34 per cent after "curative" resection. Five-year survival rates were best for right colon tumors and worst for rectal tumors (36 vs. 5 per cent: P = 0.01). The overall hospital mortality rates for colostomy and delayed resection, resection with colostomy, and resection with anastomosis were equivalent (18 to 22 per cent), but following "curative" resection the hospital mortality rate was higher for resection with colostomy than with other treatments (29 vs. 15 per cent), since two patients died following early closure of colostomy. Five-year survival was better following resection with anastomosis (48 per cent) than staged procedures (18 per cent: P = 0.01), since two patients died following late closure of colostomy.

Acute Disease↗
PubMed1984

The efficacy of agents employed to prevent anastomotic recurrence in colorectal carcinoma.

Forty-eight of 72 surgeons canvassed in the South West of England (67%) routinely use an intraluminal cytotoxic agent to prevent suture-line recurrence following partial resection of the large bowel for cancer. The most popular agents are chlorhexidine-cetrimide preparations (n = 14), mercuric perchloride (12), povidone-iodine (7) and water (12); noxythiolin, sodium hypochlorite and silver nitrate are used occasionally. The mean duration of treatment is 2 minutes. When assayed for cytotoxity against tumour cells freshly prepared from human colorectal carcinomas (n = 10), both chlorhexidine-cetrimide and povidone-iodine were rapidly lethal at a wide range of concentrations (5-100%). Mercuric perchloride (0.2%) was similarly effective, but up to 20% of tumour cells remained viable after exposure to noxythiolin and nearly 30% with water alone. Chlorhexidine-cetrimide and povidone-iodine are the agents of choice to kill malignant cells exfoliated into the colorectal lumen.

Anti-Infective Agents, Local↗
PubMed1983

Manual dilatation of the anus and elastic band ligature: an effective short stay alternative to formal haemorrhoidectomy for prolapsing haemorrhoids.

Fifty patients with second or third degree haemorrhoids were treated by manual dilatation of the anus (MDA) and elastic band ligature under general anaesthesia. All patients had prolapsing haemorrhoids at presentation associated with bleeding in 46, and pain in 39. A final review by questionnaire was undertaken one to three years later, at which time 44 patients remained symptom-free. Forty-three had experienced only mild or moderate discomfort postoperatively. Mean time from operation to pursuing all normal activities was 10 days. MDA and elastic band ligature under GA is a simple, quick and effective alternative to haemorrhoidectomy in the treatment of second and third degree haemorrhoids.

Adult↗