With increasing emphasis on sphincter preservation in the treatment of low carcinomas of the rectum, it is important to know whether such a policy results in satisfactory rectal function and long term survival. In 368 patients operated upon for carcinoma of the rectum between 1958 and 1980, a consistent policy of sphincter preservation was followed, and resulted in 222 (61 per cent) patients having a restorative resection (RR), whilst 132 (37 per cent) had an abdominoperineal excision (APE); 271 (76 per cent) had a radical operation with a hope of cure. Overall operative mortality was 5 per cent (2.6 per cent in the radical group) and the leakage rate in the 222 restorative anastomoses was 5 per cent. Follow-up of 98 per cent of patients treated over 5 years ago has been possible. Special attention has been paid to the late results in patients having a restorative resection of tumours at and below 8 cm: all these patients are continent and there is no excess of late pelvic recurrent. Corrected 5-year survival rates are 72 per cent for abdominoperineal excision and 84 per cent for restorative resection.

Adenocarcinoma↗

PubMed1982

The radiological assessment of bladder emptying.

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Humans↗

PubMed1981

A slowly growing poorly differentiated carcinoma of the caecum.

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Adenocarcinoma↗

PubMed1980

Consent for mastectomy.

The value of a system for reducing the number of women with breast lumps who consent unnecessarily to mastectomy was assessed. Sixty-one patients with breast lumps were divided preoperatively into three groups with benign, doubtful, and malignant lumps according to clinical, mammographic and ultrasound criteria. On the basis of these criteria written consent was requested from 29 patients for mastectomy and from 32 for only excision of the lump. Fourteen of the 29 patients who gave consent for mastectomy had carcinomas, and none of the 32 patients consenting to only lump excision. In an attempt to improve further on these results the same 61 patients were analysed retrospectively. Criteria based on age and the results of clinical examination and mammography were devised. By using these criteria only 19 women would have had to give consent for mastectomy. This new policy, which was devised to spare many women the stress of consenting unnecessarily to mastectomy, requires to be tested further in a much larger series of patients.

Adolescent↗

PubMedDate not supplied

The submucosa of the human colon.

Full-thickness specimens of colon were obtained at operation or autopsy from 20 patients. The submucosa was isolated from the mucosa and muscularis externa, with confirmation by light microscopy. Submucosal specimens were then fixed and prepared for scanning and transmission electron microscopy, with preservation of their orientation. The submucosa was found to consist of a series of layers of collagen fibres, each layer 0.5-2.0 microns thick. The fibres within each layer were co-directionally orientated. The autopsy specimens were comparable in appearance with the operative ones. The mean diameter of the collagen fibrils was 69 +/- 13 nm, and the mean fibril count per unit area was 159 +/- 58/microns2.

Adolescent↗