Catastrophic enterocutaneous fistulae; the role of home hyperalimentation.
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Adolescent↗
Biomedical subjects
I C Lavery
Publications and source records attributed to I C Lavery.
Protection of the intestine during radiation of the pelvic bone.
We have given a short course of intensive radiotherapy to two patients with osteogenic sarcoma of the right iliac bone while protecting the intestine by displacement. With the follow-up period now being a year and a half and two years, there is no evidence of injury to the intestine. Insertion of the pack does not require major dissection, and its removal is not traumatic. Both patients had displacement of viscera on the right side, but there is no reason anatomically why this procedure cannot be applied for similar lesions on the left side.
Bone Neoplasms↗
The curative treatment of rectal cancer at the Cleveland Clinic.
This article reviews the policy of the Cleveland Clinic regarding the curative treatment of rectal cancer. The use of Turnbull's no-touch technic permits avoidance of peroperative tumor seeding via the lumen of the bowel or the lymphovascular pedicle. The postoperative accumulation of blood in the presacral space is precluded by leaving the peritoneum of the pelvis open and by irrigation and suction via sump drains. The authors review the different factors influencing the choice of treatment.
Humans↗
Intussusception following jejunoileal bypass for morbid obesity: report of a case.
A man who had undergone jejunoileal bypass for morbid obesity had cramping abdominal pains for which no cause could be found, despite repeated clinical examinations and numerous investigations. Only during anesthesia could the large mass formed by the intussusception be palpated. Following reduction of the intussusception and refixing to the anterior abdominal wall, all symptoms abated.
Adult↗
The Ripstein procedure: a 16-year experience.
A retrospective study was undertaken, evaluating 54 patients who underwent 57 Ripstein procedures at the Cleveland Clinic Foundation during the years 1963-1978. The patients were evaluated for their preoperative characteristics as well as early and late postoperative results. Patients who experience procidentia are generally middle-aged women who have had previous gynecologic and anorectal surgery and who generally had significant disorders of bowel function. Although the operative mortality was zero, and the majority of patients were satisfied with the results of their Ripstein procedure, there was significant operative morbidity (26 per cent). Twelve and one-half per cent of patients had recurrent rectal prolapse, and 18 per cent of patients had significant long-term obstructive symptoms. The Ripstein procedure still remains the treatment of choice for rectal prolapse.
Adolescent↗
Endoscopic ultrasound in the pre-operative staging of rectal carcinoma.
Endoscopic ultrasound (EUS) was performed prospectively to stage 45 patients with rectal cancer. Patients were staged utilizing the TNM staging system. All patients subsequently underwent surgical resection with independent histopathologic staging. Depth of invasion was accurately predicted in 40 of 45 patients (89%). Presence or absence of lymph node metastasis was correctly determined in 34 of 45 patients (79%). EUS is an accurate method for local staging of rectal cancer.
Carcinoma↗