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Biomedical subjects

I M MacIntyre

Publications and source records attributed to I M MacIntyre.

16 recordsLinked to original sources
PubMed2000

Groin hernia repair in Scotland.

BACKGROUND: The use of mesh for groin hernia repair has dramatically changed the way this common operation is performed. The aim of this study was to survey the methods of groin hernia repair in Scotland and to assess patient satisfaction with the operation. METHODS: Between 1 April 1998 and 31 March 1999 all patients who underwent groin hernia repair in the National Health Service in Scotland were identified. As well as looking at the type of hernia repair performed and postoperative morbidity, patients were sent a Short Form-36 about 3 months after the operation to assess satisfaction and return to normal activity. RESULTS: Information was obtained on 5506 (97 per cent) of patients who underwent groin hernia repair during the study period. Eighty-five per cent of patients had an open mesh repair and 4 per cent had a laparoscopic repair. Most operations (85 per cent) were performed using general anaesthesia on an inpatient basis (78 per cent), and 8 per cent were for repair of a recurrent hernia. Potentially serious intraoperative complications were rare (seven patients), although they were significantly (P < 0. 001) more likely to be associated with a laparoscopic approach or repair of a femoral hernia: relative risk compared with open inguinal hernia repair 33 (95 per cent confidence interval (c.i.) 6-197) and 22 (95 per cent c.i. 3-152) respectively. Wound complications were common and 10 per cent of patients required a district nurse to attend the wound. Patients expressed a high degree of satisfaction; 94 per cent would recommend the same operation to someone else if required. CONCLUSION: An open mesh repair using general anaesthesia has become the repair of choice for a groin hernia in Scotland. Despite a high incidence of wound complications, patients are satisfied with this operation.

Aged↗
PubMed1999

Laparoscopic or Lichtenstein repair for recurrent inguinal hernia: one unit's experience.

Surgical treatment of recurrent inguinal hernia is controversial. This is a prospective study of 50 patients who had laparoscopic total extraperitoneal repair (n = 25) or Lichtenstein repair (n = 25) for recurrent inguinal hernia. The two groups of patients were comparable in age, sex and type of hernia. Post-operatively, a seroma or a wound haematoma developed in 12 patients after Lichtenstein repair and in 4 patients after laparoscopic repair (p < 0.05). On average, analgesia was taken for 6.4 days after Lichtenstein repair compared with 3.4 days after laparoscopic repair (p < 0.05). In our unit, laparoscopic repair was associated with fewer complications and a significantly shorter duration of post-operative analgesia than Lichtenstein repair for recurrent inguinal hernia.

Adult↗
PubMed1997

Gastric cancer distal to the cardia--prevention or cure?

Adenocarcinoma of the stomach distal to the cardia remains one of the most common cancers in the world. The interest in the aetiology of this disease has been rekindled because of recent epidemiological and molecular studies linking this cancer to H. pylori and certain dietary factors. The authors provide an updated review of the aetiology of gastric cancer. This review seeks to summarize the disease, to propose pathways of carcinogenesis and to suggest ways in which the "traditional" risk factors may be interpreted on the basis of evolving knowledge.

Adenocarcinoma↗
PubMed1997

Diagnostic use of endoscopic mucosal resection.

We report two cases of gastric carcinoma where repeated, multiple conventional endoscopic biopsies were falsely negative. Endoscopic mucosal resection gave a positive diagnosis in both these patients. New equipment for aspiration mucosectomy makes the technique easier to perform, and a larger, deeper biopsy is obtained.

Adenocarcinoma↗
PubMed1995

Symptomatic outcome following resection of gastric cancer.

The extent to which the different resections relieve the symptoms of gastric cancer is poorly defined. The symptoms of 57 consecutive patients undergoing standard resection of gastric adenocarcinoma by oesophagogastrectomy (n = 19), total gastrectomy [16] or partial gastrectomy [22] were studied prospectively. Common symptoms were relieved in 80% of cases and this was independent of tumour stage. Symptoms were significantly more frequent after total gastrectomy than after partial gastrectomy or oesophagogastrectomy, the difference being attributable principally to the development of new symptoms after total gastrectomy. While abdominal pain, nausea and vomiting were largely relieved by resection, dyspepsia or dysphagia worsened in 31% of patients following surgery, especially total gastrectomy (P < 0.05). Resection relieves the symptoms of gastric cancer adequately but outcome is influenced by operation type. As total gastrectomy gives a poorer symptomatic outcome, it should be avoided when the performance of an alternative procedure does not compromise established principles of resection.

Adenocarcinoma↗
PubMed1977

Management of intractable hiccup.

A patient who developed hiccups after laparotomy was treated with numerous drugs with limited success. A left phrenic nerve crush was eventually successful. A review of published work showed that the drugs most likely to succeed were chlorpromazine and metoclopramide, and that phrenic nerve injection and crush should be considered if these failed.

Adult↗