An adapted Clavien-Dindo scoring system in trauma as a clinically meaningful nonmortality endpoint.

Background: There is no consensus on reporting nonmortality trauma complications in a graded manner. The Clavien-Dindo scale of complications was originally for elective surgery and requires adaptation to provide meaningful data for trauma patients. In particular, the original score does not account for those treated without surgery.

Bile carcinoembryonic antigen levels and occult hepatic metastases from colorectal cancer.

Purpose: Up to 30 percent of patients will have occult hepatic metastases at the time of curative surgery for colorectal cancer. The ability to predict this group of patients would allow better targeting of appropriate therapy. It has been shown previously that patients with overt hepatic metastases have significantly high levels of carcinoembryonic antigen in gallbladder bile compared with serum levels.

Effect of surgeon specialty interest on patient outcome after potentially curative colorectal cancer surgery.

Objective: There are significant differences in patient outcome after potentially curative surgery for colorectal cancer that relate to the surgeon performing the procedure. The reasons for these differences remain obscure. The aim of this study was to examine the effect of the surgeon's specialty on patient outcome after potentially curative colorectal cancer surgery and to identify factors that may help explain differences in outcome among specialty groups.

Acquired abnormalities of the biliary tract from chronic gallstone disease.

Background: Acquired abnormalities of the biliary tract from chronic gallstone disease are rare. The aim of this study was to examine the frequency with which these abnormalities occur and to assess the probability of encountering such an abnormality at laparoscopic cholecystectomy.

Study Design: We conducted a prospective study of all patients undergoing elective and emergency cholecystectomy under the care of one surgeon between January 1991 and December 1997.

Effects of laparoscopy on intraperitoneal tumor growth and distant metastases in an animal model.

Background And Aims: Laparoscopic surgery for colorectal cancer is currently being evaluated in humans. The aim of this study was to examine the effect of laparoscopy on intraperitoneal tumor growth and distant metastases in an animal model. We also examined the effect of combining laparotomy with laparoscopy and on infusing the peritoneal cavity with normal saline solution (NaCl), water, and sodium hypochlorite after laparoscopy on intraperitoneal tumor growth.

General oncologic effects of the laparoscopic surgical approach. 1997 Frankfurt international meeting of animal laparoscopic researchers.

The results from the majority of the reviewed studies support the hypothesis that abdominal surgery, performed via either a large incision or CO2 pneumoperitoneum, systemically encourages tumor growth in the postoperative period. A full laparotomy incision appears to have a significantly greater effect than CO2 pneumoperitoneum on postoperative tumor growth. Whether the large tumor observed in the surgical groups are the result of increased tumor cell proliferation or diminished tumor cell death remains unclear.

Treatment of sulphasalazine-induced agranulocytosis with granulocyte macrophage-colony stimulating factor.

Sulphasalazine-induced agranulocytosis is a rare but potentially life threatening complication. A variable mortality rate has been reported, from 6% to 20%, and is related to the duration of neutropenia. Previous case reports have shown that the use of granulocyte macrophage-colony stimulating factor (GM-CSF) in treating drug-induced agranulocytosis may shorten the period of neutropenia and hence lead to improved survival.

Skin tumours of the hand. A 10-year review.

A 10-year retrospective study was performed in order to determine the incidence, distribution, histological type and behaviour of skin tumours of the hand that were referred to a regional Plastic Surgery unit. 85 patients were studied and 98 malignant or pre-malignant lesions identified. The majority were squamous cell carcinomas in male manual workers.