Background: Resection offers the only chance of cure for hepatic colorectal metastases. However, preoperative staging does not always reliably detect unresectable disease. The aim of this study was to investigate the role that laparoscopy with ultrasound may have in detecting unresectable disease, thus sparing patients from unnecessary laparotomy with the associated morbidity and cost.
View Article and Find Full Text PDFBackground: A systematic review was conducted to determine which of the methods of obtaining peritoneal access and establishing pneumoperitoneum is the safest and most effective.
Methods: Studies that met the inclusion criteria were identified from six bibliographic databases up to May 2002, the internet, hand-searches and reference lists. They were critically appraised using a validated checklist and data were extracted using standardized protocols.
Congenital posterolateral hernias rarely present in the adult. We describe an unusual case that presented after a routine total abdominal hysterectomy. The patient developed acute respiratory symptoms caused by a perforated colon and hypoplastic right hemi-liver contained within a right-sided hernia.
View Article and Find Full Text PDFBackground: In-depth knowledge of pig liver anatomy allows potential research into segmental liver resections and hepatic regeneration, as well as liver transplantation techniques. The segmental anatomy, however, remains largely unknown. This study aimed to delineate the segmental anatomy of the porcine liver in comparison with that of the human.
View Article and Find Full Text PDFJ Hepatobiliary Pancreat Surg
October 2003
The surgical management of pain in patients with chronic pancreatitis continues to provide a formidable challenge. Despite recent advances in the area of the pathophysiolgical cause of the symptoms of chronic pancreatitis there is still controversy as to the exact mechanisms that result in pain in both large and small duct disease. In addition, the surgical community has very polarized views as to the correct management of these patients.
View Article and Find Full Text PDFContext: Choledochal cysts are rare and of unknown cause. Their presentation is protean, with the classical triad of pain, jaundice, and mass rarely seen. The potential complications are serious, including pancreatitis, cholangitis, and cholangiocarcinoma.
View Article and Find Full Text PDFBackground: Pancreatic cancer has a poor prognosis, with symptomatic palliation being the priority in the majority of cases. Alternative palliative techniques, such as local ablation, are under investigation. Palliative per-ductal electrolytic ablation of the pancreas has been reported, in an experimental series.
View Article and Find Full Text PDFBackground: Rural general surgery is faced with a shortage of resident surgeons in many parts of Australia. Although it is accepted that an undergraduate rural exposure favourably influences graduates to undertake rural practice, it is not known whether postgraduate terms exert a similar effect.
Method: Advanced general surgical trainees in 2000 were rotated for 1-month terms to Whyalla, a major provincial centre in South Australia.
Hypothesis: Use of circular stapled hemorrhoidectomy will result in the same or improved safety and efficacy outcomes as those of the conventional methods for hemorrhoidectomy in patients with hemorrhoids.
Data Sources: Studies on stapled hemorrhoidectomy were identified using PREMEDLINE and MEDLINE (June 1966-June 2001), EMBASE (January 1980-June 2001), Current Contents (June 1993-June 2001), Ovid HEALTHSTAR (January 1975-June 2001), the National Institutes of Health Clinical Trials database (searched June 13, 2001), and The National Coordinating Centre for Health Technology Assessment database (searched June 14, 2001). The search terms were as follows: haemorrhoid* and (stapl* or convent*) or hemorrhoid* and (stapl* or convent*).
Background: Inoperable pancreatic cancer has a dismal prognosis. Palliation involves either stenting or surgical bypass. Stenting does not relieve gastric outlet obstruction, and surgical bypass is a major procedure.
View Article and Find Full Text PDFBackground: Electrolytic ablation is a relatively new method for the local destruction of colorectal liver metastases. Experimental work in animal models has shown this method to be safe and efficacious. However, before proceeding to clinical trials it was necessary to confirm these findings in a pilot study of five patients.
View Article and Find Full Text PDFThe Australian Safety and Efficacy Register for New Interventional Procedures - Surgical (ASERNIP-S) undertakes horizon scanning, systematic reviews and audits. By disseminating information derived from these processes, ASERNIP-S aims to improve the quality of health care. In the present article, we discuss some of the legal and ethical issues surrounding the collection of identified data for the purposes of audit.
View Article and Find Full Text PDFBackground: Partial hepatectomy is the strongest stimulator of hepatic regeneration. The process of initiation and the control of the final size of the regenerated liver have been the subject of research for many years. A better understanding of this process and the effect of disease may allow better selection of patients for partial hepatectomy.
View Article and Find Full Text PDFBackground: The response of hepatocellular carcinoma (HCC) to therapy is often disappointing and new modalities of treatment are clearly needed. Active immunotherapy based on the injection of autologous dendritic cells (DC) co-cultured ex vivo with tumor antigens has been used in pilot studies in various malignancies such as melanoma and lymphoma with encouraging results.
Methods: In the present paper, the preparation and exposure of patient DC to autologous HCC antigens and re-injection in an attempt to elicit antitumor immune responses are described.
Background: Patients with hepatic metastases are potentially curable if all the diseased tissue can be resected. Unfortunately, only 10-20 per cent of patients are suitable for curative resection. Electrolysis is a novel non-thermal method of tissue ablation.
View Article and Find Full Text PDFA number of different materials are available for incisional hernia repair. Benefits of the various types are controversial and are partly dependent on the anatomical placement of the mesh. Composite mesh has been introduced to provide tissue ingrowth for strength and a non-adherent side to protect the bowel, these layers being laminated together.
View Article and Find Full Text PDFBackground: The majority of patients with liver trauma can be managed conservatively. However, the unstable patient requires emergency laparotomy to control bleeding. Controversy exists regarding the primary surgical management of these injuries.
View Article and Find Full Text PDFHypothesis: Surgical undergraduate education in a rural setting is feasible and sound in terms of educational outcomes.
Design: The final-year surgical curriculum at the University of Adelaide, Adelaide, South Australia, was restructured to include the option of a rural surgical term.
Setting: Five provincial center hospitals in rural South Australia.
The present paper is a review of the current ablative treatment options for the treatment of colorectal liver metastases. Cryotherapy, microwave coagulation therapy, radiofrequency ablation and laser-induced thermotherapy are discussed. Electrolysis, a novel non-thermal ablative treatment, is described.
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