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A J Lamerton

Publications and source records attributed to A J Lamerton.

13 recordsLinked to original sources
PubMed2001

Long-term results of surgical decompression of thoracic outlet compression syndrome.

BACKGROUND: Thoracic outlet compression syndrome is characterised by a variety of symptoms relating to compression of the neurovascular bundle. Though no one test is specific for the syndrome, relief of symptoms may be obtained following surgery in up to 99% of cases. PATIENTS AND METHODS: The notes of 118 patients operated on in 126 operations by a single surgeon using a supraclavicular approach were reviewed. Symptoms, pre-operative investigations, and complications were all documented. Outcome at 6 weeks, 6, 12 and 24 months follow-up was also recorded. In addition, 61 patients were contacted by telephone, in order to assess current level of symptoms. RESULTS: Symptoms were predominantly motor, sensory or vasomotor, and were present for a mean of 19.6 months prior to surgery. Complications were rare, but included a pneumothorax requiring a chest drain (n = 1) and infraclavicular anaesthesia (n = 13). The mean duration of hospital stay was 2.1 days. At 6 weeks follow up, 86.5% of patients reported either an improvement, or complete resolution of their symptoms. Sixty-one patients were contactable, a mean of 55 months following decompression. Of these, 44 (72.1%) were either improved or asymptomatic. CONCLUSION: Decompression for thoracic outlet compression syndrome through a supraclavicular approach encompassing first rib resection leads to good long-term results with few complications.

Adolescent↗
PubMed1994

Operative lumbar sympathectomy for severe lower limb ischaemia: still a valuable treatment option.

Over a 5-year period, 132 operative lumbar sympathectomies were performed on 118 patients with severe peripheral vascular disease unsuitable for vascular reconstruction. In 62 patients local ulcer débridement or toe amputation was performed at the same time. There was a 45% subsequent limb loss, which occurred predominantly in the first 6 months after sympathectomy. The risk of limb loss was independent of diabetes, hypertension, ischaemic heart disease, cerebrovascular disease or concomitant reconstructive surgery. Of the limbs that survived, rest pain had resolved in 86% within 6 months and 64% recovered from all trophic changes over a similar period. This series suggests that lumbar sympathectomy coupled with local tissue management remains a valuable treatment option for the severely ischaemic limb not amenable to reconstructive surgery.

Adult↗
PubMed1993

Outcome of surgical management of the thoracic outlet compression syndrome in a district general hospital.

The 5-year experience of one surgeon in treating 50 consecutive patients (57 limbs) with the thoracic outlet compression syndrome (TOCS) is described. A predominance of neurological symptoms presented; each was treated in a similar fashion with extensive resection of the first rib and excision of fibrous bands and cervical ribs. Results of surgery (84% complete resolution or improvement of symptoms) compare favourably with others. This series demonstrates that although the technicality of the surgery demands a surgeon very familiar with the operation, this need not be undertaken in a regional centre.

Adolescent↗
PubMed1985

The femorofemoral graft. Hemodynamic improvement and patency rate.

We measured the hemodynamic improvement after femorofemoral grafting and determined the five-year cumulative patency rate in 54 consecutive high-risk patients with unilateral iliac artery occlusion who had femorofemoral grafts who were studied with ankle and brachial systolic pressure measurements before and after operation and at six-month intervals. There were two early deaths and seven early graft failures (less than 30 days) with four amputations (all operated on for rest pain). All of the remaining 45 patients' conditions improved clinically and objectively. The resting pressure index (mean +/- SD) in claudicants (n = 23) increased from 0.35 +/- 0.15 to 0.67 +/- 0.20; in patients with severe ischemia (n = 31) it increased from 0.25 +/- 0.15 to 0.50 +/- 0.20. During the follow-up period (six months to ten years), there were eight deaths and 12 late graft failures (greater than 30 days). The late cumulative patency rate was 60% at five years. Hemodynamic improvement parallels clinical success and for these high-risk patients, the femorofemoral bypass is a satisfactory alternative to a more major operation.

Adult↗
PubMed1984

Trichobezoar: two case reports--a new physical sign.

Two cases of trichobezoar in young emotionally disturbed West Indian children are reported; one was due to blanket-chewing and the other was due to trichotillomania. Both were treated successfully by surgery. The previously undescribed physical sign of indentability is introduced. The literature on trichobezoars is reviewed.

Adolescent↗
PubMedDate not supplied

The haemodynamic effects of percutaneous transluminal angioplasty.

The aim of the study was to measure the haemodynamic effect of percutaneous transluminal angioplasty (PTA). Twenty-one consecutive patients with unilateral stenosis of the iliac (n = 13) or femoropopliteal arteries (n = 8) causing intermittent claudication were studied with ankle and brachial systolic pressure measurements before and after PTA and at six monthly intervals. In 15 patients, the pressures were measured not only at rest, but after exercise on a standard treadmill. There were six technical failures. All of the remaining patients were improved clinically and objectively. The resting pressure index increased from mean (+/- ISD) of 0.65 +/- 0.22 to 0.88 +/- 0.17 and the postexercise index from 0.43 +/- 0.21 to 0.82 +/- 0.22. The preoperative claudication distance was improved from 83 m +/- 31 to 252 m +/- 104 and the recovery time from 6.3 mins +/- 5.7 to 1.5 mins +/- 2.3. During the follow up period of six weeks to 2 1/2 years, the initial improvement was maintained and there were no failures clinically or on further Doppler examination. The results suggest that for patient with a single significant stenosis, PTA is an effective alternative method of treating claudication.

Aged↗