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Biomedical subjects

D Finnis

Publications and source records attributed to D Finnis.

11 recordsLinked to original sources
PubMed2004

Irreversible lower limb ischaemia following ligation of the inferior mesenteric artery in the surgical treatment of rectal cancer.

Rectal cancer and cardiovascular disease are both commoner in the elderly and may coexist. In some severe arteriopaths the blood supply to the lower limbs may be a collateral circulation from the inferior mesenteric artery. Patients with aorto-iliac occlusion or severe stenosis may have collaterals from the inferior mesenteric artery to the lower limb blood vessels. Ligation of the inferior mesenteric artery in treating rectal cancer can result in irreversible ischaemia as outlined in this report. Routine palpation of the femoral pulses and awareness of collateral circulation may avoid the disastrous consequences seen in the two cases described.

Aged↗
PubMed2003

Effect of stoma formation on bowel care and quality of life in patients with spinal cord injury.

INTRODUCTION: Bowel management is a significant source of concern for patients with spinal cord injury (SCI) and may significantly alter quality of life. The effect of colostomy formation on both quality of life and time taken for bowel care is well recorded. We report our experience of intestinal stoma formation in SCI patients. METHODS: Medical records from the spinal unit, operating theatres and stoma clinics were reviewed to identify SCI patients for whom a stoma had been formed. Patients were interviewed using a standard questionnaire. Average age at injury was 29 years (range 6-62 years). Mean time from injury to stoma formation was 17 years (range 0-36.25 years) and the mean period of poor bowel function prior to stoma was 8 years (range 1.5-25). RESULTS: The average time spent on bowel care per week decreased from 10.3 h (range 3.5-45) prior to stoma formation to 1.9 h (range 0.5-7.75) afterwards (P<0.0001, paired t-test). In all, 18 patients felt that a stoma gave them greater independence and quality of life was described as much better by 25 patients. Complications occurred in 14 patients - eight described leakage of mucus and occasionally blood and pus per rectum, three developed parastomal hernias and three developed bowel obstruction. CONCLUSION: Elective stoma formation is a safe and well-accepted treatment for the management of chronic gastrointestinal symptoms in patients with SCI.

Adolescent↗
PubMed1999

The role of intestinal stoma in patients with spinal cord injury.

In the long term following spinal cord injury, bowel dysfunction causes major physical and psychological problems. A retrospective review of intestinal stomas performed in patients with spinal cord injury over a 10 year period was performed to investigate their role in alleviating these problems. Twelve patients underwent left iliac fossa end colostomy and two patients right iliac fossa end ileostomy. The mean age of patients at operation was 54.8 years (20-65), and the mean time from injury to stoma formation was 15 years (2-37). The mean period of unsatisfactory bowel management before stoma formation was 5.4 years (1.5-2.5). Following colostomy the mean time spent on bowel care per week fell from 8.8 h (0.6-12.2) to 1.4 h (0.3-3.5) and independence in bowel care rose from 50 to 92%. All patients stated that their bowel care was easier and 83% said their independence had increased. Ninety-two per cent wished colostomy had been offered earlier and no patient undergoing colostomy wanted it reversed. The most common complication following colostomy was exclusion colitis. The mean time of follow-up post colostomy formation was 38 months (7-130). Formation of an intestinal stoma is a safe, effective and well accepted treatment for selected patients with intractable problems of bowel management following spinal cord injury.

Adult↗
PubMed1995

Genotype-phenotype correlations of new causative APC gene mutations in patients with familial adenomatous polyposis.

Nine new causative mutations and seven previously characterised mutations of the APC gene of patients with familial adenomatous polyposis (FAP) were analysed for any genotype-phenotype correlations. The only clear genotype-phenotype correlation found was between the position of the mutation site and the presence or absence of congenital hypertrophy of the retinal pigment epithelium (CHRPE). A more distal mutation site was associated with an earlier age of onset of symptoms and a larger number of colonic polyps, but a notable amount of intrafamilial variation was observed.

Adenomatous Polyposis Coli↗
PubMed1993

Imipenem prophylaxis in elective colorectal surgery.

In a randomized controlled study of 411 patients undergoing elective colorectal surgery, the efficacy and safety of two different regimens of imipenem were compared with those of a control regimen of cefuroxime plus metronidazole. Surgical infections occurred in 92 (26.4 per cent) of 349 evaluable patients. There were no major differences between the three treatment groups. It is concluded that imipenem is as effective as cefuroxime plus metronidazole in the prevention of sepsis after elective colorectal procedures.

Aged↗
PubMed1992

Local recurrence after anterior resection for rectal cancer using a double stapling technique.

Fifty-five patients of mean age 69 (range 41-96) years with rectal cancer (Dukes' A:B:C, 11:24:20) underwent anterior resection using a double stapling technique under the care of one consultant surgeon between 1983 and 1988. The mean distance of the anastomosis from the anal margin was 7.2 (range 4-13) cm. The clinical leak rate was 9 per cent (five patients). There were three postoperative deaths from pulmonary embolism, lower limb ischaemia and renal failure. On prospective follow-up, 35 patients had no evidence of local or systemic cancer a median of 32 (range 24-84) months after operation; seven have died from unrelated diseases and ten from metastatic cancer. Pelvic recurrence, in four patients at 9, 11, 12 and 50 months, has occurred only in association with widespread metastasis. These results suggest that the theoretical risks of an increase in the local recurrence rate of rectal cancer after resection using a double stapling technique are not substantiated.

Adenocarcinoma↗
PubMed1978

Pneumatosis coli: a familial association.

A woman and her son who both developed pneumatosis coli within a period of 6 months are described. No familial or cluster association has previously been reported. The aetiology of this uncommon disease is reviewed.

Adult↗
PubMed1977

Choledochoscopy in exploration of the common bile duct.

The technique of operative fibreoptic choledochoscopy is described; the results are reported in 88 patients with gallstones requiring exploration of the common bile duct. There were no cases of retained calculi that were endoscopically undetected. Postoperative T-tube cholangiography was carried out in 81 cases and confirmed the findings of operative biliary endoscopy in all cases. Choledochoscopy is an accurate and safe operative procedure which can eliminate the problem of undetected residual calculi.

Biliary Tract Diseases↗