Biomedical subjects
G A STEVENS
Publications and source records attributed to G A STEVENS.
The role of the antrum in surgery for duodenal ulcer.
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The rationale of antrectomy and vagotomy for duodenal ulcer.
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Duodenal ulcer; rationale and results of antrectomy and subtotal vagotomy.
Results in a series of 107 cases indicated that antrectomy (hemigastrectomy) combined with subtotal vagotomy of both vagus nerves for duodenal ulcer is followed by better overall results than the more radical subtotal gastrectomy or vagotomy plus drainage procedures.Antrectomy combined with total vagotomy is followed by a slightly smaller incidence of marginal ulcer but is accompanied by more motility disturbances.
Factors involving wound dehiscence; study of one thousand cases.
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Thyroid carcinoma; an approach to management of the disease.
A clinical and pathological study was made of a series of 34 consecutive patients with thyroid carcinoma. Carcinoma occurred only in nodular goiters, and in the majority of cases was found in a gland with a solitary nodule. The degree of firmness to palpation of a thyroid nodule is unimportant in the diagnosis of carcinoma of the thyroid since hardness was an infrequent finding. In the diagnostic use of radioactive iodine, scintigram studies of a nodular goiter usually revealed an area of decreased function at the site of a thyroid carcinoma.Twenty-three per cent of the 34 patients with thyroid carcinoma died within five years. The duration of survival for various patients was compared with the type of treatment administered. It is believed that solitary thyroid nodules are best treated by lobectomy. Total thyroidectomy is indicated in cases of large thyroid carcinoma and also for smaller tumors if papillary adenocarcinoma. Radical neck dissection is warranted if lymph node metastasis is present and limited to the neck; and also in the absence of metastasis if the tumor is papillary in histologic pattern. Surgically inaccessible metastatic lesions are best palliated by radioactive iodine or external irradiation.
Incidence of unsuspected carcinoma in thyroid disease occurring in a nonendemic area.
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Surgical considerations in diseases of the pancreas.
Present data indicate that surgical treatment of pancreatitis is most successful in cases in which the disease is caused by extrahepatic disease of the biliary tract. Operation is also effective in cases of islet cell tumors, cysts, lithiasis, trauma and annular pancreas. Results seem to justify radical operation for early carcinoma of the ampulla of Vater and pancreas. The value of surgical treatment in other lesions of the pancreas is doubtful.
Surgical treatment of duodenal ulcer.
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Surgical treatment of gastrojejunal ulcer.
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Comparative concurrent results of vagotomy procedures, conventional gastric resection and hemigastrectomy with subtotal vagotomy.
The question of the best surgical treatment of duodenal ulcer remains unanswered. In a series of 132 patients, results following gastric resection and hemigastrectomy with subtotal vagotomy were better than those following vagotomy procedures alone.