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Biomedical subjects

I H Scott

Publications and source records attributed to I H Scott.

7 recordsLinked to original sources
PubMed1994

Delorme operation for rectal prolapse.

A consecutive series of 49 elderly patients of mean age 73 years with full-thickness rectal prolapse underwent the Delorme operation between 1986 and 1990. A standard technique was used, or supervised, by one surgeon. In this prospective series, 43 patients were reviewed clinically. The Delorme operation abolished rectal prolapse in 32 patients. Half of the 40 with faecal incontinence were rendered continent. Failure was related to previous anorectal surgery and/or psychiatric illness. Of the 11 patients in whom the first procedure failed, four were improved by a second Delorme operation. The Delorme operation is a suitable procedure for elderly and/or medically unfit patients with rectal prolapse. Good results have also been demonstrated for younger patients, suggesting that the operation may have wider application.

Adult↗
PubMed1990

Stapling or suturing for anastomoses of the left side of the large intestine.

Two hundred and fifty patients undergoing elective surgical treatment involving anastomoses of the left side of the colon or colon and rectum have been studied in a randomized trial in which the EEA (U. S. Surgical Corp.) circular stapler has been compared with single layer sutured anastomoses. Only patients in whom either technique was feasible were included in the analysis. The operative techniques were largely standardized. Patients were studied by means of a limited barium enema on the ninth or tenth postoperative day. The data have been analyzed for leakage rate (clinical and roentgenologic), other complications and degree of experience of the surgeon. Eleven patients were excluded from the analysis because the selected technique could not be carried out; of these, eight were in the stapled group in which it was possible to perform a sutured anastomosis. There were no instances in which it was possible to staple but not possible to suture. The remaining three exclusions were patients in whom either a coloanal anastomosis or a Hartmann procedure was performed. There was no over-all difference in the leakage rate--roentgenologic, clinical or total--between the two groups. However, when analyzed by the surgeon, the clinical leakage rate for surgeons in training was greater for sutured anastomoses than for stapled anastomoses (p = 0.053). Thus, it appears that the benefits of experience are more pronounced for sutured anastomoses but that, in experienced hands, neither technique is superior.

Aged↗
PubMed1984

Computed tomography in 101 patients with a palpable abdominal mass.

A total of 101 patients with a palpable or suspected abdominal mass of unknown origin were examined by computed tomography (CT). In 69 patients an abnormality was demonstrated at the site of the palpable mass; only in one patient was this finding erroneous (false positive). In 32 patients no lesion was demonstrated (one false negative). Such high positive and negative predictive values (99% and 97%) indicate the value of CT in determining the presence or absence of a lesion to account for a clinically apparent mass, especially when there is doubt as to its presence or organ of origin. As to the cause of the mass, CT correctly identified the responsible organ or structure in 64 out of 69 patients with a lesion (93%) and suggested the likely nature in 61 (88%).

Abdominal Neoplasms↗