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Biomedical subjects

N Menzies-Gow

Publications and source records attributed to N Menzies-Gow.

At least 19 recordsLinked to original sources
PubMed1996

Interchange between collagenous and lymphocytic colitis in severe disease with autoimmune associations requiring colectomy: a case report.

BACKGROUND: Collagenous colitis and lymphocytic colitis present with a similar clinical picture. Whether these conditions are separate entities or whether they represent different pathological stages of the same condition is an unresolved issue. PATIENT: This is a case of collagenous colitis following a fulminant course in which a colectomy was necessary. In the operative specimen the thickened collagen plate, which had been present only two weeks preoperatively had been lost and the pathology was of a lymphocytic colitis. Six months postoperatively this patient developed a CREST syndrome and primary biliary cirrhosis. CONCLUSIONS: This case shows the lability of the collagen plate and the common ground between collagenous and lymphocytic colitis, and presents evidence that these two conditions are different manifestations of the same disease. It also describes for the first time an association between collagenous colitis and CREST syndrome and primary biliary cirrhosis.

Autoimmune Diseases↗
PubMed1995

Endoscopically guided surface repair of inguinal hernia.

A novel tension-free prosthetic mesh repair for an inguinal hernia is described. This is performed through a 2-cm groin incision and the inguinal canal is traversed with the aid of a 5-mm videoendoscope. Spermatic cord mobilization, identification and excision of the indirect sac, and posterior wall repair are carried out under endoscopic guidance. Between October 1993 and January 1994, 22 primary unilateral hernia, and two bilateral repairs were undertaken. The mean (range) age was 47 (35-64) years in 23 men and one woman. The mean (range) operative time was 42 (35-58) min. All patients left hospital on the day after surgery. One patient developed a scrotal swelling that required a scrotal support.

Adult↗
PubMed1995

Laparoscopic abdominoperineal excision of the rectum.

In laparoscopic abdominoperineal resection of the rectum (LAP-AP) an abdominal incision is completely avoided as the tumor is delivered through the perineal incision. It is our belief that the view provided in the pelvis by laparoscopy is significantly better than at laparotomy and allows excellent anatomical definition and meticulous dissection. In this study we compared the adequacy of excision of the first 12 patients undergoing LAP-AP to the last 16 patients undergoing open abdominoperineal resection (OP-AP). In all patients the procedure was carried with curative intent for adenocarcinoma and the Dukes staging and Jass score's were similar in both groups. [table: see text] The data demonstrate similar nodal harvest in both groups as well as extent of radial excision. However, two patients in the open group had microscopic radial margin involvement despite being microscopically clear at surgery. We conclude that although long-term follow-up is required to address the issue of local cancer recurrence, laparoscopic rectal dissection appears as good as open surgery and may allow a more precise assessment of excision margins.

Adult↗
PubMed1995

Inflammatory markers following laparoscopic and open hernia repair.

Laparoscopic surgery may reduce the inflammatory response to surgery by the avoidance of a skin incision which is frequently the site of maximum tissue trauma. We hypothesized that the inflammatory response is less with minimally invasive procedures. The aim of this study was to evaluate the response of inflammatory mediators following laparoscopic and open hernia repair. Thirty-four patients undergoing unilateral primary inguinal hernia repair were prospectively assigned to either laparoscopic mesh hernia repair (n = 14), open mesh hernia repair (n = 11), or a Bassini repair (n = 9). Serum samples withdrawn prior to surgery, 6 h after surgery, and then again at 24 h after surgery were assayed for interleukin-6 and C-reactive protein content. Interleukin-6 levels at 24 h in the laparoscopic (13.1 +/- 3.1 pg/ml), open mesh (15.5 +/- 2.5 pg/ml), or Bassini group) (15.4 +/- 2.0 pg/ml) did not differ significantly. Neither did C-reactive protein levels at 24 h in the laparoscopic (12.4 +/- 2.7 pg/ml), open mesh (23.0 +/- 7.8 pg/ml), or Bassini group 18.6 +/- 6.6 pg/ml) differ significantly. The response of inflammatory mediators to hernia repair is not modified by undertaking the procedure laparoscopically.

C-Reactive Protein↗
PubMed1995

Simple ileal J-pouch construction using an endoscopic stapler.

An easier method in constructing a J-pouch is described using an endoscopic stapler. Although not designed for open procedures, the length of this instrument allows the J-loop to slide up the device following each staple application. Close opposition of the antimesenteric borders of the ileum is thus more easily achieved, telescoping of the bowel is avoided, and the enterostomy does not become unnecessarily enlarged.

Enterostomy↗
PubMed1994

Hernia repair.

Explore the source record for details and available documents.

Adult↗
PubMed1994

Abdominal wall metastases following laparoscopy.

Only 18 cases of recurrence at the sites of cannula insertion after laparoscopy have been reported in the literature, ten of them in the past year. The period between laparoscopic surgery and presentation of wound metastasis varies widely, from 7 days to 10 months; the lesions are typically hard, craggy and painful. The most likely mechanism is direct implantation of viable exfoliated tumour cells but three aspects specific to laparoscopy may also be important. First, there may be increased exfoliation of tumour cells following manipulation by laparoscopic instruments of an unsuspected malignancy. Second, there may be repeated close contact between tumour-laden instruments and the port. Third, the passage of resected tissue through a small incision may coat the wound with potentially malignant cells.

Abdominal Muscles↗
PubMed1994

Laparoscopic herniorrhaphy: initial experience in 126 patients.

The initial experience in laparoscopic transabdominal preperitoneal mesh (TAPP) repairs is reviewed. In this study, consecutive TAPP repairs were performed in 126 patients. There were no intraoperative complications, and only 1 procedure had to be converted to open surgery. Forty-six patients had direct inguinal hernias, 56 had indirect inguinal hernias, and 24 had both, of which 21 were recurrent. Fifty-one hernias were right sided, 46 were left sided, and 29 were bilaterals. The male/female ratio was 116:10, and the mean age of the patients was 49.8 (range 17-76). Minor complications included parasthesia over the distribution of the lateral cutaneous nerve of the thigh in 2 patients, hydrocoeles in 2 patients, hematomata in 6 patients, and testicular pain in 4 patients, all of which resolved on conservative management. Incomplete bowel obstruction has been the only major postoperative complication to date, where an area of bowel herniated between two staples in the peritoneum. This was further complicated by an aspiration pneumonia and death of the patient. The mean hospital stay was 1.2 days (range 1-3), and the mean return to unrestricted activity was 8 days (range 3-12). There have been 2 true recurrences to date. One patient had a tender swelling after the repair, which was thought to be a recurrent strangulated hernia. On investigation, it was found to be a hematoma. The mean follow-up has been 7 months (range 1-18). Although early results of the TAPP repair are encouraging, we have had 1 significant complication that may have been avoided if an endoscopic extraperitoneal approach was employed.

Adolescent↗
PubMed1994

Endometriosis and umbilical swelling.

Umbilical endometriosis should be considered in the differential diagnosis of an umbilical swelling. The diagnosis is made by histological examination as clinically there may be no relationship between the swelling and menstruation.

Adult↗
PubMed1994

Laparoscopic cholecystectomy: safe and feasible in emphysematous cholecystitis.

We report three cases of emphysematous cholecystitis managed by laparoscopic cholecystectomy. The diagnosis was made by ultrasound in all cases. Two patients developed postoperative infections. There were no fatalities. The mean postoperative stay was 6 days. In experienced hands, laparoscopic removal of the gallbladder in emphysematous cholecystitis is feasible with good results.

Aged↗
PubMed1994

Laparoscopic varicocelectomy.

We report our initial experience of laparoscopic ligation of varicocele in 13 patients with a mean age of 34 years (range 18-39). Eight patients were subfertile, and the rest complained of dragging pain and discomfort in the left scrotum. At laparoscopy the peritoneum overlying the spermatic vessels was divided, and the spermatic veins were mobilized, clipped, and divided. The spermatic artery was identified and preserved in 11 of the 13 cases. The patients were discharged within 24 h of hospital admission. Semen quality improved in seven of the eight subfertile patients studied with a mean follow-up of 8 months. Four patients who were operated on for pain and discomfort had symptomatic improvement by the time of their first outpatient visit at 3 months. One patient complained of paresthesia along the anterior aspect of his thigh, which resolved in 6 weeks. There were no other complications. Laparoscopic varicocelectomy is a safe and effective minimally invasive procedure for treatment of clinical varicocele.

Adolescent↗
PubMed1994

Methods of controlling presacral bleeding.

Rectal mobilization during abdominoperineal or low anterior resection involves careful dissection between the rectum and the sacrum. Inadvertent manipulation outside the avascular presacral space may damage presacral veins, causing troublesome and potentially life-threatening bleeding. We reviewed the current management of presacral bleeding, including the use of an endoscopic stapling device to control presacral bleeding.

Hemorrhage↗
PubMed1993

Thoracoscopic biopsy in the diagnosis of pulmonary Kaposi's sarcoma.

Thoracoscopic lung biopsy provided diagnostic histologic material with minimal patient discomfort in an HIV-positive man with diffuse pulmonary Kaposi's sarcoma. This minimally invasive procedure will have an increasing role in providing a histologic diagnosis in patients with diffuse lung disease.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Preliminary results of laparoscopic repair of perforated duodenal ulcers.

A consecutive series of six patients admitted with perforated anterior duodenal ulcer were operated on using a laparoscopic technique. Only one operation was unsuccessful and required conversion to conventional open laparotomy. The remaining five patients had a completed laparoscopic omental patch repair with peritoneal washout. There was no mortality, and two patients developed a chest infection postoperatively. Early mobilisation and discharge from the hospital (mean, 6 days) were notable features in this series. In conclusion, laparoscopic repair of uncomplicated perforated duodenal is a safe and effective technique.

Duodenal Ulcer↗
PubMed1992

Intra-abdominal panniculitis can mimic recurrent stomach carcinoma.

Carcinoma of the stomach is increasingly treated with chemotherapy. We describe two cases of intra-abdominal panniculitis in patients after laparotomy and chemotherapy for stomach carcinoma. Intra-abdominal panniculitis can result in mass lesions in the mesentery and omentum. The diagnosis should be considered in patients who have undergone chemotherapy for stomach carcinoma and who develop abdominal masses.

Abdomen↗
PubMed1992

Esophagogastrectomy: a consecutive single-center series.

We present a 7-year consecutive, nonselected, single-center series of patients (n = 140) submitted to surgery for esophageal or upper gastric malignancy. Follow-up data are complete for 96.4% of patients. Of 114 intrathoracic anastomoses, 74 (65%) were esophagogastric and 40 (35%) were esophagojejunal. Unresectable lesions were present in 26 (19%) patients. Age (mean +/- sd 64.6 +/- 11.1 years), and sex distribution were similar in all groups, while 36% of patients were over 70 years. There was no significant difference in the time from the onset of symptoms to presentation between the groups (p < 0.05). The values of admission hemoglobin, serum albumin, PaO2 or peak expiratory flow rate did not correlate with survival. There was no significant difference in 30-day operative mortality between the three procedures - esophagectomy 5%, thoraco-abdominal gastrectomy 10.8% and unresectable 11.5% (p > 0.05). The incidence of respiratory complications was the same whether a right (30%) or left (35%) thoracotomy was performed. Some 33% of patients were discharged from hospital after 14 days and 72% after 21 days (12.9% died in hospital). One-year survival was 33.4% for esophagectomy, 37.5% for total gastrectomy and 6% for unresectable lesions. The esophagectomy versus total gastrectomy survival curves were not significantly different, but there was a significant survival advantage when patients undergoing esophagectomy were compared with those who had unresectable tumors (0.02 > p > 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗