PubMed Health⌕ Search

Biomedical subjects

R S Philip

Publications and source records attributed to R S Philip.

8 recordsLinked to original sources
PubMed1996

Operations for gastric ulcer: a long-term study.

This study assesses the long-term results of operations for benign gastric ulcers. Three-hundred forty-nine patients operated upon between 1950-1979 have been followed over the past 20 years with a mean and median follow-up of 11.8 and 11.1 years. Fifty-five per cent of the patients had a gastric resection without vagotomy; 19.8 per cent had gastric resection with vagotomy; and 20.3 per cent had vagotomy, pyloroplasty, and wedge excision or biopsy of the ulcer. Operations were selected based on the type of ulcer (Types 1-4), whether the surgeon suspected cancer preoperatively, whether the operations was elective or an emergency, and the age and general health of the patient (presence of significant co-morbid disease). Overall mortality was 6.9 per cent, with a mortality for elective operations 3.6 per cent, and for emergency operations of 32.5 per cent. Age and cardiovascular disease were significant factors in operative mortality and morbidity. All operations were equivalent in long-term results. Excellent to good results were obtained in 92 per cent of patients, with an ulcer recurrence rate of 4 per cent. We conclude that vagotomy, pyloroplasty, and wedge excision or biopsy of a benign gastric ulcer is a comparable operation to a more major gastric resection, with or without vagotomy, in the surgical management of gastric ulcer. The addition of vagotomy to gastric resection does not appear to improve long-term results.

Adult↗
PubMed1995

Efficacy of preoperative bowel preparation at home.

A preliminary study was designed to determine whether preoperative bowel preparation for colorectal surgery could be performed safely at home. Medical charts of 62 patients covering 4 years of elective major colorectal surgery done by a single general surgeon were retrospectively reviewed. Patients were divided into four groups, depending on the year in which they had surgery. Each patient had been given an easy-to-understand instruction sheet as well as prescriptions for mannitol solution, neomycin, and erythromycin base. The changeover from hospital-based to home-based bowel cleansing was gradual. In the first year of the study, all patients had bowel preparation in hospital; in the final year, 88% of patients had bowel cleansing at home. Home bowel preparation resulted in no identifiable increase in morbidity or mortality. No death or wound infection occurred in any patient group. Preoperative home bowel preparation can be done safely by the patient without increased morbidity or mortality. Ordering this preparation for most colorectal surgery patients could save about $150 million in hospital costs per year in the United States.

Colorectal Surgery↗
PubMed1980

The causes of low oestrogen excretion in pregnancy: assessment of the fetal contribution by steroid measurements post partum.

Oestrogen levels in urine from 21 normotensive and 13 hypertensive pregnant women were moderately correlated (r = 0.48) with levels of 3 beta-hydroxy-5-ene steroids (oestrogen precursors) in urine from their infants. In five infants from otherwise normal pregnancies in which oestrogen excretion was very low, levels of 3 beta-hydroxy-5-ene steroids were significantly lower than normal while there was no difference between hypertensives and normals. Levels of urinary cortisol metabolites in the infants were moderately correlated with 3 beta-hydroxy-5-ene steroids (r = 0.55) and were especially low in 2 out of 5 infants in the series suffering from distress during delivery. We conclude that subnormal fetal steroidogenesis rather than reduced placental metabolism is the most common cause of low oestrogen excretion of unknown aetiology. A factor in the increased perinatal risk in this group may be an associated insufficient cortisol synthesis by the fetus.

Birth Weight↗