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Biomedical subjects

R W Hoile

Publications and source records attributed to R W Hoile.

16 recordsLinked to original sources
PubMed1998

Emergency small-bowel resection in a district general hospital.

Small-bowel resection has been identified as a core surgical skill that all general surgical trainees must acquire. Most of these resections are performed by the unsupervised higher surgical trainee on call. Reviewing 51 small-bowel resections performed over a five-year period in a district general hospital we found that, although the operation carried a high mortality rate (18%) and a high morbidity rate (21%), these had less to do with the operative technique than with the nature of the underlying disease and the hazards of emergency surgery in general. We conclude that small-bowel resection per se is relatively safe and remains a good training procedure.

Adolescent↗
PubMed1993

The National Confidential Enquiry into Peri-operative Deaths (NCEPOD).

The National Confidential Enquiry into Peri-operative Deaths (NCEPOD) is now established in the United Kingdom (excluding Scotland) as a voluntary, confidential system designed to review the clinical practice which precedes a death within 30 days of surgery. The Enquiry is comprehensive, widely representative and authoritative. To date, two reports have been published and there is an ongoing programme planned. The influence of these reports on the practice of anaesthesia and surgery in Britain is undeniable.

Anesthesia↗
PubMed1984

Rectal biopsies: inaccuracy of histological grading in carcinoma of the rectum.

In a consecutive series of 70 patients with carcinoma of the rectum, 42 had operable tumours and in these the histology of the initial biopsy was compared with that of the excised specimen. In 9 of the 42 patients the histological grading of the original biopsy was different from that of the final specimen; in 3 the carcinoma was missed despite repeated preoperative biopsies; and in 5, errors were made in the diagnosis of carcinoma in polyps. In 5 of 7 cases of poorly differentiated carcinoma the initial biopsies indicated moderate differentiation: there was therefore a 70% inaccuracy in the preoperative diagnosis of poorly differentiated carcinoma of the rectum. The implications of this inaccuracy for the surgery of rectal cancer are discussed.

Biopsy↗
PubMed1983

The use of a new suture material (Polydioxanone) in the biliary tract.

The use of a new synthetic absorbable suture material, polydioxanone, has been assessed over a period in excess of three years in 63 patients undergoing surgical procedures on the biliary tract. The material, which was used exclusively for all ligatures and sutures, has greater pliability and strength than other absorbable materials and was found to be highly satisfactory. No suture-related complications were identified and the handling properties of the material were excellent. This material can be recommended for use in the biliary tract where it is desirable to use a reliable absorbable suture which evokes minimal tissue reaction.

Adult↗
PubMed1982

The technique and clinical application of the cytochemical section bioassay for gastrin-like activity.

The technique and validation of the cytochemical section bioassay for gastrin-like activity are described. This assay utilises the measurement of hormone-induced changes of carbonic anhydrase activity in guinea-pig gastric parietal cells. The clinical use of the assay as identified elevated levels of fasting gastrin-like biological activity in the plasma of patients with duodenal ulcer and has also demonstrated discrepancies between radioimmunoreactive gastrin levels, biological activity, and the clinical presentation of peptic ulcer disease.

Adult↗
PubMed1980

A trial of suction drainage in inguinal hernia repair.

A prospective randomized trial was conducted on 301 adult males undergoing inguinal herniorrhaphy to assess the value of postoperative suction drainage. Hernias were classified into 'complicated' and 'simple'. In the 'complicated' group suction drainage for 24 h significantly reduced the incidence of wound haematoma, seroma or infection from 48.7 per cent to 17.6 per cent (P < 0.01); there was also a noticeable effect on the postoperative morbidity in the 'simple' hernias, although this just failed to achieve significance (4.5 per cent in the suction group compared with 9.8 per cent in the controls). It is concluded that suction drainage should be employed postoperatively following repair of hernias where dissection may be difficult or where other complicating factors are present.

Clinical Trials as Topic↗
PubMed1980

The cytochemical section-bioassay of gastrin-like activity.

A cytochemical section-bioassay of gastrin-like activity is described in which such activity in plasma is assayed by its stimulation of carbonic anhydrase activity in serial, 18 micrometers-thick, sections of suitably prepared gastric fundus of the guinea-pig. The index of precision was 0.1 +/- 0.05 (mean +/- SEM; n=8). Fiducial limits were 75-134%. Intra-assay variation was +/- 6.4% (n=4); inter-assay variation was +/- 16.3% (n=3). The mean gastrin-like activity in the plasma of 15 fasting normal subjects was 5.1 +/- 0.49 x 10(-12)M (range 1.4-18.2 x 10(-12)M).

Animals↗
PubMed1976

Hazards in the management of large intra-abdominal tumours.

Whatever their nature, large intra-abdominal tumours interfere with respiratory and circulatory function by producing elevation and splinting of the diaphragm and partial occlusion of the inferior vena cava. The main hazards involved in removing such tumours are consequences of abdominal decompression, which may produce a labile cardiovascular state, respiratory difficulties, and rapid intestinal distension. A knowledge of the deranged physiology and its management may avert these complications. Careful preparation, modification of anaesthetic technique, postoperative ventilation, and external abdominal compression are important. To illustrate the discussion two cases of large ovarian cysts are described.

Abdominal Neoplasms↗
PubMed1969

Emergency admissions to a general medical unit: a survey of the accompanying letters, with recommendations.

Letters of referral accompanied 166 out of 188 emergency admissions to a general medical unit over a four-month period. Of these, 129 contained useful information concerning past medical history, emergency treatment given, drugs taken, and provisional diagnosis. It is suggested that general practitioners should adopt some format based on essential criteria when writing letters of referral, so that important information is not overlooked.

Communication↗