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Biomedical subjects

T J Crofts

Publications and source records attributed to T J Crofts.

At least 37 records · Page 2Linked to original sources
PubMed1989

Intrathoracic stapled anastomosis after oesophagectomy for cancer.

Fifty consecutive oesophagectomies for cancer are reported which were performed using a two-stage technique with an intrathoracic stapled anastomosis. The oesophagus was resected through a right thoracotomy. Continuity was restored using orthotopic stomach, mobilized through an abdominal incision and anastomosed to the oesophagus at the apex of the thorax. No deaths occurred within 30 days, but two patients died without leaving hospital. Routine contrast study revealed no anastomotic leaks. Major complications were: chylothorax (one), transient bilateral recurrent laryngeal nerve palsy (one), anastomotic bleed (one), respiratory failure (one) and brain abscess (one). Four upper resection margins contained tumour (all in middle third tumours). With this technique, a reliable anastomosis can be made high in the chest. The amount of oesophagus removed is comparable with that obtained with the 'three-stage' or transhiatal procedures. The problem of occult submucosal spread in oesophageal tumours remains.

Adult↗
PubMed1989

Intraoperative assessment of lymph node involvement in gastric carcinoma.

This study compares the assessment of lymph nodes by the surgeon, at the time of operation, with the pathologist's assessment on the resected specimen in 85 cases of total gastrectomy with extended lymphadenectomy for gastric carcinoma. There was correlation in 67% of cases, in 28% the disease was overstaged, and in only 5% was it understaged by intraoperative assessment. This has important implications for the comparison of trials and management decisions based on surgical assessment.

Adult↗
PubMed1988

Endoscopic injection of adrenaline for actively bleeding ulcers: a randomised trial.

A prospective randomised trial was performed to assess the efficacy of endoscopic injection of adrenaline for actively bleeding ulcers. Emergency endoscopy in 961 patients admitted for upper gastrointestinal haemorrhage identified 68 patients with actively bleeding ulcers. These 68 patients were randomised to receive either endoscopic injection of adrenaline or no endoscopic treatment. After endoscopy both groups were managed in an identical manner, and strict criteria for emergency operation were adhered to in both groups. Bleeding was initially controlled in all 34 patients assigned to the treatment group. Significantly fewer patients in the treatment group than in the control group needed emergency operations (five v 14, respectively). In addition, in the treatment group the median transfusion requirement was significantly less (three v five units of blood) and the median hospital stay shorter (six v eight days). No complications were observed with the injection of adrenaline, and the rate of healing of ulcers in those attending for endoscopy six weeks after discharge was similar in both groups (81% (17 out of 21 patients) in the treatment group v 79% (11 out of 14) in the control group). Injection of adrenaline is effective in stopping bleeding from actively bleeding ulcers.

Clinical Trials as Topic↗
PubMed1987

Hepatic metastases in Hong Kong Chinese: evidence for an East-West difference in gastric cancer.

The incidence of hepatic metastases found at laparotomy for colorectal and gastric cancer amongst Hong Kong Chinese was found to be 16% and 5% respectively. These figures were compared to similar Western series, and the incidence of metastases from gastric cancer was significantly lower in the Chinese population. This geographical variation may have important implications for the interpretation of treatment results for gastric cancer in different parts of the world.

China↗
PubMed1987

Balloon dilation facilitates stapling in esophagojejunostomy.

A technique for facilitating stapled anastomosis in end to end esophagojejunostomy is described. The jejunal loop and the esophagus are dilated with a Sengstaken-Blakemore tube and a Foley catheter respectively prior to the introduction of the stapling gun. Balloon dilation simplifies the insertion and removal of the gun. The procedure is atraumatic and allows the use of larger size stapling cartridges.

Dilatation↗