Biomedical subjects
Publications and source records attributed to V J Lobbato.
The carcinoid tumor presented was noteworthy in several respects. It attained a large size within the space of only two months and was so extensive that it penetrated the abdominal wall. Despite its great size there were no liver metastases, and at no time did the patient exhibit any of the signs or symptoms of the carcinoid syndrome.
We believe the procedure described herein overcomes the disadvantages of percutaneous endoscopic gastrostomy in that intraperitoneal leakage of gastric contents is prevented and injury to adjacent organs is obviated. At the same time, the desirable qualities of percutaneous endoscopic gastrostomy are retained. So far, the operation has been performed safely and quickly upon four patients who have had no morbidity or mortality.
Forty-six professors of surgery in answers to a questionnaire reported that 143 patients with Zollinger-Ellison syndrome had been admitted to their hospitals within the last 2 years. The bed capacity of these hospitals totaled 27,019. In extrapolating these figures, it is seen that the capacity of the 46 institutions averaged 587 beds per hospital, and that an average 71.5 patients with Zollinger-Ellison syndrome were admitted each year. In other words, a hospital with 587 beds might expect 1.55 yearly admissions of patients suffering from this disease. Two surgical methods have emerged as today's main treatment choices for Zollinger-Ellison syndrome that is unaccompanied by isolated gastrinoma. These are 1) preoperatively administered H2 blockers followed by less-than-total gastrectomy, truncal vagotomy, and postoperative H2-blocker therapy; and 2) preoperatively administered H2 blockers followed by highly selective vagotomy plus postoperative H2-blocker therapy. Only seven of 46 respondents still maintain that total gastrectomy should be carried out to cure the disease. All respondents advocate excision of an isolated gastrinoma as the treatment of choice if one is found at surgery.
Assessment of the integrity of the ductal system of the pancreas after a penetrating injury is mandatory and can prevent potentially fatal complications. The authors report a case in which the endoscopic retrograde cholangiopancreatography (ERCP) was employed intraoperatively to carry out such assessment after a pancreatic stabwound.
The incidence of colonic cancer coexisting with an aneurysm of the abdominal aorta is approximately 2%. Such a coexistence presents a true dilemma to the surgeon for it is often difficult to decide whether to treat the carcinoma or the aneurysm first. This report summarizes the opinions of 46 Professors of General Surgery and Vascular Surgery who gave their response as to which condition should receive priority of treatment. Approximately one third of the respondents favored excision of the carcinoma first; one third stated they would excise the aneurysm first; and the remaining third said they would withhold a decision until laparotomy was performed. Two surgeons replied that they would attempt to perform aneurysmectomy and colectomy simultaneously.
Within recent years differing approaches to the treatment of cold nodules of the thyroid gland have evolved. To assess these differences and to discover whether a general consensus exists, questionnaires were sent to professors of surgery and endocrinology and to chiefs of head and neck sections at various medical colleges and university hospitals throughout the country. Fifty-three surgeons and 13 endocrinologists answered the questionnaires and their responses are analyzed and recorded here.