Bentley P. Colcock

Common-Bile-Duct Stones

IN recent years, cholecystectomy has been performed in an increasing number of patients. As a result, two serious complications of biliary-tract surgery have occurred with increasing frequency. The...

Operative Technique in Surgery for Crohn’s Disease and its Relationship to Recurrence

Crohn’s disease often presents difficult technical problems to the surgeon. Associated fistulas and obstruction make surgical correction necessary, as does failure of medical treatment to relieve symptoms. Because the recurrence rate is high, it is felt that surgery should be used only when necessary. Furthermore, since removing a wide margin of normal bowel on each side of the lesion is no guarantee against recurrence, only that portion of bowel which made surgery necessary should be removed.

Complications of abdominoperineal resection

SummaryAbdominoperineal resection was performed on 300 patients during the period from January 1950, to December 1954. All 300 cases were reviewed from the standpoint of immediate postoperative complications associated with this procedure. In 18 cases the follow up period was too short to determine whether late complications occurred.Some type of complication developed in 58.3 per cent of the group. The highest incidence of complications was related to the urinary tract (27 per cent). The most serious were cardiovascular and pulmonary complications.

The surgical treatment of ulcerative colitis.

THE treatment of ulcerative colitis is primarily medical. Experience has shown, however, that at least 25 per cent of patients with ulcerative colitis require surgical intervention,1 , 2 to preserv...

Diverticulitis: A Surgical Challenge

Discussion of four points shows why diverticulitis is such a fascinating and challenging disease to the abdominal surgeon: diverticulitis of the colon is relatively common, its differential diagnosis from carcinoma is often difficult, the morbidity associated with its surgical treatment is not as low as it could be, and a number of patients still die following surgery — some of these because of an error in judgment.

Surgical treatment of diverticulitis.

One of the serious complications of diverticulitis eventually develops in 25 to 30 per cent of patients with this disease.The use of the multiple-stage procedure for these complications has considerably reduced surgical mortality, but morbidity remains high.To reduce the surgical morbidity in diverticulitis, inadequate operative procedures should be avoided. However, a more effective method is to operate on patients likely to have obstruction or perforation before these serious complications develop. A one stage procedure can then be safely used.Inability to exclude carcinoma is also an imperative indication for surgery in patients with diverticulitis.

Gardner's Syndrome: Multiple Polyposis of Colon, Bone Tumors and Soft-Tissue Tumors

The colonic and rectal polyps of Gardners syndrome are premalignant lesions. Discovery of soft-tissue masses or osseous enlargement offers a clue to their presence. The pathologic manifestations and the treatment of the syndrome are discussed, and a case is reported. The patient was a man 26 years of age. Subtotal colectomy and ileoproctostomy were performed.

Choice of Operation for Duodenal Ulcer

The authors review their experience with all patients operated on for duodenal ulcer at the Lahey Clinic from January 1958 to June 1962, and present their indications for use of various operative procedures. All 374 patients had a gastric resection (removing 50 to 75 per cent of the stomach) with or without vagotomy. The mortality was 0.8 per cent. Some type of complication occurred in 10 per cent.

Gastric Diverticulum: Diagnosis and Indications for Surgical Excision

Summary Eleven cases of gastric diverticula have been added to 35 previously reported. In 2 of these 11 cases or in 4 of the 46 cases, resection has been carried out since our last report. Indications for surgical excision are mentioned and discussed. There is no medical treatment for uncomplicated gastric diverticulum and the lesion should usually be ignored.

Are Polyps of the Colon Premalignant

The theoretical ferment over whether colonic polyps become malignant often boils down to a practical question: Should polyps beyond the reach of the sigmoidoscope be biopsied? In Dr. Behringers opinion, they should be if the surgical risk is not too great. Dr. Prohaska feels that in some cases if two colon contrast studies show a polyp unchanged in size and location, the risk of surgery may exceed the threat of malignancy.