Showing papers in "Surgical Clinics of North America in 1989"

TL;DR: Improvement in vehicle safety, moderation of speed, and continued education should reduce the incidence and severity of chest trauma.

TL;DR: Overall, hepatic resection appears to be an important means of curing patients with metastatic colorectal cancer isolated to the liver, and it seems imperative that all patients with hepatic metastases be evaluated by an experienced hepatic surgeon for a curative resection.

TL;DR: Larotomy is desirable in most of these patients with pancreatic cancer, because it provides tissue for diagnosis, allows a definite assessment of resectability, and produces effective palliation.

TL;DR: Surgical decision-making in necrotizing pancreatitis should be based on clinical, morphologic, and bacteriologic data, and controlled prospective clinical trials should be performed in order to bring more precision to clinical decisions in respect to the role of surgery.

TL;DR: It will be of interest to learn precisely what the genetic trait is that causes the atherosclerotic aorta to fail structurally in some patients while allowing the vessel to remain intact and develop occlusive lesions in others.

TL;DR: Removing the malodorous mass from the chest wall provides excellent palliation and should be offered to patients to improve their quality of survival.

TL;DR: In high-risk populations (patients over the age of 50 with coronary artery or peripheral vascular disease), ultrasonic screening is probably cost-effective and well suited to screening.

TL;DR: Correlation of the CT findings with histologic study has changed the concept of pulmonary contusion from that of interstitial disease to that of pulmonary laceration with blood pneumonia and confidence in the method of quantitation has helped assess the severity of pulmonary parenchymal injuries.

TL;DR: In the majority of patients, pancreatic resection is performed for a proved carcinoma or for a mass in the pancreas with clinical features of carcinoma.

TL;DR: The management of cystic diseases of the liver requires an understanding of their pathophysiology and natural history and careful preoperative evaluation and planning and long-term follow-up.

TL;DR: Full functional and morphologic restitution of the pancreas is possible after an attack of acute pancreatitis if the initiating agent or process is removed, whereas chronic pancreatitis is associated with irreversible changes.

TL;DR: The most important benign hepatic tumors are hepatocytic adenoma, focal nodular hyperplasia, cavernous hemangioma, and bile duct hamartoma as discussed by the authors.

TL;DR: As the spectrum of pancreatic cysts evolves, sped by the increasing utilization of CT scanning, it becomes apparent that the surgeon must gain information preoperatively about the family history, as well as the personal history of the patient.

TL;DR: The mortality rate for all patients with hepatic injuries will be approximately 10 per cent, with 75 to 80 per cent of all deaths occurring in the perioperative period from shock or transfusion-related coagulopathies.

TL;DR: The use of endoscopic retrograde cholangiopancreatography, CT, and angiography to define the structural abnormalities has increased the surgeon's ability to select an operation matched to the patient's needs.

TL;DR: At present, the precise etiology of aneurysmal disease remains unclear, but it will most likely turn out to be a heterogenous disease with several molecular forms.

TL;DR: The authors discuss the three presentations of liver metastases, operative techniques, and prognostic factors.

TL;DR: The topographical anatomy of the liver is described in a manner most useful to the practicing surgeon in order to demonstrate the vascular anatomy.

TL;DR: The retroperitoneal approach is an excellent alternative to the trans peritoneal route for the repair of abdominal aortic aneurysms and therefore can be used in selected high-risk patients with expanding aneurYSms.

TL;DR: Thoracic great vessel injury accounts for a significant amount of the acute mortality rate from trauma and early recognition permits early repair, usually best accomplished by the simplest yet most effective technique.

TL;DR: In management, the principal areas to be considered are pain control, open wounds, pneumothorax, flail chest, and pulmonary contusion.

TL;DR: Tracheobronchial injury was considered rare until the last two decades but is becoming more common (or is being recognized more often).

TL;DR: The drainage of the pleural space with a tube thoracostomy allows more accurate monitoring of the rate of accumulation of air and blood in the Pleural space, which provides valuable information for the subsequent management of some patients, such as those with traumatic hemothorax.

TL;DR: Chest-wall resection continues to play a primary role in the management of locally and regionally recurrent breast cancer but is best combined with systemic chemotherapy, and better systemic and local therapy is needed for the recurrent soft-tissue sarcoma and the aggressive unclassified sarcomas.

TL;DR: Penetrating and blunt injuries to the heart, ranging from cardiac concussion to rupture, are seen more and more frequently and prompt diagnosis because of a high index of suspicion and timely, well-executed resuscitative efforts are rewarded by remarkable survival rates.

TL;DR: It is hoped that in the future better dietary assessment methods will help sort out the complicated, but important, contribution of diet to pancreatic cancer.

TL;DR: In Poland's syndrome, the options for reconstruction include anterior transfer of the ipsilateral latissimus dorsi muscle through a transaxillary tunnel and attachment to the clavicle and sternum.

TL;DR: Formal chest operations other than minor procedures are required by only 12 to 15 per cent of patients with thoracic trauma, but for those patients requiring thoracotomy, the operation may be required acutely or on a delayed basis.

TL;DR: The latissimus dorsi is a versatile muscle that can be employed in a variety of situations requiring chest-wall reconstruction and has within it flexibility for transposition to a number of locations based on its standard or reverse arcs of rotation.

TL;DR: The omentum is the flap of choice for the reconstruction of most radiation injuries of the chest wall and may be used to provide protection to visceral anastomoses, vascular conduits, and damaged structures in the chest, as well as to cover defects secondary to tumor excision or trauma.