Annales chirurgiae et gynaecologiae
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Comparative Study
A comparison of transthoracic and transhiatal resection for thoracic oesophageal cancer. Observations of 30 years.
The transthoracic and transhiatal resection techniques are compared using the 30-year experience of Oulu University Central Hospital. During the period 1960-1982 we favoured resections trough a transthoracic route, while during the period 1983-1989 a transhiatal route was preferred. This change, and the more enthusiastic attitude adopted towards resection, has lead to an increase in resectability from 23% (46/203) to 62% (43/69) (P less than 0.0001). ⋯ Postoperative pulmonary complications occurred in 28% (13/46) after transthoracic resection and in 14% (6/43) after transhiatal resection. No significant difference was detected in the development of late anastomotic strictures, 33% (15/46) and 30% (13/43), respectively. We conclude that transhiatal resection is as safe as transthoracic resection and seems to allow more resections to be carried out without any increase in mortality or morbidity, but long-term survival remains poor.
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From 1976 through 1985, a total of 1096 children, 0-15 years of age, was treated for fractures in Kuopio University Central Hospital. 131 patients had a femoral shaft fracture and 114 of them, including 82 boys and 32 girls, were studied. The incidence of femoral shaft fracture was 2.16 per 10,000 inhabitants 0-15 years of age. Environmental factors and the ability to move in traffic appeared to be the most important risk factors for femoral shaft fracture.