Journal of the Royal College of Surgeons of Edinburgh
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J R Coll Surg Edinb · Feb 1995
Case ReportsLigation of the thoracic duct without thoracotomy for the treatment of postoperative chylothorax: a newly designed surgical procedure.
A newly designed surgical procedure of ligation of the thoracic duct without thoracotomy for the treatment of postoperative chylothorax is presented. A case of chylothorax following resection of carcinoma of the oesophagus was treated successfully with ligation of the thoracic duct without thoracotomy. Its advantages were very prominent consisting of maintenance of the integrity of the thorax, less traumatization, no need of a drainage tube and shorter hospitalization, much easier to expose the thoracic duct than the conventional transthoracic approach. We can find no similar report in any published literature.
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J R Coll Surg Edinb · Feb 1995
Clinical TrialVideo-thoracoscopic lung biopsy in diagnosis of interstitial lung disease.
Lung biopsy remains an important investigation in the diagnosis of diffuse interstitial lung disease despite improved diagnostic yield of high resolution computed tomography scanning. We describe 19 pulmonary wedge biopsies (13 men and 6 women) performed using videothoracoscopic technique. The median age of the patients was 56 years (range 32-72 years). ⋯ There were three complications: two air leaks and one effusion. Median postoperative hospital stay was 2 days (range 2-7 days). We conclude that videothoracoscopic wedge biopsy is a safe and effective procedure and should be recommended in patients who require a histological diagnosis of diffuse interstitial lung disease.
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J R Coll Surg Edinb · Oct 1994
Efficacy of urgent thoracotomy for trauma in patients attended by a helicopter emergency medical service.
Over a 12-month period the Helicopter Emergency Medical Service underwent 1084 missions attending casualties in the London area. Sixteen patients required an emergency thoracotomy for resuscitation, nine of which were performed at the scene and seven in the emergency department. The median injury severity score of these patients was 29.9 (SIR 11.8) of which 11 had suffered blunt injuries. ⋯ No patient in this series survived resuscitative thoracotomy. It is suggested that scene thoracotomy be abandoned and emphasis placed upon the rapid transport of patients to an emergency facility. This enables other resuscitative measures in addition to thoracotomy to be applied effectively and concentrated over a brief period by a multidisciplinary team.
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J R Coll Surg Edinb · Aug 1994
A review of burns treated over a one-year period at Mpilo Central Hospital, Zimbabwe.
A retrospective study is presented of 297 patients (57% male and 43% female) treated for burns at Mpilo Central Hospital, Bulawayo, Zimbabwe in 1991. Of the patients, 73% were in the paediatric age group, 60% of whom were under 5 years of age. Most burns occurred at home (90%), with the majority occurring in the kitchen (61%). ⋯ Seven patients (five children and two adults) died, giving a mortality rate of 2%. Although it is desirable to have a purpose-built burns unit this study shows that satisfactory results can be achieved with limited facilities. In our practice, where 90% of burns occur in the home situation, an active public-education campaign would help to reduce the incidence of burns.
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J R Coll Surg Edinb · Aug 1994
Biography Historical ArticleArt and literature in the anatomy of Charles Bell.
The artistic gifts of Sir Charles Bell (1774-1842) directed the course of his life's work. There is a fairly extensive literature on the discoveries of Bell in neurology and myology but comparatively poorly documented are the ways in which Bell exploited his aesthetic talents and erudition to communicate his findings to others. This study attempted to answer the question; how did Bell use art and literature to teach anatomy? The problem is all the more interesting because, in keeping with the spirit of education and improvement of the day, Charles Bell did not limit himself to addressing the medical profession but spoke to a wider public, dwelling on artists in particular. Bell's oil paintings and drawings, and the early editions of his written works, as well as their reviews in the contemporary press formed the main source material of this study.