ENDOMETRIOSIS OF THE SIGMOID COLON AND RECTUM

Endometriosis is a common disease of women which occasionally causes serious symptoms in virtue of involvement of the distal large intestine. Two cases are reported, illustrating opposite ends of the spectrum of this disorder, one presenting with a complete large-bowel obstruction, and the other with periodical per-rectal bleeding. Endometriosis in these locations can closely mimic carcinoma, and from a consideration of our cases and the literature, those features which might help to distinguish one from the other are discussed. The treatment of endometriosis itself is briefly outlined. Either to avoid unnecessarily radical surgery, or to plan appropriate specific treatment at the time of surgery for the colorectal lesion, a preoperative diagnosis is desirable, but it Is unlikely unless the clinician is aware of this unusual form of endometriosis.     

左半结肠及直肠损伤的处理

目的：探讨左半结肠及直肠损伤的手术方法。方法：对10年来收治的左半结肠及直肠损伤的33例病人作回顾性研究,根据Flint三级法和shannon五级法的标准,采取不同的手术方法,一期手术25例,其中单纯修补19例,切除吻合3例,一期修补加近端管状造瘘3例;二期手术8例,其中外置修补2例,造口术6例。结果：一期手术25例,无并发症和死亡,平均住院15d,二期手术8例,发生盆腔脓肿3例,经保守治愈2例,死于感染性休克1例。平均住院31．5d。结论：采取现代外科的一些手段,对左半结肠及直肠损伤的病人,如果病例选择合理,可放宽一期手术适应证。     

HARTMANN'S PROCEDURE FOR CARCINOMA OF THE RECTUM AND SIGMOID COLON

A review of the Hartmann's operation for patients with rectal and sigmoid cancer over an 18 year period is presented. There were 1063 patients who had a resection for carcinoma of the rectum or sigmoid colon and 4.4% of these had a Hartmann's procedure. This operation was particularly useful in the management of patients who presented with a proximal obstruction or perforation at the tumour site. It was also effective in the elective treatment of elderly unfit patients who had locally advanced tumors or those with distant metastases. Re-anastomosis is recommended in those patients who are relatively fit and have had a potentially curative resection.     

BENIGN MESENCHYMAL TUMOURS OF THE COLON AND RECTUM: A RETROSPECTIVE STUDY

Sixteen patients were diagnosed as having a benign mesenchymal tumour of the colon or rectum at the Repatriation General Hospital, Concord, between 1950 and 1979. There were six lipomas and ten leiomyomas. Lipomas occurred more commonly in the colon, while leiomyomas predominated in the rectum. The symptoms produced by the lipomas included abdominal pain, rectal bleeding and diarrhoea. Leiomyomas were found incidentally at sigmoldoscopy in six patients, while three presented with rectal bleeding and one with constipation. Lipomas were larger than leiomyomas and were associated with more complications. Both tumours, however, produced few physical signs.     

两种术式治疗陈旧性下尺桡关节紊乱的远期效果比较

目的 评价尺骨头切除术和尺骨假关节成形术的远期效果,方法 将２３例陈旧性下尺桡关节紊乱患者分为两组,分别作有关节切除术（１１例）和尺骨假关节成形术（１２例）,腕背尺侧倒Ｌ形切口;（１）尺骨头切除术,骨膜上切除尺骨下端及尺骨头２ｃｍ,缝合骨膜,石膏托制动侧横断尺骨,造成１ｃｍ的尺骨缺损,去除下尺桡关节软骨,用一枚螺钉固定,下尺桡关节植骨融合,尺骨缺损用部分带蒂旋前方肌瓣填塞,石膏托制动３～４周,结果