Complications following 178 low anterior resections for rectal carcinoma with the EEA autosuture device are reported prospectively. The operative mortality was 2.8 percent. Clinical anastomotic leakage developed in 27 patients, but in none of the 30 patients over 76 years of age. Two of the five hospital deaths were related to leakage. Long-term steroid treatment and previous pelvic radiotherapy were associated with increased risk of leakage. Severe stenosis following anastomotic leakage was seen in one patient. Intraoperative diverting colostomy was done in 16 patients, but no benefit could be demonstrated. It was concluded that use of the upper sigmoid colon for anastomosis probably is not associated with a higher mortality and morbidity than that after more extensive resections reported in the literature. Future randomized trials should exclude very old patients, in whom no leak was seen, when the upper sigmoid colon was used for stapling after low anterior resection.
RAAS was safe, feasible and with equal efficacy to CLAS. There were however no particular advantages to performing antireflux surgery as robot-assisted procedures neither intra-operatively nor at follow-up.
The Helmstein bladder distension treatment was applied to 26 patients, who received a total of 70 treatments (52 for bladder tumour and 18 for severe bleeding; in 7 cases for both tumour and bleeding). In the T2 tumours total necrosis occurred in 27% of the cases, partial necrosis in 50% and no necrosis in 23%. Of the patients with total necrosis 64% had recurrences within 12 months. In the T3-T4 tumours only 33% had a temporary slight reduction of the tumour mass. In patients with severe bleeding from the bladder, haematuria ceased within 1 to 5 days after the treatment in 12 out of 18 cases. Bleeding, however, recurred after an average of 3 months. It is concluded that the treatment is useful in selected cases with multiple tumours of the bladder, and the method is effective in controlling severe bleeding from the bladder.
Forty mothers who had given birth to children with a clinically probable diagnosis of allo-immune neonatal thrombocytopenia were typed for ABO, HLA-ABC and Zw a antigens and their sera were investigated with the platelet complement fixation microtest (CFT), the lymphocytotoxic test (LCT), and the platelet suspension immunofluorescence test (PSIFT). Seventeen (43%) of the 40 mothers were Zwanegative, which is significantly (p < lo-'") much more frequent than in controls
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