RESUMO
A questionnaire was given to 37 members of staff of the Department of Surgery, Addenbrooke's Hospital, Cambridge, in order to determine whether their knowledge was adequate to give accurate information to patients regarding operations and thus to obtain properly informed consent for that operation. Each participant was asked to estimate the 24-h and 30-day mortality for five common elective operations. A wide range of answers was given for operations by all groups. Estimates of 24-h mortality after unilateral inguinal herniorrhaphy differed between staff grades by a factor of 3, but estimates of 24-h mortality after thyroidectomy differed by a factor of 100 between consultant surgeons and staff nurses. Our findings suggest that some members of the surgical team have insufficient knowledge about common operations to obtain properly informed consent from patients.
Assuntos
Cirurgia Geral/educação , Consentimento Livre e Esclarecido , Educação de Pacientes como Assunto , Humanos , Projetos Piloto , Complicações Pós-Operatórias/mortalidade , Fatores de TempoRESUMO
Major vascular injury during lumbar laminectomy is an extremely rare complication of one of the commonest surgical procedures performed in orthopaedic and neurosurgical units. Its occurrence may be associated with high morbidity and mortality, particularly if it is not diagnosed in the early stages. Early diagnosis and repair is associated with an improved prognosis in the long term. We illustrate these points with a description of two cases, and discuss the anatomical factors predisposing to these injuries and the importance of angiography in the management and early diagnosis of suspected cases.
Assuntos
Artéria Ilíaca/lesões , Complicações Intraoperatórias , Laminectomia/efeitos adversos , Vértebras Lombares/cirurgia , Adulto , Angiografia Digital , Feminino , Humanos , Artéria Ilíaca/diagnóstico por imagemRESUMO
Five cases are described in which hepatic nodules discovered as an incidental finding at laparotomy performed for other reasons were thought to be metastatic tumour. In each case histology and clinical course proved this assumption to be incorrect. It is emphasized that biopsy is mandatory in such circumstances to establish the diagnosis. Where the nature of the hepatic lesion might affect the choice of operative procedure frozen section examination should be performed at the time of surgery. Bacteriological culture may also be helpful.