| 1. |
- Maret-Ouda, John, et al.
(författare)
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The risk of mortality following secondary fundoplication in a population-based cohort study
- 2016
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Ingår i: The American Journal of Surgery. - Stockholm : Karolinska Institutet, Dept of Molecular Medicine and Surgery. - 0002-9610 .- 1879-1883.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Mortality following laparoscopic fundoplication has been found to be negligible. However, some patients require secondary fundoplication, and the risk of mortality following such procedure is scarcely studied. METHODS: This nationwide Swedish population-based cohort study included all patients undergoing secondary fundoplication following primary laparoscopic fundoplication in 1997 to 2013, regardless of indication. Primary outcome was mortality within 90 days of surgery, and secondary outcome was postoperative length of hospital stay. RESULTS: A total of 9,765 patients underwent primary laparoscopic fundoplication, 540 (5.5%) patients underwent secondary fundoplication. About 382 (70.7%) were conducted laparoscopically, and 158 (29.3%) were conducted with an open technique. No deaths occurred within 90 days of the secondary fundoplication. Median length of stay was longer following secondary fundoplication (4.8 days, interquartile range 1.0 to 5.0 days), compared to primary laparoscopic fundoplication (2.5 days, interquartile range 1.0 to 3.0 days). CONCLUSIONS: This population-based cohort study indicates that secondary fundoplication following primary laparoscopic fundoplication is a safe procedure. The longer hospital stay following secondary fundoplication compared to primary laparoscopic fundoplication is likely explained by the higher rate of open surgical approach.
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| 2. |
- Arnbjörnsson, Einar, et al.
(författare)
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Role of obstruction in the pathogenesis of acute appendicitis
- 1984
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Ingår i: The American Journal of Surgery. - : Elsevier BV. - 1879-1883 .- 0002-9610. ; 147:3, s. 390-392
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Tidskriftsartikel (refereegranskat)abstract
- The role of obstruction in the pathogenesis of acute appendicitis was studied by measuring the pressure in the appendix perioperatively in 24 patients operated on with an appendectomy because of suspected acute appendicitis. The technique used involved inserting a fine needle through the apex into the appendix lumen and measuring the hydrostatic pressure required to inject saline solution. In three patients with a gangrenous appendix found at operation, and in two patients with a phlegmonous appendix, there were signs of obstruction of the appendix lumen as revealed by increased pressure within it. In 14 patients with a phlegmonous appendix found at operation, no signs of obstruction were found. These experimental data suggest that obstruction is not an important causative agent of acute appendicitis, but might develop as a result of the inflammatory process.
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| 3. |
- Thörne, Johan, et al.
(författare)
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Early posttraumatic pulmonary platelet trapping and its potentiation by oral pretreatment with alcohol
- 1986
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Ingår i: The American Journal of Surgery. - : Elsevier BV. - 1879-1883 .- 0002-9610. ; 151:2, s. 216-220
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Tidskriftsartikel (refereegranskat)abstract
- Soft tissue trauma is associated with platelet aggregation and sequestration in the lungs. This is believed to be an early step in the later development of adult respiratory distress syndrome. In the present experiment using a new method for in vivo dynamic studies of platelet sequestration, we wanted to evaluate the effect of soft tissue trauma on pulmonary platelet trapping in pigs and the influence of acute alcohol intoxication. The results show that significant pulmonary platelet trapping is registered within minutes of trauma and that alcohol significantly increases platelet sequestration in the lungs. This indicates an increased risk for posttraumatic pulmonary problems in alcohol-intoxicated trauma victims
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| 4. |
- Trulsson, Lena, 1950-, et al.
(författare)
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Telomerase activity in surgical specimens and fine-needle aspiration biopsies from hyperplastic and neoplastic human thyroid tissues
- 2003
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Ingår i: American Journal of Surgery. - 0002-9610 .- 1879-1883. ; 186:1, s. 83-88
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Tidskriftsartikel (refereegranskat)abstract
- Background: Telomerase activity (TA) indicates malignancy, but activated lymphocytes also express TA. Correlation between TA in thyroid tissues and fine-needle aspiration (FNA) samples and knowledge about TA in adjacent tissue are of importance. Methods: The telomeric repeat amplification protocol assay followed by enzyme-linked immunosorbent assay detection was performed on 78 thyroid cases including 53 suspected malignancies, preoperative and perioperative FNA specimens, and adjacent tissue. Results: Benign lesions in cancer-suspected cases were TA negative. Eight of 13 papillary (62%) and 4 of 5 follicular (80%) tumors were TA positive (TA+). Lower TA was observed in conventional papillary cancer than in follicular, tall cell variant of papillary and anaplastic cancers. Adjacent tissues with lymphocyte infiltration were TA+ in 9 of 17 cases (53%). Nine of 65 adjacent tissues (14%) were TA+. Three of 6 preoperative and 9 of 11 perioperative FNA samples from malignant tumors corresponded to the tissue TA. Conclusions: High TA may reflect more severe thyroid cancer. Telomerase activity in FNA biopsies does not add reliable diagnostic information, and presence of lymphocytes can give false-positive results.
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| 5. |
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| 6. |
- Ansari, Daniel, et al.
(författare)
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Artificial neural networks predict survival from pancreatic cancer after radical surgery.
- 2013
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Ingår i: The American Journal of Surgery. - : Elsevier BV. - 1879-1883 .- 0002-9610. ; 205:1, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Artificial neural networks (ANNs) are nonlinear pattern recognition techniques that can be used as a tool in medical decision making. The objective of this study was to develop an ANN model for predicting survival in patients with pancreatic ductal adenocarcinoma (PDAC).
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| 7. |
- Apelqvist, Jan, et al.
(författare)
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Resource utilization and economic costs of care based on a randomized trial of vacuum-assisted closure therapy in the treatment of diabetic foot wounds.
- 2008
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Ingår i: The American Journal of Surgery. - : Elsevier BV. - 1879-1883 .- 0002-9610. ; 195, s. 782-788
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To evaluate resource utilization and direct economic costs of care for patients treated with negative-pressure wound therapy (NPWT), using the Vacuum-Assisted Closure (V.A.C.) system, compared to standard moist wound therapy (MWT). METHODS: A total of 162 diabetic patients with post-amputation wounds (up to the trans-metatarsal level) entered a 16-week, randomized clinical trial. Patients randomized to V.A.C. (n = 77) received therapy with dressing changes every 48 hours. Control patients (n = 85) received standard MWT. Resource utilization, procedures, and direct costs were calculated and analyzed in this post hoc retrospective study. RESULTS: There was no difference between groups for in-patient hospital stay (number of admissions or length of stay). More surgical procedures (including debridement) were required in the MWT group (120 vs 43 NPWT, P <.001). The average number of dressing changes performed per patient was 118.0 (range 12-226) for MWT versus 41 (6-140) for NPWT (P = .0001). The MWT group had 11 (range 0-106) outpatient treatment visits during the study versus 4 (range 0-47) in the NPWT group (P <.05). The average direct cost per patient treated for 8 weeks or longer (independent of clinical outcome) was $27,270 and $36,096 in the NPWT and MWT groups, respectively. The average total cost to achieve healing was $25,954 for patients treated with NPWT (n = 43) compared with $38,806 for the MWT group (n = 33). CONCLUSION: Treatment of diabetic patients with post amputation wounds using NPWT resulted in lower resource utilization and a greater proportion of patients obtaining wound healing at a lower overall cost of care when compared to MWT.
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| 10. |
- Enochsson, Lars, et al.
(författare)
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The location of bile duct stones may affect intra- and postoperative cholecystectomy outcome : a population-based registry study
- 2020
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Ingår i: American Journal of Surgery. - : Elsevier. - 0002-9610 .- 1879-1883. ; 220:4, s. 1038-1043
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Treatment for bile duct stones (BDS) depends largely on anatomical circumstances; yet, whether the outcome of cholecystectomies is impacted by the localization of intraoperatively discovered BDS remains largely unknown.METHODS: A population-based registry study using data from the national Swedish Registry for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks). 115,084 cholecystectomies 2006-2016 with the indications gallstone colic or complications were included. The surgical outcome between patients with distal BDS and those with at least one stone above the confluence was compared.RESULTS: 10,704 met the inclusion criteria. Patients with stones above the confluence had 16% longer operation times and significantly higher rates of intraoperative complications (OR 1.47), gut perforation (OR 4.60), and cholangitis (OR 1.96) compared to patients with distal BDS. The highest clearance rate (96%), as reflected by the need for re-ERCP, was seen after intraoperative ERCP, regardless of the localization of the BDS.CONCLUSIONS: Stones located above the confluence are associated with increased complication risks. These findings stress the importance of carefully considering the optimal methods for BDS removal during surgery.
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