| 1. |
|
|
| 2. |
- Angenete, Eva, 1972, et al.
(författare)
-
Stenting for colorectal cancer obstruction compared to surgery-a study of consecutive patients in a single institution.
- 2012
-
Ingår i: International journal of colorectal disease. - : Springer Science and Business Media LLC. - 1432-1262 .- 0179-1958. ; 27:5, s. 665-670
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Colonic obstruction is a common complication to colorectal cancer and surgical treatment is associated with high morbidity and mortality. Stenting has emerged as an alternative to surgery. The aim of this study was to compare short-term morbidity, mortality and hospital stay between treatment with self-expandable metallic stent and emergency surgery performed at our department during a 5-year period in a non-randomized setting. METHODS: Patients with colonic obstruction due to rectal or colon cancer referred to the Endoscopic Unit or Surgical Department for insertion of a colonic stent between 1 August 2003 and 1 August 2008 were prospectively registered and followed (n=112). A control group was identified using the hospital records of operations with the International Classification Code-10 (ICD-10) for bowel obstruction and colorectal cancer (n=60). Age, gender, indication, preoperative investigations, surgical procedure, complications and procedure-related mortality were registered. Patients were followed in accordance with local guidelines. RESULTS: The complication rate was similar in the two groups, although there was a trend toward a higher number of severe complications in the surgical group. The hospital stay was significantly lower in the stent group, median of 4 vs. 9days (p<0.0001). The procedure-related mortality was lower in the stent group; 7% vs. 20% (p<0.05). CONCLUSIONS: Stenting can be safely performed with lower or similar complication rate and lower mortality rate compared to surgery and results in significantly shorter hospital stay. The results support stenting as the treatment of choice in patients with acute colonic obstruction, especially in disseminated disease.
|
|
| 3. |
- Bergström, Maria, 1964, et al.
(författare)
-
Self-expandable metal stents as a new treatment option for perforated duodenal ulcer.
- 2013
-
Ingår i: Endoscopy. - : Georg Thieme Verlag KG. - 1438-8812 .- 0013-726X. ; 45:3, s. 222-225
-
Tidskriftsartikel (refereegranskat)abstract
- Primary stenting and drainage has been shown to be an effective and safe way to treat esophageal perforations and anastomotic leaks after gastric bypass surgery. We present a case series of eight patients with perforated duodenal ulcers treated with covered self-expandable metal stents (SEMS). The first two patients received their stents because of postoperative leakage after initial traditional surgical closure. The following six patients had SEMS placed as primary treatment due to co-morbidities or technical surgical difficulties. Endoscopy and stent treatment in these six patients was performed at a median of 3 days (range, 0-7 days) after initial symptoms. Six patients had percutaneous abdominal drainage. Early oral intake, 0-7 days after stent placement, was possible. All patients except one recovered without complications and were discharged 9-36 days after stent placement. This series indicates that primary treatment with SEMS and drainage might be an alternative to surgery in patients with perforated ulcer disease.
|
|
| 4. |
- Bergström, Maria, 1964, et al.
(författare)
-
Stress response and well-being after open, laparoscopic, and NOTES transgastric uterine horn resection in a randomized porcine model.
- 2014
-
Ingår i: Surgical Endoscopy. - : Springer Science and Business Media LLC. - 0930-2794 .- 1432-2218. ; 28:8, s. 2421-2427
-
Tidskriftsartikel (refereegranskat)abstract
- NOTES is believed to induce less surgical trauma than open and laparoscopic surgery. The degree of surgical trauma can be assessed by measuring serum levels of acute-phase proteins such as CRP and TNF-α. We conducted a prospective randomized survival trial in which the inflammatory responses after laparoscopic, open, and NOTES transgastric uterine horn resection were compared. The aim of this study was to investigate whether NOTES procedures induce less inflammatory response.
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Park, Per-Ola, 1950, et al.
(författare)
-
Transgastric peritoneoscopy and appendectomy: thoughts on our first experience in humans.
- 2010
-
Ingår i: Endoscopy. - : Georg Thieme Verlag KG. - 1438-8812 .- 0013-726X. ; 42:1, s. 81-84
-
Tidskriftsartikel (refereegranskat)abstract
- We present a series of three patients operated on by means of natural-orifice transgastric peritoneoscopy, including one appendectomy. A standard double-lumen gastroscope was used together with standard endoscopic tools. In all patients abdominal access through the gastric wall was smooth using a needle-knife/guide-wire/balloon technique. The whole abdominal cavity could be visualized and the appendix was found in two patients. In one patient the procedure was converted to laparoscopic appendectomy and in one to open surgery. In the third patient transgastric appendectomy was performed. The gastric access site was closed with the T-tag technique. Patients were allowed to drink and eat as soon as they woke up. Postoperatively patients were followed clinically and with standard laboratory tests daily until discharged. One patient (converted to open surgery) had a serious complication (pneumothorax). The transgastric approach to the abdominal cavity was shown to be feasible, but significant technical problems remain to be resolved.
|
|
