| 1. |
- Haapaniemi, Staffan, et al.
(författare)
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Mortality after elective and emergency surgery for inguinal and femoral hernia
- 1999
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Ingår i: Hernia. - 1265-4906 .- 1248-9204. ; 3:4, s. 205-208
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate mortality following elective and emergency groin hernia surgery. Information concerning 17 591 inguinal and 579 femoral hernia operations, including death of patients within 30 days of surgery, were prospectively recorded in the Swedish Hernia Register over a period of six years. Elective surgery for groin hernia is known to be a low-risk procedure. Mortality within 30 days of surgery was compared with the mortality of the general Swedish population using the standard mortality rate (SMR). Of all inguinal and femoral hernia repairs 5.1 % and 35.2 % respectively, were performed as an emergency. Following elective inguinal hernia repair the SMR for men fell significantly below unity. No significant differences between observed and expected mortality were observed following inguinal hernia surgery on females or following elective femoral hernia surgery on either gender. The reduced SMR found after elective hernia repair in men is most likely attributable to patient selection. After elective surgery on patients 70 years or older there is a tendency towards a reduction in SMR of the same order of size as for patients analysed as one group which, however, did not reach statistical significance. Mortality following both inguinal and femoral emergency procedures is increased five- to ten-fold compared to the 30-day mortality in the general population. A further increase in postoperative mortality is noted following emergency surgery with bowel resection.
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| 2. |
- Lundqvist, Erik, et al.
(författare)
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Autoimmune and Metabolic Diseases and the Risk of Early-Onset Colorectal Cancer, a Nationwide Nested Case-Control Study
- 2023
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Ingår i: Cancers. - : MDPI. - 2072-6694. ; 15:3
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Tidskriftsartikel (refereegranskat)abstract
- Simple Summary Early onset of colorectal cancer (EOCRC) is increasing in developed countries. The aim was to investigate autoimmune and metabolic conditions as risk factors for EOCRC. We investigated preexisting autoimmune and metabolic diagnoses of 2626 EOCRC patients in Sweden, diagnosed in 2007-2016, together with 15,756 controls matched for birth year, sex, and county. Comorbid diagnoses were collected from the National Patient Register. A history of metabolic disease nearly doubled the incidence of EOCRC, and presence of inflammatory bowel disease (IBD) was associated with a sixfold increased incidence of EOCRC. Patients with both IBD and metabolic disease had a lower incidence of EOCRC compared with IBD patients without metabolic condition. Non-IBD autoimmune disease was not associated with an increased incidence of EOCRC. IBD and metabolic disease are risk factors for EOCRC and should be considered in screening guidelines. Incidence of early-onset (<50 years) colorectal cancer (EOCRC) is increasing in developed countries. The aim was to investigate autoimmune and metabolic conditions as risk factors for EOCRC. In a nationwide nested case-control study, we included all EOCRC cases in Sweden diagnosed during 2007-2016, together with controls, matched for birth year, sex, and county. Information on exposure of autoimmune or metabolic disease was collected from the National Patient Register and Prescribed Drugs Registry. Hazard ratios (HR) as measures of the association between EOCRC and the exposures were estimated using conditional logistic regression. In total, 2626 EOCRC patients and 15,756 controls were included. A history of metabolic disease nearly doubled the incidence hazard of EOCRC (HR 1.82, 95% CI 1.66-1.99). A sixfold increased incidence hazard of EOCRC (HR 5.98, 95% CI 4.78-7.48) was seen in those with inflammatory bowel disease (IBD), but the risk increment decreased in presence of concomitant metabolic disease (HR 3.65, 95% CI 2.57-5.19). Non-IBD autoimmune disease was not statistically significantly associated with EOCRC. IBD and metabolic disease are risk factors for EOCRC and should be considered in screening guidelines.
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| 3. |
- Sandblom, G., et al.
(författare)
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Femoral hernias : a register analysis of 588 repairs
- 1999
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Ingår i: Hernia. - 1265-4906 .- 1248-9204. ; 3:3, s. 131-134
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Tidskriftsartikel (refereegranskat)abstract
- From 1 January 1992 to 31 December 1997 18,281 inguinal hernias and 588 femoral hernias were recorded in the Swedish Hernia Register. The aim of the present study was to characterise these femoral hernias and to evaluate the reoperation rate following their repair. 64% of all femoral hernias were located in the right groin and 36% in the left groin (p < 0.001). The male to female ratio for femoral hernia was 1:1.6; mean ages of patients with femoral and inguinal hernia were 63.4 ± 17.1 and 59.1 ± 16.4 years, respectively (p < 0.001). Emergency surgery and bowel resection at emergency surgery were more common with femoral than with inguinal hernia. The rate of ambulatory surgery was lower for femoral hernia than for inguinal hernia, mainly due to the higher emergency rate for femoral hernia. At three years the cumulative incidence of reoperation was 4.6% (95% confidence interval 2.4–6.8%) for femoral hernia and 4.0% (95% confidence interval 3.6–4.4%) for inguinal hernia (p > 0.05). Male sex and postoperative complications were associated with a significantly increased risk of reoperation following femoral hernia repair. The relative risk of reoperation was not affected by patient age, elective/emergency surgery, primary/recurrent hernia or hernia side. Repair techniques using mesh were associated with a lower reoperation rate than techniques without mesh, although the difference did not reach statistical significance.
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