| 1. |
- Maret-Ouda, John, et al.
(author)
-
The risk of mortality following secondary fundoplication in a population-based cohort study
- 2016
-
In: The American Journal of Surgery. - Stockholm : Karolinska Institutet, Dept of Molecular Medicine and Surgery. - 0002-9610 .- 1879-1883.
-
Journal article (peer-reviewed)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.
|
|
| 2. |
- Ansari, Daniel, et al.
(author)
-
Artificial neural networks predict survival from pancreatic cancer after radical surgery.
- 2013
-
In: The American Journal of Surgery. - : Elsevier BV. - 1879-1883 .- 0002-9610. ; 205:1, s. 1-7
-
Journal article (peer-reviewed)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).
|
|
| 3. |
|
|
| 4. |
- Nilsson, Hanna, et al.
(author)
-
Groin hernia repair in women - A nationwide register study
- 2018
-
In: American Journal of Surgery. - : Elsevier BV. - 0002-9610 .- 1879-1883. ; 216:2, s. 274-279
-
Journal article (peer-reviewed)abstract
- Introduction: The aim of this study was to investigate reoperation for recurrence in men and women with respect to method of repair, hernia anatomy and year of operation. Method: Since 1992, groin hernia repairs performed in Sweden are prospectively registered in the Swedish Hernia Register, (SHR). Reoperations are noted, regardless of where the reoperation is performed. Risk of reoperation for recurrence is calculated for men and women with respect of method of repair, hernia anatomy and year of operation. Results: Out of 221 108 eligible operations registered between 1992-2013,17 545 (8%) were performed on women. The risk of being operated for recurrence after laparoscopic surgery was lowered in women, RR 0,4(95%CI 0.3-0.7) and increased in men, RR 2.3(95% CI 2.0-2.7), compared to the Lichtenstein technique. Discussion: The reoperation for recurrence rate differed significantly between men and women. As regards the technique used for primary repair, laparoscopic groin hernia repair lowered the risk of reoperation for recurrence in women whereas it doubled the risk in men. (C) 2017 Elsevier Inc. All rights reserved.
|
|
| 5. |
|
|
| 6. |
- Goonawardena, J., et al.
(author)
-
Predicting conversion from laparoscopic to open cholecystectomy presented as a probability nomogram based on preoperative patient risk factors
- 2015
-
In: American Journal of Surgery. - : Elsevier BV. - 0002-9610. ; 210:3, s. 492-500
-
Journal article (peer-reviewed)abstract
- BACKGROUND: We aim to develop a risk stratification tool to preoperatively predict conversion (CONV) from a laparoscopic to open cholecystectomy. METHODS: Multiple risk factors were analyzed with multivariate logistic regression and presented as probability nomograms. RESULTS: Of 732 patients, 47 (6.4%) required CONV. Among 40 preoperative risk factors evaluated, 5 variables were found to have significant association with CONV: 2 clinical variables, previous upper abdominal surgery (odds ratio [OR] 95.2) and obesity defined as body mass index greater than 30 kg/m(2) (OR 12.3), and 3 ultrasound parameters, visible choledocholithiasis (OR 19.8), impacted stone at the neck of the gallbladder (OR 5.9), and gallbladder wall width in millimeters (OR 2.1). No-mograms based on this multivariate model demonstrate the individual preoperative probability of CONV. Internal validation using receiver operator curve analysis showed an area under the curve of .97. CONCLUSION: Four probability nomograms were developed as a practical individual risk stratification tool to predict probability of CONV. (C) 2015 Elsevier Inc. All rights reserved.
|
|
| 7. |
- Hu, A. S. Y., et al.
(author)
-
External validation of the Cairns Prediction Model (CPM) to predict conversion from laparoscopic to open cholecystectomy
- 2018
-
In: American Journal of Surgery. - : Elsevier BV. - 0002-9610. ; 216:5, s. 949-954
-
Journal article (peer-reviewed)abstract
- Background: Valid and user-friendly prediction models for conversion to open cholecystectomy allow for proper planning prior to surgery. The Cairns Prediction Model (CPM) has been in use clinically in the original study site for the past three years, but has not been tested at other sites. Methods: A retrospective, single-centred study collected ultrasonic measurements and clinical variables alongside with conversion status from consecutive patients who underwent laparoscopic cholecystectomy from 2013 to 2016 in The Townsville Hospital, North Queensland, Australia. An area under the curve (AUC) was calculated to externally validate of the CPM. Results: Conversion was necessary in 43 (4.2%) out of 1035 patients. External validation showed an area under the curve of 0.87 (95% CI 0.82-0.93, p = 1.1 x 10(-14)). Conclusions: In comparison with most previously published models, which have an AUC of approximately 0.80 or less, the CPM has the highest AUC of all published prediction models both for internal and external validation.
|
|
| 8. |
- Hu, A. S. Y., et al.
(author)
-
Risk factors for conversion of laparoscopic cholecystectomy to open surgery - A systematic literature review of 30 studies
- 2017
-
In: American Journal of Surgery. - : Elsevier BV. - 0002-9610. ; 214:5, s. 920-930
-
Research review (peer-reviewed)abstract
- Background: The study aims to evaluate the methodological quality of publications relating to predicting the need of conversion from laparoscopic to open cholecystectomy and to describe identified prognostic factors. Method: Only English full-text articles with their own unique observations from more than 300 patients were included. Only data using multivariate analysis of risk factors were selected. Quality assessment criteria stratifying the risk of bias were constructed and applied. Results: The methodological quality of the studies were mostly heterogeneous. Most studies performed well in half of the quality criteria and considered similar risk factors, such as male gender and old age, as significant. Several studies developed prediction models for risk of conversion. Independent risk factors appeared to have additive effects. Conclusion: A detailed critical review of studies of prediction models and risk stratification for conversion from laparoscopic to open cholecystectomy is presented. One study is identified of high quality with a potential to be used in clinical practice, and external validation of this model is recommended. (C) 2017 The Authors. Published by Elsevier Inc.
|
|
| 9. |
- Jeremiasen, Martin, et al.
(author)
-
Thoracoabdominal gastrectomy and distal 2/3 esophageal resection with wide lymph node dissection for type II and III adenocarcinoma at the gastro-esophageal junction
- 2019
-
In: The American Journal of Surgery. - : Elsevier BV. - 0002-9610. ; 218:2, s. 329-334
-
Journal article (peer-reviewed)abstract
- Background: For locally advanced Siewert type II and III tumors we have performed total gastrectomy including resection of the distal 2/3 of the esophagus, through separate abdominal and right chest incisions (THX-ABD). The procedure involves wide lymphadenectomy in the abdomen/chest and a Roux-en-Y jejunostomy to the level of the azygos vein or above. The aim of the study was to investigate short- and long-term results for this rarely used procedure. Methods: Retrospective study of 83 radio-chemotherapy naïve patients with adenocarcinoma at the gastro-esophageal junction (Siewert type II n = 65 and type III n = 18) operated upon 1986–2011. Results: 2/83 (2.4%) patients died in hospital. 70/83 (84%) patients had R0-resections. 82/83 (99%) patients had free longitudinal resection margins. Overall 5-year survival was 22/83 (27%). Conclusion: THX-ABD can be performed with high rates of R0 resections and with low in-hospital mortality. Long-term survival rate was not better compared with less extensive surgical procedures.
|
|
