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Adherence to national guidelines for surveillance after curative resection of nonmetastatic colon and rectum cancer: a survey among Norwegian gastrointestinal surgeons.

https://arctichealth.org/en/permalink/ahliterature133589
Source
Colorectal Dis. 2012 Mar;14(3):320-4
Publication Type
Article
Date
Mar-2012
Author
K. Søreide
J H Træland
P J Stokkeland
T. Glomsaker
J A Søreide
H. Kørner
Author Affiliation
Department of Surgery, Stavanger University Hospital, Stavanger, Norway. ksoreide@mac.com
Source
Colorectal Dis. 2012 Mar;14(3):320-4
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Colonic Neoplasms - diagnosis - surgery
Guideline Adherence - statistics & numerical data
Health Care Surveys
Hospitals - statistics & numerical data
Humans
Neoplasm Metastasis - diagnosis
Neoplasm Recurrence, Local - diagnosis
Norway
Physician's Practice Patterns - statistics & numerical data
Population Surveillance
Practice Guidelines as Topic
Rectal Neoplasms - diagnosis - surgery
Abstract
National guidelines recommend enrollment of patients in surveillance programmes following curative resection of colorectal carcinoma (CRC) in order to detect recurrence or distant metastasis at an asymptomatic/early stage when secondary curative treatment can be offered. Little is known about surgeons' adherence to such guidelines. In this national survey we analyse adherence and attitudes to postoperative follow up among Norwegian gastrointestinal surgeons involved in the care of patients with CRC.
We performed a nationwide survey of all hospitals performing surgery for colon and/or rectum cancer. The presence of a surveillance programme, the type of programme, adherence to national guidelines or report on any deviation thereof, location of follow up at the hospital or with a general practitioner (GPs) and the estimated annual volume of surgery were queried through mail and telephone.
All hospitals (n=41) performing colorectal surgery responded, of which 25 (61%) conducted postoperative follow up by surgeons in the hospital outpatient clinics, four (10%) carried out follow up with a combination of hospital outpatient visits and visits to GPs, and 12 (29%) referred surveillance to the GP alone. For total reported patient numbers, almost two-thirds (60%) received surveillance according to national recommendations through outpatient visits with the surgeon or GP, while one-third (37%) were subject to other alternative routines. A small number (2%) received informal 'ad hoc' surveillance only. More liberal use of imaging outside guideline recommendations was reported for rectal cancer patients, while colon cancer patients treated in larger hospitals were more likely to be referred for GP surveillance.
All hospitals reported having a strategy for surveillance after surgery for colon and rectal cancer, but there was considerable variance in strategy. A scientific audit of the true level of compliance, effectiveness and cost-benefit is warranted at a national level.
PubMed ID
21689321 View in PubMed
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Diagnostic accuracy of inflammatory markers in patients operated on for suspected acute appendicitis: a receiver operating characteristic curve analysis.

https://arctichealth.org/en/permalink/ahliterature33201
Source
Eur J Surg. 1999 Jul;165(7):679-85
Publication Type
Article
Date
Jul-1999
Author
H. Körner
J A Söreide
K. Söndenaa
Author Affiliation
Department of Surgery, Rogaland Central Hospital, Stavanger, Norway.
Source
Eur J Surg. 1999 Jul;165(7):679-85
Date
Jul-1999
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Appendicitis - diagnosis - pathology - surgery
Appendix - pathology
Child
Child, Preschool
Confidence Intervals
Diagnosis, Differential
Female
Humans
Logistic Models
Male
Middle Aged
Prospective Studies
ROC Curve
Reproducibility of Results
Abstract
OBJECTIVE: To analyse the diagnostic accuracy of inflammatory variables in patients operated on for suspected acute appendicitis. DESIGN: Open prospective population based study. SETTING: Teaching hospital, Norway. INTERVENTIONS: Appendicectomy in 544 patients with clinically suspected acute appendicitis. MAIN OUTCOME MEASURES: Diagnostic accuracy of inflammatory variables using receiver operating characteristic (ROC) curve analysis. Logistic regression model of inflammatory variables using results of ROC-analysis. RESULTS: A small area under the ROC curve (AUC) (between 0.56 and 0.69) indicated less diagnostic accuracy. The best cut-off values were associated with low sensitivity and specificity, varying from 46% to 88%. Age, duration of history, and histological grade of inflammation significantly influenced the test results (AUC >0.5). The white cell count (WCC) and C-reactive protein (CRP) concentration were independent predictors of acute appendicitis with cut-off values of >12.3x10(9)/L and >0 mg/L, respectively, but AUC values of over 0.5 were observed only in patients between 13 and 40 years of age. CONCLUSION: Inflammatory variables added information of limited value in the diagnosis of suspected acute appendicitis. The test results should be interpreted differently in different groups of patients.
PubMed ID
10452263 View in PubMed
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Incidence of acute nonperforated and perforated appendicitis: age-specific and sex-specific analysis.

https://arctichealth.org/en/permalink/ahliterature34356
Source
World J Surg. 1997 Mar-Apr;21(3):313-7
Publication Type
Article
Author
H. Körner
K. Söndenaa
J A Söreide
E. Andersen
A. Nysted
T H Lende
K H Kjellevold
Author Affiliation
Department of Surgery, Rogaland Central Hospital, Armauer Hansensvei 20, P.O. Box 8100, N-4003 Stavanger, Norway.
Source
World J Surg. 1997 Mar-Apr;21(3):313-7
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Age Distribution
Aged
Appendectomy
Appendicitis - diagnosis - epidemiology - surgery
Child
Child, Preschool
Cohort Studies
Female
Humans
Incidence
Intestinal Perforation - diagnosis - epidemiology - surgery
Male
Middle Aged
Norway - epidemiology
Prospective Studies
Rupture, Spontaneous
Sex Distribution
Time Factors
Abstract
This prospective study was performed to investigate epidemiological characteristics in terms of the age- and sex-specific incidence in patients with perforated and nonperforated appendicitis. The study population comprised 1486 consecutive patients who underwent appendectomy for suspected acute appendicitis between 1989 and 1993. Two patient cohorts [n = 544 (37%)] were analyzed with regard to prehospitalization duration of symptoms and in-hospital observation time. The crude incidence of acute appendicitis was 86 per 100,000 per year. Although the incidence of nonperforated appendicitis was highest among adolescents and young adults (13-40 years of age), perforated appendicitis occurred at almost the same incidence in all sex and age groups. The diagnostic accuracy was 76%. Perforated appendicitis occurred in 19%, with higher rates in small children and the elderly, irrespective of gender. A high diagnostic accuracy was not associated with an increased rate of perforation. In small children and the elderly, the diagnostic accuracy was low and the perforation rate high. Patients with perforation had a significantly longer duration of symptoms as well as in-hospital observation time than did patients with nonperforated appendicitis. Perforated appendicitis showed a different incidence pattern than nonperforated appendicitis and was associated with a significantly longer duration of symptoms and in-hospital observation time, probably due to patient-related factors. We suggest this observation deserves attention regarding clinical diagnosis and treatment decision-making for patients with suspected acute appendicitis.
PubMed ID
9015177 View in PubMed
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Long-term follow-up of 1059 consecutive primary and recurrent inguinal hernias in a teaching hospital.

https://arctichealth.org/en/permalink/ahliterature32284
Source
Eur J Surg. 2001 Feb;167(2):125-9
Publication Type
Article
Date
Feb-2001
Author
K. Søndenaa
I. Nesvik
K. Breivik
H. Kørner
Author Affiliation
Department of Surgery, Rogaland Central Hospital, Stavanger, Norway. kasoende@online.no
Source
Eur J Surg. 2001 Feb;167(2):125-9
Date
Feb-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Comparative Study
Female
Follow-Up Studies
Hernia, Inguinal - epidemiology - physiopathology - surgery
Hospitals, Teaching - statistics & numerical data
Humans
Incidence
Male
Middle Aged
Norway - epidemiology
Pain Measurement
Postoperative Complications - epidemiology
Probability
Recurrence
Reoperation - statistics & numerical data
Research Support, Non-U.S. Gov't
Retrospective Studies
Risk assessment
Statistics, nonparametric
Time Factors
Treatment Outcome
Abstract
OBJECTIVE: To study the early and late outcome of various methods of inguinal hernia repair. DESIGN: Retrospective study. SETTING: Teaching hospital, Norway. SUBJECTS: 1059 repairs of inguinal hernias in men and women by 43 surgeons. INTERVENTIONS: Analysis of patients charts, results of questionnaires concerning 712 hernias (67%) and follow-up consultations when needed. MAIN OUTCOME MEASURES: Freedom from recurrence and postoperative groin symptoms after repairs of primary and recurrent hernias. RESULTS: After a median follow-up of 5.5 years, range 3-8, the recurrence rate was 8% for primary repairs and 29% after recurrent hernias. The incidence of permanent pain or discomfort was unexpectedly high, being 11% after primary repairs and 15% after recurrent hernia repairs. CONCLUSIONS: The number of recurrences at long-term follow-up after repairs of primary and recurrent inguinal hernias was unsatisfactory. The extent of postoperative pain was surprising as this was not given enough attention during the learning period. We have introduced a uniform treatment policy with a prospective surveillance programme with the aim of improving results in our teaching programme.
PubMed ID
11266252 View in PubMed
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The New National Registry for Gastrointestinal Surgery in Norway: NoRGast.

https://arctichealth.org/en/permalink/ahliterature296886
Source
Scand J Surg. 2018 Sep; 107(3):201-207
Publication Type
Journal Article
Date
Sep-2018
Author
K Lassen
L S Nymo
H Kørner
K Thon
T Grindstein
H H Wasmuth
T Moger
B A Bjørnbeth
S Norderval
M T Eriksen
A Viste
Author Affiliation
1 Gastrointestinal Surgery, University Hospital of North Norway, Tromsø, Norway.
Source
Scand J Surg. 2018 Sep; 107(3):201-207
Date
Sep-2018
Language
English
Publication Type
Journal Article
Keywords
Digestive System Diseases - epidemiology - surgery
Digestive System Surgical Procedures - statistics & numerical data
Humans
Norway - epidemiology
Quality Improvement - statistics & numerical data
Registries - statistics & numerical data
Abstract
There is an increasing demand for high-quality data for the outcome of health care. Diseases of the gastro-intestinal tract involve large patient groups often presenting with serious or life-threatening conditions. Complications may affect treatment outcomes and lead to increased mortality or reduced quality of life. A continuous, risk-adjusted monitoring of major complications is important to improve the quality of health care to patients undergoing gastrointestinal resections. We present the development of the Norwegian Registry for Gastrointestinal Surgery, a national registry for colorectal, upper gastrointestinal, and hepato-pancreato-biliary resections in Norway.
A narrative and qualitative presentation of the development and current state of the registry.
We present the variables and the analysis tools and provide examples for the potential in quality improvement and research. Core characteristics include a strictly limited set of variables to reflect important risk factors, the procedure performed, and the clinical outcomes.
A registry with the potential to present complete national cohort data is a powerful tool for quality improvement and research.
PubMed ID
29628007 View in PubMed
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One-year results of the SCANDIV randomized clinical trial of laparoscopic lavage versus primary resection for acute perforated diverticulitis.

https://arctichealth.org/en/permalink/ahliterature285324
Source
Br J Surg. 2017 Sep;104(10):1382-1392
Publication Type
Article
Date
Sep-2017
Author
J K Schultz
C. Wallon
L. Blecic
H M Forsmo
J. Folkesson
P. Buchwald
H. Kørner
F A Dahl
T. Øresland
S. Yaqub
Source
Br J Surg. 2017 Sep;104(10):1382-1392
Date
Sep-2017
Language
English
Publication Type
Article
Keywords
Aged
Diverticulitis, Colonic - surgery
Female
Humans
Intestinal Perforation - surgery
Laparoscopy - adverse effects - methods
Male
Middle Aged
Norway
Peritoneal Lavage - adverse effects - methods
Postoperative Complications
Reoperation
Risk factors
Surgical Stomas - adverse effects
Sweden
Treatment Outcome
Abstract
Recent randomized trials demonstrated that laparoscopic lavage compared with resection for Hinchey III perforated diverticulitis was associated with similar mortality, less stoma formation but a higher rate of early reintervention. The aim of this study was to compare 1-year outcomes in patients who participated in the randomized Scandinavian Diverticulitis (SCANDIV) trial.
Between February 2010 and June 2014, patients from 21 hospitals in Norway and Sweden presenting with suspected perforated diverticulitis were enrolled in a multicentre RCT comparing laparoscopic lavage and sigmoid resection. All patients with perforated diverticulitis confirmed during surgery were included in a modified intention-to-treat analysis of 1-year results.
Of 199 enrolled patients, 101 were assigned randomly to laparoscopic lavage and 98 to colonic resection. Perforated diverticulitis was confirmed at the time of surgery in 89 and 83 patients respectively. Within 1 year after surgery, neither severe complications (34 versus 27 per cent; P = 0·323) nor disease-related mortality (12 versus 11 per cent) differed significantly between the lavage and surgery groups. Among the 144 patients with purulent peritonitis, the rate of severe complications (27 per cent (20 of 74) versus 21 per cent (15 of 70) respectively; P = 0·445) and disease-related mortality (8 versus 9 per cent) were similar. Laparoscopic lavage was associated with more deep surgical-site infections (32 versus 13 per cent; P = 0·006) but fewer superficial surgical-site infections (1 versus 17 per cent; P = 0·001). More patients in the lavage group underwent unplanned reoperations (27 versus 10 per cent; P = 0·010). Including stoma reversals, a similar proportion of patients required a secondary operation (28 versus 29 per cent). The stoma rate at 1 year was lower in the lavage group (14 versus 42 per cent in the resection group; P
PubMed ID
28631827 View in PubMed
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Perforated and non-perforated acute appendicitis--one disease or two entities?

https://arctichealth.org/en/permalink/ahliterature31978
Source
Eur J Surg. 2001 Jul;167(7):525-30
Publication Type
Article
Date
Jul-2001
Author
H. Körner
K. Söndenaa
J A Söreide
Author Affiliation
Department of Surgery, Rogaland Central Hospital, Stavanger, Norway.
Source
Eur J Surg. 2001 Jul;167(7):525-30
Date
Jul-2001
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Aged
Aged, 80 and over
Appendicitis - diagnosis
Child
Child, Preschool
Female
Humans
Intestinal Perforation - diagnosis
Logistic Models
Male
Middle Aged
Prospective Studies
ROC Curve
Research Support, Non-U.S. Gov't
Abstract
OBJECTIVE: To analyse the pattern of clinical presentation of perforated and non-perforated acute appendicitis in 544 unselected patients treated surgically for suspected acute appendicitis; to find out if their presentation differed. DESIGN: Open prospective population-based study. SETTING: Teaching hospital, western Norway. PATIENTS: All 434 patients operated on for suspected acute appendicitis from the catchment area of a single hospital in whom the diagnosis was confirmed. INTERVENTIONS: Appendicectomy; history, clinical findings, and inflammatory markers were recorded in all patients. MAIN OUTCOME MEASURES: Odds Ratio (OR) and 95% confidence interval (CI) obtained by logistic regression analysis of symptoms and signs of acute appendicitis with regard to independent predictors of perforation of the appendix. Receiver operating characteristic (ROC) curve analysis of inflammatory markers. RESULTS: The perforation rate was 20% (n = 88). Perforation was unlikely when abdominal pain was limited to the right iliac fossa, (OR 0.13, 95% CI 0.05 to 0.33). Increased C-reactive protein (CRP) concentration >50 U/L (OR 4.6, 95% Cl 2.44 to 8.75) and greater age (by decade; OR 1.18, 95% CI 1.02 to 1.36) were independent predictors of perforation of the appendix. CONCLUSIONS: Clinical differences between perforated and non-perforated acute appendicitis could be explained by the presence of advanced inflammation in patients with perforated appendicitis. Our data do not support the hypothesis that they are two clinically different diseases.
PubMed ID
11560388 View in PubMed
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Risk factors associated with poor lymph node harvest after colon cancer surgery in a national cohort.

https://arctichealth.org/en/permalink/ahliterature114781
Source
Colorectal Dis. 2013 Jun;15(6):e301-8
Publication Type
Article
Date
Jun-2013
Author
B S Nedrebø
K. Søreide
A. Nesbakken
M T Eriksen
J A Søreide
H. Kørner
Author Affiliation
Department of Surgery, Stavanger University Hospital, Stavanger, Norway. nedreboe@me.com
Source
Colorectal Dis. 2013 Jun;15(6):e301-8
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - pathology - surgery
Age Factors
Aged
Cohort Studies
Colonic Neoplasms - pathology - surgery
Female
Humans
Logistic Models
Lymph Node Excision - standards - statistics & numerical data
Lymph Nodes - pathology - surgery
Male
Middle Aged
Multivariate Analysis
Neoplasm Staging
Norway
Risk factors
Sex Factors
Sigmoid Neoplasms - pathology - surgery
Abstract
Evaluation of = 12 lymph nodes (LNs) is recommended after surgery for colon cancer. A harvest of = 8 is considered poor, but few reports have evaluated risk factors associated with a poor harvest. This aims of this study were to analyse the clinical, surgical and pathological factors associated with poor LN harvest (LNH), the total number of examined nodes and the effect of LN number on stage.
All patients reported to the Norwegian Colorectal Cancer Registry during 2007 and 2008 who underwent curative resection for Stage I-III colon cancer were studied. Risk factors for poor LNH and the proportion of Stage III disease were analysed by univariate and multivariate analyses.
A total of 2879 patients were included in the study. The median LNH was 14. Overall, 69.9% had = 12 lymph nodes and 14.4% had = 8 LN (poor harvest). Multivariate analysis showed that male sex, age > 75 years, sigmoid tumours, pT category 1-2, failure to use the pathology report template and distance of = 5 cm from the bowel resection margin were all independent factors for poor LNH. Age
PubMed ID
23582027 View in PubMed
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Stability in incidence of acute appendicitis. A population-based longitudinal study.

https://arctichealth.org/en/permalink/ahliterature32296
Source
Dig Surg. 2001;18(1):61-6
Publication Type
Article
Date
2001
Author
H. Körner
J A Söreide
E J Pedersen
T. Bru
K. Söndenaa
L. Vatten
Author Affiliation
Department of Surgery, Rogaland Central Hospital, Stavanger, Norway.
Source
Dig Surg. 2001;18(1):61-6
Date
2001
Language
English
Publication Type
Article
Keywords
Acute Disease
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Appendectomy - statistics & numerical data
Appendicitis - diagnosis - epidemiology - surgery
Child
Child, Preschool
Confidence Intervals
Female
Humans
Incidence
Longitudinal Studies
Male
Middle Aged
Norway - epidemiology
Probability
Prospective Studies
Research Support, Non-U.S. Gov't
Risk factors
Sex Distribution
Abstract
BACKGROUND/AIM OF THE STUDY: During the past 50 years, a decrease in incidence of appendicitis has been reported. The various studies were retrospective and based on different data sources. In the present study, we analyze prospectively the incidence of acute appendicitis during a 10-year period in a well defined population of 265,000. METHODS: Prospective registration of all operations performed in patients with suspected acute appendicitis in the catchment area of a single institution. The diagnosis of acute appendicitis was based on histology in all cases. The annual incidence of acute appendicitis was calculated with regard to nonperforated and perforated acute appendicitis. MAIN RESULTS: Between 1989 and 1998, 2,861 patients underwent surgery for suspected acute appendicitis. In 2,232 (78%) patients, acute appendicitis was confirmed histologically. Mean annual incidence was 84/100,000 (95% confidence interval 80 to 88/100,000). Crude incidence remained stable during the study period, with the exception of a significant increase in 1991 followed by a significant decrease the next year. Nonperforated acute appendicitis showed a different incidence pattern as compared to perforated acute appendicitis. CONCLUSION: In our prospective study, the incidence of acute appendicitis remained stable in our well-defined study population during the study period of 10 years. This is in contrast to the majority of studies during the last decades.
PubMed ID
11244262 View in PubMed
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Survival effect of implementing national treatment strategies for curatively resected colonic and rectal cancer.

https://arctichealth.org/en/permalink/ahliterature136825
Source
Br J Surg. 2011 May;98(5):716-23
Publication Type
Article
Date
May-2011
Author
B S Nedrebø
K. Søreide
M T Eriksen
L M Dørum
J T Kvaløy
J A Søreide
H. Kørner
Author Affiliation
Department of Surgery, Stavanger University Hospital, Stavanger, Norway; Department of Surgical Sciences, University of Bergen, Bergen, Norway.
Source
Br J Surg. 2011 May;98(5):716-23
Date
May-2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Colonic Neoplasms - mortality - surgery
Female
Humans
Lymphatic Metastasis
Male
Middle Aged
Norway - epidemiology
Practice Guidelines as Topic
Rectal Neoplasms - mortality - surgery
Registries
Survival Analysis
Treatment Outcome
Abstract
The surgical management of rectal cancer has changed substantially over the past decade. There are limited data on the long-term outcome of implementing systematic management strategies.
Survival of a national cohort of patients treated surgically for colonic and rectal cancer over a 10-year interval was analysed. All 31 158 patients in Norway diagnosed with adenocarcinoma of the colon and rectum between 1994 and 2003 were identified from the Cancer Registry of Norway and the Norwegian Rectal Cancer Registry. Changes in 5-year relative survival were compared by age, stage and tumour location during the early and late years.
The study population included 19 053 patients who had a curative resection. The relative 5-year survival rate significantly improved for both colonic cancer (73·8 versus 78·0 per cent; P
PubMed ID
21341253 View in PubMed
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10 records – page 1 of 1.