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112 records – page 1 of 12.

Association between surgical delay and survival in high-risk emergency abdominal surgery. A population-based Danish cohort study.

https://arctichealth.org/en/permalink/ahliterature275068
Source
Scand J Gastroenterol. 2016 Jan;51(1):121-8
Publication Type
Article
Date
Jan-2016
Author
Morten Vester-Andersen
Lars Hyldborg Lundstrøm
David Levarett Buck
Morten Hylander Møller
Source
Scand J Gastroenterol. 2016 Jan;51(1):121-8
Date
Jan-2016
Language
English
Publication Type
Article
Keywords
Abdomen - surgery
Aged
Aged, 80 and over
Cohort Studies
Denmark
Emergencies
Female
Hospitalization - statistics & numerical data
Humans
Laparoscopy - methods
Laparotomy - methods
Logistic Models
Male
Middle Aged
Odds Ratio
Outcome Assessment (Health Care)
Registries
Risk factors
Surgical Procedures, Operative - mortality
Time Factors
Abstract
In patients with perforated peptic ulcer, surgical delay has recently been shown to be a critical determinant of survival. The aim of the present population-based cohort study was to evaluate the association between surgical delay by hour and mortality in high-risk patients undergoing emergency abdominal surgery in general.
All in-patients aged = 18 years having emergency abdominal laparotomy or laparoscopy performed within 48 h of admission between 1 January 2009 and 31 December 2010 in 13 Danish hospitals were included. Baseline and clinical data, including surgical delay and 90-day mortality were collected. The crude and adjusted association between surgical delay by hour and 90-day mortality was assessed by binary logistic regression.
A total of 2803 patients were included. Median age (interquartile range [IQR]) was 66 (51-78) years, and 515 patients (18.4%) died within 90 days of surgery. Over the first 24 h after hospital admission, each hour of surgical delay beyond hospital admission was associated with a median (IQR) decrease in 90-day survival of 2.2% (1.9-3.3%). No statistically significant association between surgical delay by hour and 90-day mortality was shown; crude and adjusted odds ratio with 95% confidence interval 1.016 (1.004-1.027) and 1.003 (0.989-1.017), respectively. Sensitivity analyses confirmed the primary finding.
In the present population-based cohort study of high-risk patients undergoing emergency abdominal surgery, no statistically significant adjusted association between mortality and surgical delay was found. Additional research in diagnosis-specific subgroups of high-risk patients undergoing emergency abdominal surgery is warranted.
PubMed ID
26153059 View in PubMed
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[A video archive on the Internet for dissemination of knowledge of minimally invasive techniques].

https://arctichealth.org/en/permalink/ahliterature181071
Source
Lakartidningen. 2004 Feb 12;101(7):561-2
Publication Type
Article
Date
Feb-12-2004
Author
Lars-Göran Larsson
Author Affiliation
Sektionen för övre gastrointestinal kirurgi, Universitetssjukhuset, Orebro. lars-goran.larsson@orebroll.se
Source
Lakartidningen. 2004 Feb 12;101(7):561-2
Date
Feb-12-2004
Language
Swedish
Publication Type
Article
Keywords
Archives
Diffusion of Innovation
General Surgery - education
Humans
Internet
Laparoscopy - methods
Patient Education as Topic
Surgical Procedures, Minimally Invasive - education - methods
Sweden
Videotape Recording
PubMed ID
15024863 View in PubMed
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Changes in end-tidal carbon dioxide during gynecologic laparoscopy: spontaneous versus controlled ventilation.

https://arctichealth.org/en/permalink/ahliterature54901
Source
J Clin Anesth. 1994 May-Jun;6(3):199-203
Publication Type
Article
Author
M. Vegfors
L. Engborg
A. Gupta
C. Lennmarken
Author Affiliation
Department of Anesthesiology, University Hospital, Linköping, Sweden.
Source
J Clin Anesth. 1994 May-Jun;6(3):199-203
Language
English
Publication Type
Article
Keywords
Adult
Anesthesia, Inhalation
Anesthesia, Intravenous
Carbon Dioxide - administration & dosage - analysis - blood
Cardiac Complexes, Premature - etiology
Female
Fentanyl - administration & dosage
Genitalia, Female - surgery
Humans
Hypertension - etiology
Insufflation
Intubation, Intratracheal
Isoflurane - administration & dosage
Laparoscopy - methods
Monitoring, Physiologic
Nitrous Oxide - administration & dosage
Respiration - physiology
Respiration, Artificial
Tidal Volume
Abstract
STUDY OBJECTIVE: To study the changes in PETCO2 during spontaneous and controlled ventilation in patients undergoing gynecologic laparoscopy. DESIGN: Randomized, unblinded study. SETTING: Department of Gynecology, University Hospital, Linköping, Sweden; Central Hospital, Norrköping, Sweden. PATIENTS: Forty healthy patients undergoing gynecologic laparoscopy. INTERVENTIONS: Patients were divided into 4 groups: Group 1 breathed spontaneously via an endotracheal tube, while the other three groups underwent controlled ventilation to an initial PETCO2 of 3 kPa (22 mmHg) (Group 2), 4 kPa (30 mmHg) (Group 3), or 5 kPa (37 mmHg) (Group 4). MEASUREMENTS AND MAIN RESULTS: PETCO2 levels were measured at fixed time intervals. Arterial blood gas analyses were done to compare the difference between PETCO2 and PaCO2. In Group 1, PETCO2 increased soon after insufflation and remained above 6 kPa (44 mmHg) throughout the procedure. In Groups 2, 3, and 4, PETCO2 also rose after insufflation, and an initial PETCO2 of 4 kPa (30 mmHg) was ideal, as all PETCO2 values were less than 5.5 kPa (41 mmHg). Occasional episodes of arrhythmia were seen in Group 1. However, no major adverse effects were observed in any of the groups. CONCLUSIONS: In view of the high PETCO2 levels, spontaneous breathing should be avoided during gynecologic laparoscopy, and ventilation to an initial PETCO2 of 4 kPa (30 mmHg) is recommended during controlled ventilation.
PubMed ID
7520257 View in PubMed
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Complications in Laparoscopic Versus Open Incisional Ventral Hernia Repair. A Retrospective Comparative Study.

https://arctichealth.org/en/permalink/ahliterature274103
Source
World J Surg. 2015 Dec;39(12):2872-7
Publication Type
Article
Date
Dec-2015
Author
Mirella Ahonen-Siirtola
Tero Rautio
Jaana Ward
Jyrki Kössi
Pasi Ohtonen
Jyrki Mäkelä
Source
World J Surg. 2015 Dec;39(12):2872-7
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Anastomosis, Surgical - adverse effects
Female
Finland
Hernia, Ventral - surgery
Herniorrhaphy - methods
Humans
Intestines - surgery
Laparoscopy - methods
Length of Stay
Male
Middle Aged
Postoperative Complications
Postoperative Period
Retrospective Studies
Risk
Surgical Wound Infection - etiology
Tissue Adhesions - complications
Abstract
The objective of the study was to evaluate peri- and postoperative outcomes, especially severe complications in adult incisional ventral hernia repair performed by open or laparoscopic surgery.
Adult patients who were operated for incisional ventral hernias in two tertiary hospitals in Finland during 2006-2012 were included in the study. Clinical data were collected from patient registers. Peri- and postoperative parameters were gathered and compared between open and laparoscopic groups. Postoperative complications were analyzed, and the focus was on major complications.
The results of 818 hernioplasties were evaluated: 291 (36.3 %) open and 527 (63.7 %) laparoscopic operations. In the laparoscopic group, the number of patients with postoperative complications was slightly lower (18.4 vs. 23.4 %, p = 0.090), and there were significantly fewer surgical site infections (3.2 vs. 8.6 %, p = 0.001). Twelve major complications occurred. In the laparoscopic group, four of the five major complications were consequences of undetected enterotomies, leading to reoperations, longer hospital stays, and death of one patient. Major complications in the open group consisted of four cardiac infarctions and three septic surgical site infections. Complex adhesions had a significant influence on major complications, enterotomies, and surgical site infections. Laparoscopic operations had a lower mean blood loss (13 vs. 31.5 ml, p = 0.028), and hospital stay (4 vs. 6 days, p = 0.001) compared to open operations.
Laparoscopic incisional ventral hernia repair has a low rate of postoperative complications but it is associated with an increased risk of undetected enterotomies, in particular during cases involving adhesiolysis.
PubMed ID
26296841 View in PubMed
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Current status of laparoscopic inguinal hernia repair in Denmark.

https://arctichealth.org/en/permalink/ahliterature156457
Source
Hernia. 2008 Dec;12(6):583-7
Publication Type
Article
Date
Dec-2008
Author
J. Rosenberg
M. Bay-Nielsen
Author Affiliation
Surgical Department D, Gentofte and Herlev Hospital, University of Copenhagen, Niels Andersens Vej 65, DK-2900, Hellerup, Denmark. jaro@geh.regionh.dk
Source
Hernia. 2008 Dec;12(6):583-7
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Denmark
General Surgery - education
Hernia, Inguinal - surgery
Humans
Laparoscopy - methods - utilization
Questionnaires
Abstract
Laparoscopic inguinal hernia repair is becoming more common in many countries, but the quality of care, experience of the operating surgeon, and details of the surgical technique are not known in detail on a national level in Denmark. In a period of expanding surgical volume for laparoscopic inguinal hernia repair, it is important to know the typical indications for surgery, re-operation rates, details of surgical technique, and status of surgical training on a national level in order to rationalize interventions to improve outcome.
Data from the National Hernia Database for the last 8 years regarding laparoscopic inguinal hernia repair were used in combination with questionnaire data obtained from all surgical units in Denmark. The questionnaire included issues such as the number of operating surgeons in the department, number of residents training in the laparoscopic technique, and the experience level of the most experienced surgeon in the department regarding laparoscopic inguinal hernia repair. The questionnaire also included details of the surgical technique.
The frequency of laparoscopic repair has been increasing over the last 8 years and now accounts for about 16% of the total number of inguinal herniorrhaphies with the main indication nationwide being bilateral hernias and recurrent hernias. We found slight variations in surgical technique although all departments used the TAPP repair. The majority used adequate mesh sizes at or above 10 x 15 cm, and most departments used coils or tacks for mesh fixation and peritoneal closure. Fifteen of 25 departments had only one or two surgeons performing laparoscopic inguinal hernia repair and 12 of 25 departments did not have any young surgeons in training for laparoscopic inguinal hernia repair. Ten departments had one surgeon in training, and three departments had two surgeons in training.
Laparoscopic inguinal hernia repair in Denmark is increasing in prevalence. Indications for surgery as well as operative techniques differ although all departments use the TAPP technique. Few surgeons are currently learning the laparoscopic technique, and it is therefore important to initiate meetings and courses to ensure uniform indications for surgery and operative techniques throughout the country.
PubMed ID
18584280 View in PubMed
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[Current trends in surgical treatment of peritonitis].

https://arctichealth.org/en/permalink/ahliterature159601
Source
Khirurgiia (Mosk). 2007;(11):36-9
Publication Type
Article
Date
2007
Author
V P Sazhin
A L Avdovenko
V A Iurishchev
Source
Khirurgiia (Mosk). 2007;(11):36-9
Date
2007
Language
Russian
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Animals
Disease Models, Animal
Dogs
Drainage - methods
Female
Follow-Up Studies
Humans
Laparoscopy - methods - trends
Laparotomy - methods - trends
Male
Middle Aged
Peritonitis - diagnosis - mortality - surgery
Retrospective Studies
Russia - epidemiology
Severity of Illness Index
Survival Rate - trends
Treatment Outcome
Abstract
Results of treatment using laparoscopic operations, traditional laparotomy with passive abdominal drainage and laparostomy at 1835 patients with peritonitis are analyzed. It is demonstrated that choice of surgical policy depends on ethiology, generalization of peritonitis, abdominal microphlora, degree of endogenous intoxication and organs failure, prognosis of disease. Lethality after laparoscopic operations was 1.8%, after traditional laparotomy--3.4%, after laparostomy--47.7%. Lethality at local peritonitis was 1.3%, at generalized--13.8%, at postoperative--22%. General lethality was 7.4%. Experimental studies on 55 mongrel dogs demonstrated the advantage of mechanical suture at peritonitis that prevents insufficiency of anastomoses.
PubMed ID
18163121 View in PubMed
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Danish surgeons' views on minimally invasive surgery.

https://arctichealth.org/en/permalink/ahliterature260151
Source
J Laparoendosc Adv Surg Tech A. 2014 Jan;24(1):1-7
Publication Type
Article
Date
Jan-2014
Author
Hellen Edwards
Lars Nannestad Jørgensen
Source
J Laparoendosc Adv Surg Tech A. 2014 Jan;24(1):1-7
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Adult
Attitude of Health Personnel
Cholecystectomy - methods
Denmark
Endoscopy, Gastrointestinal - utilization
Female
Humans
Laparoscopy - methods
Male
Middle Aged
Minimally Invasive Surgical Procedures - utilization
Natural Orifice Endoscopic Surgery - utilization
Population Surveillance
Questionnaires
Risk assessment
Surgeons - statistics & numerical data
Abstract
Advancements in minimally invasive surgery have led to increases in popularity of single-incision laparoscopic surgery (SILS) and natural orifice translumenal surgery (NOTES(®); American Society for Gastrointestinal Endoscopy [Oak Brook, IL] and Society of American Gastrointestinal and Endoscopic Surgeons [Los Angeles, CA]) due to their postulated benefits of better cosmesis, less pain, and quicker recovery. This questionnaire-based study investigated Danish surgeons' attitudes toward these new procedures.
A 26-item questionnaire was developed and distributed electronically via e-mail to a total of 1253 members of The Danish Society of Surgeons and The Danish Society of Young Surgeons.
In total, 352 (approximately 30%) surgeons completed the questionnaire, 54.4% were over 50 years of age, and 76.6% were men. When choosing surgery, the most important factors taken into consideration were the risk of complication and short convalescence, whereas the least important factors were cosmesis and option of local anaesthesia. If the surgeons themselves were to undergo cholecystectomy, 35.5% would choose SILS, and 14.5% would choose NOTES provided that the risk was equal to traditional laparoscopy (3%). The fraction of surgeons willing to learn SILS and NOTES was 44.6% and 32.7%, respectively. The desire to learn was higher among less experienced and surgically active surgeons. Of the responders, 68.8% considered SILS and 43.2% considered NOTES would become standard techniques for cholecystectomy within 6 years.
The importance of risk of complications has not surprisingly a high priority among surgeons in this questionnaire. Why this is has to be investigated further before implementing SILS and NOTES as standard of care.
PubMed ID
24131341 View in PubMed
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[Discussion about therapeutic tactics in case of acute appendicitis].

https://arctichealth.org/en/permalink/ahliterature256749
Source
Khirurgiia (Mosk). 2014;(4):20-2
Publication Type
Article
Date
2014
Author
V M Timerbulatov
M V Timerbulatov
Source
Khirurgiia (Mosk). 2014;(4):20-2
Date
2014
Language
Russian
Publication Type
Article
Keywords
Appendectomy - methods - statistics & numerical data
Appendicitis - epidemiology - surgery - ultrasonography
Health services needs and demand
Humans
Laparoscopy - methods - statistics & numerical data
Organizational Policy
Patient Selection
Russia
Abstract
The authors' opinion about conservative treatment of acute appendicitis is presented in the article. Conservative treatment of acute appendicitiswas proposed by K. Varadhan, etc. (2009). It was presented the examination results of 7216 patients who werehospitalized with suspected acute appendicitis. Also it was analyzed the results of appendectomy, which were performed in 5172 patients. Validity of diagnostic laparoscopy, informational content of ultrasonic scanning and Alvarado scale were discussed in the article. The authors propose that wide application of conservative treatment of acute appendicitis is premature in Russian Federation. Technique approbation is necessary on base of several medical organizations with discussion of its results within the Russian Society of Surgeons.
PubMed ID
24816382 View in PubMed
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[Elective treatment of colon cancer: surgical and oncological]

https://arctichealth.org/en/permalink/ahliterature16646
Source
Ugeskr Laeger. 2005 Nov 7;167(45):4258-60
Publication Type
Article
Date
Nov-7-2005
Author
Anders Fischer
Torben Skovsgaard Jensen
Linda Bardram
Jacob Rosenberg
Author Affiliation
Amtssygehuset i Gentofte, Kirurgisk Gastroenterologisk Afdeling D, Hellerup. jaro@gentoftehosp.kbhamt.dk
Source
Ugeskr Laeger. 2005 Nov 7;167(45):4258-60
Date
Nov-7-2005
Language
Danish
Publication Type
Article
Keywords
Anastomosis, Surgical
Antineoplastic Combined Chemotherapy Protocols
Chemotherapy, Adjuvant
Colonic Neoplasms - classification - pathology - surgery
English Abstract
Humans
Laparoscopy - methods
Sentinel Lymph Node Biopsy
Surgical Procedures, Elective - methods
Abstract
Around 2,300 new cases of colon cancer are diagnosed in Denmark every year. Surgical treatment follows the standard criteria, including removal of as many lymph nodes as possible to ensure correct classification of the disease. For staging, the sentinel node principal may also be advantageous, but this is not yet routine in colon cancer. Patients with Dukes' C disease routinely receive adjuvant chemotherapy. For patients with Dukes' B disease, chemotherapy is not routine but may be given in selected cases.
PubMed ID
16277923 View in PubMed
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112 records – page 1 of 12.