European Journal of Surgery最新文献

{"title":"Treatment of bleeding peristomal varices","authors":"Knut J. Labori M.D., Erik Carlsen","doi":"10.1002/ejs.6161681118","DOIUrl":"https://doi.org/10.1002/ejs.6161681118","url":null,"abstract":"","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"168 11","pages":"654-656"},"PeriodicalIF":0.0,"publicationDate":"2014-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ejs.6161681118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109230514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small bowel obstruction caused by intestinal metastases from undiagnosed breast cancer: Report of two cases","authors":"Lisa Rydén, Gunilla Chebil, Per-Ebbe Jönsson","doi":"10.1002/ejs.6161681116","DOIUrl":"https://doi.org/10.1002/ejs.6161681116","url":null,"abstract":"","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"168 11","pages":"648-650"},"PeriodicalIF":0.0,"publicationDate":"2014-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ejs.6161681116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109162016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of failure of primary wound healing on subsequent recurrence of pilonidal sinus. Combined prospective study and randomised controlled trial","authors":"Karl Søndenaa,&nbsp;Remi Diab,&nbsp;Idunn Nesvik,&nbsp;Frank Petter Gullaksen,&nbsp;Roy Magne Kristiansen,&nbsp;Arve Sæbø,&nbsp;Hartwig Kørner M.D.","doi":"10.1002/ejs.6161681108","DOIUrl":"https://doi.org/10.1002/ejs.6161681108","url":null,"abstract":"<p><i>Objective:</i> To find out whether failure of primary wound healing after excision and primary suture for chronic pilonidal sinus predicts recurrence.</p><p><i>Design:</i> Follow-up of one prospective study and one subsequent randomised, multicentre study.</p><p><i>Setting:</i> Three teaching hospitals in Western Norway.</p><p><i>Subjects:</i> A total of 197 consecutive patients operated on for chronic pilonidal sinus.</p><p><i>Interventions:</i> Fifty two patients in the prospective group were given cloxacillin perioperatively. In the randomised study, 145 patients were randomised to have either a single preoperative dose of cefoxitin 2 g intravenously (<i>n</i> = 73) or no prophylaxis (<i>n</i> = 72). Patients were followed up for a median of 7 years.</p><p><i>Main outcome measures:</i> Recurrence of pilonidal sinus.</p><p><i>Results:</i> In the prospective group there were 10 recurrences (19%). In the randomised study 6 patients (8%) who had been given antibiotic prophylaxis had a recurrence compared with 14 patients (19%) who had not been given prophylaxis (<i>p</i> = 0.09). In both groups, failure of primary normal healing was significantly associated with early recurrence (<i>p</i> = 0.0002). Neither the use of antibiotics nor sex had any significant influence on the incidence of recurrences. Most recurrences occurred within the first year.</p><p><i>Conclusion:</i> Wound complications significantly influenced the recurrence rate whereas antibiotics did not. Most recurrences were seen early.</p>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"168 11","pages":"614-618"},"PeriodicalIF":0.0,"publicationDate":"2014-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ejs.6161681108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109162034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of appendiceal masses","authors":"Bobby Tingstedt,&nbsp;Elinor Bexe-Lindskog,&nbsp;Mats Ekelund,&nbsp;Roland Andersson M.D., Ph.D.","doi":"10.1002/ejs.6161681102","DOIUrl":"https://doi.org/10.1002/ejs.6161681102","url":null,"abstract":"<p><i>Objective:</i> To evaluate the outcome of patients treated for appendiceal abscess, and managed either conservatively or surgically, and to describe the short and long-term outcome as well as incidence of interval appendicectomy in those treated conservatively.</p><p><i>Design:</i> Retrospective study.</p><p><i>Setting:</i> University hospital, Sweden.</p><p><i>Patients:</i> Ninety-three patients with the diagnosis of appendiceal abscess, 50 treated conservatively and 43 who were operated on, with a mean age of 46 (14–93) years. Mean (range) follow-up for patients operated on was 65 (11–135) and for those treated conservatively 66 (6–136) months.</p><p><i>Main outcome measures:</i> Course of acute disease, recorded complications, recurrence of appendicitis and incidence of interval appendicectomy during follow-up.</p><p><i>Results:</i> The duration of pain before admission was 4 (0.5–82) days for those operated on and 7 (2–60) days for those treated conservatively. A palpable mass was more common in the conservatively managed group. Complications were common among patients who were operated on. No interval appendicectomies were done during the second half of the study period. 4 of the patients treated conservatively (8%) had an underlying tumour diagnosed at follow-up.</p><p><i>Conclusions:</i> Operative management of patients with appendiceal masses seems to be associated with a high risk of postoperative complications and the risk of a more extensive surgical procedure. If possible, a conservative approach should be advocated. Because of inaccurate radiological imaging during the acute phase and the risk of an underlying malignancy. routine follow-up is necessary. Routine interval appendicectomy cannot be recommended.</p>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"168 11","pages":"579-582"},"PeriodicalIF":0.0,"publicationDate":"2014-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ejs.6161681102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109162041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing the path of inguinal hernia surgery decreased the recurrence rate ten-fold. Report from a county hospital","authors":"F. Berndsen M.D.,&nbsp;D. Sevonius","doi":"10.1002/ejs.6161681105","DOIUrl":"https://doi.org/10.1002/ejs.6161681105","url":null,"abstract":"<p><i>Objective:</i> To audit the effect of changes in treatment of inguinal hernias on recurrence rate.</p><p><i>Design:</i> Retrospective analysis of consecutive patients operated on in 1990 and prospective analysis of consecutive patients operated on in 1996. Follow up with questionnaire followed by selective clinical examination.</p><p><i>Setting:</i> County hospital, Sweden.</p><p><i>Subjects:</i> 144 patients with 147 inguinal hernias operated on in 1990 and 154 patients with 165 inguinal hernias operated on in 1996.</p><p><i>Interventions:</i> In 1993, we changed many aspects of the treatment of inguinal hernia. We introduced new techniques such as Shouldice, Lichtenstein, and laparoscopic hernia repair. Non-absorbable polypropylene sutures replaced the braided absorbable sutures previously used. Inguinal herniorrhaphy went from a “low status” operation to a high status operation and became a primary teaching operation for surgical residents.</p><p><i>Main outcome measures:</i> Recurrence rate at 5 year follow up.</p><p><i>Results:</i> The 5 year recurrence rate decreased from 28% in 1990 to 3% in 1996 (<i>p</i> &lt; 0.001). The median operating time increased from 35 minutes in 1990 to 78 minutes in 1996 (<i>p</i> &lt; 0.001).</p><p><i>Conclusion:</i> Changing the strategy of inguinal hernia surgery by introducing uniform operating techniques and new materials dramatically improved the results and allowed us to achieve recurrence rates comparable to those seen in specialised hernia centres.</p>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"168 11","pages":"592-596"},"PeriodicalIF":0.0,"publicationDate":"2014-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/ejs.6161681105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109164759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elective transumbilical compared with standard laparoscopic cholecystectomy","authors":"Fabrizio Bresadola,&nbsp;Alberto Pasqualucci,&nbsp;Annibale Donini,&nbsp;Paolo Chiarandini,&nbsp;Gabriele Anania,&nbsp;Giovanni Terrosu,&nbsp;Marco A. Sistu,&nbsp;Alberto Pasetto","doi":"10.1080/110241599750007478","DOIUrl":"10.1080/110241599750007478","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective:</h3>\u0000 \u0000 <p>To compare the transumbilical technique of laparoscopic cholecystectomy with standard laparoscopic cholecystectomy.j:</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design:</h3>\u0000 \u0000 <p>Randomised open study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting:</h3>\u0000 \u0000 <p>Teaching hospital, Italy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects:</h3>\u0000 \u0000 <p>90 patients who required elective cholecystectomy under general anaesthesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interventions:</h3>\u0000 \u0000 <p>Standard laparoscopic cholecystectomy through 4 ports or transumbilical cholecystectomy through 2 ports.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures:</h3>\u0000 \u0000 <p>Amount of pain and analgesia, cost, side effects, and cosmesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results:</h3>\u0000 \u0000 <p>25 patients were excluded from analysis (8 in the standard group because relevant data were not recorded; and 17 in the transumbilical group in 4 of whom relevant data were not recorded, and 13 for technical reasons). 32 patients who had standard, and 25 who had transumbilical cholecystectomy had operative cholangiograms. There were no complications, no side effects, and no conversions to open cholecystectomy. Those who had transumbilical cholecystectomy had significantly lower pain scores (<i>p</i> &lt; 0.05) and required significantly less analgesia during the first 24 hours (<i>p</i> &lt; 0.05) than those who had standard laparoscopic cholecystectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion:</h3>\u0000 \u0000 <p>Once the learning curve has been completed, transumbilical cholecystectomy is possible without some of difficulties associated with standard laparoscopic cholecystectomy. Copyright © 1999 Taylor and Francis Ltd.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"165 1","pages":"29-34"},"PeriodicalIF":0.0,"publicationDate":"2009-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241599750007478","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20942660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forced air warming and intraoperative hypothermia","authors":"R. Lindwall,&nbsp;H. Svensson,&nbsp;S. Söderström,&nbsp;H. Blomqvist","doi":"10.1080/110241598750004896","DOIUrl":"10.1080/110241598750004896","url":null,"abstract":"<div>\u0000 \u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives:</h3>\u0000 \u0000 <p>To compare a forced air warming system with passive measures to avoid perioperative hypothermia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design:</h3>\u0000 \u0000 <p>Prospective open study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting:</h3>\u0000 \u0000 <p>University hospital, Sweden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects:</h3>\u0000 \u0000 <p>28 Patients scheduled for extensive thoracoabdominal operations under standard combined general and regional anaesthesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures:</h3>\u0000 \u0000 <p>Temperature measured before, repeatedly under anaesthesia and during the operation for up to three hours, and then up to eight hours postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results:</h3>\u0000 \u0000 <p>Three patients were excluded. In the 12 patients who had forced air warming, temperature was preserved, and ranged from a mean (SD) of 36.8 (0.7)°C, (95% confidence interval (CI) 36.4 to 37.2) at the start to 36.9 (0.8)°C, (95% CI 36.5 to 37.3) after 3 hours. In patients who had conservative passive heat preservation techniques the mean temperature fell significantly perioperatively, from 36.8 (0.6)°C (95% CI 36.5 to 37.1) at the start to 35.1 (0.5)°C, (95% CI 34.9 to 35.3), after three hours of anaesthesia and surgery. This was a significant fall compared with the temperature in the study group (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion:</h3>\u0000 \u0000 <p>Forced air warming intraoperatively can preserve normothermia during extensive thoracoabdominal operations. Copyright © 1998 Taylor and Francis Ltd.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 1","pages":"13-16"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004896","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20462403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reoperation as Surrogate Endpoint in Hernia Surgery","authors":"A. Kald,&nbsp;E. Nilsson,&nbsp;B. Anderberg,&nbsp;M. Bragmark,&nbsp;P. Engström,&nbsp;U. Gunnarsson,&nbsp;S. Haapaniemi,&nbsp;J. Lindhagen,&nbsp;P. Nilsson,&nbsp;G. Sandblom,&nbsp;A. Stubberöd","doi":"10.1080/110241598750004940","DOIUrl":"10.1080/110241598750004940","url":null,"abstract":"<div>\u0000 \u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective:</h3>\u0000 \u0000 <p>Analysis of reoperation and recurrence rates three years after repair of groin hernias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design:</h3>\u0000 \u0000 <p>Prospective audit by questionnaire and selective follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting:</h3>\u0000 \u0000 <p>Eight Swedish hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Subjects:</h3>\u0000 \u0000 <p>All groin hernia operations done during 1992 on patients between the ages of 15 and 80 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures:</h3>\u0000 \u0000 <p>Postoperative complications, reoperation for recurrence, and recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results:</h3>\u0000 \u0000 <p>During 1992, 1565 hernia operations were done. The postoperative complication rate was 8% (125/1565). At 36 months postoperatively 108 recurrences had already been reoperated on, six patients with recurrences were on the waiting list for reoperation and a further 36 recurrences had been detected at follow-up. The interhospital variation in recurrence rate ranged from 3% to 20%. Postoperative complications, recurrent hernia, direct hernia and hospital catchment area over 100 000 inhabitants were all factors associated with an increased relative risk of recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions:</h3>\u0000 \u0000 <p>The recurrence rate exceeded the reoperation rate for recurrence by almost 40% which should be taken into account if the reoperation rate is used as the endpoint after repairs of groin hernia. An audit scheme, based on prospective recording, reoperation rate, and (periodic) calculation of the recurrence rate may be used to identify risk factors for recurrence and areas in need of improvement. Copyright © 1998 Taylor and Francis Ltd.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 1","pages":"45-50"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004940","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20462408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Full thickness resection of radiation-induced ulcers of the chest wall: reconstruction with absorbable implants, pedicled omentoplasty, and split skin graft","authors":"Albert N. van Geel,&nbsp;Caroline M. E. Contant,&nbsp;Theo Wiggers","doi":"10.1080/110241598750004544","DOIUrl":"10.1080/110241598750004544","url":null,"abstract":"","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 4","pages":"305-307"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/110241598750004544","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20559653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of endoscopic sympathectomy","authors":"Alan E. P. Cameron","doi":"10.1080/11024159850191111","DOIUrl":"10.1080/11024159850191111","url":null,"abstract":"<p>Four cases are presented in which complications occurred during or after thoracic endoscopic sympathectomy (TES). In one patient inappropriate TES resulted in disabling hyperhidrosis. In one patient laceration of the subclavian artery required major surgery. In two cases intraoperative cerebral damage occurred. Training in TES is essential. Copyright © 1998 Taylor and Francis Ltd.</p>","PeriodicalId":100508,"journal":{"name":"European Journal of Surgery","volume":"164 S1","pages":"33-35"},"PeriodicalIF":0.0,"publicationDate":"2003-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/11024159850191111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20560833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}