Scandinavian Journal of Surgery最新文献

{"title":"Corrigendum to \"Incidence, treatment, and survival of isolated patients with colorectal cancer lung metastases: A registry-based retrospective cohort study\".","authors":"","doi":"10.1177/14574969251346669","DOIUrl":"10.1177/14574969251346669","url":null,"abstract":"","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"400"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of HoloLens for intra-operative assessment of a retrosternal thyroid goiter.","authors":"Eugene Kwong Fei Leong, Aldred Cheng, James Wai Kit Lee, Yujia Gao, Kee Yuan Ngiam","doi":"10.1177/14574969251360147","DOIUrl":"10.1177/14574969251360147","url":null,"abstract":"","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"378-380"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges to preserve vascular access functioning after surgical correction for arteriovenous access ischemic steal in hemodialysis patients: A single-center study.","authors":"Eeva-Maija Weselius, Maria Söderström, Maarit Venermo","doi":"10.1177/14574969251319854","DOIUrl":"10.1177/14574969251319854","url":null,"abstract":"<p><strong>Background and aims: </strong>Arteriovenous access ischemic steal (AVAIS) is a rare complication that causes morbidity and threatens hemodialysis access usability in patients with end-stage kidney disease (ESKD). This study aimed to determine the incidence of AVAIS over a 15-year period and assess the access usability after surgical correction.</p><p><strong>Methods: </strong>Access operations between January 2007 and August 2022 at Helsinki University Hospital were reviewed. Demographics, clinical, duplex, and contrast examinations with brachial artery volume flows, finger pressures, and delays to surgery were evaluated. Symptom relief, complications, access closures/re-interventions, primary, secondary, and functional patencies were assessed. Endpoints were permanent cessation of access use due to complication(s), transplantation, closure, definitive occlusion, or death.</p><p><strong>Results: </strong>Among 2914 access-related operations, the overall incidence of AVAIS was 2.2%. At the first vascular consultation 52% had ulcer(s) or gangrene(s) resulting in 28 direct closures, and 30 corrections as follows: 20 proximalization of arterial inflow (PAI), 6 flow reduction procedures, 2 distal revascularization with interval ligation (DRIL), 1 distal radial artery ligation (DRAL), and 1 venous bypass. The median time from consultation to surgery was 18 days (range: 0-348 days) for direct closures and 43 days (0-170 days) for corrective surgery. The functional patencies after correction were 60% at 1 year and 55% at 2 years; the primary patencies were 45% and 28% and secondary patencies 61% and 57%, respectively. The functional patencies after PAI were 41% and 31%, respectively.</p><p><strong>Conclusion: </strong>In AVAIS, access preservation is challenging in ESKD patients with multiple diseases. Attention should be paid to the original choice of vascular access by considering each patient's risks. Delay to vascular consultation and intervention should be minimized. PAI should be reserved for selected patients when no other option is preferable.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"365-373"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary aortic intervention may not impair survival in patients treated with TEVAR for type B aortic dissection: A Finnish national registry study.","authors":"Juhana Toimela, Marja Hedman, Tuomas Selander, Annastiina Husso","doi":"10.1177/14574969251321967","DOIUrl":"10.1177/14574969251321967","url":null,"abstract":"<p><strong>Background and aims: </strong>This study investigated patients with type B aortic dissection (TBAD) who were treated with thoracic endovascular aortic repair (TEVAR). The aim was to study whether patients who needed secondary aortic intervention (SAI) had worse survival than patients who did not require SAI after the initial TEVAR.</p><p><strong>Methods: </strong>Data were collected from the National Care Register for Health Care (CRHC) at the Finnish National Institute for Health and Welfare. All Patients over 15 years of age with TBAD (ICD-10; I71.01) treated with TEVAR during the years 2000-2019 were included in the study. Data were collected retrospectively. A data search of the Official Statistics of Finland Cause of Death registry was carried out to identify the date and cause of death in patients with TBAD.</p><p><strong>Results: </strong>236 patients with TBAD received TEVAR as primary operative treatment from year 2000 to 2019. SAI after initial TEVAR was performed in 45 (17%) patients during median follow-up time of 5.1 years. There was no significant difference in survival between the patients who underwent primary TEVAR alone and those who required additional SAI (<i>p</i> = 0.063). Age-adjusted survival did not differ between the groups either. Median follow-up time was significantly longer in the SAI group compared to patients with no SAI (5.9 vs 4.9 years, <i>p</i> = 0.047). The most common cause of death in both groups was an aortic-related event (47%).</p><p><strong>Conclusions: </strong>Based on this study, SAIs may not impair the overall survival of patients previously treated with TEVAR for TBAD. Systematic follow-up after the initial TEVAR may be beneficial in identifying patients with TBAD who may require secondary operation.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"358-364"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term glycemic control after sleeve gastrectomy and biliopancreatic diversion with duodenal switch in patients with type 2 diabetes mellitus.","authors":"Randi S Gamlestøl, John R Andersen, Villy Våge","doi":"10.1177/14574969251321965","DOIUrl":"10.1177/14574969251321965","url":null,"abstract":"<p><strong>Background and objectives: </strong>Long-term studies exploring factors associated with glycemic control of type 2 diabetes mellitus (T2DM) after bariatric surgery are being requested. This prospective cohort study aimed to evaluate potential predictors of long-term glycemic control 5 years after surgery.</p><p><strong>Methods: </strong>Patients were operated between 2002 and 2014. Data were collected prospectively in a database after obtaining written informed consent from the patients. Surgical methods were sleeve gastrectomy (SG) or biliopancreatic diversion with duodenal switch (BPDDS). Possible predictors of postoperative long-term glycemic control (HbA1c) were investigated using multiple path regression analysis, which handles missing data.</p><p><strong>Results: </strong>A total of 181 patients were included consecutively, 87 after SG and 94 after BPDDS. The follow-up rate was 124/181 (69%), 57 (66%) after SG and 67 (71%) after BPDDS. We found that 39/57 (68%) of the patients who underwent SG and 54/67 (81%) of the patients who underwent BPDDS had remission of T2DM at 5 years. Lower preoperative HbA1c (P < 0.010), higher preoperative C-peptide (P = 0.004), greater percent total weight loss (P < 0.005), and the BPDDS procedure (P < 0.001) were associated with better postoperative long-term glycemic control (explained variance = 39.4%).</p><p><strong>Conclusions: </strong>Both procedures, especially BPDDS, were effective in achieving long-term glycemic control. Lower preoperative HbA1c, higher C-peptide levels, greater weight loss, and the BPDDS procedure were key predictors of better long-term glycemic control.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"327-333"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of malignancy in indeterminate biliary tract strictures: Retrospective cohort study.","authors":"Joonas Sirén, Leena Kylänpää, Mia Rainio, Outi Lindström, Fredrik Åberg, Johanna Savikko, Arto Kokkola, Arno Nordin, Ville Sallinen","doi":"10.1177/14574969251321966","DOIUrl":"10.1177/14574969251321966","url":null,"abstract":"<p><strong>Background: </strong>Indeterminate biliary strictures, that is, a stricture with benign brush cytology but without clear etiology in clinical or radiological assessment, pose a challenge for clinicians. This study aimed to assess the incidence and risk factors for malignant disease in patients with indeterminate biliary strictures.</p><p><strong>Methods: </strong>This is a single-center retrospective study of patients with indeterminate biliary stricture undergoing first endoscopic retrograde cholangiopancreatography (ERCP) and biliary brushing between March 2011 and March 2020. The study included patients with atypical cytology in the first ERCP biliary brushing samples. Main exclusion criteria were primary sclerosing cholangitis, apparent malignancy or tumor in imaging studies, postoperative strictures, chronic pancreatitis, biliary tract stone, and no ≥12-month follow-up or a final pathological diagnosis.</p><p><strong>Results: </strong>A total of 2279 patients underwent first ERCP procedure because of a biliary tract stricture during the study period, of which 51 patients (2.2%) had an indeterminate biliary stricture and were included. A total of 30 patients (58.8%) had final diagnosis of malignant disease. The patients with final diagnosis of malignant disease were mostly men (n = 19, 63.3%), had jaundice (n = 25, 86.2%), and had significantly higher bilirubin and CA19-9 values than those with benign disease. A total of 25 patients were operated on, of which 21 patients (84%) had malignant disease. Twenty-six patients were followed up only, of whom nine patients (34.6%) had a malignant disease.</p><p><strong>Conclusion: </strong>Indeterminate biliary strictures are uncommon, but two-thirds of the initially indeterminate biliary strictures are malignant. The presence of clinical jaundice and elevated bilirubin and CA19-9 values are associated with increased risk of malignancy.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"319-326"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic spacers of the lower jaw after complex reconstructive surgery: 10-year single-center experience.","authors":"Malla Salli, Emilia Marttila, Karri Mesimäki, Tommy Wilkman","doi":"10.1177/14574969251343464","DOIUrl":"10.1177/14574969251343464","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>In orthopedic surgery, the use of antibiotic-impregnated spacers is a well-established method for treating periprosthetic joint infections with excellent outcomes. However, their application in head and neck surgery remains poorly documented, despite the high susceptibility of these patients to persistent infections. The objective of this study was to evaluate the 10-year outcomes of antibiotic spacers in the treatment of persistent mandibular infections unresponsive to conventional methods, prior to definitive reconstruction.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with persistent mandibular infections treated with antibiotic-impregnated spacers between 2014 and 2023. Patient characteristics, surgical details, infection type, and clinical outcomes were assessed. The two-stage surgical protocol was described.</p><p><strong>Results: </strong>Seven patients (mean age 49 years, range 20-77) were included. Six had undergone complex mandibular reconstructions for malignant tumors (n = 3), benign tumors (n = 1), or congenital anomalies (n = 2). One patient had osteomyelitis of the jaw with extensive necrosis. Following spacer placement, complete resolution of infection occurred in 3/7 patients, a transition to non-suppurative infection in 3/7, and suppurative infection in 1/7. On average, infections recurred 5 months postoperatively. All infections resolved by the time of spacer removal, allowing definitive reconstruction.</p><p><strong>Conclusion: </strong>Antibiotic-impregnated spacers appear to be a promising adjunct in managing persistent mandibular infections, facilitating successful permanent reconstruction in complex head and neck cases.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"342-350"},"PeriodicalIF":1.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Dome technique: A single-stage liposuction and dermopexy treatment for high-grade gynecomastia.","authors":"Umut Zereyak, Onur Aksoy","doi":"10.1177/14574969251363334","DOIUrl":"https://doi.org/10.1177/14574969251363334","url":null,"abstract":"<p><strong>Background: </strong>Gynecomastia is a benign, excessive development of the male breast that occurs at an overall incidence of 32% to 36%. The goals of surgical treatment are to restore the breast contour with minimal scarring and protect the areolar anatomy and sensation. Here, a new single stage technique is described where peripheral fat tissue is effectively removed using ultrasound-assisted liposuction (UAL) followed by a Dome breast lifting from the superior parabolic periareolar incision without touching the complex inferior pedicle.</p><p><strong>Methods: </strong>A retrospective review of outcomes for 29 patients aged between 18 and 49 years with grade IIB or grade III gynecomastia who were treated with UAL and the Dome technique. Health-related quality-of-life and aesthetic outcomes were evaluated using a modified version of the Breast Evaluation Questionnaire (BEQ).</p><p><strong>Results: </strong>The mean Likert-type score (LS) increased from 1.82 (18%) preoperatively to 4.10 (81%) months postoperatively (<i>p</i> < 0.05). No infection, nipple-areola complex necrosis, nipple retraction, or saucer deformity was encountered.</p><p><strong>Conclusion: </strong>The use of UAL and Dome technique for the treatment of severe gynecomastia allows for the effective removal of both the fat and glandular tissue of the breast through a minimal periareolar parabolic incision. This technique can achieve excellent aesthetic results with inconspicuous scarring in a single session.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969251363334"},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of burns and their anatomical distribution: A nationwide register study in Finland.","authors":"Lotta Purola, Jyrki Vuola, Heli Kavola, Raimo Palmu, Sina Hulkkonen","doi":"10.1177/14574969251357211","DOIUrl":"https://doi.org/10.1177/14574969251357211","url":null,"abstract":"<p><strong>Background and aims: </strong>To provide a register-based analysis of the incidence, anatomical distribution, and associated operative care of all burn injuries treated in specialist care in Finland.</p><p><strong>Methods: </strong>This is a register-based epidemiological study covering the entire population of Finland from 2011 to 2015. Our data include all burn patients registered in the Care Register for Health Care. We used the International Classification of Diseases, 10th Revision code for burn injuries and the Nordic Medico-Statistical Committee Classifications of Surgical Procedures for procedure codes. We calculated the mean crude and adjusted (to European Standard Population 2013) incidence rates of burns as cases per 100,000 person-years assuming Poisson distribution of cases for calculating 95% confidence intervals.</p><p><strong>Results: </strong>The study included 16,575 patients with burn injuries (male 63%). The mean standardized annual incidence rate per 100,000 person-years of any burn injury during the study period was 60.8 (95% CI 59.9-61.7). The corresponding values were 76.3 (95% CI 74.9-77.8) and 45.2 (95% CI 44.1-46.3) for male and female. Among patients admitted for ⩾2 days, the incidence rate per 100,000 was 10.9 (male 15.5 and female 6.5). The mean (SD) age was 32 (23) years. Hand injuries were the most common burns. The most frequently operated regions were the upper limb injuries. A total of 8.8% of patients were admitted for ⩾2 days, with a mean inpatient time of 12 (SD 29) days for females and 11 (19) days for. No male patient had inpatient time > 100 days.</p><p><strong>Conclusions: </strong>Male patients had more burn injuries and were admitted to specialist care more often than females. Hand and wrist injuries were common but rarely operated. Limb and torso injuries were operated on most often. Females had a longer mean length of stay (LOS) than males in the age group 11-30 years. The reasons for this is unknown.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969251357211"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TSH variability and atrial fibrillation in patients with DTC: A regional cohort study.","authors":"Maximilian Zoltek, Therese M-L Andersson, Christel Hedman, Caroline Nordenvall, Catharina I Lundgren","doi":"10.1177/14574969251364947","DOIUrl":"https://doi.org/10.1177/14574969251364947","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to analyze thyroid-stimulating hormone (TSH) levels quantitatively and investigate their potential correlation with the risk of incident atrial fibrillation (AF) in differentiated thyroid cancer (DTC) patients.</p><p><strong>Methods: </strong>DTC cases diagnosed between 1995 and 2015 in Stockholm, Sweden, were identified from the Swedish Cancer Registry. Medical records were scrutinized, and follow-up began 9 months post-surgery with tracking data until the earliest AF record, censoring, or 31 August 2022. TSH values were classified as unsuppressed (TSH > 0.5 mE/L), mildly suppressed (TSH 0.1-0.5 mE/L), or suppressed (TSH < 0.1 mE/L), with graphical analysis spanning up to a 10-year follow-up period. In addition, a nested case-control study assessed the impact of TSH category on incident AF. Additional data on cardiovascular risk factors were gathered.</p><p><strong>Results: </strong>Among 608 patients, approximately 78% maintained suppressed TSH levels for over half of their follow-up time. Notably, there was a decrease in the proportion of patients receiving long-term TSH suppression after 2013. Among 39 newly diagnosed AF cases, most were in the suppressed TSH category. Moreover, about half of these new AF patients had established cardiovascular risk factors prior to DTC diagnosis.</p><p><strong>Conclusion: </strong>DTC patients generally adhered to TSH suppression guidelines, with a decline observed in the proportion of suppressed TSH values following the adoption of individualized treatment in 2013. The study could not establish a clear link between TSH suppression and the risk of incident AF, highlighting the need for further investigation.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969251364947"},"PeriodicalIF":1.8,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}