Scandinavian Journal of Surgery最新文献

{"title":"Letter in response to: Sex differences as a catalyst for the next step in surgeon personality research.","authors":"My Blohm","doi":"10.1177/14574969251336874","DOIUrl":"10.1177/14574969251336874","url":null,"abstract":"","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"173"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049211","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":"Implementation of a nationwide program for total pancreatectomy and islet autotransplantation in chronic pancreatitis: A Scandinavian single-center observational study.","authors":"Anne Waage, Ammar Khan, Knut Jørgen Labori, Kåre Inge Birkeland, Hanne Scholz, Trond Geir Jensen, Tore Tholfsen, Pål-Dag Line, Morten Hagness","doi":"10.1177/14574969241298985","DOIUrl":"10.1177/14574969241298985","url":null,"abstract":"<p><strong>Background: </strong>Tailoring surgical treatment is mandatory to optimize outcomes in chronic pancreatitis. Total pancreatectomy (TP) offers pain relief in a subset of patients. TP with islet autotransplantation (IAT) has the potential to reduce the burden of postsurgical diabetes. We present the first Scandinavian prospective study assessing outcomes following total pancreatectomy and islet autotransplantation (TPIAT) in chronic pancreatitis. Our aim was to assess short- and long-term outcomes following implementation of a nationwide program of TPIAT at a tertiary reference center for pancreatic surgery in Norway.</p><p><strong>Methods: </strong>A prospective, observational single-center study enrolling consecutive patients undergoing TPIAT for chronic pancreatitis at Oslo University Hospital. The selection of potential candidates for TPIAT was based on discussions at multidisciplinary team (MDT) meetings, focusing on tailored surgery in chronic pancreatitis. Patients were finally evaluated in a dedicated TPIAT team. The outcome measures included pain relief, quality of life (QoL) assessed by EORTC QLQ-C30, complications, and glycemic control.</p><p><strong>Results: </strong>Between August 2017 and November 2022, 15 patients underwent TPIAT. The follow-up rate was 87% with a median follow-up of 26 months (range = 14-65). Pain relief was achieved in 92%. EORTC QLQ-C30 analysis revealed clinically significant improvements in 28 of 30 domains, particularly in pain and role- and social-functioning. The Clavien-Dindo ≥IIIa complications occurred in one patient. There was no 90 days mortality. All patients maintained C-peptide positivity, although none of the patients reached insulin independence.</p><p><strong>Conclusion: </strong>TPIAT was as a safe and effective treatment for a selected group of patients with chronic pancreatitis, providing substantial pain relief and enhanced QoL. Islet autotransplantation prevented complete insulin deficiency, reducing diabetes severity postpancreatectomy. Dedicated chronic pancreatitis MDT meetings were key factor in the success of the program.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"174-182"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669693","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":"Assessing the accuracy gap in early postoperative complication surveillance: ICD-10 codes versus manual curation-clinical and economic implications.","authors":"Emilie Even Dencker, Alexander Bonde, Stephan Sloth Lorenzen, Anders Troelsen, Martin Sillesen","doi":"10.1177/14574969241294263","DOIUrl":"10.1177/14574969241294263","url":null,"abstract":"<p><strong>Background and objective: </strong>Assessing surgical outcomes, notably postoperative complications (PCs), is crucial for healthcare systems. However, reliance on International Classification of Diseases, 10th revision (ICD-10) codes, may be suboptimal. This study aims to compare the accuracy of ICD-10 codes against manual curation of electronic healthcare records (EHRs) for identifying 13 individual PCs and evaluate associated resource utilization.</p><p><strong>Methods: </strong>EHR data from 11,827 surgical cases across 18 Danish hospitals in November 2021 were analyzed. PCs were identified and extracted through both manual curation and ICD-10 codes. Outcomes such as readmission, admission days, intensive care unit (ICU) stays, reoperations, and radiology procedures were assessed as proxies for resource consumption. Statistical and economic analyses quantified resource utilization and associated costs.</p><p><strong>Results: </strong>In total, 1047 PCs were found through manual curation and 439 PCs were found through ICD-10 codings. Only 218 of the PCs found through ICD-10 codes were retrieved during manual curation-corresponding to a correct ICD-10 coding of 20.8% of PCs. Patients with PCs experienced significantly higher resource utilization, including a 6.6 times higher readmission rate, 6 additional admission days, 2 extra ICU days, 7.7 times more reoperations. PCs incurred substantial economic costs, with additional admission days alone accounting for €25.5 million annually, over four times higher than estimates from ICD-10 codes.</p><p><strong>Conclusions: </strong>ICD-10 codes inadequately capture early PCs highlighting the need for improved detection strategies. The actual costs associated with PCs far exceed current estimates, emphasizing the necessity for enhanced monitoring for informed decision-making. In the Danish healthcare system, ICD-10 codes only capture approximately 21% of PCs, making it inadequate for surgical quality monitoring. The actual costs related to PCs, based on study assumptions, are more than four times higher than estimated from current standard. This calls for novel strategies for PC detection to improve healthcare as well as political and financial decision-making.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"218-229"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711687","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":"Radiological comparison of atelectasis formation and pleural effusion after open versus thoracoscopic minimally invasive esophagectomy.","authors":"Christine J Hannan, Arnar Thorisson, Erland Östberg, Magnus Sundbom, Jakob Hedberg","doi":"10.1177/14574969251331671","DOIUrl":"10.1177/14574969251331671","url":null,"abstract":"<p><strong>Background: </strong>Esophagectomy is associated with pulmonary complications. This study evaluated if thoracoscopic minimally invasive esophagectomy (MIE) mitigates these risks by comparing pulmonary findings on postoperative computed tomography (CT) between open esophagectomy and MIE.</p><p><strong>Method: </strong>Postoperative (day 5) thoracic CT from 40 patients (20 open and 20 MIE) who had undergone esophagectomy with epidural analgesia and right-sided thoracic drainage were reviewed. On an axial view, the areas of atelectasis and pleural effusion were measured at 1 and 5 cm above the right diaphragmatic dome and at the level of the carina. In addition, the total distribution of atelectasis and pleural effusion was estimated on an ordinal scale (0-5), with ≥3 considered clinically important.</p><p><strong>Results: </strong>The groups were well-matched in terms of age, sex, and smoking status. There were no differences in the areas of atelectasis or pleural effusion for open surgery compared with MIE. The groups did not differ in the proportion of patients with clinically important atelectasis (right: 30% vs. 25%, left: 65% vs. 65%) or pleural effusion (right: 15% vs. 15%, left: 65% vs. 45%). More pleural effusion and atelectasis at the 1-cm level was present on the left side at day 5 in both open and MIE patients.</p><p><strong>Conclusion: </strong>Despite major differences in surgical trauma and ventilation strategies between open and MIE, CT evaluation at day 5 was surprisingly similar. Less right-sided pleural effusion demonstrates the effect of surgical drains. We believe that the defined levels of measurement used in this study, performed at clear anatomical landmarks, can be of value in future studies.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"258-265"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044516","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":"Subtle Lisfranc: When is minimal displacement equal to stability, and does it matter?","authors":"Tim Schepers, Esmee W M Engelmann, Jens A Halm","doi":"10.1177/14574969251326386","DOIUrl":"10.1177/14574969251326386","url":null,"abstract":"","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"162-163"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659593","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":"Response to letter to the editor on emergency surgery influences oncological outcome in small intestinal neuroendocrine tumors.","authors":"Frederike Butz, Martina T Mogl, Eva Maria Dobrindt","doi":"10.1177/14574969251333906","DOIUrl":"10.1177/14574969251333906","url":null,"abstract":"","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"297-298"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037280","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 expanding role of surgery in metastatic disease: A modern perspective.","authors":"Malin Sund, Sheraz Yaqub","doi":"10.1177/14574969251347342","DOIUrl":"10.1177/14574969251347342","url":null,"abstract":"","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"113-114"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477559","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":"Translation and validation of the Finnish version of the Fecal Incontinence Quality of Life Scale.","authors":"Helena Komokallio, Tero Rautio, Pasi Ohtonen, Tarja Pinta, Anne Mattila, Antti Turunen, Johanna Mäkelä-Kaikkonen","doi":"10.1177/14574969251337855","DOIUrl":"https://doi.org/10.1177/14574969251337855","url":null,"abstract":"<p><strong>Background and aims: </strong>The Fecal Incontinence Quality of Life Scale (FIQL) is a health-related questionnaire that measures the quality of life among patients with fecal incontinence. This questionnaire comprises 29 items divided into four subscales: Lifestyle, Coping/Behavior, Depression/Self-Perception, and Embarrassment. The aim of the study was to validate the FIQL questionnaire in the Finnish language.</p><p><strong>Methods: </strong>A multiphase validation method was used consisting of a two-panel translation process followed by a psychometric evaluation process. The validation process was used to ensure the consistency and quality of the questionnaire through the test-retest process. The internal consistency between the four subscales was measured with Cronbach's alpha, and the stability over time was assessed by intra-class correlation coefficient (ICC) analysis. Spearman's correlations were used to examine the construct validity.</p><p><strong>Results: </strong>A total of 82 patients with fecal incontinence and 10 reference participants were included in this study. The results for Finnish FIQL indicated that all four subscales had good internal consistency, except for the embarrassment subscale, which had a slightly lower Cronbach's alpha value for the test (0.68). Between subscales, ICC ranged from 0.83 to 0.90, indicating almost perfect stability over time. Correlations were moderate between the FIQL and the severity of fecal incontinence.</p><p><strong>Conclusions: </strong>The Finnish version of the FIQL has been successfully validated and shown to be feasible. The questionnaire can be used for both research and clinical purposes in Finnish patients with fecal incontinence.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969251337855"},"PeriodicalIF":2.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040761","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":"Type of anastomosis in rectal cancer surgery is not associated with anastomotic leakage and impaired bowel function at long-term follow-up.","authors":"Emil Pieniowski, Pernilla Lagergren, Asif Johar, Mirna Abraham-Nordling","doi":"10.1177/14574969251335478","DOIUrl":"https://doi.org/10.1177/14574969251335478","url":null,"abstract":"<p><strong>Background and objective: </strong>The optimal type of anastomosis for preventing anastomotic leakage (AL) and bowel dysfunction after colorectal surgery remains uncertain. The aim of the study was to evaluate anastomotic type after anterior resection (AR) in relation to AL and functional outcome in long-term follow-up.</p><p><strong>Methods: </strong>This was a population-based study using data from the Swedish Colorectal Cancer Registry (SCRCR). The patients were categorized into two groups, based on anastomotic design (\"J-pouch/side-to-end (STE) anastomosis\" or \"end-to-end (ETE) anastomosis\"). AL was established using SCRCR and supplemented with review of medical records. The low anterior resection syndrome (LARS) score questionnaire and Cleveland Clinic Florida Fecal Incontinence score (CCFFIS) were used for the assessment of bowel function. The associations and the predefined confounders were adjusted for using logistic regression/linear mixed-effects models.</p><p><strong>Results: </strong>A total of 710 patients who underwent curative rectal cancer surgery with AR between 2007 and 2013 were included. AL occurred in 87 (15.7%) patients in the STE group and 10 (10.2%) in the ETE group. After adjustment, the type of anastomosis (STE versus ETE) did not affect the odds of AL (odds ratio (OR) 0.80 (95% CI: 0.37-1.76)). There was no association between the anastomotic technique and bowel dysfunction (LARS score: OR 1.14 (95% CI: 0.58-2.27) and CCFFIS: OR -0.08 (95% CI: -1.63 to -1.46)).</p><p><strong>Conclusions: </strong>This is the first study examining anastomotic type and the risk of AL and bowel dysfunction in a long-term perspective beyond 3 years among patients who underwent AR. The anastomosis type did not show any association for AL or bowel dysfunction.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"14574969251335478"},"PeriodicalIF":2.5,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054239","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":"Metabolic and bariatric surgery for adolescents with severe obesity: Benefits, risks, and specific considerations.","authors":"Kajsa Järvholm, Annika Janson, Pia Henfridsson, Martin Neovius, Lovisa Sjögren, Torsten Olbers","doi":"10.1177/14574969241297517","DOIUrl":"10.1177/14574969241297517","url":null,"abstract":"<p><p>International and national guidelines recommend metabolic and bariatric surgery (MBS) as a treatment option for adolescents with severe obesity, but few countries offer MBS to adolescents in routine clinical care. This narrative review summarizes existing adolescent MBS guidelines and the available underpinning evidence. Two randomized trials and additional prospective studies have demonstrated efficacy and safety in adolescent MBS, and the health benefits appear to be similar or superior to outcomes in adults. However, there are specific challenges regarding the intervention during adolescence related to decision-making capacity and a peak in risk-taking behavior. Adolescents with severe obesity have-as a group-a mental health vulnerability, and specific nutritional concerns need to be addressed in relation to MBS. This review also describes how study findings can be translated into clinical care. We use Sweden as an example, where the National Board of Health and Welfare recommends MBS for selected adolescents with severe obesity aged 15 years or older. We present practical advice for implementing and integrating MBS in adolescents in the framework of multidisciplinary pediatric and adolescent care for obesity.</p>","PeriodicalId":49566,"journal":{"name":"Scandinavian Journal of Surgery","volume":" ","pages":"95-106"},"PeriodicalIF":2.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649499","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}