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Acta chirurgica Scandinavica最新文献

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Perforated small bowel diverticulosis. Case report. 穿孔性小肠憩室病。病例报告。
Acta chirurgica Scandinavica Pub Date : 1990-06-01
A J Manouras, V A Katergiannakis, A P Stamatiadis, B N Pararas, N S Apostolidis
{"title":"Perforated small bowel diverticulosis. Case report.","authors":"A J Manouras,&nbsp;V A Katergiannakis,&nbsp;A P Stamatiadis,&nbsp;B N Pararas,&nbsp;N S Apostolidis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Three patients who presented with perforated small bowel diverticulosis were healed by resection of the perforated segment and primary anastomosis. Clinical awareness of this disease may reduce the relatively high mortality reported by most authors.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13269362","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}
引用次数: 0
Tetracycline sclerotherapy of hydroceles and epididymal cysts. Long-term results. 四环素硬化治疗鞘膜积液和附睾囊肿。长期的结果。
Acta chirurgica Scandinavica Pub Date : 1990-06-01
M Honnens de Lichtenberg, J Miskowiak, J Krogh
{"title":"Tetracycline sclerotherapy of hydroceles and epididymal cysts. Long-term results.","authors":"M Honnens de Lichtenberg,&nbsp;J Miskowiak,&nbsp;J Krogh","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fourty patients with 32 hydroceles and 11 epididymal cysts were treated by aspiration and instillation of tetracycline. After a follow up period of 24-39 months the cure rate was 77%. Most of the early recurrences were the results of chemical inflammation and vanished spontaneously. This group should therefore not be operated on until three months after their initial treatment. As aspiration of the fluid had allowed palpation of the testis and cytological examination, only a small proportion of patients with recurrences wanted further treatment. We therefore recommend tetracycline sclerotherapy because it is quick, easy, safe, and effective in the long as well as the short term.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13517021","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}
引用次数: 0
Indications for thyroxine therapy after surgery for nontoxic benign goitre. 无毒性良性甲状腺肿术后甲状腺素治疗的适应症。
Acta chirurgica Scandinavica Pub Date : 1990-06-01
J Berglund, L Bondesson, S B Christensen, A S Larsson, S Tibblin
{"title":"Indications for thyroxine therapy after surgery for nontoxic benign goitre.","authors":"J Berglund,&nbsp;L Bondesson,&nbsp;S B Christensen,&nbsp;A S Larsson,&nbsp;S Tibblin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Of 287 consecutive patients, surgically treated at our department for benign, nontoxic goitre during a six-year period, 261 could be followed up, on average, 8.0 years postoperatively. Unilateral surgical procedures had been used in 199 patients, subtotal thyroidectomy in 62. 29 patients were treated with thyroxine (T4) immediately postoperatively (\"recurrence prophylaxis\"); in the other patients thyroxine was only given in cases of hypothyroidism (significant increase of s-TSH). 26 patients had a goitre recurrence 0.5-10 years after surgery; of these 3 had got T4 as \"recurrence prophylaxis\" and 23 had not. There was no significant difference between patients with and without T4 postoperatively regarding the rate of recurrence. Of 55 patients treated with subtotal thyroidectomy, 33 had postoperative latent (n = 26) or manifest (n = 7) hypothyroidism. Only 13 of 177 patients operated on unilaterally developed hypothyroidism; two of these had Hashimoto's thyroiditis. All cases of hypothyreosis except 4 were detected within the first 12 months of follow-up. This study indicates that routine use of thyroxine as prophylaxis against recurrence after surgery for benign nontoxic goitre can be strongly questioned and that the risk of hypothyroidism is high after subtotal thyroidectomy.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13516389","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}
引用次数: 0
Prophylactic treatment with an aerosolized corticosteroid liposome in a porcine model of early ARDS induced by endotoxaemia. 雾化皮质类固醇脂质体预防内毒素血症引起的早期急性呼吸窘迫综合征猪模型。
Acta chirurgica Scandinavica Pub Date : 1990-06-01
P E Forsgren, J A Modig, C M Dahlbäck, B I Axelsson
{"title":"Prophylactic treatment with an aerosolized corticosteroid liposome in a porcine model of early ARDS induced by endotoxaemia.","authors":"P E Forsgren,&nbsp;J A Modig,&nbsp;C M Dahlbäck,&nbsp;B I Axelsson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The effects of prophylactic treatment with an aerosolized corticosteroid liposome (CSL) in high dose were evaluated in a porcine model of early Adult Respiratory Distress Syndrome (ARDS) induced by endotoxaemia. Intermittent positive pressure ventilated (IPPV) pigs under chlormethiazole anaesthesia were infused with E. coli endotoxin (18 micrograms.kg-1.h-1) over 4 h. Eight animals served as controls and were pretreated with aerosolized placebo liposomes, either 15 min or 2 h, before start of the endotoxin infusion. Eight animals were pretreated with CSL in aerosolized form 15 min before start of endotoxin, and eight animals were pretreated 2 h before start of endotoxin. Pretreatment with CSL, both 15 min and 2 h before endotoxin, modified and partly counteracted the late endotoxin-induced impairment in expiratory resistance (EXPres), dynamic compliance (Cdyn) and mean pulmonary artery pressure (MPAP). The administration of CSL did not seem to have a restrictive influence on the endogenous cortisol production estimated by repeated measurements of serum cortisol levels. These results indicate that CSL, administered prophylactically in an aerosolized form to the lung, might be valuable as a modulator without systemic side effects in regard to some of the endotoxin-induced pulmonary impairments seen in this experimental model of early ARDS.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13348487","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}
引用次数: 0
Complications, surgical revision and quality of life with conventional and continent ileostomy. 常规和自制回肠造口术的并发症、手术矫正和生活质量。
Acta chirurgica Scandinavica Pub Date : 1990-05-01
R Sjödahl, E Lemon, P O Nyström, G Olaison
{"title":"Complications, surgical revision and quality of life with conventional and continent ileostomy.","authors":"R Sjödahl,&nbsp;E Lemon,&nbsp;P O Nyström,&nbsp;G Olaison","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Continent ileostomy remains an alternative to restorative proctocolectomy in selected cases. Results with continent ileostomy in 55 patients are reported--in 82% after conversion from conventional ileostomy. Three years postoperatively 93% were continent and 7% partially continent, and after 5 years 95% were continent. Complications requiring laparotomy arose in ten patients (18%) during the immediate postoperative period (30% among the first 27 patients, 7% of the subsequent 28). The incidence of late complications requiring laparotomy was 16% in the first year, 10% in the next 2 years and 5% after the third year. Slipping of the nipple occurred in 9% of the patients in the first postoperative year. No reservoir has been removed. The quality of life improved after colectomy with conventional ileostomy, but most patients experienced a dramatic further improvement after construction of the continent ileostomy. The improvement in ultimate quality of life was not influenced by revision for malfunction of continent ileostomy.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13497724","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}
引用次数: 0
Role of the renin-angiotensin system in liver blood flow reduction produced by positive end-expiratory pressure ventilation. 肾素-血管紧张素系统在呼气末正压通气引起的肝血流减少中的作用。
Acta chirurgica Scandinavica Pub Date : 1990-05-01
D Arvidsson, S Lindgren, P Almqvist, K E Andersson, U Haglund
{"title":"Role of the renin-angiotensin system in liver blood flow reduction produced by positive end-expiratory pressure ventilation.","authors":"D Arvidsson,&nbsp;S Lindgren,&nbsp;P Almqvist,&nbsp;K E Andersson,&nbsp;U Haglund","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Positive end-expiratory pressure (PEEP), often used in critically ill patients, reduces cardiac output, and its adverse effects on splanchnic circulation imply a risk of regional secondary organ failure. To investigate if the renin-angiotensin system (RAS) mediates PEEP-induced circulatory changes, hemodynamic effects of PEEP were measured in four groups of pigs: controls (C), nephrectomized (N), or given enalaprilate, an angiotensin-converting enzyme inhibitor (E), or saralasin, a competitive inhibitor of angiotensin II (S). Groups N, E and S represented interference with RAS effects at different sites. With PEEP at 10 cmH2O, mean arterial pressure, cardiac index, portal venous and hepatic arterial blood flow decreased in all groups, while portal and central venous pressures rose, without significant intergroup difference. Systemic and preportal bloodflow resistance increased in groups S and N, and hepatic arterial resistance in group C. Accentuation of the flow and pressure changes occurred with 20 cm PEEP in all groups, with increase of systemic and hepatic resistance in S and N, or preportal resistance in group N and protal resistance in group C. The study suggested that RAS is not a major mediator of PEEP-induced circulatory changes. Differing responses within groups N, S and E may have been due to interference with the action of RAS and of other vasoactive substances.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13315044","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}
引用次数: 0
Independent predictors of operative mortality and postoperative complications in surgically treated carcinomas of the oesophagus and cardia--is the aggressive surgical approach worthwhile? 食管癌和贲门癌手术死亡率和术后并发症的独立预测因素——积极的手术方法值得吗?
Acta chirurgica Scandinavica Pub Date : 1990-05-01
H H Kimose, O Lund, J M Hasenkam, M T Aagaard, M Erlandsen
{"title":"Independent predictors of operative mortality and postoperative complications in surgically treated carcinomas of the oesophagus and cardia--is the aggressive surgical approach worthwhile?","authors":"H H Kimose,&nbsp;O Lund,&nbsp;J M Hasenkam,&nbsp;M T Aagaard,&nbsp;M Erlandsen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>During the 25 years 1960-84, 657 patients were operated on for carcinomas of the thoracic oesophagus (n = 347) or gastric cardia (n = 310). Resection was carried out in 514 (78%) and oesophagogastrostomy in 481 (73%). Overall operative mortality (defined as death within 30 days) was 19% (n = 122). Pulmonary complications developed in 167 patients (25%), cardiovascular complications in 100 (15%), and anastomotic leakage and mediastinitis in 36 (6%). After radical resection of a localised tumour (n = 144), or non-localised tumour (n = 224), pallative resection (n = 146), or exploration (n = 143), the operative mortality and five year cumulative survival were 10% and 26%, 15% and 8%, 27% and 0, and 24% and 0, respectively (p less than 0.01 and p less than 0.0001). Using logistic regression analysis several variables were found to be independent predictors of operative mortality, pulmonary complications, cardiovascular complications, and anastomotic leakage. The predictor variables reflected both general preoperative status of the patients, preexisting cardio-pulmonary diseases, stage of the cancer, and surgical procedures. Based on the final logistic regression models the patients were stratified into risk groups (12 for operative mortality, pulmonary complications, and cardiovascular complications, and eight for anastomotic leakage). Operative mortality varied from 0 to 80%, pulmonary complications from 3 to 100%, cardiovascular complications from 0 to 100%, and anastomotic leakage from 0 to 50% (p less than 0.0001 in each case). Given the high operative mortality and complication rates, and the low five year survival rate after palliative procedures or exploratory operations, a more selective surgical approach seems warranted. Patients likely to have a good response should be identified before operation.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12858948","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}
引用次数: 0
Preoperative biliary drainage. 术前胆道引流。
Acta chirurgica Scandinavica Pub Date : 1990-05-01
N J Lygidakis
{"title":"Preoperative biliary drainage.","authors":"N J Lygidakis","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13497727","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}
引用次数: 0
Surgical management of duodenal diverticula. 十二指肠憩室的外科治疗。
Acta chirurgica Scandinavica Pub Date : 1990-05-01
E Trondsen, A R Rosseland, A O Bakka
{"title":"Surgical management of duodenal diverticula.","authors":"E Trondsen,&nbsp;A R Rosseland,&nbsp;A O Bakka","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Surgical treatment of duodenal diverticula, although infrequently indicated, implies a high risk of postoperative complications. Diverticuloplasty was performed on five patients, four of whom had biliary or pancreatic duct obstruction and also underwent cholecystectomy and sphincteroplasty. The fifth patient had chronic abdominal pain. Complications occurred in three cases--postoperative diverticular bleeding, retroperitoneal hematoma and peroperative perforation of the common bile duct. The long-term results (3-10 years) were excellent in all cases.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13267451","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}
引用次数: 0
Biliary stent or surgical bypass in unresectable pancreatic cancer with obstructive jaundice. 胆道支架或旁路手术治疗无法切除的胰腺癌伴梗阻性黄疸。
Acta chirurgica Scandinavica Pub Date : 1990-05-01
M K Hyöty, I H Nordback
{"title":"Biliary stent or surgical bypass in unresectable pancreatic cancer with obstructive jaundice.","authors":"M K Hyöty,&nbsp;I H Nordback","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To investigate the effects of surgical and non-surgical palliation of jaundice in unresectable pancreatic carcinoma this retrospective study was performed. Between 1980 and 1983 90 patients were treated of whom 54 (69%) were jaundiced. Of these 36 were treated with biliary bypass (67%), four underwent resection (7%), five were treated by percutaneous drainage (9%) and nine (17%) were in such poor general condition that no treatment for jaundice was possible. Ninety-eight patients were treated between 1984 and 1987 when the initial approach to palliation of jaundice was endoscopic stenting. Transhepatic drainage was used only if stenting failed, and operation only if both non-surgical methods failed. Seventy-two of the 98 patients (73%) were jaundiced, of whom 18 (25%) received a stent placed endoscopically, 11 (15%) underwent transhepatic drainage, 27 (38%) underwent biliary bypass, and 14 (19%) underwent pancreatic resection. Significantly fewer patients in the second group could not be treated because of their poor general condition (n = 2, 3%, p less than 0.02). There were no differences among the methods in overall and 30 day complication rates, or the length of hospital stay, but the late complication rate was 1/63 (2%) for biliary bypass compared with 7/29 (24%) for biliary stenting (p less than 0.001). The difference was because of the high incidence of blockage of the stents causing recurrent jaundice, but the stents could easily be replaced. There was no difference in mortality between the two periods. We conclude that stenting is an acceptable alternative to biliary decompression in the treatment of obstructive jaundice in unresectable pancreatic cancer.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"12858949","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}
引用次数: 0
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