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Bent S Ottesen

Publications and source records attributed to Bent S Ottesen.

At least 19 recordsLinked to original sources
PubMed2006

[The first HPV vaccine is now available].

More than two thirds of carcinomas of the uterine cervix are caused by human papilloma virus (HPV) types 16 and 18, and 90% of all genital warts are caused by HPV 6 and 11. In June 2006, the US Food and Drug Administration accepted the first prophylactic HPV vaccine against HPV 6, 11, 16 and 18 to be offered to girls and young women. This new vaccine is also now available in Denmark. Questions concerning economics, ethics, organization, and vaccine monitoring need to be discussed in connection with the establishment of a vaccine program. In addition, information to the general population as well as to health care providers and decision-makers should have been given a high priority.

Adolescent↗
PubMed2006

[Simulation training of laparoscopic skills in gynaecology].

Laparoscopic techniques are increasingly being applied in gynaecology in Denmark. Despite this, the training and assessment of basic skills are still not managed with a valid, reliable and systematic approach. Laparoscopic simulators might be the innovative answer to this challenge, but implementation needs to be evidence-based This paper discusses the latest metaanalysis of the evidence of simulator systems for evaluation and transfer of technical surgical skills, and the paper also points out areas that need further investigation before implementation of simulators in the gynaecological surgical curriculum.

Clinical Competence↗
PubMed2006

[Accelerated course after operation for ovarian cancer].

INTRODUCTION: Introduction of principles for postoperative multimodal rehabilitation (fast track surgery) has decreased hospital stay from about 8-10 days to 2-4 days after colonic resection. The aim of this study was to investigate the effect of a similar fast track regimen in patients operated for ovarian cancer. METHOD: 72 consecutive patients operated with a conventional perioperative treatment regimen (group 1) were compared with the initial 69 consecutive patients (group 2) with a multimodal rehabilitation regimen and the next 50 consecutive patients (group 3) where the fast track regimen was implemented as a routine. RESULTS: Patients demographics and surgical characteristics were comparable between groups. Median postoperative hospital stay was reduced from six days in group 1, to five days in group 2, and four days in group 3 (p < 0,05). Surgical complications were similar while medical complications were reduced from 12% to 1% (p < 0,05) and readmissions from 10% to 2% (p < 0,05) with the fast track regimen. CONCLUSION: Principles for postoperative multimodal rehabilitation from colonic surgery lead to faster rehabilitation, decreased risk of medical complications and hospital stay in patients operated for ovarian cancer.

Adult↗
PubMed2006

[Ovarian cancer in Denmark. Status of the surgical intervention].

INTRODUCTION: In Denmark women have not only one of the highest risks of ovarian cancer but also the highest mortality rate. The primary surgery is a key factor in the outcome. MATERIALS AND METHODS: Surgery for the treatment of ovarian cancer in Denmark was evaluated for the period from 1 July 2002 to 31 December 2003 using data from the Danish National Patient Registry (Landspatientregisteret, LPR) as well as the letter with the discharge note. The analysis included all primary surgical procedures during this period where information about number of surgical procedures per department, post-operative hospital stay, complications and mortality were obtained. RESULTS: 765 women, mean age 61 years (range 5-96 years), were operated on for ovarian cancer. The operations were distributed among 52 different hospital departments, and the surgery for advanced stage III patients took place in 32 different departments. The mean postoperative hospital stay was 9.0 days; 28% experienced one or more complications, and 8.1% were reoperated. The mortality rate was 4.2%. CONCLUSION: This first nationwide evaluation of surgery for ovarian cancer in Denmark showed that the surgery took place in far more hospital departments than the five recommended by the Danish National Board of Health. There seems to be room for improvement of quality, and a plan for the next five years is presented.

Adolescent↗
PubMed2005

[The Danish Hysterectomy Database seen from a public health-economic perspective].

INTRODUCTION: National clinical databases are a tool for quality improvement in clinical divisions. Furthermore, they can be used to make the quality of health care contributions visible to the population, as part of the free choice of hospital. Using data from one of the Danish nationwide databases, this article is the first to illustrate the potential economic resource gains from the use of these databases. MATERIALS AND METHODS: The calculations performed are based on the Danish Hysterectomy Database. This database has selected quality indicators and measures for quality improvements for a three years period and include reduction of complications to one in three (from 18% to 6%), reduction of admission to one in two (from 4 to 2 days) and reduction of rehospitalisation and reoperation to one in two (from 6% to 3%). RESULTS: Provided the proposed improvements are achieved, the expected resource gain will be approximately Dkr. 22 million (depending on the method of calculation). In-bed per day charges and "hotel charges" may vary considerably among hospitals. DISCUSSION: Every year, Dkr. 15 million are allocated to the national clinical databases, and in 2003, 34 different databases received financial support. The maximum amount that each database can receive is Dkr. 500,000. The amount currently allocated to quality monitoring is small compared to the potential resource gains from these databases and the annual expenditures by the Danish health care sector, which amount to a total of Dkr. 48 billion.

Clinical Competence↗
PubMed2005

Total versus subtotal hysterectomy: an observational study with one-year follow-up.

The aim of this study was to compare total and subtotal abdominal hysterectomy for benign indications, with regard to urinary incontinence, postoperative complications, quality of life (SF-36), constipation, prolapse, satisfaction with sexual life, and pelvic pain at 1-year postoperative. Eighty women chose total and 105 women chose subtotal abdominal hysterectomy. No significant differences were found between the 2 operation methods in any of the outcome measures at 12 months. Fourteen women (15%) from the subtotal abdominal hysterectomy group experienced vaginal bleeding and three women had their cervix removed.

Adult↗
PubMed2004

Sexuality after total vs. subtotal hysterectomy.

BACKGROUND: The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies. AIMS: To compare total abdominal hysterectomy (TAH) to subtotal abdominal hysterectomy (SAH) regarding effects on sexuality. METHODS: In a Danish multicenter trial 319 women were randomized to TAH (n = 158) or SAH (n = 161); 185 women had self-selected TAH (n = 80) or SAH (n = 105) in a simultaneously conducted observational study. Women were followed for 1 year by strict data collection procedures, including postal questionnaires. Results were analyzed by intention to treat (ITT) analyses. RESULTS: No significant differences were observed between TAH and SAH at 1-year follow-up in both the randomized trial and the observational study regarding women's desire for sex, frequency of intercourse, frequency of orgasm, quality of orgasm, localization of orgasm, satisfaction with sexual life, and dyspareunia. None of these sexual variables changed significantly from entry to the 1-year follow-up, apart from dyspareunia, which was significantly (p = 0.009) reduced in both intervention groups. Significant (p < 0.05) predictors for satisfaction with sexual life after hysterectomy were the preoperative satisfaction with sexual life [odds ratio (OR) 32, 95% confidence interval (CI) 10-125], good relationship with partner (OR 50, 95% CI 9-354), physical well-being (OR 0.30, 95% CI 0.09-0.88) and hormone replacement therapy (OR 0.23, 95% CI 0.06-0.78). CONCLUSIONS: Both TAH and SAH significantly reduce dyspareunia without having a negative effect on sexual function. The shift toward SAH seems unwarranted.

Cervix Uteri↗
PubMed2003

[Surgical services in Denmark--time for reorganization?].

Denmark is a small country (about 5 million inhabitants) and has a unique registration of hospital admissions, surgical procedures and specific person-numbers in national registers. However, there is currently no system to monitor the overall quality of surgical care. Also, surgical services are provided in a large number of hospitals. In order to provide a rational basis of professional and administrative strategies to monitor and improve the quality of surgical care, establishment of a nation-wide monitoring system and quality improvement programme is required as well as regionalisation of major procedures.

Denmark↗