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Biomedical subjects

H E Myrvold

Publications and source records attributed to H E Myrvold.

At least 19 recordsLinked to original sources
PubMed1990

[Laser treatment of inoperable cancer of the esophagus and cardia].

The palliative effect of laser treatment for obstructing carcinomas of the oesophagus and gastric cardia was evaluated in 16 patients, between 59 and 81 years of age (median 73 years) and treated during the years 1986-89. All patients had severe dysphagia and none were able to eat solid food. They were judged inoperable because of advanced disease (9), reduced general condition, high age or concomitant disease (5). Two patients refused surgery. There was no procedure-related mortality. Complications were oesophageal perforation (1), bleeding (1) and development of fibrotic stricture (1). Ability to swallow was improved in all but one patient, and 13 became able to eat solid food. Seven patients needed repeated treatment 1-5 times at intervals of 3-10 weeks (median five weeks) between treatments. The results suggest that endoscopic laser treatment represents a good alternative in the palliative treatment of malignant obstructions in the oesophagus and gastric cardia.

Aged↗
PubMed1990

[Continent urostomy using Kock's method].

Urinary diversion via a continent ileal reservoir ad modum Kock was performed in eight patients. There was no operative mortality. Early complications necessitated reoperation in three patients, two patients were reoperated due to leakage from the uretero-enteric anastomosis and one patient because of postoperative acute acalculous cholecystitis. Late complications were seen in two patients who were reoperated because of stenosis in the uretero-enteric anastomosis. All patients had excellent functional results with continence without reflux to the upper urinary tract.

Adult↗
PubMed1990

The benefit of colonoscopy.

In a prospective study involving 833 consecutive outpatient and open-access colonoscopies, attempts were made to characterize the benefit of colonoscopy in terms of both predicted and unpredicted findings and therapeutic procedures. The endoscopist therefore predicted the endoscopic findings before the endoscopy. The results were compared for the different indications for colonoscopy. The overall agreement between the predictions and the colonoscopic findings was 61%. Clinically significant abnormalities were found in about half the examinations. The most frequent abnormal findings were benign polyps (24%), inflammatory bowel disease (17%), and malignancy (5%). In about half the patients with a malignancy the indication for colonoscopy was rectal bleeding, and half of the malignancies were not predicted. The greatest benefit of colonoscopy was found in patients referred because of overt rectal bleeding or occult faecal blood, and abnormal barium enema or endoscopy findings. The importance of complete colonoscopy in connection with operation for colorectal carcinoma is emphasized.

Colonic Polyps↗
PubMed1989

[Diagnosis and routines in abdominal injuries].

In patients with suspected intra-abdominal injuries the diagnostic process must conclude with a decision to do a laparotomy or to observe the patient. If the circulation is unstable because of intra-abdominal bleeding, or the patient has peritonitis, he must be operated on without delay. Otherwise, a range of different diagnostic tools may be chosen. It is wise to work according to a plan and to choose diagnostic methods that are able to give considerable help in deciding whether to operate or not. Ultrasonography or computed tomography will often be good choices.

Abdominal Injuries↗
PubMed1989

[Abdominal injuries. Occurrence and outcome].

A retrospective study of intra-abdominal injuries treated during the ten-year period 1977 to 1986, show that road traffic accidents were responsible for the injury in 38% of 221 patients. Accidents from sports and recreation were the cause in 23% of the cases. The median age was 19 years. Renal injuries were most common, followed by splenic injuries. 119 patients (54%) were operated for abdominal injury. 90 patients (41%) needed blood transfusions and 29 (13%) were treated by respirator. 95 patients had concommitant extraabdominal injuries. The overall lethality was 9%.

Abdominal Injuries↗
PubMed1989

[Grading and prognosis of abdominal injuries].

The present study was carried out in order to find out the relationship between injury grading and the use of different resources and the result of the treatment in patients with intra-abdominal injuries. The injuries were graded according to two trauma scores: The Injury Severity Score and the Norwegian Injury Score. In 221 patients with intra-abdominal injuries there were good correlations between these two scores and the time of hospitalization, units of blood transfusions, need for respirator treatment and lethality.

Abdominal Injuries↗
PubMed1989

Ileoanal anastomosis with interposition of the ileal 'Kock pouch'. Preliminary results.

For patients needing proctocolectomy, there are several alternatives available today for the previously dominating conventional ileostomy. Currently, the ileal pouch-anal anastomosis attracts major interest. Various reservoir procedures have been proposed, but the ideal reservoir design is still debated. The double-folded ileal reservoir (Kock pouch) has a large capacity, low pressure, and is expandable. It is successfully used for the construction of continent ileostomies, continent urostomies, and for replacing the urinary bladder by connecting the reservoir to the urethra. In view of these facts, it was decided to interpose the Kock pouch between the ileum and the anus after colectomy and mucosal proctectomy in a small number of patients, and to study and evaluate its merits in this position. Six consecutive patients formed the study group. Three months after ileostomy closure the stool frequency was 4 every 24-hours, range 3 to 5, and remained so during the follow-up period. All patients could sleep through the night without bowel movements or soiling. None of the patients used pads. The capacity of the reservoir increased from a mean of 100 ml preoperatively to 550 ml one year after ileostomy closure. The large reservoir capacity and the low pressure can explain the good functional results.

Adolescent↗
PubMed1988

Quality of life in ileostomy patients before and after conversion to the continent ileostomy.

In a prospective study the quality of life was evaluated in 31 consecutive patients before and after conversion from a conventional to a continent ileostomy. Patient expectations, immediate emotional reactions after the operation and attitudes at the time of the interview were more positive towards the continent ileostomy than the conventional ileostomy. An improved working capacity was affirmed after conversion to the continent ileostomy. Leisure activities and the quality of sexual life were most positively influenced by the continent ileostomy, whereas established family and social relations were not considerably influenced by either type of ileostomy. In conclusion the continent ileostomy improves the quality of life in patients requesting conversion from a conventional ileostomy.

Adaptation, Psychological↗
PubMed1988

Glucose and alanine absorption following massive small bowel resection.

A 90% small bowel resection in 8 dogs resulted in a significant decrease (p less than 0.05) in D-xylose and D-glucose absorption during the early postoperative period. The absorptive capacity of the residual gut with regard to L-alanine, however, remained unchanged. Anemia and hypoalbuminemia also occurred in time, suggesting a malabsorptive state. Control studies were performed in 8 dogs with small bowel transections. The results suggest that a high protein diet might be of benefit during the early postoperative period after massive small bowel resection.

Absorption↗
PubMed1988

Colonic reservoirs.

During the last decades several types of surgical techniques have been utilized in order to provide the patient with a continent colostomy using the colon as a reservoir. None of the methods have gained wide acceptance and continence is usually dependent upon successful irrigation. By constructing a cecal reservoir with an intussuscepted nipple valve, using the same principle as for the continent ileostomy, a colostomy with perfect continence for both gas and feces can be created. Although improving life quality significantly when successful, the method is hampered by a high rate of complications and malfunction. So far none of the methods introduced offer any great advantage to conventional sigmoidostomy with irrigation. There is, however, evidence that the functional results after coloanal anastomosis may be improved by constructing a pouch-anal anastomosis. The clinical significance of this technical modification is not yet fully evaluated.

Cecostomy↗
PubMed1988

Surgical procedures in colorectal cancer emergencies.

About one third of the patients with colorectal cancer presents with large bowel obstruction, perforation or life threatening bleeding. In large bowel obstruction there is a trend towards primary resection and immediate anastomosis, also in cancer of the left colon. Among the techniques used are orthograde irrigation and primary resection with colo-colonic anastomosis, and in selected cases subtotal colectomy with ileosigmoid or ileorectal anastomosis. For sigmoid neoplasms causing obstruction immediate resection and end colostomy is recommended. In perforation at the tumour site, primary resection and immediate anastomosis may be justifiable if the peritonitis is localized. If diffuse peritonitis is present, primary resection with end colostomy seems to be the best choice. Although primary resection with or without immediate anastomosis has its merits, staged resection still remains a good and safe alternative in many cases.

Colorectal Neoplasms↗