PubMed Health⌕ Search

Biomedical subjects

I Balslev

Publications and source records attributed to I Balslev.

7 recordsLinked to original sources
PubMed1992

Time to loco-regional recurrence after resection of Dukes' B and C colorectal cancer with or without adjuvant postoperative radiotherapy. A multivariate regression analysis.

Factors influencing time to loco-regional recurrence were identified in a multivariate regression analysis of data from a series of 468 radically operated patients (260 Dukes' B and 208 Dukes' C) with carcinoma of the rectum and the rectosigmoid. A number of clinical and pathological characteristics were prospectively collected and recorded. In addition, carcinoembryonic antigen (CEA) was measured within 1 week before surgery. The endpoint used was recurrence below the level of the umbilicus. All patients were followed for at least 5 years or until time of death. The two Dukes' stages B and C were analysed in two separate analyses using the Cox proportional hazards model. In patients with Dukes' B tumours, an increased risk of loco-regional recurrence was associated with perineural invasion, tumour located less than 10 cm from the anal verge, patient aged above 70 years, and small tumour size. In patients with Dukes' C tumours, the necessity to resect neighbour organs, perineural and venous invasion, tumour located less than 10 cm from the anal verge, and large tumour size were all associated with a poor loco-regional outcome. Postoperative radiotherapy was not a significant prognosticator for loco-regional control. An update of the 5-year results of the randomised study of post-operative radiotherapy (50 Gy with 2 Gy per fraction in an overall treatment time of 7 weeks) showed no survival benefit from adjuvant radiotherapy in either Dukes' category and no statistically significant improvement in the 5-year loco-regional control rate. However, when the comparison was restricted to a group of high-risk patients there was a statistically significant benefit from radiotherapy with respect to loco-regional control (P = 0.03) but not with respect to survival (P = 0.23). The potential advantage, in terms of the required number of patients, of restricting clinical trials of intensified loco-regional therapies to the high-risk patients, is illustrated.

Adult↗
PubMed1992

A double-blinded multicenter trial of somatostatin in the treatment of acute pancreatitis.

To evaluate the effect of somatostatin in the treatment of acute pancreatitis, 63 patients were randomly allocated to continuous intravenous infusion for three days of 250 micrograms of somatostatin (Dura Scan, Odense, Denmark) per hour (n = 33), or placebo (n = 30). Patients with a first attack of pancreatitis, serum amylase level of more than 450 units per liter and symptoms for less than 24 hours were eligible for participation in the study. Apart from a slightly significant faster decrease in serum amylase concentrations, we were unable to demonstrate any significant benefit from somatostatin with regard to paraclinical values and clinical course.

Acute Disease↗
PubMed1992

Surgical treatment of acute malignant large bowel obstruction.

OBJECTIVE: To evaluate the morbidity and mortality in all patients operated on urgently for acute large bowel obstruction caused by carcinoma of the colon or rectum during a 10 year period. DESIGN: Retrospective study. SETTING: Aalborg Hospital, Denmark. SUBJECTS: 156 consecutive patients operated on for obstructing primary colorectal cancers. MAIN OUTCOME MEASURES: Operations done, morbidity and mortality. RESULTS: 95 patients (61%) had advanced disease (Dukes' stage C or "D") and their median age was 73 years (range 38-93). 97 had the obstructing lesion resected with a 30 day mortality of 5%. 43 patients underwent primary resection and 4 died (9%), and 54 underwent staged resection with one death (2%). Complications were common, particularly after staged resections, median hospital stay being 19 days after primary, compared with 30 days after staged resection. 59 patients (38%) had palliative operations with 29 deaths (49%); in 39 the tumor was completely unresectable. CONCLUSION: Patients with obstructing primary colorectal cancers are a high risk group who are characterised by advanced disease and old age. Only prospective trials comparing different operations can assess whether it is possible to achieve a reduction in mortality.

Adult↗
PubMed1978

Operative technique for recurrent ulcer after vagotmoy and Jaboulay gastroduodenostomy.

Seven patients with ulcer recurrence following primary operation by vagotomy and Jaboulay gastroduodenostomy were treated by methods depending on the site of recurrence. A recurrent ulcer in the stomach was treated with a broad Billroth I reconstruction. In the anterior wall of the duodenum it was necessary to excise the penetrating ulcer cutting throught the bridge to the resection edge in the first part of the duodenum. A solid longitudinal closure is practical provided that the medial collar of the second part of the duodenum is at least 1 cm from pancreas. Recurrent ulcer in the posterior duodenal wall was in one case treated by leaving a collar of the antrum after removing the mucosa. This collar was used to close the gastroduodenostomy. If a large recurrent ulcer involves the second part of the duodenum, as in three of the referred patients, it was necessary to resect not only the duodenal bulb but also the proximal extent of the second part of the duodenum. One patient developed significant postoperative complications following this procedure. We feel that the procedure itself is technically difficult and should be taken account of by all who contemplate introducing gastroduodenostomy as a routine drainage procedure.

Adult↗