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J Järhult

Publications and source records attributed to J Järhult.

At least 19 recordsLinked to original sources
PubMed2005

Graves' disease with moderate-severe endocrine ophthalmopathy-long term results of a prospective, randomized study of total or subtotal thyroid resection.

The optimal thyroid surgery to be performed in patients with Graves' disease and concomitant endocrine ophthalmopathy is a matter of debate. We randomly assigned 44 patients with moderate-severe eye signs in a trial of treatment with subtotal, leaving a small (approximately 2 g) thyroid remnant, or total thyroidectomy. At inclusion, the patients had been treated with antithyroid drugs, and corticosteroids been given to 12 (27%). All received postoperative thyroxine supplementation and were followed for 3 years at regular examinations. The eye disease improved in all cases, and throughout the study, the two groups did not differ with regard to subjective and objective eye symptoms and laboratory findings. At the study start, motility disturbances were present in 8 and 11 of the cases in the subtotal and total resection group and proptosis in 16 and 17, respectively. After 3 years, the corresponding data were 3 and 6 cases with motility defects and 16 and 15 cases with proptosis. Thyrotropin (TSH)-receptor antibody levels gradually fell and became nondetectable in 21 (49%). The surgical complication rate (permanent recurrent laryngeal nerve paresis and permanent hypoparathyroidism) was significantly higher in the total thyroidectomy group. The data indicate that in patients with Graves' disease and active endocrine ophthalmopathy, subtotal thyroidectomy, leaving a small thyroid remnant, will reduce the risk of surgical complications but not the beneficial effect of surgery.

Adult↗
PubMed2005

Is preoperative evaluation of the biliary tree necessary in uncomplicated gallstone disease? Results of a randomized trial.

AIM: To analyse if preoperative radiology is of value in patients with uncomplicated gallstone disease. MATERIAL: 312 patients intended for laparoscopic cholecystectomy were randomly allocated to undergo preoperative radiology (intravenous cholangiography or magnetic resonance cholangiography) or to a control group. Intraoperative cholangiography was not used routinely in either group. RESULTS: There was no bile duct injury and no difference in complication frequency between the two groups. The incidence of common bile duct stones was 3.8% within the first postoperative year with no statistical difference between the two groups. CONCLUSIONS: Routine preoperative evaluation of the bile tree seems unnecessary before laparoscopic cholecystectomy in patients with uncomplicated gallstone disease.

Adult↗
PubMed2004

Equal results with laparoscopic and Shouldice repairs of primary inguinal hernia in men. Report from a prospective randomised study.

AIM: To compare the laparoscopic and Shouldice techniques for repair of inguinal hernia. MATERIAL: 261 healthy men over 50 years with primary, unilateral inguinal hernia were randomly allocated to laparoscopic (total extraperitoneal approach, TEP) treatment (n = 131) or to a modified Shouldice technique (n = 130). RESULTS: Apart from a longer operative time in the laparoscopic group, there were no significant differences between the two methods with regard to perioperative complications, hospital stay, recurrencies or pain in the groin. CONCLUSIONS: Results following the total extraperitoneal laparoscopic and the Shouldice technique do not differ significantly 2 years after hernia repair.

Aged↗
PubMed2000

[Endoscopic ultrasound in the investigation of gastric tumors].

Preoperative staging has been considered to be of importance in gastric cancer. Recently, 133 patients were examined preoperatively using endoscopic ultrasound, and 77 of these had gastric cancer. Preoperative staging (T + M) using endoscopic ultrasound coincided with findings at surgery in 84% of the cases. The depth of penetration was accurate in 92% of the cases. It is concluded that endoscopic ultrasound is more reliable for preoperative staging than conventional ultrasound, computer tomography or magnetic resonance imaging for gastric cancer. Whether or not improved preoperative staging has a bearing on the treatment of patients with gastric cancer, depends largely on whether or not cytostatic therapy is used. We believe that centralizing diagnosis and treatment of gastric cancer is beneficial.

Adult↗
PubMed2000

[Nerve damage after thyroid-parathyroid surgery. Recurrent nerve paralysis significantly impair quality of life in many patients].

Forty-seven cases of permanent vocal cord paralysis after neck surgery are investigated. Very few operations were described as technically problematical. The recurrent laryngeal nerve was identified in 77% of the procedures. Patients in particular need of an excellent voice in their work or leisure activities described a definite decrease in quality of life after surgery. Straightforward information concerning this complication should always be given to the patient preoperatively.

Adult↗
PubMed1999

Laparoscopic treatment of recurrent inguinal hernias: experience from 281 operations.

The results of laparoscopic repair of 281 recurrent inguinal hernias in 260 patients are presented. One hundred sixty-eight totally extraperitoneal (TEP) and 113 transabdominal preperitoneal (TAPP) procedures were performed. Four major complications occurred in the early postoperative period, three of them in the TAPP group. After 2-4 years, the results were controlled by questionnaires and clinical reexaminations, if necessary. Eleven percent of the TAPP patients and 2% of the TEP patients experienced a recurrence. About 20% of the patients reported occasional discomfort and pain in the operated groin. We conclude that laparoscopic herniorrhaphy provides acceptable results in reoperative hernia surgery.

Female↗
PubMed1998

[Minilaparotomy is a careful method in right colon tumor surgery].

In a series of 47 patients, right colon tumours were treated surgically with a minilaparotomy approach, entailing a skin incision of less than 10 centimetres. The procedure allows appropriate oncological management of the tumour, and is associated with a mild postoperative course and a rapid recovery and resumption of normal life. The short-term outcome in this series has been promising, and the minilaparotomy approach would thus appear to be an attractive alternative to traditional open surgery of the right colon.

Aged↗
PubMed1998

Minilaparotomy approach to tumors of the right colon.

OBJECTIVE: The study contained herein was undertaken to describe the minilaparotomy approach to tumors of the right colon. METHOD: Clinical data were prospectively registered from 47 patients who were undergoing resection of the right colon via minilaparotomy. RESULTS: Bowel function returned after two days and passage of stools after four days. Pain medication was necessary only during the first three postoperative days. Major complications were few, and no postoperative deaths occurred. Tumors 10 cm or smaller could be handled by minilaparotomy, and the technique allowed a relevant number of lymph nodes to be removed. No local recurrences were detected during the early postoperative period. CONCLUSION: The minilaparotomy approach to tumors of the right colon seems to be an attractive alternative to conventional colon surgery.

Aged↗
PubMed1997

Multiple endocrine neoplasia type 1 and the search for the genetic trigger.

Multiple endocrine neoplasia type 1 (MEN-1) is characterized by primary hyperparathyroidism, endocrine pancreatic-duodenal and anterior pituitary tumors. The diagnosis is challenging and involves the exclusion of other endocrine neoplasia syndromes with overlapping features. The predisposing genetic defect was assigned to chromosomal region 11q13 based on linkage analysis. Combined tumor and pedigree genotype analysis showed that allele losses in pancreatic, parathyroid and pituitary tumors eliminated the wild-type allele at the 11q13 loci, suggesting inactivation of a tumor suppressor gene in this region. A 5-Mb integrated map of the region has been established by the European consortium on MEN-1. Based on this mapping the critical interval was restricted to 2 Mb, a region within which eight candidate genes are located.

Chromosome Mapping↗