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Biomedical subjects

K Søndenaa

Publications and source records attributed to K Søndenaa.

At least 19 recordsLinked to original sources
PubMed1992

[Local resection of cancer of the Vater's papilla].

Tumours of the papilla of Vater are almost always adenocarcinomas and are often less than 2.5 cm in diameter. Lymph node metastases occur in one fourth of the patients with tumours with a diameter of less than 2.5 cm. Whipple's procedure has been the most common operation when attempting radical excision. Local resection has not won acclaim, even though the five year survival rates are often reported to be about the same as for Whipple's procedure. We present a patient who was operated on by local resection, and describe the operative technique.

Adenocarcinoma↗
PubMed1992

[Acute appendicitis. Preoperative observation time and diagnostic accuracy].

The indication for operative treatment of suspected acute appendicitis is based mainly on clinical examination. In this retrospective study of 327 emergency laparotomies the accuracy of the surgeons diagnosis was 69.4%. The overall rate of unnecessary laparotomy was 28.4%, and 45.6% of the operated females, aged 12 to 40 years, did not actually require surgery. The median postadmission delay before operation was three hours 28 minutes. With increasing observation time, the diagnostic accuracy was significantly decreased from 77.7 to 52.2%, and the incidence of perforation rose from 18.6 to 33.3%. 8.7% of the patients with a surgical condition suffered from excessive delay (greater than 12 hours) before surgery. There was no correlation between time of admission and operation and accuracy of diagnosis, but a considerable variation in accuracy between different surgeons. The difficulty in obtaining a correct pre-operative diagnosis in patients with suspected acute appendicitis is still a clinical problem of major concern.

Acute Disease↗
PubMed1992

Rapid C-reactive protein (CRP) measurements in the diagnosis of acute appendicitis.

C-reactive protein (CRP) has been measured in plasma of patients with acute appendicitis and in controls without appendicitis to test the accuracy and diagnostic performance of a new rapid test kit for CRP (NycoCard CRP). The values obtained for CRP by the rapid test correlated well (Rs = 0.92) with the reference method for measuring CRP. The sensitivity, specificity and predictive values were calculated at different cut-off values. At values > 10 mg l-1 a sensitivity of 58% and a negative predictive value of 72% were found. Higher values of sensitivity were observed for men than for women, 69% and 44% respectively. Patients with acute appendicitis who had had symptoms for more than 24 h, had elevated CRP values (cut-off > 10 mg l-1) in more than 80% of cases. Our study shows that the rapid CRP test and the reference CRP test gave an almost identical result.

Acute Disease↗
PubMed1992

Value of computed tomography in preoperative evaluation of resectability and staging in oesophageal carcinoma.

OBJECTIVE: To evaluate computed tomography (CT) as a method of staging patients with oesophageal carcinoma. DESIGN: Retrospective study. SETTING: Ullevaal Hospital, Oslo, Norway. SUBJECTS: 85 patients who presented with oesophageal carcinoma between February 1982 and December 1989. INTERVENTIONS: Assessment by CT was made in all patients. MAIN OUTCOME MEASURES: Correlation with findings at operation, and histological examination of operative specimens. RESULTS: From the findings at operation in the 46 patients who were operated on (resection, n = 39; exploration only, n = 7) the sensitivity, specificity, and accuracy of CT staging of the growth were 80%, 91%, and 88%, and when histological confirmation of infiltration was taken into consideration the figures were 25%, 84%, and 54%, respectively. The sensitivity, specificity, and accuracy of CT detection of lymph node metastases were 22%, 95%, and 55%. CONCLUSION: Staging of oesophageal cancer with CT before operation is useful in judging resectability, but the smaller tumours should be assessed with caution. CT is unreliable in the diagnosis of the depth of infiltration and the presence of lymph node metastases compared with histological examination.

Adenocarcinoma↗
PubMed1991

Mucosal surface area of a reversed intestinal segment in rats.

Only scarce knowledge exists of morphologic changes after antiperistaltic reversal of the small intestine. Previous animal models using a reversed segment of the small intestine after massive intestinal resection have been mostly concerned with assessing absorption. A rat model was therefore developed for the purpose of studying mucosal surface area in the small intestine after reversal of an intestinal segment. A reversal of 10 cm, representing a length of about 10%, was found suitable for the investigation. Marked dilatation of the reversed segment occurred. A pronounced increase in mucosal surface area caused by mucosal hyperplasia was observed. The mucosal surface area in an anastomosed, but not reversed, segment also increased markedly compared with a group undergoing no operation, although less than in the reversed segment. We conclude that a reversed intestinal segment will increase mucosal surface area in an optimal length used for this purpose. This increase is possibly caused by prolonged exposure to intestinal chyme.

Animals↗
PubMed1990

[Transfusion therapy and volume treatment in elective surgery and traumas].

New light has recently been shed on transfusion therapy. Early recurrence of cancer, ill effects on the immune system and increased incidence of postoperative infections have all been suggested as possible complications of overenthusiastic transfusion therapy. The need for perioperative transfusions has been overestimated in the past, since new physiological investigations show that a hemoglobin level of 8 g/100 ml can be tolerated at elective surgery provided that the patient is normovolemic and normothermic. Neither has the danger of virus contamination been entirely eliminated. With this in mind, blood component therapy, giving erythrocytes and plasma components according to documented need, has been started. The article describes our institution's suggested policy for transfusion therapy and volume treatment in elective and trauma surgery.

Blood Coagulation Factors↗
PubMed1990

A prospective study of the length of the distal margin after low anterior resection for rectal cancer.

The length of distal margin between the lower border of the tumour and the level of division during low anterior resection may be related to the rate of local recurrence. The method of measuring the distal clearance is not usually stated in reports of the operation. The distal margin was measured prospectively in 5 different ways in 20 patients. A difference was observed between various methods of measurement of the same specimen in situ, unpinned and pinned out before and after fixation. The margin was significantly less (p less than 0.001) in unpinned compared with pinned specimens. There was poor correlation between the in situ measurement and that determined by the pathologist in both unpinned and pinned specimens. There was no significant difference before and after fixation if the specimen had been pinned but significant (p less than 0.001) shrinkage occurred with fixation when the specimen had not been pinned.

Aged↗
PubMed1990

Traumatic rupture of the thoracic aorta. A clinicopathological study.

In a county hospital serving a population of roughly 240,000, the hospital records from the period 1982 to 1987 included 27 patients who presented with traumatic rupture of the thoracic aorta. Eighteen patients died instantaneously, one was dead on admission, five died in hospital and three survived operation. Two patients had direct cross clamping of the aorta and Dacron interposition graft soon after admission; both survived. The third patient had a Gott shunt and Dacron interposition graft the day after the accident and survived with paraplegia. In all patients who died in hospital except one, the condition was not diagnosed before death. We conclude that traumatic rupture of the thoracic aorta occurs more frequently than is generally thought. Although most patients die at the scene of the accident, a liberal use of angiography is indicated in all trauma cases admitted to hospital with a history of a forceful deceleration or acceleration injury.

Accidents, Traffic↗
PubMed1989

A comparative study of polydioxanone (PDS) and polyglactin 910 (Vicryl) in colonic anastomoses in rats.

The use of polyglactin 910 (Vicryl) in colonic anastomoses is theoretically undesirable because its short dissolution time and multifilament structure may lead to local sepsis and anastomotic leakage. We have compared Vicryl with a newly introduced monofilament absorbable suture which has a longer dissolution time than Vicryl. In a study of 98 rat colonic anastomoses no difference was found in complication rates or cellular reaction to the suture material between Vicryl and polydioxanone (PDS). The use of monofilament suture with longer dissolution time does not necessarily imply added security for colonic anastomoses.

Anastomosis, Surgical↗