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Biomedical subjects

O Swenson

Publications and source records attributed to O Swenson.

At least 19 recordsLinked to original sources
PubMed1989

A 40-year multinational retrospective study of 880 Swenson procedures.

This report reviews the experience of pediatric surgeons in seven cities in North American and Western Europe where the Swenson procedure was performed on 880 patients. Information on the diagnosis, treatment, complications, and long-term results was collected by reviewing the hospital records, the treating physicians' office records, and by interviewing the patients in person or by telephone. A follow-up evaluation was obtained on 814 patients. The patients' ages at the time of the resection ranged from four days to 50 years. The length of follow-up averaged 10.3 years, while the longest follow-up was 39.5 years. The overall postoperative mortality was 2.4% during the entire 40 years of the study. The postoperative mortality has decreased to 1.25% for the last 20 years. Significant factors influencing postoperative mortality included Down's syndrome, the patient's age at the time of the operation, and leak of the distal colonic anastomosis. Most of the patients followed for over 5 years have normal bowel habits, report one to three bowel movements per day, and have no soiling. No patient has urinary incontinence or impotence.

Adolescent↗
PubMed1989

My early experience with Hirschsprung's disease.

Prior to 1948, when the first distal colonic resection with preservation of continence was performed for Hirschsprung's disease, there was no clear understanding of the etiology of the disease. Early explanations for the cause of the disease included mechanical obstruction, "neurologic imbalance," and congenital malformation of the entire colon. No medical or surgical treatment had proved successful in treating the disease. It is generally assumed today that the absence of ganglion cells was widely known and accepted as the cause of Hirschsprung's disease prior to 1948 and that this led to the concept of distal colon dysfunction and formed the basis for the distal colonic resection. As a matter of fact, it played no role whatsoever in devising the successful operation. The rare absence of ganglion cells was widely held to be produced by the massive distention and chronic stasis in the megacolon and was considered of no pathologic significance. This report reviews the early work in developing the concept of a distal physiologic obstruction that led to a successful surgical treatment.

Colectomy↗
PubMed1980

Specialization: What it holds for the future of medicine.

Specialization in medicine developed in response to the ever-increasing volume and complexity of scientific knowledge. While diverse factors may have contributed to improved health of people in the United States, the medical profession undoubtedly played an important role. Despite this achievement our profession is held in low esteem probably because of the high cost of medical care and unsubstantiated charges in the United States that some surgery is performed unnecessarily. In contemplating the future we must guard against the establishment of unrealistic small areas of specialization. Specialty groups must refrain from treatment of disease entities or anatomical regions. Such claims indicate self-aggrandizement and lead to acrimonious, destructive disputes within the profession.

Costs and Cost Analysis↗
PubMed1978

An improved mechanical device for control of urinary incontinence.

Results of tests on implantable artificial sphincters with a subcutaneous control unit encased in a plastic envelope were previously reported. The plastic deteriorated and in 12 to 18 months caused instrument failure. To obviate this failure, (control) units of titanium alloy with protruding levers were tested in 17 animals for a period of up to 6 months to determine whether fibrosis and tissue ingrowth would hamper the function of the control levers. The device was placed around the urethra distal to the bladder neck. It was set to obstruct the urethra against pressures varying from 40 to 80 cm of water. Erosion of the urethra did not take place. In no instance was the action of the subcutaneous control levers hampered by tissue ingrowth or fibrosis.

Animals↗
PubMed1976

An experimental implantable urinary sphincter.

An artificial urethral sphincter was implanted in 10 dogs and observed for periods up to 18 months. No necrosis or strictures of the urethra developed. The plastic part of the device failed in 10 to 18 months.

Animals↗
PubMed1975

The treatment and postoperative complications of congenital megacolon: A 25 year followup.

In 1948 one of us (O.S.) proposed a new method of treatment, abdominoperineal resection, for patients with congential megacolon. Since then, 483 patients have been treated by 13 pediatric surgeons in Chicago and Boston using this technique. Two hundred and eight-two of the patients were last interviewed and examined more than 5 years after the resection. There were 16 postoperative deaths (3.3%) and 6 late deaths (1.2%) from enterocolitis. Both early and late complications were infrequent and are discussed in detail. Almost 90% of the patients reported that they now have normal bowel habits. None of the patients developed urinary incontinence or impotence, although ten patients (2.1%) reported permanent fecal soiling. This is the first large group of patients treated for congenital megacolon who have been followed to adulthood. The low incidence of postoperative complications and minimal frequency of long-term complications indicate that the abdominoperineal resection is a safe, effective method of treatment for congenital megacolon.

Adolescent↗