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Biomedical subjects

P Jess

Publications and source records attributed to P Jess.

At least 19 recordsLinked to original sources
PubMed2002

Quality of life after anterior resection versus abdominoperineal extirpation for rectal cancer.

BACKGROUND: Abdominoperineal extirpation has been assumed to put patients at higher risk of disruption to quality of life than sphincter-preserving surgery in rectal cancer surgery. The aim of this study was to investigate quality of life in patients after anterior resection versus abdominoperineal extirpation for rectal cancer and to evaluate the psychometrics of the Danish version of a symptom-specific Fecal Incontinence Quality of Life Scale. METHODS: Fourteen patients undergoing abdominoperineal extirpation and 26 undergoing anterior resection. The generic quality of life instrument SF-36 together with a new symptom-specific Fecal Incontinence Quality of Life Scale were used. Psychometric analysis of the symptom-specific scale was carried out. RESULTS: The only significant difference between the two groups was found in the total score of the symptom-specific scale in favour of anterior resection (P = 0.02). Psychometric evaluation of the symptom-specific fecal incontinence questionnaire proved it reliable and valid. CONCLUSIONS: The present study shows that a stoma influences quality of life only slightly, while a relatively high anterior resection does not. However, a few appropriate newer studies indicate that the cost of spinchter-preserving techniques in the form of incontinence disturbances may influence the quality of life seriously, which should be borne in mind when low anterior resection is intended. Further studies in this field are necessary and could benefit from use of the Fecal Incontinence Quality of Life Scale, including its total score.

Abdomen↗
PubMed2001

Acute terminal ileitis, yersiniosis, and Crohn's disease: a long-term follow-up study of the relationships.

Background: During the past decade, very little has been published on the relationships between Yersinia enterocolitica, acute terminal ileitis (ATI), and Crohn's disease, possibly due to a decrease in Yersinia infections and, consequently, in ATI. Methods: Fifty-three patients admitted to Herlev University Hospital during the period 1976-1998 were diagnosed as having ATI while undergoing surgery for suspected acute appendicitis. The patients were followed up, and both Yersinia titers and the development of Crohn's disease were registered. Results: Forty-four patients (83%) were tested for Yersinia, 17 of whom (39%; 95% confidence limits, 24-55%) were positive. The incidence of yersiniosis in ATI decreased significantly during the observation period (P<0.05), whereas the incidence of ATI itself was unchanged. Thirteen of the 53 patients (25%; 95% confidence limits, 14-38%) had, in addition to ATI, an inflamed appendix. Three patients developed Crohn's disease during a median observation period of 13 years (cumulative risk 6.1%). None of them had yersiniosis. Conclusions: The incidence of ATI remained stable during the observation period, even though the number of Yersinia infections decreased. This may have been due to an increase in gastrointestinal infections caused by other enteric pathogens. In accordance with previous findings, ATI patients who developed Crohn's disease did not have yersiniosis. Thus, it is still of prognostic value to test patients with ATI for Yersinia and perhaps for other enteric pathogens as well.

Journal Article↗
PubMed2000

Systemic inflammatory responses during laparoscopic and open inguinal hernia repair: a randomised prospective study.

OBJECTIVE: To see if the inflammatory responses during and after laparoscopic and open inguinal hernia repairs differed. DESIGN: Randomised prospective study. SETTING: County hospital, Denmark. PATIENTS: 18 men aged 25-77 years with unilateral inguinal hernias. INTERVENTIONS: Ten patients had a laparoscopic repair and 8 an open tension-free repair. MAIN OUTCOME MEASURES: Serum concentrations of interleukin (IL)-2 receptors (R) of the alpha group (IL-2Ralpha), IL-6, anti-IL-6, IL-10, tumour necrosis factor (TNF)-alpha, sTNF-RI and sTNF-RII before and 2, 6, 12, and 24 hours after the repairs. Duration of operation and time for return to normal activities or work were also recorded. RESULTS: Serum IL-6 concentrations increased significantly after operation in both groups (p < 0.0001), but the increase was significantly higher after open than after laparoscopic surgery at all sampling times (p = 0.00) at 6 hours postoperatively). Anti-IL-6 and IL-10 remained undetectable at all time points. There were no significant differences or increases in the concentrations of TNF-alpha or sTNF-RII. However, sTNF-RI concentrations increased significantly in both groups (p < 0.001) though there was no difference in between the two groups. IL-2Ralpha decreased significantly in both groups (p < 0.01) with no differences between the groups. The median operation time was 85 min (range 55-100 min) in the laparoscopic group and 52 min (range 45-79 min) in the "open" group (p < 0.01). Median time to return to normal activities/work were 2 and 13 days after laparoscopic and open operations, respectively (p < 0.01). CONCLUSION: The surgical trauma of laparoscopic inguinal hernia repair is less than that of open tension-free hernia operations as assessed by circulating mediators of the postoperative inflammatory response. The clinical relevance of this finding must be evaluated in larger randomised studies.

Adult↗
PubMed1999

[Gastroscopic removal of penetrating gastric band].

Gastric wall penetration of a gastric band after operation for morbid obesity is a well known late complication. The treatment is usually reoperation. In this case report we show that a band penetrating the gastric wall can be successfully treated by gastroscopic operation. This technique is more simple than reoperation, especially in case of morbid obesity at the time of the complication.

Adult↗
PubMed1999

[Laparoscopic ileocecal resection in Crohn disease].

Laparoscopic intestinal surgery has theoretical advantages compared with conventional intestinal surgery by minimizing the surgical trauma. The aim of the study was to examine the operative and postoperative course as well as the time for recovery after laparoscopic-assisted ileocoecal resection for Crohn's disease. Seventeen patients were operated on. The operations were assessed with regard to duration of operation, rate of conversion to open procedure, complications, time for discharge from hospital, and ability to take up work. Median operation time was 145 min. Two operations (12%) were converted to open procedure. Complications occurred in three patients (18%). Median postoperative time to discharge was five days. Median time to return to work was 26 days. In conclusion laparoscopic-assisted ileocoecal resection seems suited to Crohn's disease, but the benefit of the method needs confirmation in controlled, randomized studies.

Adolescent↗
PubMed1999

Long-term results of repair of the internal ring for primary inguinal hernia.

OBJECTIVE: To evaluate the long-term results of repair of the internal ring for primary inguinal hernia. DESIGN: Retrospective study. SETTING: University hospital, Denmark. SUBJECTS: 1159 patients with primary unilateral inguinal hernia. INTERVENTIONS: Repair of the internal ring--annulorrhaphy. MAIN OUTCOME MEASURES: Recurrence during the median observation period of 10 years (range 1-17). RESULTS: Eighty-four (7%) were women, and the overall median age was 49 years (range 18-90). The overall recurrence rate calculated by life table analysis was 18%. Twenty-one of the recurrences were indirect hernias (49%), 11 were direct (26%), 8 were combined direct and indirect (19%) and 3 (7%) were femoral hernias. CONCLUSION: Repair of the internal ring alone carries an unacceptably high recurrence rate.

Adolescent↗
PubMed1999

Gastroscopic treatment of gastric band penetrating the gastric wall.

Gastric wall penetration of a gastric band after operation for morbid obesity is a well known late complication. The treatment is usually reoperation. In this case report we show that a band penetrating the gastric wall can be successfully treated by gastroscopic operation. This technique is more simple than reoperation, especially in case of morbid obesity at the time of the complication.

Adult↗
PubMed1998

Neuroticism in relation to recovery and persisting pain after laparoscopic cholecystectomy.

BACKGROUND: Persisting pain is seen in 20%-30% of patients after cholecystectomy for symptomatic gallbladder stones. The only preoperative factor that seems predictive is psychic vulnerability or neuroticism. Findings with regard to the influence of psychologic factors on recovery are contradictory, too. The aim of the present study was to examine a possible relationship between neuroticism and recovery and the outcome of operation. METHODS: Ninety-four patients who had had a laparoscopic cholecystectomy performed were tested psychologically with a Danish psychic vulnerability scale and with the Eysenck Neuroticism Scale before and 1 year after operation. The course of recovery was registered 1 month after operation, and outcome with regard to persisting pain 1 year postoperatively. RESULTS: No correlations were found between neuroticism scores and postoperative hospital stay or time to regain work/normal activities (P > 0.05). Persisting pain was found in 18% of the patients 1 year after operation. Although the patients with persisting pain had higher neuroticism scores preoperatively, the difference from the patients with successful outcome of the operation first became statistically significant 1 year postoperatively (P < 0.01-0.05). CONCLUSIONS: The results do not indicate that neuroticism influences the short recovery process after laparoscopic cholecystectomy. With regard to persisting pain, the higher neuroticism scores in these patients 1 year after the operation could be the consequence of the pain rather than aetiologic factors.

Adolescent↗
PubMed1997

CT in the diagnosis of abdominal wall hernias: a preliminary study.

The aim of the study was to estimate the value of CT in the diagnosis of abdominal wall hernias and at the same time to create a standard for this CT investigation. Twenty-four patients with suspected hernia of the abdominal wall were examined. All were operated on. The CT scans were assessed by two radiologists to estimate the interobserver variation. The CT diagnoses made by the two radiologists were correct in 83 % and 79 % of cases, respectively. The sensitivity was 0.83 in both CT evaluations and the specificity was 0.83 and 0.67, respectively. The predictive value of a positive CT finding was 0.94 and 0.88, while the predictive value of a negative CT finding was 0.63 and 0.57, respectively. The interobserver variation (kappa) was 0.87. The study therefore indicates that a positive CT finding of abdominal wall hernia is reliable, while a negative finding does not exclude the diagnosis. The interobserver variation of the CT diagnoses is acceptable. To achieve the highest diagnostic accuracy, it is recommended to always use the Valsalva manoeuvre, oral intake of contrast and 10/10 mm CT slices.

Adult↗
PubMed1996

Laparoscopic-assisted ileocecal resection for Crohn's disease: a preliminary study.

BACKGROUND: The aim of the study was to present our preliminary results with laparoscopic-assisted ileocecal resection in Crohn's disease of the terminal ileum. METHODS: Eight patients were operated on. The operations were assessed with regard to duration of operation, rate of conversion to open procedure, complications, time for discharge from hospital, and ability to take up work. RESULTS: Median operation time was 145 min. One operation (12.5%) was converted to open procedure. Minor complications occurred in one patient (12.5%). Median postoperative time for discharge was 5 days. Median time to return to work was 21 days. CONCLUSIONS: Laparoscopic-assisted ileocecal resection seems suited to Crohn's disease, but the benefit of the method needs confirmation in controlled, randomized studies.

Adolescent↗
PubMed1995

[Personality characteristics in ulcer disease. A cohort study].

The purpose of the study was to investigate the direction of a possible relationship between peptic ulcer disease and personality disorders. A cohort study was carried out in Glostrup County, Denmark (population 100,000). A representative sample of 50-years old persons born in 1914 (n = 673) were followed for 20 years. All 673 filled in the Minnesota Multiphasic Personality Inventory (MMPI) in 1964 and 513 were retested with MMPI in 1974. The prevalence of peptic ulcer disease in 1964 was 7% and the average annual incidence in the period 1964-1984 was 2.1 per 1000 persons. The persons with incidental peptic ulcer in 1964-84 had normal MMPI scores in 1964, while persons with peptic ulcer in 1964 had a slight but statistically significant increase in one neuroticism scale (HS) only. The group with prevalent ulcer disease in 1974 exhibited statistically significant increases in the three neuroticism scales (HS, D, HY) and in scale Pd and scale Pt at MMPI retesting. In addition they had statistically significantly higher scores in the three neuroticism scales compared with the other persons who still had normal scores in all scales. It is concluded that personality disorders in persons with peptic ulcer are consequences of the disease and not causal factors.

Cohort Studies↗
PubMed1995

[Laparoscopic ultrasonography of liver, biliary tract and pancreas with flexible tip transducers].

The scanning procedure and the ultrasound-anatomy of the liver, gall-bladder, bile ducts and pancreas are presented. Ten consecutive patients referred for laparoscopic cholecystectomy were scanned through a 10/11 mm trocar inserted periumbilically. In two cases concrements in the bile ducts were found peroperatively. The flexible-tip enables operator steering of the transducer which ensures an optimal acoustic contact. Colour and spectral Doppler were frequently used to identify vascular structures. We conclude that a flexible-tip laparoscopic ultrasound-scanner provides valuable assistance in abdominal laparoscopic procedures, and may substitute the palpation of the abdominal organs in laparoscopic abdominal surgery.

Biliary Tract Diseases↗
PubMed1995

Rate and treatment of pelvic recurrence after abdominoperineal resection and low anterior resection for rectal cancer.

PURPOSE: This study was designed to analyze factors of importance for local recurrence after radical surgery for rectal cancer and to analyze course and outcome of treatment of pelvic recurrence. METHODS: One hundred seventy-five patients treated for rectal cancer with low anterior resection (LAR) or abdominoperineal resection (APR) were studied, retrospectively. Seventy-four patients had LAR and 101 had APR. RESULTS: The two groups were comparable with respect to Dukes classification, histologic differentiation, and male to female ratio. The rate of pelvic recurrence was 18 percent for LAR and 24 percent for APR (not significant). Recurrence rates were 27 percent after stapled anastomoses and 10 percent after handsewn anastomoses respectively (P = 0.09). Twenty five had pelvic recurrence diagnosed without signs of distant metastatic disease. They were treated with radiotherapy, palliative operations, or analgesics. The group receiving radiotherapy had a significantly longer survival (15.9 months) compared with other groups (2.4 months; P < 0.001). CONCLUSIONS: There is no difference in local recurrence rate after LAR and APR. Radiotherapy seems to increase survival in patients with an unresectable recurrence and should be offered irrespective of pain.

Abdomen↗
PubMed1994

Laparoscopic loop ileostomy for fecal diversion.

PURPOSE: The aim of this study was to describe the procedure for laparoscopic loop ileostomy. METHODS: Technique description is given. CONCLUSION: The method is suitable for temporary fecal diversion in patients with anal disorders, where no other intraperitoneal operation is required.

Anus Diseases↗
PubMed1994

Personality pattern in peptic ulcer disease: a cohort study.

OBJECTIVES: To investigate the direction of a possible relationship between peptic ulcer disease and personality disorders. DESIGN: A cohort study of 50-year old patients, observed for 2 decades. SETTING: Glostrup County, Denmark (population 100000). SUBJECTS: A representative sample of 50-year old people born in 1914 (n = 673) were followed for 20 years. All 673 filled in the Minnesota Multiphasic Personality Inventory (MMPI) in 1964 and 513 were retested with MMPI in 1974. MAIN OUTCOME MEASURES: Prevalence of peptic ulcer disease 1964, incidence of peptic ulcer disease 1964-84, MMPI scores. RESULTS: The prevalence of peptic ulcer disease in 1964 was 7% and the average annual incidence in the period 1964-84 was 2.1 per 1000 persons. Those with incidental peptic ulcer in 1964-84 had normal MMPI scores in 1964, whilst those with peptic ulcer in 1964 had a slight but statistically significant increase in one neuroticism scale (HS) only. The group with prevalent ulcer disease in 1974 exhibited statistically significant increases in the three neuroticism scales (HS, D, HY) and in scale Pd and scale Pt at MMPI retesting. In addition they had statistically significantly higher scores in the three neuroticism scales compared with the other persons who still had normal scores in all scales. CONCLUSIONS: Personality disorders in patients with peptic ulcer are consequences of the disease and not causal factors.

Aged↗