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Steinar Solberg

Publications and source records attributed to Steinar Solberg.

12 recordsLinked to original sources
PubMed2006

[Waiting time for surgery of lung cancer].

BACKGROUND: Surgical resection is the mainstay of curative treatment for lung cancer. It is important that the resection is done as soon as the disease is diagnosed. The waiting time in Norway can be longer than desirable. MATERIAL AND METHODS: Patients who underwent resection for primary lung cancer in the period 1998-2001 were identified in the Cancer Registry of Norway. When malignancy was confirmed preoperatively by histopathology or cytology, the time interval from diagnostic procedure to the pathologist's answer was calculated as response time and further the time from diagnosis to surgery was calculated as waiting time. Covariates important for waiting time were analysed by univariable and multivariable regression analyses. RESULTS: Of the 1351 patients that were operated in the period, 924 had a positive cytological or histological preoperative diagnosis. Pathology response time was median 3 days and waiting time for surgery was median 26 days (range 0-406 days). Multivariable regression analysis demonstrated that disease stage, histology and patient referral between hospitals contributed to waiting time from diagnosis to operation. Patients undergoing investigation and surgery at the same hospital had a median 9 days shorter waiting time than those referred from other hospitals. INTERPRETATION: Our investigation revealed a longer waiting time than desired. A high proportion of patients did not have a positive preoperative biopsy or cytology.

Adenocarcinoma↗
PubMed2005

[Treatment of combined carotid and cardiac disease].

BACKGROUND: The proper management strategy for patients with combined carotid and cardiac disease remains unsettled. It is controversial whether the operations should be synchronous, staged or reversed staged, and most publications also lack conservatively treated control groups. The role of endovascular treatment in this situation has not been documented. We present our current treatment strategy and results. MATERIAL AND METHODS: During the period January 2001 to December 2003, 95 procedures for internal carotid artery stenosis were performed in 81 patients. Median age was 70 years, range 44-83; 24 were women. In 37 patients invasive treatment of carotid stenosis and cardiac disease was performed (group A). In another 23 patients the carotid stenoses were treated invasively, while the cardiac disease was treated conservatively (group B). No heart disease was diagnosed in 21 patients treated for carotid stenoses (group C). Postoperative stroke/death was registered after all interventions. RESULTS: Stroke/death: Group A: one ipsilateral non-disabling stroke after carotid endarterectomy and one cardiac death after coronary artery bypass surgery (5.4%). Group B: one ipsilateral fatal cerebral haemorrhage and 1 contralateral ischaemic stroke (8.7%). Group C: none. DISCUSSION: Meta-analyses have calculated the risk of stroke/death after treatment for combined carotid and cardiac disease to be 7-9%, independently of whether the procedures are performed synchronously, staged or reversed staged. Our results are comparable. The aim of treatment for carotid and cardiac disease is to prevent death, stroke and heart failure. The benefit from treatment thus depends on a low complication rate, but patients with combined disease have an increased risk of complications. Counseling of these patients should be based on a multidisciplinary approach, taking into account all possible treatment options including conservative, endovascular and surgical, with an aim to reducing total cardiovascular risk.

Adult↗
PubMed2003

[Elective stent treatment of abdominal aortic aneurysm].

BACKGROUND: First described in 1991, endovascular treatment is a simplified method for abdominal aortic aneurysm repair (EVAR). The enthusiasm created by few complications and early mobilisation was replaced by scepticism because of the high frequency of secondary complications such as endoleak, stenosis, graft migration, aneurysm enlargement and late rupture. Though the method still is considered experimental, thousands of grafts are inserted every year. MATERIAL AND METHODS: From 1998, 53 patients underwent EVAR electively at our institution, 17 of whom were for medical reasons considered inoperable in open surgery. They were followed up with CT scans, which together with angiograms were evaluated retrospectively. Co-morbidity and complications were registered. Follow up was at 26 (4-50) months for 49 patients. RESULTS: Two patients died. There were two other complications in addition to two superficial wound infections. There were no surgical conversions. 18 patients had 25 secondary interventions. Cumulative intervention rate was 25% after 12 months, 28% after 24 months and 53% after 36 months. Four stenoses were seen the first 6 months. 19 patients had an endoleak (1 had type I after 24 months, 6 had type II endoleak, 5 had type III endoleak of which two appeared after 3 years). Graft migration was observed in 9 patients (5 at 3 years control). Two ruptures were corrected with endovascular technique. Survival and interventions were equal among inoperable and operable patients. INTERPRETATION: Few early complications are overshadowed by the frequent and unpredictable late complications after EVAR; patients have to be followed up for years. For patients unfit for open surgery this is, however, an optional treatment if intervention is otherwise indicated.

Aged↗
PubMed2003

Prediction of acute renal failure after cardiac surgery: retrospective cross-validation of a clinical algorithm.

BACKGROUND: Acute renal failure (ARF) after cardiac surgery is associated with high costs and a poor prognosis. Based on the results of a large US study, an algorithm has been developed for predicting ARF from pre-operative risk factors. The aim of this study was to cross-validate this algorithm in a patient population from Europe, and to assess its usefulness as a clinical tool. METHODS: All coronary bypass and valvular surgery patients from a 5-year period were included. Data on pre-operative risk factors for all patients who developed dialysis-dependent ARF and for a random sample of patients without ARF were retrospectively obtained from hospital databases and medical records. For each patient, a risk score for ARF was calculated on the basis of the algorithm. The sensitivity, specificity, positive and negative predictive values and area under receiver operating characteristic (ROC) curve of the score's ability to predict ARF were estimated. RESULTS: 2037 patients were included. The risk of ARF was 1.9%, and the area under the ROC curve 0.71. For a risk score of 6 or higher, the sensitivity was 0.53, the specificity 0.71, the positive predictive value 0.03 and the negative predictive value 0.99. CONCLUSIONS: The validity of the algorithm was confirmed in a population differing in several aspects from the US populations where it was developed. Although it is useful for estimating the risk of ARF in groups of patients, the low risk of ARF limits the algorithm's ability to predict the outcome for individual patients.

Acute Kidney Injury↗
PubMed2002

[Open surgery of abdominal aortic aneurysm].

BACKGROUND: We wanted to evaluate the results after open surgical treatment of abdominal aortic aneurysm. MATERIAL AND METHODS: We present a retrospective survey of 581 patients operated for infrarenal abdominal aortic aneurysm at the Tromsø University Hospital from 1980 through 1998. RESULTS: The number of elective operations increased from two in 1980 to 18 in 1998. The frequency of conditions regarded as co-morbidity increased during the observed time period. Mean body mass index for electively operated men increased from 24.2 in 1980-84 to 26.1 in 1995-98 (p < 0.01). Mean aneurysms diameter of those operated electively was 60 mm. The operative (30 days) mortality rate was 7.6% for those operated electively, 9.8% for those with impending rupture, and 40% for those with ruptured aneurysm. INTERPRETATION: We find these results comparable with those presented in other reports.

Adult↗
PubMed2002

[Incisional hernia after surgery for abdominal aortic aneurysm].

BACKGROUND: Incisional hernia in patients electively operated on the abdominal aorta is common. METHODS: Patients with abdominal aortic aneurysm and with aorto-iliac occlusive disease (n = 231) operated at Tromsø University Hospital between 1992 and 1998 were identified. Data were obtained from patient files and from a postal questionnaire sent to 172 patients and returned by 140 (85%). RESULTS: Mean follow-up time was 3.5 years; 49 out of 140 patients (35%) had incisional hernia, 42 of these had been operated for aneurysm and seven for occlusive disease. Patients operated for aneurysm had an increased risk of developing incisional hernia (OR 3.1, p = 0.03). Obesity and smoking were associated risk factors. The hernias appeared earlier in patients with aorta aneurysm than in patients with occlusive disease (p < 0.01). A large proportion of the patients reported discomfort due to their hernias. INTERPRETATION: Abdominal aorta aneurysm seems to be associated with alterations in the connective tissue. Incisional hernia is a significant source of morbidity in patients operated for abdominal aortic aneurysm.

Aged↗