PubMed Health⌕ Search

Biomedical subjects

T Bjerkeset

Publications and source records attributed to T Bjerkeset.

48 records · Page 3Linked to original sources
PubMed1980

Systemic prophylaxis with metronidazole (Flagyl) in elective surgery of the colon and rectum.

The effect of metronidazole prophylaxis in elective colonic and rectal surgery was studied in a prospective double-blind trial in which metronidazole was compared with a placebo. Fifty-six patients were included in the study, and the patients were randomly allocated to the two groups. Twenty-five patients received 2 gm of metronidazole the day before operation and 1.2 gm as a single daily dose for 5 days after operation. Twenty-one patients were given placebos in the same dosage. Before operation all patients were prepared with mechanical evacuation of the bowel. A significantly lower frequency of wound spesis, intraabdominal complications, and septicemia was found in the metronidazole group as compared to the placebo group. The incidence was 4.0% and 36%, respectively. Following protectomy, infection in the perineal area occurred in 33% and 43% of the respective groups. In the metronidazole-treated patients, however, this was the only complication, whereas 50% of the patients in the placebo group developed intraabdominal complications as well. After operation anaerobic bacteria were isolated from 8% of the patients who received prophylactic metronidazole. In the control group 67% of the patients had a positive postoperative anaerobic culture. Bacteroides fragilis was isolated from 13 of 14 patients with postoperative infection in the placebo group. B. fragilis was not isolated from any of the metronidazole-treated patients. The study indicates that anaerobic bacteria are the major contributors to would infection following colonic and rectal surgery and that metronidazole prophylaxis greatly reduces the frequency of postoperative infection.

Bacteroides Infections↗
PubMed1977

Pneumoperitoneum without clinical peritonitis due to bilateral pyosalpinx.

A case of pneumoperitoneum without clinical peritonitis due to bilateral pyosalpinx is presented. This clinical condition has in the literature been called "spontaneous or idiopathic pneumoperitoneum", and conservative treatment in such cases has been advocated. As shown in our case severe intraperitoneal pathology may exist, and we therefore advocate early explorative laparotomy in all patients with pneumoperitoneum without peritonitis.

Aged↗
PubMed1977

Highly selective vagotomy in the treatment of duodenal ulcer in a teaching hospital. A one-to-three year follow-up relating results to the number of operating surgeons, their surgical experience, and training conditions.

In the present series, highly selective vagotomy (HSV) was used in the treatment of duodenal ulcer and the patients were followed up 1 to 3 years after operation. Three months after operation, 57% of the patients had positive insulin tests (early and late positive). Ulcer recurrence rate was approximately 6.5%, whereas 18% of the results were judged to be therapeutic failures. The operations were done during the period of introduction of the method in a general surgical department of a teaching hospital, when the enthusiasm was great and the experience of the individual surgeon with HSV was small. The moderately poor results in this series are thought to be due to too many surgeons operating on a rather limited number of patients. Unrelated to this situation, a statistically significant increase in the frequency of positive insulin tests during the observation period was found, giving an incidence of 80% positive tests 2 years after the operation.

Adolescent↗
PubMedDate not supplied

Irradiation and surgery of primarily inoperable rectal adenocarcinoma.

Preoperative irradiation followed by radical surgical removal of the tumor should be attempted in all patients with locally advanced rectal adenocarcinomas, including patients with moderate distant metastases. If the tumor is not operable after half dose of irradiation (3150 rads), the patients should be re-explored for resectability after full irradiation dose. Resectability can only be adequately determined by exploratory laparotomy and an attempt to resect the tumor-bearing segment by anatomic dissection, and not solely by rectal exploration or palpation of the pelvis at laparotomy.

Adenocarcinoma↗
PubMedDate not supplied

Association between transfusion of stored blood and bacterial infective complications after biliary operations.

OBJECTIVE: To examine the association between blood transfusion and infective complications after biliary operations. DESIGN: Retrospective cohort study. SETTING: District hospital. SUBJECTS: 875 consecutive patients who required biliary operations. MAIN OUTCOME MEASURES: Postoperative infective morbidity in hospital. RESULTS: 73 patients (8%) developed postoperative infections in hospital. Univariate analysis showed that the development of infections was significantly associated with blood transfusion (p < 0.001), stones in the common bile duct (p < 0.001), operations on the common bile duct (p < 0.001), T-tube drainage (p < 0.001), duration of operation (p = 0.008), and age (p = 0.03). Multivariate logistic regression analysis showed that only blood transfusion and stones in the common bile duct were independent predictors of infection. The corrected odds ratios for infection were 4.7 (95% confidence interval (CI) 2.4 to 9.3) when 1-3 units of blood were given and 5.6 (95% CI 2.3 to 13.6) when more than three units were given. CONCLUSION: Transfusion is an independent risk factor in the development of postoperative infection in hospital in patients who have had biliary operations.

Adolescent↗
PubMedDate not supplied

Colorectal cancer in patients over 80 years of age.

BACKGROUND/AIMS: The aim of the study was to compare the short- and long-term outcome of older and younger patients treated for colorectal cancer. We also wanted to study whether age was independently associated with post-operative mortality. METHODOLOGY: We conducted a retrospective study of 503 consecutive patients treated for colorectal cancer. One hundred and six (21%) were 80 years of age or older. The median follow-up was 5.5 years (2-16.8 years) or until death. RESULTS: Post-operative mortality was 6% (0.7% in patients less than 65 years and 16% in patients over 80 years). Multiple logistic regression analysis showed that age, emergency operation, advanced T-stage, and ASA-class were each independently related to post-operative mortality. The overall estimated 5-year survival rate was 59% in patients less than 65 years and 24% in patients over 80 years. The cancer specific 5-year survival was 62% in patients less than 65 years and 45% in patients over 80 years. CONCLUSIONS: The study demonstrated that age was an independent risk factor for post-operative mortality. In very old patients surviving the post-operative period, the long-term outcome was good. Advanced age alone should not be used as a criterion to deny surgery for colorectal cancer.

Adult↗