Lund University Publications
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Lund University Lund University Publications2000-01-01T00:00+00:001dailyMinimal invasive LASER-resection vs. radiotherapy as primary treatment of early glottic cancer. A population-based study with, up to 16 years follow up of survival, rate of laryngectomy and voice function
https://lup.lub.lu.se/search/publication/dd4101ce-7f5b-4636-8498-3506dd2421eb
Rydell, RolandAndreasson, JosefineGustafsson Baldwin, SaraClarhed, Nathalie2024-01-31BACKGROUND: Early glottic cancer can be treated with laser resection or radiotherapy. In an earlier study, we found that voice function after laser resection was inferior to that after radiotherapy.OBJECTIVES: This study was designed to determine if reduced margins at laser resection improved voice function without impairing oncologic results.METHOD: A total of 268 patients with previously untreated T1-T2 glottic carcinoma were studied. They were primarily treated with either radiotherapy (n = 119) or laser resection (n = 149). Survival, need for additional treatment (radiotherapy and/or total layngectomi) and voice function was compared.RESULT: Median follow up time was 7 years with range 0.5-16.6. There was no difference in the overall survival (p = .065) or disease-specific survival. (p = .126). After radiotherapy 32/119 patients and after laser resection 57/149 patients had recurrence. Total rate of laryngectomy was 24% in the radiotherapy group, and 8% in the laser resection group (p = .001). Voice analysis (T1A) showed more roughness in the radiotherapy group, otherwise no difference.CONCLUSIONS: By reducing the surgical margins, we have achieved a better voice function (T1A) but more patients have needed repeated laser excisions and some have also needed supplementary radiotherapy. The risk of laryngectomy and survival were apparently not affected.https://lup.lub.lu.se/record/dd4101ce-7f5b-4636-8498-3506dd2421ebhttp://dx.doi.org/10.1080/00016489.2023.2299674pmid:38294703scopus:85184185030engActa Oto-Laryngologica; pp 1-7 (2024)ISSN: 1651-2251SurgeryCancer and OncologyMinimal invasive LASER-resection vs. radiotherapy as primary treatment of early glottic cancer. A population-based study with, up to 16 years follow up of survival, rate of laryngectomy and voice functioncontributiontojournal/articleinfo:eu-repo/semantics/articletextEndoscopic and Surgical Management of Non-Metastatic Ampullary Neuroendocrine Neoplasia : A Multi-Institutional Pancreas2000/EPC Study
https://lup.lub.lu.se/search/publication/8140f9ee-fe24-46ea-96bb-185e854aef54
Karam, EliasHollenbach, MarcusAbou Ali, EinasAuriemma, FrancescoAnderloni, AndreaBarbier, LouiseBelfiori, GiulioCaillol, FabriceCrippa, StefanoDel Chiaro, MarcoDe Ponthaud, CharlesDahel, YanisFalconi, MassimoGiovannini, MarcHeling, DominikInoue, YosukeJarnagin, William R.Leung, GalenLupinacci, Renato M.Mariani, AlbertoMasaryk, ViliamMiksch, Rainer ChristophMusquer, NicolasNapoleon, BertrandOba, AtsushiPartelli, StefanoPetrone, Maria C.Prat, FrédéricRepici, AlessandroSauvanet, AlainSalzmann, KatrinSchattner, Mark A.Schulick, RichardSchwarz, LilianSoares, KevinSouche, François R.Truant, StéphanieVaillant, Jean C.Wang, TiegongWedi, EdrisWerner, JensWeismüller, Tobias J.Wichmann, DörteWill, UweZaccari, PieraGulla, AisteHeise, ChristianRegner, SaraGaujoux, Sébastien2023-10Introduction: Ampullary neuroendocrine neoplasia (NEN) is rare and evidence regarding their management is scarce. This study aimed to describe clinicopathological features, management, and prognosis of ampullary NEN according to their endoscopic or surgical management. Methods: From a multi-institutional international database, patients treated with either endoscopic papillectomy (EP), transduodenal surgical ampullectomy (TSA), or pancreaticoduodenectomy (PD) for ampullary NEN were included. Clinical features, post-procedure complications, and recurrences were assessed. Results: 65 patients were included, 20 (30.8%) treated with EP, 19 (29.2%) with TSA, and 26 (40%) with PD. Patients were mostly asymptomatic (n = 46; 70.8%). Median tumor size was 17 mm (12-22), tumors were mostly grade 1 (70.8%) and pT2 (55.4%). Two (10%) EP resulted in severe American Society for Gastrointestinal Enterology (ASGE) adverse post-procedure complications and 10 (50%) were R0. Clavien 3-5 complications did not occur after TSA and in 4, including 1 postoperative death (15.4%) of patients after PD, with 17 (89.5%) and 26 R0 resection (100%), respectively. The pN1/2 rate was 51.9% (n = 14) after PD. Tumor size larger than 1 cm (i.e., pT stage >1) was a predictor for R1 resection (p < 0.001). Three-year overall survival and disease-free survival after EP, TSA, and PD were 92%, 68%, 92% and 92%, 85%, 73%, respectively. Conclusion: Management of ampullary NEN is challenging. EP should not be performed in lesions larger than 1 cm or with a endoscopic ultrasonography T stage beyond T1. Local resection by TSA seems safe and feasible for lesions without nodal involvement. PD should be preferred for larger ampullary NEN at risk of nodal metastasis.https://lup.lub.lu.se/record/8140f9ee-fe24-46ea-96bb-185e854aef54http://dx.doi.org/10.1159/000531712pmid:37369186scopus:85174640309engNeuroendocrinology; 113(10), pp 1024-1034 (2023)ISSN: 0028-3835SurgeryAmpulla of vaterAmpullary neuroendocrine neoplasiaEndoscopic papillectomyPancreaticoduodenectomyTransduodenal surgical ampullectomyEndoscopic and Surgical Management of Non-Metastatic Ampullary Neuroendocrine Neoplasia : A Multi-Institutional Pancreas2000/EPC Studycontributiontojournal/articleinfo:eu-repo/semantics/articletextEffect of thyroid hormone replacement therapy on mortality rate in patients undergoing total or hemithyroidectomy for benign multinodular goitre
https://lup.lub.lu.se/search/publication/edf3395d-09e6-4c45-99f1-1c7887a86463
Nordenström, ErikRanstam, JonasBergenfelz, Anders2024-02Background: Thyroid surgery for benign non-toxic nodular goitre is a common endocrine surgical procedure. It is not known whether thyroid hormone replacement therapy following surgery for benign thyroid disease influences mortality or morbidity rates. Methods: A retrospective observational study was conducted using national registries in Sweden. Overall mortality and morbidity rates were compared for patients with or without thyroid hormone replacement therapy in patients operated on with hemithyroidectomy or total thyroidectomy for a diagnosis of benign non-toxic nodular goitre. Results: Between 1 July 2006 and 31 December 2017, 5573 patients were included, 1644 (29.5%) patients were operated on with total thyroidectomy and 3929 patients with hemithyroidectomy. In the hemithyroidectomy group, 1369 (34.8%) patients were prescribed thyroid hormone replacement therapy in the follow-up. The patients who underwent hemithyroidectomy and did not use thyroid hormone replacement therapy in the follow-up had a standard mortality ratio of 1.31 (95% confidence interval, 1.09-1.54). The mortality ratio was not increased in patients who underwent total thyroidectomy or hemithyroidectomy and used thyroid hormone replacement therapy. The risk of death analysed by multivariable Cox regression for patients operated on with hemithyroidectomy without later thyroid hormone replacement therapy, adjusted for age and sex, showed an increased hazard ratio of 1.65 (1.19-2.30) compared with hemithyroidectomy with hormone replacement therapy. Conclusion: Patients subjected to hemithyroidectomy without later hormone replacement therapy had a 30% higher risk of death compared with the normal Swedish population and a 65% increased risk of death compared with patients undergoing hemithyroidectomy with postoperative hormone replacement therapy.https://lup.lub.lu.se/record/edf3395d-09e6-4c45-99f1-1c7887a86463http://dx.doi.org/10.1093/bjsopen/zrae012pmid:38372505scopus:85185614825engBJS Open; 8(1), no zrae012 (2024)ISSN: 2474-9842SurgeryEffect of thyroid hormone replacement therapy on mortality rate in patients undergoing total or hemithyroidectomy for benign multinodular goitrecontributiontojournal/articleinfo:eu-repo/semantics/articletextNationwide paediatric cohort study of a protective association between allergy and complicated appendicitis
https://lup.lub.lu.se/search/publication/cc6c6813-a1ac-43ab-b252-45a08ec125f4
Omling, ESalö, MStenström, PMerlo, JGudjonsdottir, JRudolfson, NHagander, L2021-10-24BACKGROUND: In a nationwide cohort the potentially protective association between allergy and complicated appendicitis was analysed, and the influence of seasonal antigens, antihistamine treatment, and timing of allergy onset assessed.METHODS: Some 1 112 571 children born between 2000 and 2010 were followed from birth until the end of 2014. A cross-sectional analysis of appendicitis cases, with comparison of allergic versus non-allergic children for absolute risk and odds of complicated appendicitis was first undertaken. This was followed by a longitudinal analysis of children with allergy and matched controls who had never had an allergy, for incidence rate and hazard of subsequent complicated or simple appendicitis.RESULTS: Of all children, 20.4 per cent developed allergy and 0.6 per cent had appendicitis during follow-up. Among children with appendicitis, complicated appendicitis was more common among non-allergic children (18.9 per cent, 948 of 5016) than allergic children (12.8 per cent, 173 of 1351) (P < 0.001), and allergic children had a lower adjusted odds of complicated appendicitis (adjusted odds ratio (OR) 0.80, 95 per cent c.i. 0.67 to 0.96; P = 0.021). The risk of complicated appendicitis among children with manifest allergy was reduced by one-third in the longitudinal analysis (incidence rate 0.13 versus 0.20 per 1000 person-years; hazard ratio (HR) 0.68, 95 per cent c.i. 0.58 to 0.81; P < 0.001), whereas the risk of simple appendicitis remained unchanged (incidence rate 0.91 versus 0.91; HR 1.00, 0.94 to 1.07; P = 0.932). Seasonal antigen exposure was a protective factor (adjusted OR 0.82, 0.71 to 0.94; P = 0.004) and ongoing antihistamine medication a risk factor (adjusted OR 2.28, 1.21 to 4.28; P = 0.012).CONCLUSION: Children with allergy have a lower risk of complicated appendicitis, but the same overall risk of simple appendicitis. Seasonal antigen exposure reduced, and antihistamine treatment increased, the risk of complicated disease.https://lup.lub.lu.se/record/cc6c6813-a1ac-43ab-b252-45a08ec125f4http://dx.doi.org/10.1093/bjs/znab326scopus:85122546355pmid:34689186engThe British journal of surgery; 108(12), pp 1491-1497 (2021)ISSN: 1365-2168SurgeryNationwide paediatric cohort study of a protective association between allergy and complicated appendicitiscontributiontojournal/articleinfo:eu-repo/semantics/articletextNavigating the Twist and Turn : Deciphering Misalignment in FEVAR
https://lup.lub.lu.se/search/publication/62574f1a-1bcc-4c0a-b99d-6ccd1891b55a
Karelis, AngelosDias, Nuno V.2023https://lup.lub.lu.se/record/62574f1a-1bcc-4c0a-b99d-6ccd1891b55ahttp://dx.doi.org/10.1016/j.ejvs.2023.11.014pmid:37952632scopus:85180311043engEuropean journal of vascular and endovascular surgery; (2023)ISSN: 1078-5884SurgeryNavigating the Twist and Turn : Deciphering Misalignment in FEVARcontributiontojournal/commentinfo:eu-repo/semantics/othertextMetabolic remission precedes possible weight regain after gastric bypass surgery
https://lup.lub.lu.se/search/publication/b2d68ee1-b28e-4120-ada4-4917fd305951
Rogova, OksanaHerzog, KatharinaAl-Majdoub, MahmoudMiskelly, MichaelLindqvist, AndreasBennet, LouiseHedenbro, Jan LWierup, NilsSpégel, Peter2023-08-16OBJECTIVE: Some patients regain weight to a variable extent from 1 year after Roux-en-Y gastric bypass surgery (RYGB), though rarely reaching preoperative values. The aim of the present study was to investigate whether, when, and to what extent metabolic remission occurs.METHODS: Fasting metabolite and lipid profiles were determined in blood plasma collected from a nonrandomized intervention study involving 148 patients before RYGB and at 2, 12, and 60 months post RYGB. Both short-term and long-term alterations in metabolism were assessed. Anthropometric and clinical variables were assessed at all study visits.RESULTS: This study found that the vast majority of changes in metabolite levels occurred during the first 2 months post RYGB. Notably, thereafter the metabolome started to return toward the presurgical state. Consequently, a close-to-presurgical metabolome was observed at the time when patients reached their lowest weight and glucose level. Lipids with longer acyl chains and a higher degree of unsaturation were altered more dramatically compared with shorter and more saturated lipids, suggesting a systematic and reversible lipid remodeling.CONCLUSIONS: Remission of the metabolic state was observed prior to notable weight regain. Further and more long-term studies are required to assess whether the extent of metabolic remission predicts future weight regain and glycemic deterioration.https://lup.lub.lu.se/record/b2d68ee1-b28e-4120-ada4-4917fd305951http://dx.doi.org/10.1002/oby.23864scopus:85168110045pmid:37587639engObesity; 31(10), pp 2530-2542 (2023)ISSN: 1930-739XSurgeryMetabolic remission precedes possible weight regain after gastric bypass surgerycontributiontojournal/articleinfo:eu-repo/semantics/articletext