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E Friis

Publications and source records attributed to E Friis.

At least 19 recordsLinked to original sources
PubMed2005

Radiation doses to staff involved in sentinel node operations for breast cancer.

BACKGROUND: The use of radioactive compounds for sentinel node biopsy is now a generally accepted part of the surgical treatment of breast cancer and melanoma, with the risk of radiation exposure to the operating team. The aim of this investigation was to study the levels of this exposure in relation to the permissible radiation dose limits. METHODS: The radiation exposure to the hands and bodies of the operating surgeons (the 'risk persons') was measured by thermoluminescent dosimeters in 79 operations and to the pathologists handling the specimens in 17 cases. Radioactivity and dose rate measurement from tumours and breast specimens were also performed. RESULTS: During an operation the mean skin dose (+/-SD) to the thermoluminescent dosimeters placed at the hand and the abdominal wall were 0.04 +/- 0.04 mSv (79 operations) and 0.01 +/- 0.02 mSv (67 operations) respectively. For the pathologist, the mean hand dose per operation was below the detection limit (17 operations). Correlation between the measured dose rate and the radioactive content of the tumours was 0.998. CONCLUSIONS: The radiation exposure to the staff involved in sentinel node (SN) biopsy for breast cancer using radioactive labelled tracers will be considerably below the permissible limits, even with high numbers of SN biopsy procedures. Pregnant staff members should participate in <100 SN operations.

Body Burden↗
PubMed2005

Intraoperative frozen section examination of axillary sentinel lymph nodes in breast cancer.

The study presents the results from intraoperative frozen section assessment of axillary sentinel lymph nodes (SLNs) in breast cancer. Routine histological frozen sections from one level were used, two sections stained with haematoxylin and eosin. Immunohistochemistry for cytokeratins was applied to the permanent SLN paraffin sections only. Axillary dissection was performed on all SLN-positive cases regardless of the size of the metastatic deposits. With a detection rate of 83%, 272 patients entered the study over a period of 46 months. A total of 61 cases were SLN positive by frozen section analysis. The paraffin sections gave an additional 23 SLN-positive cases. The false-negative rate for frozen sections was then 27% (23/84). Micrometastases were found in 28 of 84 cases, and macrometastases in 56. The false-negative rate of frozen sections for micrometastases was 71% (20/28), and for macrometastases 5% (3/56). A total of 73% (61/84) of the patients underwent axillary surgery as a one-step procedure.

Adult↗
PubMed2004

Factors of importance for scintigraphic non-visualisation of sentinel nodes in breast cancer.

PURPOSE: The aim of this study was to analyse different factors of possible significance for non-visualisation of sentinel nodes (SNs) by preoperative lymphoscintigraphy, in order to enable improvement of the success rate of SN visualisation through modification or alteration of some of the factors. METHODS: Between March 1998 and January 2003 we analysed a series of 442 women with unilateral stage T1 and clinical N0 breast cancer. Lymphoscintigraphy was performed after periareolar or peritumoural injection of 99mTc-albumin nanocolloid, with image acquisition after 2-6 h or 18-24 h. Until January 2001, all patients received around 20 MBq tracer, irrespective of time to operation. From January 2001, patients injected on the day before surgery received at least 100 MBq while patients injected on the day of surgery received around 50 MBq. RESULTS: An SN was visualised in 87% of the patients, and at surgery the SN was detected with the hand-held gamma probe in 42% of the remaining patients. By multiple logistic regression analysis, statistically significant independent variables that increased the risk for non-visualisation were increasing age (p=0.0007), increasing body weight (p=0.0189) and peritumoural injection (p<0.0001). Significant interaction was found for imaging time and injected activity (p=0.0017). CONCLUSION: This study conclusively shows that the risk of unsuccessful SN imaging increases with age and body weight. Our findings suggest that the scintigraphic success rate may be improved by periareolar (rather than peritumoural) injection. Early and late imaging procedures are equally efficient, but if a late imaging procedure is used, activity (adjusted for physical decay) in the patient on day 2 should be more than 10 MBq.

Adult↗
PubMed2002

Smoking as a risk factor for wound healing and infection in breast cancer surgery.

AIM: Clinical studies suggest that smoking is associated with wound necrosis after breast cancer surgery. However, the significance of smoking as a risk factor for wound infection, skin flap necrosis, and epidermolysis when adjusting for other potential risk factors remains to be studied. METHODS: From June 1994 through August 1996, 425 patients underwent breast cancer surgery as simple mastectomy, modified radical mastectomy, or breast conserving surgery. The patients were evaluated postoperatively for wound infection, skin flap necrosis, and epidermolysis. Association between these complications and 17 patient, operative, and postoperative variables were analysed by three separate multiple logistic regression analyses. RESULTS: When compared to non-smoking, smoking was significantly associated with wound infection after all types of surgery (light smoking (1-14 grams per day): [odds ratio (OR)=2.95, 95% confidence interval (95% CI)=1.07-8.16], and heavy smoking (>/=15 grams per day): OR=3.46 (1.52-7.85). A similar significant association was found as regards skin flap necrosis and epidermolysis after simple mastectomy and modified radical mastectomy: both light and heavy smoking were predictive for skin flap necrosis: light smoking: OR=6.85 (1.96-23.90), heavy smoking: OR=9.22 (2.91-29.25) and for epidermolysis: light smoking: OR=3.98 (1.52-10.43) and heavy smoking: OR=4.28 (1.81-10.13). No significant dose-response relation was disclosed. Other risk factors and confounders associated with complicated wound healing were adjusted for in the analysis: diabetes, obesity, alcohol, NSAIDs, duration of surgery, and surgical experience. CONCLUSION: Independent of other risk factors, smoking is predictive for post-mastectomy wound infection, skin flap necrosis, and epidermolysis.

Adult↗
PubMed2000

[Tension-free herniotomy using the Lichtenstein's method. Results of five years' experience].

The results after 230 initial open tension-free hernioplasties a.m. Lichtenstein for groin hernias are evaluated 24 months after operation. Of the 167 primary operations 57% were performed under local analgesia, and 68% of the patients were discharged on the day of operation after primary herniotomy. Infection occurred after 2.7% of the operations, but in no case did the mesh have to be removed. Complications occurred after 7.4% of the operations, necessitating reoperation after 4.3% of the operations. After 24 months 96% of live patients were controlled for recurrences. After 154 primary herniotomies 2.6% recurred. No indirect hernia recurred, 3.6% of direct hernias recurred. After 57 operations for secondary hernias 7.0% recurred. Thirty-eight different surgeons operated 1-19 hernias (median 4). It is concluded that recurrences after open tension-free hernia-repairs are rare, complications few, the operation is simple to perform and can be done under local analgesia in a same day regime.

Adult↗
PubMed1996

The tension-free hernioplasty in a randomized trial.

BACKGROUND: The tension-free hernioplasty as introduced by Lichtenstein has gained increasing acceptance during the last decade although the technique has not been evaluated in a randomized trial. METHODS: This randomized study compares the 2-year follow-up results after 102 tension-free hernioplasties with implantation of a prolene mesh in all groin hernias to 53 Cooper ligament repairs in direct hernias and 53 abdominal ring repairs in indirect hernias. RESULTS: After tension-free repairs five hernias recurred (5%), and after either Cooper ligament or abdominal ring repair, 16 recurrences were found (15%) (P = 0.025). No indirect hernias recurred after a tension-free repair; 2 recurred after abdominal ring repair (4%; NS). The recurrence rate after tension-free repairs for primary direct inguinal hernias was 7% as compared with 30% after Cooper ligament repair (P = 0.0081). No difference in complication rate between the tested methods was found. CONCLUSION: Recurrence rate is reduced to one-third after tension-free herniotomies as compared with the conventionel herniotomies without increase in complication rate.

Absenteeism↗
PubMed1996

Comparison of tenoxicam by intramuscular injection or wound infiltration for analgesia after inguinal herniorrhaphy.

We compared wound infiltration with small-dose tenoxicam (7.5 mg) to intramuscular (IM) administration of the same dose to treat pain after herniorrhaphy. In a randomized, double-blind study, 50 patients received either preoperative wound infiltration with tenoxicam, 7.5 mg in 40 mL of 0.9% saline (WI group; n = 25) or IM tenoxicam 7.5 mg (IM group; n = 25). In each group a saline placebo of equal volume was given by the alternate route, i.e., those who received wound infiltration with tenoxicam received 0.75 mL of 0.9% saline IM; those who received IM tenoxicam received 40 mL of 0.9% saline for wound infiltration. Postoperative pain was assessed with a verbal pain scale and a visual analog scale (VAS) at rest and during movement and cough, 1, 2, 4, 6, and 24 h postoperatively. Wound tenderness was assessed with an electronic algometer preoperatively, and 2, 4, and 6 h postoperatively. The need for supplementary analgesics (acetaminophen and morphine) was registered. No differences were observed between groups in VAS pain scores, verbal rating pain scores, pain pressure thresholds, or in need for supplementary analgesics. We conclude that tenoxicam 7.5 mg has no local analgesic effect on postoperative pain after herniorrhaphy.

Abdomen↗
PubMed1990

A phase III trial of zoladex and flutamide versus orchiectomy in the treatment of patients with advanced carcinoma of the prostate.

In a multicenter Phase III trial 264 patients with advanced prostatic cancer were randomized to either bilateral orchiectomy or treatment with zoladex supplemented by flutamide. Presently, median follow-up time is 30 months. A small difference in objective response was recorded in favor of the combination therapy, whereas no statistically significant difference was found in subjective response to therapy, time to progression, and overall survival. Adverse effects were more commonly encountered in the pharmacologically treated patients. It is concluded that the combination of zoladex plus flutamide is not clinically superior to orchiectomy in the treatment of patients with advanced carcinoma of the prostate.

Aged↗
PubMed1985

[Clinical liver transplantation in East Germany].

In the GDR 28 liver transplantations have been performed up to now. The 1 year survival rate amounts to 30%. At present 8 patients are alive between 3 months and 5 years. There were no biliary complications since the biliary reconstruction was performed by using a special 'mucosa suture'-technique. Ischaemic graft failure was a main cause for early postoperative mortality. A better immunosuppressive treatment may help to improve the results of liver transplantation in future.

Adult↗
PubMed1982

Urinary incontinence and genital prolapse: a prospective blind study of the value of urodynamic evaluation.

The value of urodynamic examination was studied in 44 women treated for genital prolapse and/or urinary incontinence. A preoperative urodynamic examination was done but not considered in the planning of the operations. The treatment performed after clinical examination was identical to that proposed after urodynamic evaluation in 20 of 34 incontinent patients (59 per cent), while the treatments differed in 14 (41 per cent). The results were considerably better 6 months postoperatively in the former than in the latter patients. Of the 44 patients 11 (25 per cent) had detrusor instability, which resolved 6 months postoperatively in 4 and the symptoms had vanished or decreased in 6.

Adult↗