Search PubMed⌕ Search

Biomedical subjects

M Støckel

Publications and source records attributed to M Støckel.

At least 19 recordsLinked to original sources
PubMed2004

Prospective analysis of convalescence and early pain after uncomplicated laparoscopic fundoplication.

BACKGROUND: The aim of this study was to define factors that limit a short period of convalescence and to characterize the pain experienced after laparoscopic fundoplication. METHODS: This prospective study included 60 consecutive patients who underwent uncomplicated laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease. Patients were recommended to convalesce for 2 days after operation. Duration of convalescence, dysphagia, fatigue, nausea, vomiting and different pain components were registered daily during the first week and on days 10 and 30 after fundoplication. RESULTS: Thirty-nine patients took a median of 13 (range 3-41) days off work and 60 stayed away from recreational activity for a median of 4 (range 1-22) days. Pain, fatigue and plans made before operation were the main contributors to prolonged convalescence. Some 30-40 per cent of the patients reported moderate or severe dysphagia during the study period. Fatigue scores were significantly increased for 6 days after surgery (P < 0 . 001). Visceral pain dominated over incisional and shoulder pain throughout the study. At day 30, 17 per cent of the patients reported moderate or severe visceral pain. CONCLUSION: Pain and dysphagia are significant problems after uncomplicated total laparoscopic fundoplication. The time taken off work and away from recreational activity exceeded the recommended 2 days of convalescence, justifying further efforts to optimize early clinical outcome after total laparoscopic fundoplication.

Adult↗
PubMed2001

[Gastroesophageal reflux surgery in Denmark 1997-1999].

INTRODUCTION: The incidence and length of postoperative stay in hospital in Denmark after oesophageal reflux surgery has not been described previously. MATERIAL AND METHODS: We examined the national patient hospital register and discharge information from the hospitals for the number of reflux operations carried out, the length of postoperative hospital stay, readmissions, and postoperative complications occurring within 30 days in the period, 1997-1999. RESULTS: Twenty-four departments performed 4.9 operations/100,000 inhabitants per year, corresponding to 788 operations. The postoperative 30-day mortality was 0.4% and 6.6% of the operations were followed by serious surgical complications. The combined primary + readmission hospital stay was 3.7 days in the first postoperative month. DISCUSSION: The small number of oesophageal reflux operations performed in many departments in Denmark is not in agreement with the Danish National Board of Health recommendations from 1996, which say that the operations should be done in only five departments. The spreading of surgery means that only few surgeons can reach sufficient training of surgery and that statistical comparison between the departments of the early results of treatment is not meaningful. Overall, national results are comparable to international results. The incidence of oesophageal reflux surgery is about three times lower than in other Scandinavian countries. On these results, it is recommended that the operation is performed in fewer departments and by fewer surgeons.

Clinical Competence↗
PubMed2000

[Transnasal gastroscopy].

The use of transnasal endoscopy has not been reported earlier in Denmark. This study describes the preliminary experiences with transnasal gastroscopy using the Olympus XGIF-N200 prototype. Patients scheduled for diagnostic gastroscopy were examined transnasally. The patients answered questions regarding anxiety and discomfort, and the endoscopist commented on the quality of the procedure. Of sixty patients included, 56 (93%) were examined transnasally. Two patients did not have nasal passage and were examined orally, and two patients were examined with standard gastroscope because of technical difficulties. Sixty-eight percent of the procedures were unsedated, 55% of the patients did not experience gag-reflexes. The procedure was described by most patients as "slightly uncomfortable". Twenty-five percent had uncomplicated epistaxis. Pulse rate and saturation levels were stable. Transnasal gastroscopy seems to be well tolerated by the patients, as both subjective and objective criteria were better than those for conventional gastroscopy.

Gastroscopes↗
PubMed2000

Transnasal gastroscopy.

INTRODUCTION: The use of transnasal gastroscopy (TNG) has not previously been described in a Danish hospital. The method seems to be better tolerated compared with conventional oral gastroscopy. METHODOLOGY: Patients scheduled for diagnostic gastroscopy were included, and examined with a thin endoscope transnasally (Olympus XGIF-N200 prototype, diameter 6 mm). RESULTS: Sixty patients were included, and transnasal gastroscopy was possible in 56 patients (93%). Two patients were examined transorally, as there were no passage through the nose. One patient had fluid retention in the stomach, and in another patient the endoscope looped continuously in the esophagus, preventing introduction into the stomach. The quality in 48 examinations (80%) was satisfactory. Unsedated examination was possible with 38 patients (68%), and 55% of patients did not have gag-reflexes or nausea. The unpleasantness of TNG was rated on a scale from 1 to 4, and the median score was 2 (slightly unpleasant). TNG would be the method of choice in 88% of patients, if they should undergo another gastroscopy in the future. Fifteen patients had uncomplicated epistaxis as the only complication. Pulse rate and oxygen saturation values were stable during the TNG examinations. CONCLUSION: TNG with a thin endoscope seems to be well tolerated by the patients, this is supported by the subjective experience of the patients, and also by the stable values of oxygen saturation and heart rate during the examinations.

Adult↗
PubMed1997

[Laparoscopic fundoplication in gastroesophageal reflux].

Gastro-oesophageal reflux disease (GORD) is a chronic disorder requiring lifelong medical therapy or surgery. In the present study we evaluated the postoperative course and effect of laparoscopic fundoplication on GORD in 27 patients with a median age of 44 (range 27-73) years. Fifteen were operated on with a Watson procedure, and 12 patients had a Nissen procedure. Median stay and convalescence after surgery was one and 10 days respectively. Three patients had to be converted into open surgery (bleeding: two, unclear anatomy: one). No major complications were seen, but four patients had postoperative complications (stenosis requiring dilatation: one, subcutaneous emphysema: one, wound sepsis: one, hernia: one. The two latter complications were seen in converted patients). Two patients had prolonged dysphagia, and two patients needed slight dietetic advice for gasbloat syndrome. In 25 of 27 patients good control of GORD was accomplished as judged by symptomatology, endoscopy and 24-hour pH measurements. It is concluded that laparoscopic fundoplication offers good control of GORD with few complications, and short hospital stay and convalescence.

Adult↗
PubMed1986

Inflatable splints: do they cause tissue ischaemia?

The effect of increasing pneumatic splint pressure on cutaneous oxygen tension measured transcutaneously (TcPO2) was investigated in 12 subjects. The mean initial TcPO2 was 70.6 mmHg. TcPO2 decreased linearly on increasing the pressure within the splint. TcPO2 became zero at a mean splint pressure of 28 mmHg. Second, three accepted methods used by the ambulance crew to assess inflation pressures of the splint were investigated and found to be unreliable. In the light of these findings the risk of ischaemic complications as a result of applying pneumatic splints to a fractured limb is discussed. We advocate a recommended maximum splint pressure of 15 mmHg and that the splint should be manufactured with a security blow-off valve set at 15 mmHg.

Adult↗
PubMed1986

Liver-cell adenoma. Case report.

A young woman taking oral contraceptives presented with acute, severe abdominal pain. A liver-cell adenoma (weight 1.6 kg), with intrahepatic bleeding and necrosis, was enucleated at elective laparotomy. The clinical presentation of liver-cell adenoma, ranging from incidental finding to sudden death, is reviewed and the evidence linking oral contraceptives to the tumour is discussed. Reported cases of symptomatic liver-cell adenoma have numerically declined in the past decade. Acute surgical treatment is indicated only to control bleeding. In addition to withdrawal of oral contraceptive medication, enucleation of the tumour or hepatic resection is generally recommended as elective, definitive treatment.

Adult↗
PubMed1985

Estimation of 131I-hippuran blood activity from externally registered activity.

The application of data-processing methods such as deconvolution or computer-assisted background subtraction to renography requires knowledge of the input to the kidneys. The two most commonly used approximations to the kidney input in 131I-hippuran probe renography are to assume that the kidney input is described either by the time-activity curve recorded over the subclavian region (mode I) or by the time derivative of mode I (mode II). A third approximation to the kidney input using two externally recorded time-activity curves, pre-injection of 131I-albumin and two venous samples has previously been described. This approach has been modified in this work, in which two externally recorded time-activity curves and two capillary samples are used to construct an estimate for the kidney input (mode III). The three modes are compared with a reference, which is constructed from capillary samples drawn during the renography examination. Eleven patients participated in this study, all of whom were referred for routine renography. The results show that only mode III is close to the reference in all cases.

Adult↗
PubMed1984

Proximal glomerulo-tubular balance in patients with type 1 (insulin-dependent) diabetes mellitus.

To evaluate the glomerulo-tubular balance of sodium and water in the proximal tubules of diabetic patients with elevated glomerular filtration rate, the renal plasma clearance of lithium and the glomerular filtration rate (51Cr-EDTA plasma clearance) were determined simultaneously in 11 ambulatory Type 1 (insulin-dependent) diabetic patients (aged 25-35 years) with no evidence of diabetic nephropathy and in 10 age-matched healthy subjects. The renal plasma clearance of lithium, which is a measure of flow from the proximal tubule into the thin descending limb of the loop of Henle, did not differ between diabetic and control subjects (28.9 +/- 4.0 versus 28.3 +/- 5.1 ml/min per 1.73 m2 surface area, mean +/- SD), whereas the glomerular filtration rate in the diabetic patients was significantly higher than in the control subjects (136 +/- 10.2 versus 108 +/- 13.6 ml/min per 1.73 m2, p less than 0.001). The same held true for the fractional reabsorption rate in the proximal tubules (78.7 +/- 3.2 versus 73.6 +/- 4.9%, p less than 0.02). The results indicate that the elevation of the glomerular filtration rate in diabetic patients is associated with a parallel increase in the proximal reabsorption rate. This type of glomerulo-tubular balance implies that the flow of water and flux of sodium to the segments distal to the proximal tubule are kept constant during variations in the glomerular filtration rate.

Absorption↗
PubMed1984

Bone metastases in primary operable breast cancer. The role of serial scintigraphy.

In 1978 and 1979, 1060 Danish patients with primary operable breast cancer were bone-scanned for osseous metastases before entering a nationwide therapeutical trial. A re-reading group interpreted the scans produced in 12 participating hospitals. As a consequence standardized guide-lines for interpretation were agreed upon from 1979. The frequency of positive bone scans suggesting bone metastases fell abruptly from 1978 to 1979, as read both locally and by the re-reading group. As measured statistically the difference between the interpretation of the local and the re-reading groups remained unchanged. Of the 1060 patients 760 were followed by repeated pre-scheduled scans 6 and 12 months after surgery until any kind of recurrence was diagnosed. Only 37 of the 760 patients (4.9%) developed bone metastases verified by radiology or autopsy during the first 2 yr after surgery. A single positive scan, especially performed 6 or 12 months after surgery, as well as two or three scans repeatedly staying or becoming positive increase significantly the risk of developing bone metastases within 12 months after the latest scan. In 13 of the 37 patients with otherwise subsequently proven bone metastases the latest scan(s) were negative. It is concluded that a fixed schedule of repeated bone scans in patients with breast cancer is not warranted.

Bone Neoplasms↗
PubMed1984

Measurement of skin perfusion pressure by photoelectric technique--an aid to amputation level selection in arteriosclerotic disease.

During a period of 14 months 60 amputations, 41 below-knee and 19 above-knee, were performed on 54 patients with gangrene of the lower limb. Wound healing was evaluated in 59 amputations. A newly introduced standardized photoelectric technique for measurement of the local skin perfusion pressure (SPP) was used preoperatively, the result of which served as a guide to the selection of the proper amputation level. An overall healing rate of 90 per cent was found. Sixty-eight per cent of the amputations were performed below-knee. The healing rates for individual SPP levels were identical to those obtained with the isotope washout technique. The standardized photoelectric technique is simple and rapid and gives only negligible discomfort to the patient allowing repeated measurements at different levels on the leg.

Adult↗
PubMed1983

Anaphylactic reaction to orthoiodohippurate.

A case of an anaphylactic reaction following administration of 125I- and 131I-o-iodohippurate in a 32-year-old woman is reported. The patient had a renography performed because of hematuria. She was known to react to an intravenous pyelography previously performed with an anaphylactic shock. The importance of reporting all adverse reactions to radiopharmaceuticals for central registration is stressed.

Adult↗
PubMed1983

Prediction of spleen size by routine radioisotope scintigraphy.

Technetium-99m scintigraphy of the spleen was performed in 32 patients with various haematologic disorders prior to splenectomy. From the gamma camera image of the spleen, the weight of the spleen was estimated using two different mathematical formulas, and the results obtained were compared to the postoperative spleen weight. Both formulas revealed spleen weights showing highly significant correlations to the postoperative spleen weight and with similar standard deviations. Visual evaluation of the scintigram by an experienced examiner with classification of the spleens into four groups according to spleen weight revealed results as good as the mathematical calculations in predicting the postoperative spleen weight, both techniques giving diagnostic specificities of 0.70-0.80 for all groups and diagnostic sensitivities of 0.80-1.00. Physical examination of the abdomen showed that about 50% of the spleens weighing between 250 and 1,000 g were not palpable. Therefore, it is concluded that physical examination of the abdomen alone is unreliable. Radioisotope scintigraphy of the spleen is recommended, this method being fast, with negligible discomfort to the patient, and with sufficient accuracy for daily clinical work.

Adult↗
PubMed1982

Standardized photoelectric technique as routine method for selection of amputation level.

During a period of 11 months 45 amputations, 31 below-knee and 14 above-knee, were performed in 42 patients with gangrene of the lower extremity. A newly introduced standardized photoelectric technique for measurement of local skin perfusion pressure (SPP) was used preoperatively and the result used in selection of the proper amputation level. An overall healing rate of 89 per cent was found. 69 per cent of the amputations were performed below-knee. The healing rates for individual SPP-levels were identical to those obtained with the cumbersome isotope washout technique. The standardized photoelectric technique is simple, rapid and causes the patient only negligible discomfort, allowing repeated measurements on different levels of the leg.

Adult↗