Scand J Surg
-
Investigating the impact of percutaneous transluminal angioplasty (PTA) on clinical status and health related quality of life in patients with claudication and critical limb ischaemia (CLI). ⋯ Technical success and one-year results in claudication are good, and the rate of complications is low. However, although PTA resulted in an immediate improvement in the quality of life, this effect was not seen in the long term. In critical limb ischemia there was a group of patients in whom PTA led to a significant benefit in terms of limb salvage and quality of life.
-
Minimally invasive repair of pectus excavatum (MIRPE) is the preferred technique for repair of funnel chest deformity. The aim of this study is to evaluate our initial postoperative results, to identify factors related to postoperative complications and to examine the acceptability of MIRPE by the patients. ⋯ MIRPE is a safe operation and gives a cosmetically good result. Thoracoscopy is needed during the operation. The early postoperative period in hospital is painful and there the patients need intensive care. We found the high epidural analgesia beneficial and safe during early period of pain treatment. The bar is removed not earlier than 3 years after the operation as a day care surgical procedure.
-
Practice Guideline
Scandinavian Guidelines--"The massively bleeding patient".
-
Fluid resuscitation of trauma victims currently differs, depending on whether the Advanced Trauma Life Support (ATLS), Prehospital Trauma Life Support (PHTLS) or Battlefield Advanced Trauma Life Support (BATLS) algorithm is utilised. Resuscitation protocol depends on the situation of the patient before definitive surgical control of the haemorrhage can be achieved, that is, in the prehospital phase (the urban, rural or battlefield setting) or in the emergency room. The principle difference is between hypotensive (PHTLS and BATLS, in the prehospital phase) and normotensive (ATLS, in the emergency room) resuscitation. The aim of this review was to determine if there is sufficient evidence to consider altering the ATLS resuscitation algorithm to a hypotensive model prior to definitive surgical control of haemorrhage. ⋯ There is insufficient evidence to alter the current ATLS algorithm in the emergency room in favour of hypotensive resuscitation. The future of resuscitation is considered.
-
To study the mechanism, management and outcome of patients who had sustained pancreatic trauma. ⋯ Blunt trauma is the main cause of pancreatic injury in our country. Early CT scan may miss pancreatic injury in almost a quarter of the patients. Thin sliced CT scan, with special views in a dedicated abdominal pancreatic study, is recommended. A high index of clinical suspicion, depending on the mechanism of injury, is important for diagnosis of pancreatic injury. Mortality is mainly attributable to other associated injuries so simple procedures should initially be adopted for pancreatic injury, especially in haemodynamically unstable patients.