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  • 1.
    Dam-Larsen, Sanne
    et al.
    Koege Hospital, Denmark.
    Darkahi, Bahman
    Enkoping Hospital, Sweden.
    Glad, Arne
    Bispebjerg Hospital, Denmark.
    Gleditsch, Dagfinn
    Drammen Hospital, Norway.
    Gustavsson, Lena
    Sahlgrens University Hospital, Sweden.
    Halttunen, Jorma
    University of Helsinki, Finland; University of Helsinki, Finland.
    Johansson, Karl-Erik
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.
    Pischel, Andreas
    Sahlgrens University Hospital, Sweden.
    Reiertsen, Ola
    Akershus University Hospital, Norway.
    Tornqvist, Bjorn
    Karolinska University, Sweden.
    Zebski, Hubert
    Department Gastroenterol, Germany.
    Best practice in placement of percutaneous endoscopic gastrostomy with jejunal extension tube for continuous infusion of levodopa carbidopa intestinal gel in the treatment of selected patients with Parkinsons disease in the Nordic region2015In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 50, no 12, p. 1500-1507Article in journal (Refereed)
    Abstract [en]

    Objective. Continuous infusion of levodopa carbidopa intestinal gel (LCIG) is associated with a significant improvement in the symptoms and quality of life of selected patients with advanced Parkinsons disease. Percutaneous endoscopic gastrostomy with jejunal extension (PEG/J) was first described in 1998 and has become the most common and standard technique for fixing the tubing in place for LCIG infusion. Material and methods. A workshop was held in Stockholm, Sweden, to discuss the PEG/J placement for the delivery of LCIG in Parkinsons disease patients with the primary goal of providing guidance on best practice for the Nordic countries. Results. Suggested procedures for preparation of patients for PEG/J placement, aftercare, troubleshooting and redo-procedures for use in the Nordic region are described and discussed. Conclusions. LCIG treatment administered through PEG/J-tubes gives a significant increase in quality of life for selected patients with advanced Parkinsons disease. Although minor complications are common, serious complications are infrequent, and the tube insertion procedures have a good safety record. Further development of delivery systems and evaluation of approaches designed to reduce the demand for redo endoscopy are required.

  • 2.
    Eriksson, Per
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rheumatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Rheumatology in Östergötland.
    Jacobs, Claudia
    Linköping University, Department of Clinical and Experimental Medicine, Rheumatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Rheumatology in Östergötland.
    Johansson, Karl-Erik
    Linköping University, Department of Clinical and Experimental Medicine, Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery UHL.
    Remission of arthritis after esophagectomy in three patients with severe achalasia2013In: Diseases of the esophagus, ISSN 1120-8694, E-ISSN 1442-2050, Vol. 26, no 3, p. 226-230Article in journal (Refereed)
    Abstract [en]

    In the 1960s and 1970s, intestinal bypass surgery was performed to treat patients with extreme obesity. However, this is now done with great restriction due to the risk of complications, for instance, polyarthritis. An association between severe achalasia and arthritis has also been described, but very few articles on this topic are cited in PubMed, and most of the published case reports are old. In this article, we present a retrospective case series of three patients with severe achalasia and arthritis from the departments of rheumatology and surgery at a university hospital. The complaints from the esophagus as well as arthritis were resolved after esophagectomy and esophageal reconstruction. We conclude that severe achalasia can be associated with arthritis, and both can be cured by esophageal reconstruction. Thus, we want to remind of this rare, but probably largely unrecognized, association between achalasia and joint disease.

  • 3.
    Franzen, Thomas
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Anderberg, Bo
    Wirén, Michael
    Johansson, Karl-Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Long-term outcome is worse after laparoscopic than after conventional Nissen fundoplication2005In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 40, no 11, p. 1261-1268Article in journal (Refereed)
    Abstract [en]

    Objective. No long-term studies of laparoscopic and open fundoplication were available in 1994. The aim of this study was to compare reflux control and side effects after laparoscopic and open fundoplication. Material and methods. Adult patients with uncomplicated gastro-oesophageal reflux disease were included in this prospective randomized clinical trial between laparoscopic and open 360° fundoplication. Patients with uncomplicated gastro-oesophageal reflux disease were included with the exception of those with weak peristalsis or suspected short oesophagus. Two senior surgeons, well trained in laparoscopic antireflux surgery, performed the 45 laparoscopic operations. Forty-eight patients underwent open surgery performed or supervised by two other senior surgeons, also well trained in gastro-oesophageal surgery. One of the latter recruited all the patients. Manometry and 24-h oesophageal pH monitoring were performed before operation and 6 months postoperatively. Manometry also included a short-term reflux test, an acid clearing test and an acid perfusion test. Symptom evaluation was performed before surgery, 6 moths after and at long-term follow-up (33-79 months postoperatively) by the same surgeon. Long-term follow-up also included endoscopy. Results. Six months after laparoscopy 4 patients had disabling dysphagia. None of the patient had disabling dysphagia after laparotomy. Four patients had mild heartburn 6 months after laparoscopy and 2 patients after laparotomy. Between 6 months' follow-up and long-term follow-up, 6 patients were reoperated on in the laparoscopy group and 2 patients in the laparotomy group. Three patients operated on with laparotomy had died of intercurrent diseases. After laparoscopy, at long-term follow-up, 62% of patients (28/45) were satisfied compared with 91% (41/45) after laparotomy. The difference was significant (p < 0.01). Conclusions. Early postoperative reflux control was similar for laparoscopic and conventional fundoplication. At long-term follow-up significantly more patients were satisfied after laparotomy than after laparoscopy. © 2005 Taylor & Francis.

  • 4.
    Franzen, Thomas
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Surgery. Linköping University, Faculty of Health Sciences.
    Johansson, Karl-Erik
    Linköping University, Department of Biomedicine and Surgery, Surgery. Linköping University, Faculty of Health Sciences.
    Prospective study of symptoms and gastro-oesophageal reflux 10 years after posterior partial fundoplication - reply2000In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 87, no 1, p. 122-122p. 122-Article in journal (Other academic)
    Abstract [en]

    No abstract is available for this article.

  • 5.
    Franzén, Thomas
    et al.
    Linköping University, Department of Biomedicine and Surgery, Surgery. Linköping University, Faculty of Health Sciences.
    Anderberg, Bo
    Linköping University, Department of Biomedicine and Surgery, Surgery. Linköping University, Faculty of Health Sciences.
    Tibbling Grahn, Lita
    Linköping University, Department of Biomedicine and Surgery, Surgery. Linköping University, Faculty of Health Sciences.
    Johansson, Karl-Erik
    Linköping University, Department of Biomedicine and Surgery, Surgery. Linköping University, Faculty of Health Sciences.
    Prospective evaluation of laparoscopic and open 360o fundoplication in mild and severe gastro-oesophageal reflux disease2002In: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 168, no 10, p. 539-545Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    To investigate the relationship between five-year control of reflux and early postoperative oesophageal function after total fundoplication done either laparoscopically or through a laparotomy in severe and mild reflux disease.

    DESIGN:

    Prospective open study.

    SETTING:

    University hospital, Sweden.

    PATIENTS:

    In the group with severe disease 9 patients had a laparotomy and 7 laparoscopy. The corresponding figures for the group with mild disease were 21 and 34 respectively.

    RESULTS:

    The increase in lower oesophageal sphincter pressure 6 months after operation in patients with recurrent disease was significantly less than that for patients with good reflux control (p < 0.01). In patients who had laparotomy, including 30% (9/30) with severe reflux disease, good long-term reflux control was found in 93% (27/29). In patients operated on laparoscopically including 17% (7/41) with severe reflux disease good long-term reflux control was found in 90% (35/39).

    CONCLUSION:

    The mechanism of recurrence differed between patients with severe disease who had a laparotomy and patients with mild disease operated on laparoscopically. Early postoperative manometry was prognostic for recurrence. Long-term reflux control seems to be similar after laparotomy and laparoscopy. Further randomised studies are needed.

  • 6.
    Franzén, Thomas
    et al.
    Linköping University, Department of Biomedicine and Surgery, Surgery. Linköping University, Faculty of Health Sciences.
    Anderberg, Bo
    Linköping University, Department of Biomedicine and Surgery, Surgery. Linköping University, Faculty of Health Sciences.
    Wirén, Michael
    Linköping University, Department of Biomedicine and Surgery, Surgery. Linköping University, Faculty of Health Sciences.
    Johansson, Karl-Erik
    Linköping University, Department of Biomedicine and Surgery, Surgery. Linköping University, Faculty of Health Sciences.
    Laparoscopic or conventional fundoplication for long-term management of gastroesophageal reflux disease?Manuscript (preprint) (Other academic)
    Abstract [en]

    Background: The study started in 1994 after over 50 laparoscopic 360o fundoplications had been performed by the surgeons involved. Complete mobilization of the fundus with posterior crural repair was used where a short floppy total fundoplication was constructed using three non-absorbable sutures, two of them including the esophageal wall. Initial experience in the first 50 consecutive patients operated laparoscopically in this center demonstrated 90% good reflux control.

    Methods: Adult patients with uncomplicated reflux disease during the years 1994-1998 were included in this prospective ranomized clincal trial between laparoscopic and open total fundoplication. Patients with long segment Barrett's esophagus, strictures, unhealed severe esophagitis or paraesophageal hernia were excluded, as were patients with previous esophagus or stomach operations, those with weak peristalsis or suspected short esophagus. Two senior surgeons well trained in laparoscopic antireflux surgery performed the 45 laparoscopic operations. Forty-eight patients underwent open surgery performed and supervised by two other senior surgeons well trained in gastroesophageal surgery. One of the latter recruited all patients. Manometry and 24-h esophageal pH monitoring were performed before operation and half a year postoperatively. Manometry also included a short-term reflux test, an acid clearing test and an acid perfusion test. Symptom evaluation (modified DeMeester score) was performed before operation, half a year after and at long-term follow-up (33-79 months postoperatively). Long-term follow-up also included endoscopy.

    Results: Half a year after laparoscopy four patients had disabling dysphagia. No patient had disabling dysphagia after laparotomy. Four patients had mild heartburn six mouths after laparoscopy and two patients after laparotomy. Between six months follow-up and long-term follow up six patients were reoperated in the laparoscopy group and two patients in the laparotomy group. Three patients operated with laparotomy had died in intercurrent diseases. After laparoscopy, at long-term follow-up, 62% (28/45) were satisfied compared to 91% ( 41145) after laparotomy. The difference was significant (p<0.01).

    Conclusions: Early postoperative reflux control was similar for laparoscopic and conventional fundoplication. At long-term follow-up significantly more patients were satisfied after laparotomy than after laparoscopy.

  • 7.
    Franzén, Thomas
    et al.
    Linköping University, Department of Biomedicine and Surgery, Surgery. Linköping University, Faculty of Health Sciences.
    Boström, J.
    Linköping University, Department of Biomedicine and Surgery, Surgery. Linköping University, Faculty of Health Sciences.
    Tibbling Grahn, Lita
    Linköping University, Department of Biomedicine and Surgery, Surgery. Linköping University, Faculty of Health Sciences.
    Johansson, Karl-Erik
    Linköping University, Department of Biomedicine and Surgery, Surgery. Linköping University, Faculty of Health Sciences.
    Prospective study of symptoms and gastro-oesophageal reflux 10 years after posterior partial fundoplication1999In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 86, no 7, p. 956-960Article in journal (Refereed)
    Abstract [en]

    Background:

    This was a prospective study of symptoms, and short-term and long-term reflux competence after partial fundoplication.

    Methods:

    Some 101 patients were operated consecutively with posterior partial (270°) fundoplication. Indications for surgery were reflux disease without erosive oesophagitis in 25 patients, moderate oesophagitis in 43, severe oesophagitis in 25 and paraoesophageal hernia in eight. Symptom score, manometry and pH tests were performed before operation, 6 months after operation and after 6–14 years.

    Results:

    All patients (n = 101) were free from heartburn and regurgitation at early follow-up. There was evidence of clinical recurrence at late follow-up (n = 87) in two of 22 patients without oesophagitis before operation, two of 39 with moderate oesophagitis before operation and three of 19 patients with severe oesophagitis before operation; 92 per cent had good reflux control at late follow-up.

    Conclusion

    Posterior partial fundoplication shows excellent reflux control at early follow-up. Ten years later fewer than 10 per cent of patients have recurrence, which is more common in patients who had severe oesophagitis before operation.

  • 8.
    Franzén, Thomas
    et al.
    Linköping University, Department of Biomedicine and Surgery, Surgery. Linköping University, Faculty of Health Sciences.
    Johansson, Karl-Erik
    Linköping University, Department of Biomedicine and Surgery, Surgery. Linköping University, Faculty of Health Sciences.
    Symptoms and reflux competence in relation to anatomical findings at reoperation after laparoscopic total fundoplication2002In: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 168, no 12, p. 701-706Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    To investigate the mechanisms and anatomical failures after total laparoscopic fundoplication using the symptoms and findings at reoperation.

    DESIGN:

    Prospective open study.

    SETTING:

    University hospital, Sweden.

    PATIENTS:

    Twenty-one patients who were reoperated on a median of 33 (0.5-102) months after laparoscopic fundoplication.

    INTERVENTIONS:

    The patients were divided into three groups according to the mode of presentation. The first group presented with dysphagia and no gastro-oesophageal reflux (GOR) (n = 6). The second group (n = 11) had recurrent GOR and the third group (n = 4) complained of a sense of excessive fullness.

    RESULTS:

    In the dysphagia group the reason for it in 4 patients was severe fibrosis in the hiatal region including the right part of the fundoplication. One patient had correctly located fundoplication but it was too tight. In the last patient the part of the stomach used was too low down. All patients in the GOR group had a slippage and rupture of the fundoplication. Ten patients also had a recurrent hernia. In 6/11 patients the fundal mobilisation was incomplete. In the last group (excessive fullness) one patient had a postoperative leak from the fundal part, one patient a para-oesophageal hernia, and one patient an intact but herniated repair. One further patient had an intact abdominal oesophagus and crural repair, but a large portion of the stomach had herniated through the left part of the fundoplication and acted as a volvulus.

    CONCLUSIONS:

    Dysphagia was caused by hiatal fibrosis or other technical failures rather than a normal tight fundoplication. Using the wrong part of the stomach causes recurrent heartburn. The laparoscopic suturing technique must be improved.

  • 9.
    Johansson, J.
    et al.
    Department of Surgery, Kalmar County Hospital, Linköping, Sweden, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Department of Medical Epidemiology and Biostatistics, PO Box 281, SE-171 77 Stockholm, Sweden.
    Hakansson, H.-O.
    Håkansson, H.-O., Department of Surgery, Kalmar County Hospital, Linköping, Sweden.
    Mellblom, L.
    Department of Pathology, Kalmar County Hospital, Linköping, Sweden.
    Kempas, A.
    Department of Surgery, Växjö County Hospital, Linköping, Sweden.
    Granath, F.
    Department of Medicine, Karolinska Institutet, University Hospital, Stockholm, Sweden.
    Johansson, Karl-Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery . Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Nyren, O.
    Nyrén, O., Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Diagnosing Barrett's oesophagus: Factors related to agreement between endoscopy and histology2007In: European Journal of Gastroenterology and Hepathology, ISSN 0954-691X, E-ISSN 1473-5687, Vol. 19, no 10, p. 870-877Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND STUDY AIM: Few previous studies have addressed the agreement between endoscopy and histology regarding Barrett's oesophagus in unselected endoscopy patients. Our aim was to quantify this agreement, and to study its relation to clinical and endoscopic characteristics in consecutive patients coming for first-time gastroscopy. METHODS: We invited consecutive patients aged 18-79 years and endoscoped for the first time at endoscopy units exclusively serving defined catchment areas in southeast Sweden. Endoscopic and clinical data were recorded according to a predetermined protocol, and biopsies were taken from the distal oesophagus in all patients. RESULTS: Among 705 patients included, 17% [95% confidence interval (CI): 14-20] had endoscopically visible columnar mucosa above the oesophagogastric junction and 38% (95% CI: 34-42) had columnar mucosa in at least one biopsy irrespective of the endoscopic finding. The overall concordance between endoscopy and histology regarding presence (or absence) of columnar mucosa above the oesophagogastric junction was 74% (95% CI: 71-77) and the agreement beyond chance, as measured by Kappa (?) statistics, was fair, ?=0.38 (95% CI: 0.32-0.45). The agreement between the endoscopic assessment and intestinal metaplasia at biopsy was 86% (95% CI: 83-88), but ? was only 0.31 (95% CI: 0.21-0.41). Our data were consistent with a lower threshold for macroscopic detection of columnar epithelium above the oesophagogastric junction, when risk factors for Barrett's oesophagus were present. CONCLUSION: The agreement between macroscopic and microscopic assessments of Barrett's oesophagus is no more than fair, and partly dependent on the presence of patient characteristics suggestive of pathology in this region. © 2007 Lippincott Williams & Wilkins, Inc.

  • 10.
    Johansson, J.
    et al.
    Department of Surgery, Kalmar County Hospital, Sweden, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, Department of Medical Epidemiology and Biostatistics, P.O. Box 281, SE-171 77 Stockholm, Sweden.
    Hakansson, H.-O.
    Håkansson, H.-O., Department of Surgery, Kalmar County Hospital, Sweden.
    Mellblom, L.
    Department of Pathology, Kalmar County Hospital, Sweden.
    Kempas, A.
    Department of Surgery, Växjö County Hospital, Växjö, Sweden.
    Johansson, Karl-Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery . Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Granath, F.
    Unit of Clinical Epidemiology, Department of Medicine, Karolinska Institutet and University Hospital, Stockholm, Sweden.
    Nyren, O.
    Nyrén, O., Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Risk factors for Barrett's oesophagus: A population-based approach2007In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 42, no 2, p. 148-156Article in journal (Refereed)
    Abstract [en]

    Objective. Given its often subclinical course, Barrett's oesophagus (BO) hardly lends itself to epidemiologically stringent evaluations. The objective of this study was to investigate risk factors for incident BO diagnosed in a defined population in southeast Sweden while paying particular attention to epidemiological aspects of the study design. Material and methods. Consecutive patients (aged 18-79 years) who were endoscoped with new indications at units exclusively responsible for all gastroscopies in defined catchment area populations were invited to take part in the study. Biopsies were taken above and immediately below the gastro-oesophageal junction, and exposure information was collected through self-administered questionnaires. Endoscopy-room-based cross-sectional data from 604 patients were supplemented with exposure data from 160 population controls. Associations, expressed as odds ratios (ORs), were modelled by means of multivariable logistic regression. Results. In the comparison with population controls, reflux symptoms and smoking indicated a 10.7- and 3.3-fold risk, respectively, for BO (95% confidence interval (CI) 3.5-33.4 and 1.1-9.9, respectively). Body mass was unrelated to risk. In the cross-sectional analysis among endoscopy-room patients, reflux symptoms were associated with an OR of 2.0 (95% CI 0.8-5.0). This association was, however, modified by the subjunctional presence of Helicobacter pylori, although the infection was not in itself significantly connected with risk, a combination of reflux symptoms and H. pylori infection was linked to an almost 5-fold risk (95% CI 1.4-16.5) as compared with the absence of both factors. The BO prevalence increased by 5% per year of age (95% CI 1-9%). Conclusions. Reflux is the predominant risk factor for BO, and proximal gastric colonization of H. pylori seems to amplify this risk. © 2007 Taylor & Francis.

  • 11.
    Johansson, Johan
    et al.
    Karolinska Institute.
    Hakansson, Hans-Olof
    Kalmar County Hospital.
    Mellblom, Lennart
    Kalmar County Hospital.
    Kempas, Antti
    Vaxjö County Hospital.
    Kjellen, Gerhard
    Kalmar County Hospital.
    Brudin, Lars
    Kalmar County Hospital.
    Granath, Fredrik
    Karolinska Institute.
    Johansson, Karl-Erik
    Linköping University, Department of Biomedicine and Surgery, Division of surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Nyren, Olof
    Karolinska Institute.
    Pancreatic acinar metaplasia in the distal oesophagus and the gastric cardia: prevalence, predictors and relation to GORD2010In: JOURNAL OF GASTROENTEROLOGY, ISSN 0944-1174, Vol. 45, no 3, p. 291-299Article in journal (Refereed)
    Abstract [en]

    The nature of pancreatic acinar metaplasia (PAM) in the gastro-oesophageal junction (GOJ) remains obscure. We aimed to estimate its prevalence and investigate into its risk factors in a population-based series of first-time endoscopy patients. We investigated consecutive patients, endoscoped for the first time, representing defined catchment area populations. Biopsies were taken immediately below the GOJ and from the distal oesophagus. Endoscopy room-based cross-sectional clinical data were supplemented with exposure data from 160 population controls. Associations, expressed as odds ratios (OR), were modelled with multivariable logistic regression. A subsample of 26 patients underwent oesophageal pH monitoring. Among 644 patients (mean age 53 years, 43% men), PAM was found in 121 patients (19%), exclusively above the GOJ in 40 (6%), below GOJ in 67 (10%), and both above and below GOJ in 14 (2%). PAM exclusively above the GOJ and PAM exclusively below the GOJ were both borderline associated with age (2% increase in prevalence per year). PAM exclusively above the GOJ was significantly associated with female gender (OR 2.8, 95% CI 1.3-6.3) and presence of Helicobacter pylori immediately below the GOJ (OR 2.6, 95% CI 1.3-5.4). Out of 21 patients with Barretts oesophagus (BO), 8 (38%) had PAM above the GOJ. The mean value for percentage time with oesophageal pH andlt; 4.0 was 7.3% (95% CI 4.3-10.2%) among patients who had PAM above the GOJ (reference value 3.4%). Pancreatic acinar metaplasia might be an age-dependent lesion, associated with H. pylori, female gender and gastro-oesophageal reflux if located above the GOJ.

  • 12. Johansson, Johan
    et al.
    Håkansson, Hans-Olof
    Mellblom, Lennart
    Kempas, Antti
    Johansson, Karl-Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Granath, Fredrik
    Nyrén, Olof
    Prevalence of precancerous and other metaplasia in the distal oesophagus and gastro-oesophageal junction2005In: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 40, no 8, p. 893-902Article in journal (Refereed)
    Abstract [en]

    Objective. The epidemiology of Barrett's oesophagus (BO) is characterized by divergent results. The aim of this study was to estimate the prevalence of BO and intestinal metaplasia (IM) at the gastro-oesophageal junction (GOJ) in a population-based series of patients referred for first-time gastroscopy. Material and methods. Consecutive patients who underwent endoscopy for the first time at endoscopy units exclusively serving defined catchment areas were invited to take part in the study. Biopsies were taken immediately below the GOJ and from the distal oesophagus, and clinical data were recorded. Results. A total of 769 patients (mean age 53 years, 43% M) were examined. Overall IM prevalence was 14%. BO was noted in 4%. Overall, the prevalence of IM increased by 8% (95% CI 6-10%) per year of age. BO patients were predominately women (69%). Presence of cardia-type mucosa in the cardia increased with age from 25% among the youngest to 59% among the oldest patients. Pancreatic acinar metaplasia (PAM) was found in 18%. Conclusions. While BO is not common among Swedish gastroscopy patients, IM and PAM are found in every 7th and 6th patient, respectively. Age-dependent increments in prevalence suggest that not only BO and IM, but also cardia-type mucosa are acquired and/or progressive lesions. © 2005 Taylor & Francis.

  • 13.
    Redéen, Stefan
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Engström, Helena
    Erikson, Stina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Urology in Östergötland.
    Haldestam, Ingvar
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Leinsköld, Ted
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Johansson, Karl-Erik
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Abdominell tuberkulos - en nygammal diagnostisk utmaning2005In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 102, no 30-31, p. 2151-2153Article in journal (Other academic)
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