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Your search keyword '"Koivukangas, V. (Vesa)"' showing total 3 results
Start Over Author "Koivukangas, V. (Vesa)" Publisher elsevier
3 results on '"Koivukangas, V. (Vesa)"'

1. Preoperative hemoglobin count and prognosis of esophageal cancer, a population-based nationwide study in Finland

Author

Jokela, E. M. (Ella M.K.), Kauppila, J. H. (Joonas H.), Helminen, O. (Olli), Helmiö, M. (Mika), Huhta, H. (Heikki), Kallio, R. (Raija), Koivukangas, V. (Vesa), Kokkola, A. (Arto), Laine, S. (Simo), Lietzen, E. (Elina), Meriläinen, S. (Sanna), Ohtonen, P. (Pasi), Pohjanen, V.-M. (Vesa-Matti), Rantanen, T. (Tuomo), Ristimäki, A. (Ari), Räsänen, J. V. (Jari V.), Saarnio, J. (Juha), Sihvo, E. (Eero), Toikkanen, V. (Vesa), Tyrväinen, T. (Tuula), Valtola, A. (Antti), Jokela, E. M. (Ella M.K.), Kauppila, J. H. (Joonas H.), Helminen, O. (Olli), Helmiö, M. (Mika), Huhta, H. (Heikki), Kallio, R. (Raija), Koivukangas, V. (Vesa), Kokkola, A. (Arto), Laine, S. (Simo), Lietzen, E. (Elina), Meriläinen, S. (Sanna), Ohtonen, P. (Pasi), Pohjanen, V.-M. (Vesa-Matti), Rantanen, T. (Tuomo), Ristimäki, A. (Ari), Räsänen, J. V. (Jari V.), Saarnio, J. (Juha), Sihvo, E. (Eero), Toikkanen, V. (Vesa), Tyrväinen, T. (Tuula), and Valtola, A. (Antti)

Abstract

Background: The prognostic value of preoperative hemoglobin in patients undergoing esophagectomy is unknown. The aim of this study was to examine whether preoperative hemoglobin is associated with prognosis in patients undergoing esophagectomy for cancer. Materials and methods: This was a population-based nationwide retrospective cohort study in Finland, using Finnish National Esophago-Gastric Cancer Cohort (FINEGO). Esophagectomy patients with available preoperative hemoglobin measurement were included. Multivariable cox regression provided hazard ratios (HR) with 95% confidence intervals (CI), adjusted for calendar period of surgery, age at surgery, sex, comorbidity (Charlson Comorbidity Index), tumor histology, tumor stage, neoadjuvant therapy, type of surgery (minimally invasive or open) and annual hospital volume. Results: Of the 1313 patients, 932 (71.0%) were men and 799 (60.9%) had esophageal adenocarcinoma. Overall all-cause mortality was significantly higher in the lowest hemoglobin count tertile (HR 1.26 (1.07–1.47)) compared to the highest tertile, but this association was attenuated after adjustment for confounding. No differences were found between the preoperative hemoglobin groups in the adjusted analyses of 90-day all-cause, 5-year all-cause, and 5-year cancer-specific mortality. Conclusions: In this population-based nationwide study, preoperative hemoglobin count had no independent prognostic significance in esophageal cancer.

Published
2022

2. Gastrointestinal manifestations after Roux-en-Y gastric bypass surgery in individuals with and without type 2 diabetes

Author

Härma, M.-A. (Mari-Anne), Adeshara, K. (Krishna), Istomin, N. (Natalie), Lehto, M. (Markku), Blaut, M. (Michael), Savolainen, M. J. (Markku J.), Hörkkö, S. (Sohvi), Groop, P.-H. (Per-Henrik), Koivukangas, V. (Vesa), Hukkanen, J. (Janne), Härma, M.-A. (Mari-Anne), Adeshara, K. (Krishna), Istomin, N. (Natalie), Lehto, M. (Markku), Blaut, M. (Michael), Savolainen, M. J. (Markku J.), Hörkkö, S. (Sohvi), Groop, P.-H. (Per-Henrik), Koivukangas, V. (Vesa), and Hukkanen, J. (Janne)

Abstract

Background: Roux-en-Y gastric bypass (RYGB) surgery is an effective treatment for obesity, which improves cardiovascular health and reduces the risk of premature mortality. However, some reports have suggested that RYGB may predispose patients to adverse health outcomes, such as inflammatory bowel disease (IBD) and colorectal cancer. Objectives: The present prospective study aimed to evaluate the impact of RYGB surgery on cardiovascular risk factors and gastrointestinal inflammation in individuals with and without type 2 diabetes (T2D). Setting: University hospital setting in Finland. Methods: Blood and fecal samples were collected at baseline and 6 months after surgery from 30 individuals, of which 16 had T2D and 14 were nondiabetics. There were also single study visits for 6 healthy reference patients. Changes in cardiovascular risk factors, serum cholesterol, and triglycerides were investigated before and after surgery. Fecal samples were analyzed for calprotectin, anti-Saccharomyces cerevisiae immunoglobulin A antibodies (ASCA), active lipopolysaccharide (LPS) concentration, short-chain fatty acids (SCFAs), intestinal alkaline phosphatase activity, and methylglyoxal-hydro-imidazolone (MG-H1) protein adducts formation. Results: After RYGB, weight decreased on average −21.6% (−27.2 ± 7.8 kg), excess weight loss averaged 51%, and there were improvements in cardiovascular risk factors. Fecal calprotectin levels (P < 0.001), active LPS concentration (P < 0.002), ASCA (P < 0.02), and MG-H1 (P < 0.02) values increased significantly, whereas fecal SCFAs, especially acetate (P < 0.002) and butyrate (P < 0.03) levels, were significantly lowered. Conclusion: The intestinal homeostasis is altered after RYGB, with several fecal markers suggesting increased inflammation; however, clinical significance of the detected changes is currently uncertain. As chronic inflammation may predispose patients to adverse health effects, our findings may have relev

Published
2021

3. Laparoscopic versus open adhesiolysis for adhesive small bowel obstruction (LASSO):an international, multicentre, randomised, open-label trial

Author

Sallinen, V. (Ville), Di Saverio, S. (Salomone), Haukijärvi, E. (Eija), Juusela, R. (Risto), Wikström, H. (Heidi), Koivukangas, V. (Vesa), Catena, F. (Fausto), Enholm, B. (Berndt), Birindelli, A. (Arianna), Leppäniemi, A. (Ari), and Mentula, P. (Panu)

Abstract

Background: Although laparoscopic adhesiolysis for adhesive small bowel obstruction is being done more frequently, it is not widely accepted due to the lack of supporting evidence of its superiority over an open approach and concerns regarding its benefits. We aimed to investigate whether laparoscopic adhesiolysis was a superior treatment for adhesive small bowel obstruction compared with an open approach in terms of length of postoperative hospital stay and morbidity. Methods: In this international, multicentre, parallel, open-label trial, we randomly assigned patients (1:1) aged 18–95 years who had adhesive small bowel obstruction that had not resolved with conservative management to have either open or laparoscopic adhesiolysis. The study was done in five academic university hospitals and three community (central) hospitals in two countries (Finland [n=3 academic university hospitals; n=3 community hospitals] and Italy [n=2 academic university hospitals]). We included only patients with high likelihood of a single adhesive band in the trial; additionally, patients who had an anaesthesiological contraindication, were pregnant, living in institutionalised care, or who had a hospital stay of more than 1 week before the surgical consultation were excluded from the trial. The randomisation sequence was generated using block randomisation, with randomly varied block sizes and stratified according to centre. The primary outcome was postoperative length of hospital stay assessed at time of discharge in the modified intention-to-treat population. Findings: Between July 18, 2013, and April 9, 2018, 566 patients were assessed for eligibility, of whom 104 patients were randomly assigned to the open surgery group (n=51) or to the laparoscopy group (n=53). Of these patients, 100 were included in the modified intention-to-treat analyses (49 in the open surgery group; 51 in the laparoscopy group). The postoperative length of hospital stay for open surgery group was on average 1·3 days longer than that in the laparoscopy group (geometric mean 5·5 days [range 2–19] vs 4·2 days [range 1 −20]; ratio of geometric means 1·31 [95% CI 1·06–1·61]; p=0·013). 21 (43%) patients in the open surgery group and 16 (31%) patients in the laparoscopy group had postoperative complications (Clavien-Dindo any grade) within 30 days (odds ratio 0·61 [95% CI 0·27–1·38]; p=0·23). One patient died in each group within 30 days. Interpretation: Laparoscopic adhesiolysis provides quicker recovery in selected patients with adhesive small bowel obstruction than open adhesiolysis.

Published
2019

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