Frederik Helgstrand

Frederik Helgstrand
Zealand University Hospital · Surgery

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72
Publications
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Publications

Publications (72)
Article
Background: Mesh is recommended for umbilical hernias with defects > 1 cm to reduce recurrence. For umbilical hernias with defect width ≤ 1 cm, the literature is sparse. The aim of this nationwide cohort study was to assess outcomes after suture and mesh repair of umbilical hernias with defect width ≤ 1 cm and to evaluate outcomes after onlay mesh...
Article
Evidence for mesh-related surgical complications and chronic pain after umbilical hernia repair is only sparsely reported. The present study used economic claims and compensation as a proxy for mesh-related complications and chronic pain. Mesh-related complications and chronic pain may be important adverse long-term outcomes following umbilical her...
Article
Aim High level evidence recommends the use of mesh for umbilical hernias with defects >1 cm to reduce recurrence rates without increasing the risk of postoperative complications. For umbilical hernias with defect width ≤1 cm, the literature is sparse. The aim of the study was to assess outcomes after suture and mesh repair of umbilical hernias with...
Article
Aim Although laparoscopic repair of incisional hernias decreases the incidence of wound complications as compared with open repair, there has been a rising concern related to intraperitoneal mesh placement. The aim of this study was to examine outcomes after open or laparoscopic elective incisional hernia mesh repair on a nationwide basis. Materia...
Article
Aim The risk of mesh-related surgical complications after umbilical hernia repair is not known and chronic pain has only sparsely been analysed. Economic claims may represent a surrogate for poor postoperative surgical outcomes. Thus, the present study used mesh-related complications and chronic pain as primary and secondary outcomes, respectively....
Article
Aim The aim of the study was to evaluate the rates of 90-day readmission and reoperation for complication, together with rate of operation for recurrence after either open or laparoscopic mesh repair for primary umbilical or epigastric hernias with defect widths above 1 cm. Material and Methods A merge of data between the Danish Hernia Database an...
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Full-text available
Aim To examine the incidence of primary and recurrent repair and types of repair performed in patients with parastomal bulging. Material and Methods We linked prospectively collected data on parastomal bulging from the Danish Stoma Database to surgical data on repair of parastomal bulging from the Danish National Patient Register. Survival statist...
Article
Increasing overweight is a rising issue worldwide. In 2017, 17% of the Danish population had a body mass index (BMI) > 40 kg/m2 also defined as extreme obesity. Bariatric surgery is the most effective long-term treatment and the status in Denmark is summarized in this review. The most common procedures are Roux-en-Y-gastric bypass and gastric sleev...
Article
Traditionally, the quality of ventral hernia repair has been measured by hard outcomes such as morbidity and recurrence, but patient-reported outcome measures (PROMs) have become increasingly popular. In this review we suggest, that only a minor subset of PROMs has improved in patients undergoing elective large-sized incisional hernia repair. For u...
Article
There is an increasing focus on patient-reported outcome measures (PROMs) to document bariatric surgical quality. In this review, the literature has been scrutinised, and 19 clinical studies (including 14 validated bariatric procedure/disease-specific and generic questionnaires) have been analysed. Long-term PROMs are significantly improved after b...
Article
Objective: Changes in the secretion of gut-derived peptide hormones have been associated with the metabolic benefits of Roux-en-Y gastric bypass (RYGB) surgery. In this study, the effects of RYGB on anthropometrics, postprandial plasma hormone responses, and mRNA expression in small intestinal mucosa biopsy specimens before and after RYGB were eva...
Article
Introduction: Patients with chronic pain after laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery frequently report intense postprandial abdominal pain. Reduced blood supply due to atherosclerosis was hypothesised to be a contributing cause. Methods: This was a retrospective, single-centre cohort study including all patients with LRYGB surger...
Article
Aim To examine i) the incidence of primary repair, ii) the incidence of recurrent repair and iii) the types of repair performed in patients with parastomal bulging. Method Prospectively collected data on parastomal bulging from the Danish Stoma Database were linked to surgical data on repair of parastomal bulging from the Danish National Patient R...
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Background Until now, no detailed long-term data regarding patients with declining quality of life or occupational status after laparoscopic Roux-en-Y gastric bypass surgery have been presented. The aim of this study was to evaluate the long-term effect of laparoscopic Roux-en-Y gastric bypass surgery on quality of life and occupational status. Me...
Article
Background Smoking and obesity are well-known risk factors for surgical site infection, but it is unknown whether these factors influence outcomes after repair of small umbilical and epigastric hernias with defects ≤2 cm. The aim of this study was to evaluate whether smoking and obesity are associated with readmission, reoperation for complications...
Article
The review summarises the handling of open abdomen with fistula, which is one of the most serious complications in connection with abdominal surgery. Most often, morbidity and mortality are caused by lack of fistula control and multi-organ dysfunction. The primary aim is to prevent sepsis, control the fistula and optimise the patient's physiology....
Article
Background Systematic reviews play a crucial role in clinical decision making and resource allocation and are expected to be unbiased and consistent. The aim of this study is a review of systematic reviews on the use of prophylactic mesh to prevent parastomal hernia (PH) formation using ROBIS and AMSTAR tools to assess the risk of bias and methodol...
Article
Objective: To investigate the prevalence and risk factors for chronic abdominal pain after Roux-en-Y gastric bypass (RYGB) surgery. Summary background data: Abdominal pain is a frequent postoperative complication after RYGB surgery. Even if there have been defined several long-term complications, the literature regarding patients with unexplaine...
Article
This review updates the literature on surgical treatment algorithm for umbilical, epigastric and incisional hernias by proposing an algorithm. It is recommended, that small hernias (horizontal defect 0-2 cm) are repaired openly with sublay or onlay mesh with 1 cm mesh overlap. Medium-sized hernias (horizontal defect 2-6 cm) may be repaired laparosc...
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Full-text available
Background: There are various ways of fixating an intraperitoneal onlay mesh during a laparoscopic ventral hernia repair. The risk of complications is high, and around 22% of the hernias will recur within 3.5 years. The aim of this study was to assess if sutures in addition to tack fixation would reduce the re-operation rate for recurrence compare...
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Background International guidelines on the prevention and treatment of parastomal hernias are lacking. The European Hernia Society therefore implemented a Clinical Practice Guideline development project. Methods The guidelines development group consisted of general, hernia and colorectal surgeons, a biostatistician and a biologist, from 14 European...
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Purpose: All surgical procedures elicit a complex systemic inflammatory response effectuated and modulated by cytokines. The purpose of this systematic review was to present an overview of the inflammatory response and the serum markers associated with hernia repair and to compare the response between patients treated with and without mesh. Metho...
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Magnesium defciency can cause a variety of symptoms, including potentially life-threatening complications such as seizures, cardiac arrhythmias and secondary electrolyte disturbances. Hypomagnesemia can be a serious adverse effect to proton pump inhibitor (PPI) therapy, which is worrying due to the widespread use of PPIs. Current evidence suggest t...
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Full-text available
PurposePostoperative surgical complications arising from ventral hernia repair have been assessed by a variety of outcome measures. The objective of this study was to correlate the Clavien Dindo Classification (CDC) graded complications with the 30-day readmission rate as early outcome measures in ventral hernia repair. Secondarily, we wanted to in...
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Full-text available
Background: Laparoscopic Roux-en-Y gastric bypass excludes the biliary tree from traditional evaluation and treatment with endoscopic retrograde cholangiopancreatography (ERCP). Due to the initial rapid weight loss, gastric bypass patients have an increased risk of developing gallstones in the gallbladder as well as in the common bile duct. Variou...
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Background Repair of large incisional hernias remains a surgical and costly challenge. Temporary paralysis of the lateral abdominal wall muscles with topical administration of botulinum toxin A (BTA) is a new therapeutic concept, which may obviate the need for component separation technique (CST) for repair of large incisional hernias. Current lite...
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PurposeBenign elective procedures give rise to heterogeneity in indication for surgery and surgical technique among specialized surgeons in a variety of surgical fields. The objective was to analyze the extent of agreement in surgical management among expert hernia surgeons when evaluating the same patient in a standardized setting. Methods Five Da...
Article
In Reply Mesh reinforcement is almost always used in elective repair of an incisional hernia to minimize the risk of recurrence,¹ as well as in repair of small umbilical and epigastric hernias.² The expert consensus recommendation for the use of mesh was based on evidence from randomized trials from specialized hernia centers with high internal val...
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Full-text available
Background Computed tomography (CT) is the gold standard in the initial evaluation of the hemodynamically stable patient with suspected liver trauma. However, the adverse effects of radiation exposure are of specific concern in the pediatric population. It is therefore desirable to explore alternative diagnostic modalities. Aspartate aminotransfera...
Article
It is estimated that 15% of patients above 65 years of age are frail. Frail patients have significantly higher risk of post-operative complications when undergoing both elective and emergency surgery than patients who are not frail. Therefore, it is recommended that all patients above 65 years are frailty scored prior to a surgical procedure. It se...
Article
Importance: Prosthetic mesh is frequently used to reinforce the repair of abdominal wall incisional hernias. The benefits of mesh for reducing the risk of hernia recurrence or the long-term risks of mesh-related complications are not known. Objective: To investigate the risks of long-term recurrence and mesh-related complications following elect...
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Full-text available
Aim The Danish Ventral Hernia Database (DVHD) provides national surveillance of current surgical practice and clinical postoperative outcomes. The intention is to reduce postoperative morbidity and hernia recurrence, evaluate new treatment strategies, and facilitate nationwide implementation of evidence-based treatment strategies. This paper descri...
Article
Objective: Exsanguination due to coagulopathy and vascular injury is a common cause of death among trauma patients. Arterial injury can be treated either by angiography and embolization or by explorative laparotomy and surgical packing. The purpose of this study was to compare 30-day mortality and blood product consumption in trauma patients with...
Article
Ventral hernia repairs are among the most frequently performed surgical procedures. The variations of repair techniques are multiple and outcome has been unacceptable. Despite the high volume, it has been difficult to obtain sufficient data to provide evidence for best practice. In order to monitor national surgical quality and provide the warrante...
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Full-text available
Purpose Due to risks of postoperative morbidity and recurrence some patients with a ventral hernia are not offered surgical repair. There is limited data on the rate and consequences of a watchful waiting (WW) strategy for these patients. The objective of this cohort study was to analyse outcomes for patients with a ventral hernia who underwent wat...
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Introduction: Hematogenous spread of bacteria from the bowel due to bacterial translocation has been postulated in animal and trauma studies. This case presents a patient with possible hematogenous bacterial spreading after acute laparotomy. Case presentation: A 57-year old woman was admitted with abdominal pain. A computed tomography showed mec...
Article
Intrathoracic anastomotic leakage after intended curative resection for cancer in the esophagus or gastroesophageal junction has a negative impact on long-term survival. The aim of this study was to investigate whether an anastomotic leakage was associated with an increased recurrence rate. This nationwide study included consecutively collected dat...
Article
Background The mesh fixation technique in laparoscopic incisional hernia repair may influence the rates of hernia recurrence and chronic pain. This study investigated the long-term risk of recurrence and chronic pain in patients undergoing laparoscopic incisional hernia repair with either absorbable or non-absorbable tacks for mesh fixation.Methods...
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Conventional laparoscopic cholecystectomy (CLC) is regarded as the gold standard for cholecystectomy. However, single-incision laparoscopic cholecystectomy (SLC) has been suggested to replace CLC. This study aimed at comparing long-term incidences of port-site hernia and chronic pain after SLC versus CLC. We conducted a matched cohort study based o...
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Full-text available
Hepatic pseudoaneurysm (HPA) is a rare complication after liver trauma, yet it is potentially fatal, as it can lead to sudden severe haemorrhage. The risk of developing posttraumatic HPA is one of the arguments for performing follow-up CT of patients with liver injuries. The aim of this study was to investigate the occurrence of HPA post liver trau...
Article
Development of a hepatic pseudoaneurysm (HPA) is a well-known, yet rare complication after liver trauma. We found 135 cases reported in the literature since 1965. Ruptured HPAs may have severe consequences with sudden massive haemorrhage and death. A clear strategy towards diagnosis and management of HPA post liver trauma is needed and outlined in...
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Full-text available
Background The construction of a colostomy is a common procedure, but the evidence for the different parts of the construction of the colostomy is lacking. Parastomal hernia is a common complication of colostomy formation. The aim of this study is to standardise the colostomy formation and to compare three types of colostomy formation (one includin...
Article
There are no randomized studies that compare outcomes after single-incision (SLC) and conventional multi-incision (MLC) laparoscopic cholecystectomy under an optimized perioperative analgesic regimen. This patient- and assessor-blinded randomized three-centre clinical trial compared SLC and MLC in women admitted electively with cholecystolithiasis....
Article
Surgical outcome results after repair for parastomal hernia are sparsely reported and based on small-scale studies. This study aims to analyze surgical risk factors for 30-day reoperation and mortality, and, secondarily, to report the risk of reoperation for recurrence. This is a retrospective analysis of nationwide perioperative surgical variables...
Article
Ventral hernia repairs are common surgical procedures and quality monitoring with a high validity is mandatory. The aim of the present study was to validate the data quality of the Danish Ventral Hernia Database (DVHD). All ventral hernia repairs performed in the Region of Zealand and registered in the DVHD between 1 October 2010 and 1 October 2011...
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Full-text available
Repair for a small (≤2 cm) umbilical and epigastric hernia is a minor surgical procedure. The most common surgical repair techniques are a sutured repair or a repair with mesh reinforcement. However, the optimal repair technique with regard to risk of reoperation for recurrence is not well documented. The aim of the present study was in a nationwid...
Article
The primary aim of the present study was to investigate risk factors for readmission after elective umbilical and epigastric hernia repair and secondarily to evaluate causes for readmission. All patients with elective umbilical or epigastric hernias registered in The Danish Hernia Database during January 2007-January 2011 were included. A 100 % 30-...
Article
Background: Early surgical results after emergency repairs for the most frequent ventral hernias (epigastric, umbilical, and incisional) are not well described. Thus, the aim of present study was to investigate early results and risk factors for poor 30-day outcome after emergency versus elective repair for ventral hernias. Methods: All patients...
Article
Objective: Abdominal aortic aneurysm disease has been hypothesized as associated with the development of abdominal wall hernia. We evaluated the risk factors for incisional hernia repair after open elective aortic reconstructive surgery for aortoiliac occlusive disease and abdominal aortic aneurysm. Methods: A retrospective analysis of prospecti...
Article
Background: Incisional hernia repair is a frequent surgical procedure, but perioperative risk factors and outcomes have not been prospectively assessed in large-scale studies. The aim of this nationwide study was to analyze surgical risk factors for early and late outcomes after incisional hernia repair. Study design: We conducted a prospective...
Article
Full-text available
Purpose: Elective repair for umbilical or epigastric hernia is a frequent minor surgical procedure. Several studies have demonstrated chronic pain after groin hernia repair but long-term complaints have been only scarcely studied. This study was undertaken to investigate long-term pain and discomfort after open repair for small umbilical or epigas...
Article
Objective: To compare the clinical recurrence rate with reoperation rate for recurrence after ventral hernia repair. Background: Reoperation is often used as an outcome measure after ventral hernia repair, but it is unknown whether reoperation rate reflects the overall clinical risk for recurrence. Methods: The study cohort was recruited from...
Article
Early outcome after elective ventral hernia repair is unsatisfactory, but detailed analyses are lacking. The aim of this study was to describe the aetiology of prolonged hospital stay (LOS), readmission and death < 30 days after elective ventral hernia repair. The present study was a nationwide case-control study based on prospective results from e...
Article
The risk of trocar site hernia (TSH) may be 0-22%, but no large scaled data with long-term follow-up are available. The purpose of this study was to estimate the long-term risk of TSH repair. All patients in Denmark who underwent a laparoscopic procedure in 1997 were identified using the Danish National Patient Register and followed during a 12-yea...
Article
There is a risk of developing a trocar site hernia (TSH) after laparoscopic surgery, but data is sparse and based mostly on retrospective studies with a short and poorly defined follow-up period. Surgical approaches and patient-related co-morbidity have also been suggested as risk factors for development of TSH. The aim of the present review was to...
Article
The evidence for choice of surgical technique in ventral hernia treatment is poor. The outcomes have so far been associated with high recurrence rates and significant morbidity. Data from the Danish Ventral Hernia Database show large variations in the surgical approach. On the basis of a consensus meeting, agreement on a national strategy for ventr...
Article
Outcome after ventral hernia repair is not optimal. The surgical technique relies on personal preferences or evidence from small-scale studies, rather than large-scale prospective data with high external validity. The purpose of this paper was to describe the establishment and potential of the Danish Ventral Hernia Database (DVHD). Furthermore, the...
Article
Parastomal hernia is a well known clinical problem, and up to 50% of all patients having a stoma will eventually develop a parastomal hernia. There are many surgical options available for the repair of a parastomal hernia, but the prevention of hernia development has only recently received scientific attention. The most encouraging results have inc...
Article
Transanal endoscopic microsurgery (TEM) was developed by Gerhard Buess in 1983 as an alternative to traditional transanal surgery. The method has become more and more widespread in the treatment of benign as well as T1 rectum tumours. We have used the method for several years and we present our results in this paper. Retrospective examination of pa...

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