National specialised medical care

The assignment covers surgical procedures on children and adolescents in three areas: diaphragmatic hernia, malformations in the oesophagus and pelvic floor, bowel, and urinary tract.

Skåne University Hospital has been assigned this together with Karolinska University Hospital. For Skåne University Hospital, this amounts to about 50 patients per year.

Since 1 January 2021, Skåne University Hospital, the women's healthcare area also provides some endometriosis care as national specialised medical care.

Skåne University Hospital in Lund has a national centre for paediatric cardiac surgery that provides national care. Around 250 children and adolescents from all over the country undergo surgery here every year. More than half of all patients are less than one year old.

Cardiac surgery on adults with congenital heart defects was one of the first areas to become a national healthcare.

Skåne University Hospital in Lund provides national healthcare in this area. They perform about 20 operations each year on adults with congenital heart defects.

Skåne University Hospital in Lund provides highly specialised care within heart transplantation and performs around 30 heart transplantations a year.

Skåne University Hospital in Lund also provides national specialised medical care within lung transplantation. Around 15 lung transplantations are performed here each year.

The women's healthcare at Skåne University Hospital has been assigned to provide national specialised medical care in prolapse mesh surgery.

Skåne University Hospital provides care for various forms of spinal cord injuries within the assignment to provide national specialised medical care. These can be injuries after accidents or injuries caused by illness, such as inflammation or oxygen deficiency.

Skåne University Hospital is one of five hospitals in Sweden that provides national specialised medical care for primary sclerosing cholangitis (PSC), a liver disease that may eventually lead to cancer of the biliary tract.

Skåne University Hospital is one of two hospitals in Sweden that provides national specialised medical care for certain types of penile cancer. The assignment focuses on advanced surgery, which is needed by approximately 140-160 patients in Sweden each year.

Skåne University Hospital is one of four hospitals in Sweden that provides national specialised medical care in the treatment of transjugular intrahepatic portosystemic shunt (TIPS). The treatment is mainly used when diseases such as cirrhosis of the liver, also known as hepatic cirrhosis, or other injuries impair the flow of blood to and through the liver.

Skåne University Hospital is one of four hospitals in Sweden that provides national specialised medical care for neuroendocrine tumours of the abdomen (NET) and advanced adrenal tumours. In Sweden, 400-500 people a year are diagnosed with NET and 120-130 people a year with advanced adrenal tumours.

Skåne University Hospital is one of two hospitals in Sweden that provides national specialised medical care for head and neck paraganglioma, a mostly benign tumour that affects a few people in Sweden each year. The assignment involves surgical treatment, but also some investigation and follow-up.

Skåne University Hospital provides national specialised medical care within the field of neuromuscular diseases. The care is provided on behalf of the National Board of Health and Welfare.

The assignment concerns rare neuromuscular diseases that affect 6,000-7,000 patients annually in Sweden and involves an in-depth neurological investigation where a diagnosis has not been made.

Systemic sclerosis is an autoimmune disease that causes the body's immune system to incorrectly target the body's own tissues. Individuals with severe systemic sclerosis can be treated through autologous stem cell transplantation. This means that the patient's own stem cells are taken from the blood, purified and then returned. 

Annually, Skåne University Hospital treats 100 patients who have been diagnosed with various ailments using autologous stem cell transplantation. The university has well-developed research in diagnostics and treatment options for patients with systemic sclerosis and other autoimmune diseases. One of the world's most extensive long-term studies on patients with systemic sclerosis is being conducted here.

The National Board of Health and Welfare has commissioned Skåne University Hospital to provide national highly specialised care for children suffering from certain chronic pulmonary diseases.

The commission involves providing care when any of the following four diagnoses are made:

• Primary ciliary dyskinesia (PCD)
• Chronic obstructive pulmonary diseases of unclear origin and/or that are refractory
• Bronchiectasis, that is, diseases of the bronchial tree, or other secondary lung damage
• Congenital central hypoventilation syndrome (CCHS), other chronic respiratory disorders, and children in need of assisted ventilation.

Retinopathy of prematurity (ROP) is a retinal disease that can develop in babies born prematurely, and means that blood vessels in the retina grow incorrectly. This can result in severe visual impairment or blindness unless it is treated in time. In Sweden, approximately 40-50 patients need treatment for severe ROP each year.

Skåne University Hospital is one of three hospitals tasked with providing national highly specialised care for certain care in cases of retinopathy of prematurity (ROP).

Congenital metabolic diseases are a collective term for rare inherited conditions that involve errors in the body's metabolism of carbohydrates, protein, fat and certain vitamins. This can cause damage to various organs such as the brain, heart and liver and prevent the normal functioning of cells.

The patient's team includes a paediatrician specialising in congenital metabolic diseases, a paediatric neurologist, specialised dieticians, a contact nurse, a welfare officer, a psychologist, a physiotherapist and an occupational therapist. There are similar teams within adult care and there is close cooperation between the two teams. We also work closely with specialist maternity care, paediatric intensive care, specialists in clinical chemistry and clinical genetics, patients' local hospitals and nationally.

As of spring 2023, the Centre for Advanced Medicinal Therapy Products (ATMP) at Skåne University Hospital is the only Nordic treatment centre for gene therapy in the severe neurometabolic disease metachromatic leukodystrophy (MLD). We aim to expand gene therapy treatment options for patients with congenital metabolic diseases.

Pacemaker device extraction involves removing the pacemaker box and the electrodes that run through the vascular system and connect the box to the heart. The most common reason for removing a pacemaker device is an infection.

About 400 patients are treated annually in Sweden, of which about 120 are treated at Skåne University Hospital. The procedure is complex and may require the presence of several healthcare specialties. Skåne University Hospital has long experience and a well-functioning organisation for the patient group, where cardiologists, infectious disease specialists, anaesthesiologists, thoracic surgeons and intensive care cooperate. There is good preparedness to deal with serious complications around the clock and good conditions for post-operative care in our cardiac and infectious disease wards.

Several research projects in this area are ongoing at Skåne University Hospital. For example, research is being carried out on which bacteria can be grown in infections in pacemaker systems and whether there are infections that can also be treated conservatively without surgery.

About 81,000 people in Sweden have epilepsy, of which 11,000 are children. Around two-thirds of people who take medication for epilepsy become seizure-free. There is a small group of patients with severe epilepsy where medicinal treatment is inadequate. These patients can be evaluated for epilepsy surgery by thoroughly examining the area of the brain that causes seizures. Whether surgery is possible depends on the type of seizure and where in the brain the seizures start. In Sweden, about 50 people are operated on annually, but the need is greater.

The epilepsy surgery service at Skåne University Hospital has many years of experience and expertise with both adults and children. We have good and consistent results over a long period of time, as well as an extensive activity with high and broad expertise that is strongly rooted in clinical and translational research.

Skåne University Hospital is one of three hospitals in Sweden that provides national specialised medical care in advanced pelvic surgery. This assignment involves the assessment and, if necessary, surgery of patients with bladder, prostate, rectum/colon, and gynaecological cancer. This type of surgery may also be relevant for patients experiencing long-term effects of previous cancers and patients with certain uncommon tumour forms in the pelvis.

Employees from various medical specialties within Skåne University Hospital collaborate on national and international research projects in the fields of colorectal, gynaecological, and urological cancer. Furthermore, there is a well-established interdisciplinary collaboration concerning this patient group, both during the assessment process and surgical procedures.

The assignment involves counselling, investigation, treatment, and follow-up of hospitalised patients with severe skin symptoms, where the diagnosis is unclear and standard treatments do not provide sufficient results.

Skåne University Hospital has previously provided dedicated care facilities for severe skin diseases and has extensive experience and broad expertise in this field. There is also a well-established and close collaboration with other relevant disciplines, including infection, internal medicine, rheumatology, nephrology, and vascular care.

Chronic intestinal failure in children refers to a condition where the child requires long-term parenteral nutrition (nutrition and fluids delivered through the bloodstream) to survive. The underlying causes of intestinal failure can be congenital malformations or previous intestinal injuries resulting in short bowel syndrome. Intestinal failure can also be caused by the absence of nerve cells in a section of the intestine (aganglionosis) as seen in Hirschsprung's disease, nerve and muscle disorders in the intestine (pseudoobstruction), or congenital enteropathy.

Skåne University Hospital is an active participant in the national paediatric intestinal failure group, which facilitates the exchange of knowledge and experiences among various national centres. This collaboration also involves the development of national guidelines for the management of this patient group. Furthermore, we engage in research focused on nutrition and related areas in the context of intestinal failure.

Polio is caused by the poliovirus. Approximately 1 in 200 individuals affected by polio experience paralysis in their legs, arms, or impaired respiratory function. In some cases, polio can result in permanent functional disabilities.

The assignment associated with national specialised medical care for PPS encompass:

• Investigation and diagnostics
• Determining appropriate treatments, rehabilitation, and follow-up care.

As a result of these responsibilities, there will be an increased influx of patients, further strengthening the ongoing research on post-polio syndromes that has been conducted for the past 20 years. In terms of education, this presents an opportunity to continue providing comprehensive and high-quality rehabilitation training for all relevant professional groups.

As one of the four hospitals in Sweden, Skåne University Hospital has been assigned to provide national specialised medical care for patients with disseminated peritoneal metastases through cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC). Approximately 200 patients in Sweden undergo this treatment annually. The Department of Surgery and Gastroenterology at Skåne University Hospital possesses all the necessary specialist capabilities to perform HIPEC treatment and has previously undertaken a national concentrated care assignment in this field.

Vulval cancer refers to the presence of a malignant tumour in the vulva. It is a relatively uncommon cancer that primarily affects individuals aged 70 and above. In Sweden, approximately 200 people are diagnosed with vulval cancer each year.

Skåne University Hospital is one of the four hospitals entrusted with providing national specialised medical care for vulval cancer.
Skåne University Hospital has long been recognised as one of the four national centres for the surgical treatment of vulval cancer. Within the hospital's women's healthcare department, there exists extensive expertise in the diagnosis and treatment of vulval cancer, including complex cases.

The four national centres also collaborate closely and engage in joint research, which has contributed to the development and improvement of care in recent years.