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2. Twelve-year outcomes of watchful waiting versus surgery of mildly symptomatic or asymptomatic inguinal hernia in men aged 50 years and older: a randomised controlled trial

Author

van den Dop, Matthijs, van Egmond, Sarah, Heijne, Jort, van Rosmalen, Joost, Tanis, Pieter, de Goede, Barry, Kleinrensink, Gert-Jan, Jeekel, Johannes, Lange, Johan F., Van Ramshorst, Gabrielle H., Klitsie, Pieter J., van Kempen, Bob J.H., Hunink, Myriam G.M., Hop, Wim C., Halm, Jens A., Burger, Pim J.W.A., Brandt, Alexandra, Franssen, Gaston J.H., Oomen, Jan, Wijsmuller, Arthur R., Roumen, Rudi M.H., Schelting, Marc R.M., Boelens, Oliver, Susa, Denis, Verhagen, Tim, Rath, Hiltjo J., Lont, Harold E., Mannaerts, Guido H., de Haan, Jeroen, Mastboom, Walter, Swank, Dingeman J., Schmitz, Roderick F., Zijsling, Bonnie, Bouvy, Nicole D., Schreinemacher, Marc H.F., van Barneveld, Kevin, Ploeg, Arianne J., Contant, C., van der Harst, Erwin, de Rooij, Peter D., Deelman, Tara, van Hout, Naomi, Stasssen, Laurents P.S., Go, Peter M.N.Y.H., Roumen, R., Simons, Maarten P., Schreurs, Hermien W.H., Keyzer-Dekker, Claudia M.G., Takkenberg, Marijn, Ugahary, Franz, Liqui Lung, Paul F., de Roos, Marnix A.J., Ong, Paul K.H., Wijffels, Rob T.M., Vierhout, Bas P., Donse, Irene F., Pierik, E.G.J.M., Buijk, Steven, Dawson, Imro, Kloppenberg, Frank, van den Broek, Rob W.F.R., van Geloven, A., Postema, Roelf R., Cate, W. Ten, Rakic, Serdjan, Schoenmaeckers, Ernst J.P., Plaisier, Peter W., Berendes, Thomas, Oostenbroek, Rob J., Poyck, Paul P.C., van Geffen, Erwin H.J.A.A., Ruurda, Jelle, Smulders, Frans J.F., Pierik, Robert E.G.J.M., Miserez, Marc, Haers, Paul, Mulier, Karel, Van den Dop, L. Matthijs, Van Egmond, Sarah, and Tanis, Pieter J.

Published
2023
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4. Long-term effect of sleeve gastrectomy vs Roux-en-Y gastric bypass in people living with severe obesity:a phase III multicentre randomised controlled trial (SleeveBypass)

Author

Biter, L. Ulas, ‘t Hart, Judith WH, Noordman, Bo J., Smulders, J. Frans, Nienhuijs, Simon, Dunkelgrün, Martin, Zengerink, Johannes F., Birnie, Erwin, Friskes, Irene AM, Mannaerts, Guido HH, Apers, Jan A., Biter, L. Ulas, ‘t Hart, Judith WH, Noordman, Bo J., Smulders, J. Frans, Nienhuijs, Simon, Dunkelgrün, Martin, Zengerink, Johannes F., Birnie, Erwin, Friskes, Irene AM, Mannaerts, Guido HH, and Apers, Jan A.

Abstract

Background: Sleeve gastrectomy is the most performed metabolic surgical procedure worldwide. However, conflicting results offer no clear evidence about its long-term clinical comparability to Roux-en-Y gastric bypass. This study aims to determine their equivalent long-term weight loss effects. Methods: This randomised open-label controlled trial was conducted from 2012 until 2017 in two Dutch bariatric hospitals with a 5-year follow-up (last follow-up July 29th, 2022). Out of 4045 patients, 628 were eligible for metabolic surgery and were randomly assigned to sleeve gastrectomy or Roux-en-Y gastric bypass (intention-to-treat). The primary endpoint was weight loss, expressed by percentage excess body mass index (BMI) loss. The predefined clinically relevant equivalence margin was −13% to 13%. Secondary endpoints included percentage total kilograms weight loss, obesity-related comorbidities, quality of life, morbidity, and mortality. This trial is registered with Dutch Trial Register NTR4741: https://onderzoekmetmensen.nl/nl/trial/25900. Findings: 628 patients were randomised between sleeve gastrectomy (n = 312) and Roux-en-Y gastric bypass (n = 316) (mean age 43 [standard deviation (SD), 11] years; mean BMI 43.5 [SD, 4.7]; 81.8% women). Excess BMI loss at 5 years was 58.8% [95% CI, 55%–63%] after sleeve gastrectomy and 67.1% [95% CI, 63%–71%] after Roux-en-Y gastric bypass (difference 8.3% [95% CI, −12.5% to −4.0%]). This was within the predefined margin (P < 0.001). Total weight loss at 5 years was 22.5% [95% CI, 20.7%–24.3%] after sleeve gastrectomy and 26.0% [95% CI, 24.3%–27.8%] after Roux-en-Y gastric bypass (difference 3.5% [95% CI, −5.2% to −1.7%]). In both groups, obesity-related comorbidities significantly improved after 5 years. Dyslipidaemia improved more frequently after Roux-en-Y gastric bypass (83%, 54/65) compared to sleeve gastrectomy (62%, 44/71) (P = 0.006). De novo gastro-oesophageal reflux disease occurred more frequently after sleeve gastre

Published
2024

5. Twelve-year outcomes of watchful waiting versus surgery of mildly symptomatic or asymptomatic inguinal hernia in men aged 50 years and older:a randomised controlled trial

Author

Van den Dop, L. Matthijs, Van Egmond, Sarah, Heijne, Jort, van Rosmalen, Joost, de Goede, Barry, Wijsmuller, Arthur R., Kleinrensink, Gert Jan, Tanis, Pieter J., Jeekel, Johannes, Lange, Johan F., Klitsie, Pieter J., van Kempen, Bob J.H., Hunink, Myriam G.M., Hop, Wim C., Halm, Jens A., Burger, Pim J.W.A., Brandt, Alexandra, Franssen, Gaston J.H., Oomen, Jan, Roumen, Rudi M.H., Scheltinga, Marc R.M., Boelens, Oliver, Susa, Denis, Verhagen, Tim, Rath, Hiltjo J., Lont, Harold E., Mannaerts, Guido H., Haan, Jeroen de, Mastboom, Walter, Swank, Dingeman J., Schmitz, Roderick F., Zijsling, Bonnie, Bouvy, Nicole D., Schreinemacher, Marc H.F., van Barneveld, Kevin, Ploeg, Arianne J., Contant, C., van der Harst, Erwin, de Rooij, Peter D., Deelman, Tara, van Hout, Naomi, Stasssen, Laurents P.S., Go, Peter M.N.Y.H., Simons, Maarten P., Keyzer-Dekker, Claudia M.G., Pierik, E. G.J.M., Buijk, Steven, Dawson, Imro, Van den Dop, L. Matthijs, Van Egmond, Sarah, Heijne, Jort, van Rosmalen, Joost, de Goede, Barry, Wijsmuller, Arthur R., Kleinrensink, Gert Jan, Tanis, Pieter J., Jeekel, Johannes, Lange, Johan F., Klitsie, Pieter J., van Kempen, Bob J.H., Hunink, Myriam G.M., Hop, Wim C., Halm, Jens A., Burger, Pim J.W.A., Brandt, Alexandra, Franssen, Gaston J.H., Oomen, Jan, Roumen, Rudi M.H., Scheltinga, Marc R.M., Boelens, Oliver, Susa, Denis, Verhagen, Tim, Rath, Hiltjo J., Lont, Harold E., Mannaerts, Guido H., Haan, Jeroen de, Mastboom, Walter, Swank, Dingeman J., Schmitz, Roderick F., Zijsling, Bonnie, Bouvy, Nicole D., Schreinemacher, Marc H.F., van Barneveld, Kevin, Ploeg, Arianne J., Contant, C., van der Harst, Erwin, de Rooij, Peter D., Deelman, Tara, van Hout, Naomi, Stasssen, Laurents P.S., Go, Peter M.N.Y.H., Simons, Maarten P., Keyzer-Dekker, Claudia M.G., Pierik, E. G.J.M., Buijk, Steven, and Dawson, Imro

Abstract

Background: Inguinal hernia belongs to the most common surgical pathology worldwide. Approximately, one third is asymptomatic. The value of watchful waiting (WW) in patients with asymptomatic or mildly symptomatic inguinal hernia has been established in a few randomised controlled trials (RCTs). The aim of this study was to assess long-term outcomes of a RCT comparing WW and elective surgery.Methods: In the original study, men aged ≥50 years with an asymptomatic or mildly symptomatic inguinal hernia were randomly assigned to WW or elective repair. In the present study, the primary outcome was the 12-year crossover rate to surgery, secondary outcomes were time-to-crossover, patient regret, pain, quality of life and incarceration. Dutch Trial Registry: NTR629. Findings: Out of 496 originally analysed patients, 488 (98.4%) were evaluable for chart review (WW: n = 258, surgery: n = 230), and 200 (41.0%) for telephone contact (WW: n = 106, surgery: n = 94) between November 2021 and March 2022 with a median 12 years follow-up (IQR 9–14). After 12 years, the estimated cumulative crossover rate to surgery was 64.2%, which was higher in mildly symptomatic than in asymptomatic patients (71.7% versus 60.4%, HR 1.451, 95% CI: 1.064–1.979). Time-to-crossover was longer in asymptomatic patients (50% after 6.0 years versus 2.0 years, p = 0.019). Patient regret was higher in the WW group (37.7 versus 18.0%, p = 0.002), as well as pain/discomfort (p = 0.031). Quality of life did not differ (p = 0.737). In the WW group, incarceration occurred in 10/255 patients (3.9%). Interpretation: During 12-year follow-up, most WW patients crossed over to surgery, significantly earlier with mildly symptomatic hernia. Considering the relatively low incarceration rate, WW might still be an option in asymptomatic patients with a clear preference and being well-informed about pros and cons.

Published
2023

6. Deep Learning-Based Automatic Assessment of Lung Impairment in COVID-19 Pneumonia: Predicting Markers of Hypoxia With Computer Vision

Author

Statsenko, Yauhen, primary, Habuza, Tetiana, additional, Talako, Tatsiana, additional, Pazniak, Mikalai, additional, Likhorad, Elena, additional, Pazniak, Aleh, additional, Beliakouski, Pavel, additional, Gelovani, Juri G., additional, Gorkom, Klaus Neidl-Van, additional, Almansoori, Taleb M., additional, Al Zahmi, Fatmah, additional, Qandil, Dana Sharif, additional, Zaki, Nazar, additional, Elyassami, Sanaa, additional, Ponomareva, Anna, additional, Loney, Tom, additional, Naidoo, Nerissa, additional, Mannaerts, Guido Hein Huib, additional, Al Koteesh, Jamal, additional, Ljubisavljevic, Milos R., additional, and Das, Karuna M., additional

Published
2022
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10. Cost-effectiveness of laparoscopic ileocaecal resection versus infliximab treatment of terminal ileitis in Crohn's disease: the LIR!C Trial

Author

de groof, E. Joline, Stevens, Toer W., Eshuis, Emma J., Gardenbroek, Tjibbe J., Bosmans, Judith E., van Dongen, J. M., Mol, Bregje, Buskens, Christianne J., Stokkers, Pieter C. F., Hart, Ailsa, D'Haens, Geert R., Bemelman, Willem A., Ponsioen, Cyriel Y., Warusavitarne, Janindra, van Bodegraven, Ad A., Brink, Menno A., J Consten, Esther C., van Wagensveld, Bart A., M Rijk, Marno C., P H Crolla, Rogier M., Noomen, Casper G., J Houdijk, Alexander P., Mallant, Rosalie C., Boom, Maarten, Marsman, Willem A., Stockmann, Hein B., Bruin, Karlien, Maring, John, Ditzhuijsen, Theo van, Prins, Hubert, den Brande, Jan van, Kingma, Paul, Geloven, Anna van, de Boer, Nanne, der Peet, Donald van, Jansen, Jeroen, Gerhards, Michael, van der Woude, Janneke, Schouten, Ruud, Oldenburg, Bas, van Hillegersberg, Richard, West, Rachel, Mannaerts, Guido, Spanier, Marcel, Spillenaar Bilgen, Ernst Jan, Lieverse, Rob, der Zaag, Edwin van, Depla, Annekatrien, de Laar, Arnold van, Cahen, Djuna, Health Economics and Health Technology Assessment, APH - Mental Health, APH - Methodology, APH - Health Behaviors & Chronic Diseases, AMS - Ageing and Morbidity, Surgery, Gastroenterology and hepatology, AGEM - Digestive immunity, AII - Inflammatory diseases, Amsterdam Reproduction & Development (AR&D), AGEM - Re-generation and cancer of the digestive system, Gastroenterology and Hepatology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, and AGEM - Endocrinology, metabolism and nutrition

Subjects
Ileocaecal resection, Male, Cost effectiveness, Cost-Benefit Analysis, Inflammatory bowel disease, law.invention, 0302 clinical medicine, Crohn Disease, Randomized controlled trial, law, Cecum, Colectomy, Crohn's disease, Infliximab/economics, Gastroenterology, Health Care Costs, Ileitis, Colectomy/economics, Treatment Outcome, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, medicine.drug, Adult, medicine.medical_specialty, Terminal Ileitis, Ileum/surgery, Cecum/surgery, 03 medical and health sciences, Young Adult, Gastrointestinal Agents, SDG 3 - Good Health and Well-being, Ileum, medicine, Humans, Gastrointestinal Agents/economics, Laparoscopy/economics, Retrospective Studies, Crohn Disease/economics, business.industry, medicine.disease, Infliximab, Ileitis/diagnosis, Surgery, Clinical trial, Laparoscopy, business, Follow-Up Studies
Abstract

ObjectiveEvaluate the cost-effectiveness of laparoscopic ileocaecal resection compared with infliximab in patients with ileocaecal Crohn’s disease failing conventional therapy.DesignA multicentre randomised controlled trial was performed in 29 centres in The Netherlands and the UK. Adult patients with Crohn’s disease of the terminal ileum who failed >3 months of conventional immunomodulators or steroids without signs of critical strictures were randomised to laparoscopic ileocaecal resection or infliximab. Outcome measures included quality-adjusted life-years (QALYs) based on the EuroQol (EQ) 5D-3L Questionnaire and the Inflammatory Bowel Disease Questionnaire (IBDQ). Costs were measured from a societal perspective. Analyses were performed according to the intention-to-treat principle. Missing cost and effect data were imputed using multiple imputation. Cost-effectiveness planes and cost-effectiveness acceptability curves were estimated to show uncertainty.ResultsIn total, 143 patients were randomised. Mean Crohn’s disease total direct healthcare costs per patient at 1 year were lower in the resection group compared with the infliximab group (mean difference €−8931; 95% CI €−12 087 to €−5097). Total societal costs in the resection group were lower than in the infliximab group, however not statistically significant (mean difference €−5729, 95% CI €−10 606 to €172). The probability of resection being cost-effective compared with infliximab was 0.96 at a willingness to pay (WTP) of €0 per QALY gained and per point improvement in IBDQ Score. This probability increased to 0.98 at a WTP of €20 000/QALY gained and 0.99 at a WTP of €500/point of improvement in IBDQ Score.ConclusionLaparoscopic ileocaecal resection is a cost-effective treatment option compared with infliximab.Clinical trial registration numberDutch Trial Registry NTR1150; EudraCT number 2007-005042-20 (closed on 14 October 2015).

Published
2019

11. The effect of sex and menopause on carotid intima-media thickness and pulse wave velocity in morbid obesity

Author

van Mil, Stefanie R., Ulas Biter, L., van de Geijn, Gert Jan M., Birnie, Erwin, Dunkelgrun, Martin, IJzermans, Jan N.M., van der Meulen, Noelle, Mannaerts, Guido H.H., Castro Cabezas, Manuel, van Mil, Stefanie R., Ulas Biter, L., van de Geijn, Gert Jan M., Birnie, Erwin, Dunkelgrun, Martin, IJzermans, Jan N.M., van der Meulen, Noelle, Mannaerts, Guido H.H., and Castro Cabezas, Manuel

Published
2019

12. The ladies trial: laparoscopic peritoneal lavage or resection for purulent peritonitisA and Hartmann's procedure or resection with primary anastomosis for purulent or faecal peritonitisB in perforated diverticulitis (NTR2037)

Author

Bruin Sjoerd C, Mannaerts Guido HH, Cense Huib A, Blanken-Peeters Charlotte FJM, Neijenhuis Peter A, Karsten Thomas M, Hoofwijk Anton GM, Gerhards Michael F, van Duijn Eino B, Consten Esther CJ, Slooter Gerrit D, Coene Peter-Paul LO, van Wagensveld Bart A, Tollenaar Rob AEM, Stockmann Hein BAC, Prins Hubert A, Pierik Robert EGJM, Weidema Wibo F, de Graaf Eelco JR, Steup Willem H, Swank Dingeman J, Kruyt Philip M, Boom Maarten J, Bosker Robbert JI, Nienhuijs Simon W, Sosef Meindert N, Crolla Rogier MPH, Stassen Laurents PS, van der Hoeven Joost AB, Mulder Irene M, Lange Johan F, Vermeulen Jefrey, Swank Hilko A, Eijsbouts Quirijn AJ, Wiezer Marinus J, Hazebroek Eric J, van Geloven Anna AW, Maring John K, D'Hoore André JL, Kartheuser Alex, Remue Christophe, van Grevenstein Helma MU, Konsten Joop LM, van der Peet Donald L, Govaert Marc JPM, Engel Alexander F, Reitsma Johannes B, and Bemelman Willem A

Subjects
Surgery, RD1-811
Abstract

Abstract Background Recently, excellent results are reported on laparoscopic lavage in patients with purulent perforated diverticulitis as an alternative for sigmoidectomy and ostomy. The objective of this study is to determine whether LaparOscopic LAvage and drainage is a safe and effective treatment for patients with purulent peritonitis (LOLA-arm) and to determine the optimal resectional strategy in patients with a purulent or faecal peritonitis (DIVA-arm: perforated DIVerticulitis: sigmoidresection with or without Anastomosis). Methods/Design In this multicentre randomised trial all patients with perforated diverticulitis are included. Upon laparoscopy, patients with purulent peritonitis are treated with laparoscopic lavage and drainage, Hartmann's procedure or sigmoidectomy with primary anastomosis in a ratio of 2:1:1 (LOLA-arm). Patients with faecal peritonitis will be randomised 1:1 between Hartmann's procedure and resection with primary anastomosis (DIVA-arm). The primary combined endpoint of the LOLA-arm is major morbidity and mortality. A sample size of 132:66:66 patients will be able to detect a difference in the primary endpoint from 25% in resectional groups compared to 10% in the laparoscopic lavage group (two sided alpha = 5%, power = 90%). Endpoint of the DIVA-arm is stoma free survival one year after initial surgery. In this arm 212 patients are needed to significantly demonstrate a difference of 30% (log rank test two sided alpha = 5% and power = 90%) in favour of the patients with resection with primary anastomosis. Secondary endpoints for both arms are the number of days alive and outside the hospital, health related quality of life, health care utilisation and associated costs. Discussion The Ladies trial is a nationwide multicentre randomised trial on perforated diverticulitis that will provide evidence on the merits of laparoscopic lavage and drainage for purulent generalised peritonitis and on the optimal resectional strategy for both purulent and faecal generalised peritonitis. Trial registration Nederlands Trial Register NTR2037

Published
2010
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13. The ACCURE-trial: the effect of appendectomy on the clinical course of ulcerative colitis, a randomised international multicenter trial (NTR2883) and the ACCURE-UK trial: a randomised external pilot trial (ISRCTN56523019)

Author

Gardenbroek, Tjibbe J., Pinkney, Thomas D., Sahami, Saloomeh, Morton, Dion G., Buskens, Christianne J., Ponsioen, Cyriel Y., Tanis, Pieter J., Löwenberg, Mark, van den Brink, Gijs R., Broeders, Ivo A. M. J., Pullens, Hendrikus J. M., Pullens, Paul H. J. M., Seerden, Tom, Boom, Maarten J., Mallant-Hent, Rosalie C., Pierik, Robert E. G. J. M., Vecht, Juda, Sosef, Meindert N., van Nunen, Annick B., van Wagensveld, Bart A., Stokkers, Pieter C. F., Gerhards, Michael F., Jansen, Jeroen M., Acherman, Yair, Depla, Annekatrien C. T. M., Mannaerts, Guido H. H., West, Rachel, Iqbal, Tariq, Pathmakanthan, Shrikanth, Howard, Rebecca, Magill, Laura, Singh, Baljit, Oo, Ye H., Htun Oo, Ye, Negpodiev, Dmitri, Dijkgraaf, Marcel G. W., D'Haens, Geert R. A. M., Bemelman, Willem A., Other departments, Graduate School, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Surgery, Gastroenterology and Hepatology, AII - Amsterdam institute for Infection and Immunity, and Clinical Research Unit

Subjects
medicine.medical_specialty, Colectomies, business.industry, Standard treatment, General Medicine, medicine.disease, Ulcerative colitis, Inflammatory bowel disease, Surgery, law.invention, Clinical trial, Study Protocol, Randomized controlled trial, law, Multicenter trial, Medicine, Appendectomy, Disease course, business, Prospective cohort study
Abstract

Background: Over the past 20 years evidence has accumulated confirming the immunomodulatory role of the appendix in ulcerative colitis (UC). This led to the idea that appendectomy might alter the clinical course of established UC. The objective of this body of research is to evaluate the short-term and medium-term efficacy of appendectomy to maintain remission in patients with UC, and to establish the acceptability and cost-effectiveness of the intervention compared to standard treatment. Methods/Design: These paired phase III multicenter prospective randomised studies will include patients over 18 years of age with an established diagnosis of ulcerative colitis and a disease relapse within 12 months prior to randomisation. Patients need to have been medically treated until complete clinical (Mayo score

Published
2015

15. Erratum to: The ACCURE-trial: the effect of appendectomy on the clinical course of ulcerative colitis, a randomised international multicenter trial (NTR2883) and the ACCURE-UK trial: a randomised external pilot trial (ISRCTN56523019)

Author

Gardenbroek, Tjibbe J., primary, Pinkney, Thomas D., additional, Sahami, Saloomeh, additional, Morton, Dion G., additional, Buskens, Christianne J., additional, Ponsioen, Cyriel Y., additional, Tanis, Pieter J., additional, Löwenberg, Mark, additional, van den Brink, Gijs R., additional, Broeders, Ivo A. M. J., additional, Pullens, Hendrikus J. M., additional, Seerden, Tom, additional, Boom, Maarten J., additional, Mallant-Hent, Rosalie C., additional, Pierik, Robert E. G. J. M., additional, Vecht, Juda, additional, Sosef, Meindert N., additional, van Nunen, Annick B., additional, van Wagensveld, Bart A., additional, Stokkers, Pieter C. F., additional, Gerhards, Michael F., additional, Jansen, Jeroen M., additional, Acherman, Yair, additional, Depla, Annekatrien C. T. M., additional, Mannaerts, Guido H. H., additional, West, Rachel, additional, Iqbal, Tariq, additional, Pathmakanthan, Shrikanth, additional, Howard, Rebecca, additional, Magill, Laura, additional, Singh, Baljit, additional, Oo, Ye H., additional, Negpodiev, Dmitri, additional, Dijkgraaf, Marcel G. W., additional, D’Haens, Geert R. A. M., additional, and Bemelman, Willem A., additional

Published
2016
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16. The Sleeve Bypass Trial: a multicentre randomized controlled trial comparing the long term outcome of laparoscopic sleeve gastrectomy and gastric bypass for morbid obesity in terms of excess BMI loss percentage and quality of life

Author

Biter, L. Ulas, primary, Gadiot, Ralph P. M., additional, Grotenhuis, Brechtje A., additional, Dunkelgrün, Martin, additional, van Mil, Stefanie R., additional, Zengerink, Hans J. J., additional, Smulders, J. Frans, additional, and Mannaerts, Guido H. H., additional

Published
2015
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19. Polymerase chain reaction for Enterococcus faecalis in drain fluid: the first screening test for symptomatic colorectal anastomotic leakage. The Appeal-study: analysis of parameters predictive for evident anastomotic leakage.

Author

Komen, Niels, Slieker, Juliette, Willemsen, Paul, Mannaerts, Guido, Pattyn, Piet, Karsten, Tom, de Wilt, Hans, van der Harst, Erwin, Van Leeuwen, Willem, Decaestecker, Christine, Jeekel, Hans, Lange, Johan F, Komen, Niels, Slieker, Juliette, Willemsen, Paul, Mannaerts, Guido, Pattyn, Piet, Karsten, Tom, de Wilt, Hans, van der Harst, Erwin, Van Leeuwen, Willem, Decaestecker, Christine, Jeekel, Hans, and Lange, Johan F

Abstract

With current diagnostic methods, the majority of patients with symptomatic colorectal anastomotic leakage(CAL) is identified approximately 1 week after operation.The aim of this study is to determine whether real-time polymerase chain reaction (RT-PCR) for detection of Escherichia coli and Enterococcus faecalis on drain fluid can serve as a screening test for CAL in the early postoperative phase., Journal Article, Research Support, Non-U.S. Gov't, SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2014

24. Race, Ethnicity, and Geography as Determinants of Excessive Weight and Low Physical Activity in Pediatric Population: Protocol for Systematic Review and Meta-Analysis.

Author

Statsenko Y, Smetanina D, Simiyu GL, Belghali M, Ghenimi N, Mannaerts GHH, Almaramah L, Alhashmi M, Chun Mohammad N, Al Hamed R, Alblooshi SF, Talbi K, Albreiki M, Alkaabi F, Ponomareva A, and Ljubisavljevic M

Abstract

The rationale for the current study is the sparsity of data on the combined effect of the environmental and individual risks of obesity and sedentary lifestyle in children of different races/ethnicities from different regions. An effective weight management strategy is hard to design due to insufficient evidence. This work was initiated to study race, ethnicity, and geography as determinants of excessive weight and low physical activity in the pediatric population. To achieve this aim, we systematically review publications on daily length of physical activity of light, moderate, and vigorous intensity, as well as sedentary time and BMI and its dynamics in children of different races/ethnicities and geographies. The extracted data are stratified into six major geographic regions and six races/ethnicities. Then, a random-effects meta-analysis is used to calculate the pooled mean of each outcome measure. A ridge regression is constructed to explore age-related change in BMI. A Kruskal-Wallis H test is applied to compare the pooled duration of physical activity and sedentary time in the subgroups. Finally, we calculate paired correlation coefficients between BMI and physical activity/inactivity for each group. The findings can be further used in public health surveillance to clarify the epidemiology of obesity, to guide priority setting and planning, and to develop and evaluate public health policy and strategy.

Published
2024
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25. The ladies trial: laparoscopic peritoneal lavage or resection for purulent peritonitis and Hartmann's procedure or resection with primary anastomosis for purulent or faecal peritonitis in perforated diverticulitis (NTR2037).

Author

Swank HA, Vermeulen J, Lange JF, Mulder IM, van der Hoeven JA, Stassen LP, Crolla RM, Sosef MN, Nienhuijs SW, Bosker RJ, Boom MJ, Kruyt PM, Swank DJ, Steup WH, de Graaf EJ, Weidema WF, Pierik RE, Prins HA, Stockmann HB, Tollenaar RA, van Wagensveld BA, Coene PP, Slooter GD, Consten EC, van Duijn EB, Gerhards MF, Hoofwijk AG, Karsten TM, Neijenhuis PA, Blanken-Peeters CF, Cense HA, Mannaerts GH, Bruin SC, Eijsbouts QA, Wiezer MJ, Hazebroek EJ, van Geloven AA, Maring JK, D'Hoore AJ, Kartheuser A, Remue C, van Grevenstein HM, Konsten JL, van der Peet DL, Govaert MJ, Engel AF, Reitsma JB, and Bemelman WA

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Anastomosis, Surgical, Colectomy, Colostomy, Female, Humans, Intestinal Perforation etiology, Laparoscopy, Middle Aged, Peritonitis etiology, Treatment Outcome, Diverticulitis complications, Intestinal Perforation surgery, Peritoneal Lavage methods, Peritonitis surgery
Abstract

Background: Recently, excellent results are reported on laparoscopic lavage in patients with purulent perforated diverticulitis as an alternative for sigmoidectomy and ostomy.The objective of this study is to determine whether LaparOscopic LAvage and drainage is a safe and effective treatment for patients with purulent peritonitis (LOLA-arm) and to determine the optimal resectional strategy in patients with a purulent or faecal peritonitis (DIVA-arm: perforated DIVerticulitis: sigmoidresection with or without Anastomosis)., Methods/design: In this multicentre randomised trial all patients with perforated diverticulitis are included. Upon laparoscopy, patients with purulent peritonitis are treated with laparoscopic lavage and drainage, Hartmann's procedure or sigmoidectomy with primary anastomosis in a ratio of 2:1:1 (LOLA-arm). Patients with faecal peritonitis will be randomised 1:1 between Hartmann's procedure and resection with primary anastomosis (DIVA-arm). The primary combined endpoint of the LOLA-arm is major morbidity and mortality. A sample size of 132:66:66 patients will be able to detect a difference in the primary endpoint from 25% in resectional groups compared to 10% in the laparoscopic lavage group (two sided alpha = 5%, power = 90%). Endpoint of the DIVA-arm is stoma free survival one year after initial surgery. In this arm 212 patients are needed to significantly demonstrate a difference of 30% (log rank test two sided alpha = 5% and power = 90%) in favour of the patients with resection with primary anastomosis. Secondary endpoints for both arms are the number of days alive and outside the hospital, health related quality of life, health care utilisation and associated costs., Discussion: The Ladies trial is a nationwide multicentre randomised trial on perforated diverticulitis that will provide evidence on the merits of laparoscopic lavage and drainage for purulent generalised peritonitis and on the optimal resectional strategy for both purulent and faecal generalised peritonitis., Trial Registration: Nederlands Trial Register NTR2037.

Published
2010
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