6 results on '"Jeroen Nieuwenhuizen"'
Search Results
2. Mesh versus suture repair of umbilical hernia in adults: a randomised, double-blind, controlled, multicentre trial
- Author
-
Bronno van der Holt, Jeroen Nieuwenhuizen, R. Kaufmann, Jens A. Halm, Gert-Jan Kleinrensink, Pieter J Klitsie, Hasan H. Eker, Johan F. Lange, Martijne van ’t Riet, Dick van Geldere, Erwin van der Harst, Johannes Jeekel, Maarten Simons, Surgery, and Neurosciences
- Subjects
Adult ,Male ,medicine.medical_specialty ,Population ,030230 surgery ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Suture (anatomy) ,Randomized controlled trial ,Double-Blind Method ,law ,Recurrence ,Germany ,Outcome Assessment, Health Care ,Medicine ,Humans ,Hernia ,education ,Aged ,Netherlands ,education.field_of_study ,Sutures ,business.industry ,Suture Techniques ,General Medicine ,Middle Aged ,Surgical Mesh ,medicine.disease ,Surgery ,Umbilical hernia ,Surgical mesh ,Italy ,030220 oncology & carcinogenesis ,Seroma ,Number needed to treat ,Quality of Life ,Female ,business ,Hernia, Umbilical - Abstract
Background: Both mesh and suture repair are used for the treatment of umbilical hernias, but for smaller umbilical hernias (diameter 1–4 cm) there is little evidence whether mesh repair would be beneficial. In this study we aimed to investigate whether use of a mesh was better in reducing recurrence compared with suture repair for smaller umbilical hernias. Methods: We did a randomised, double-blind, controlled multicentre trial in 12 hospitals (nine in the Netherlands, two in Germany, and one in Italy). Eligible participants were adults aged at least 18 years with a primary umbilical hernia of diameter 1–4 cm, and were randomly assigned (1:1) intraoperatively to either suture repair or mesh repair. In the first 3 years of the inclusion period, blocked randomisation (of non-specified size) was achieved by an envelope randomisation system; after this time computer-generated randomisation was introduced. Patients, investigators, and analysts were masked to the allocated treatment, and participants were stratified by hernia size (1–2 cm and >2–4 cm). At study initiation, all surgeons were invited to training sessions to ensure they used the same standardised techniques for suture repair or mesh repair. Patients underwent physical examinations at 2 weeks, and 3, 12, and 24–30 months after the operation. The primary outcome was the rate of recurrences of the umbilical hernia after 24 months assessed in the modified intention-to-treat population by physical examination and, in case of any doubt, abdominal ultrasound. This trial is registered with ClinicalTrials.gov, number NCT00789230. Findings: Between June 21, 2006, and April 16, 2014, we randomly assigned 300 patients, 150 to mesh repair and 150 to suture repair. The median follow-up was 25·1 months (IQR 15·5–33·4). After a maximum follow-up of 30 months, there were fewer recurrences in the mesh group than in the suture group (six [4%] in 146 patients vs 17 [12%] in 138 patients; 2-year actuarial estimates of recurrence 3·6% [95% CI 1·4–9·4] vs 11·4% (6·8–18·9); p=0·01, hazard ratio 0·31, 95% CI 0·12–0·80, corresponding to a number needed to treat of 12·8). The most common postoperative complications were seroma (one [
- Published
- 2018
3. Prevention of incisional hernia with prophylactic onlay and sublay mesh reinforcement versus primary suture only in midline laparotomies (PRIMA):2-year follow-up of a multicentre, double-blind, randomised controlled trial
- Author
-
René H. Fortelny, Jakob R. Izbicki, Ewout W. Steyerberg, Pieter J. Klitsie, Gert-Jan Kleinrensink, Hans Jeekel, Jan A Charbon, Arie C. van der Ham, Wim C. J. Hop, David van Klaveren, Robert E G J M Pierik, André L. Mihaljevic, Lucas Timmermans, Hasan H. Eker, Pim C W Burger, Reinier Timman, Michiel van de Berg, Philip Knebel, Christoph Schuhmacher, Panagiotis Fikatas, An P. Jairam, Johan F. Lange, Hence J.M. Verhagen, Imro Dawson, Markus Golling, Jeroen Nieuwenhuizen, Neurosciences, Surgery, Public Health, Psychiatry, and AGEM - Re-generation and cancer of the digestive system
- Subjects
medicine.medical_specialty ,Intention-to-treat analysis ,Abdominal Wound Closure Techniques ,Incisional hernia ,business.industry ,Standard treatment ,General Medicine ,030230 surgery ,medicine.disease ,Abdominal aortic aneurysm ,Surgery ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Surgical mesh ,Randomized controlled trial ,law ,030220 oncology & carcinogenesis ,medicine ,business ,Abdominal surgery - Abstract
Summary Background Incisional hernia is a frequent long-term complication after abdominal surgery, with a prevalence greater than 30% in high-risk groups. The aim of the PRIMA trial was to evaluate the effectiveness of mesh reinforcement in high-risk patients, to prevent incisional hernia. Methods We did a multicentre, double-blind, randomised controlled trial at 11 hospitals in Austria, Germany, and the Netherlands. We included patients aged 18 years or older who were undergoing elective midline laparotomy and had either an abdominal aortic aneurysm or a body-mass index (BMI) of 27 kg/m 2 or higher. We randomly assigned participants using a computer-generated randomisation sequence to one of three treatment groups: primary suture; onlay mesh reinforcement; or sublay mesh reinforcement. The primary endpoint was incidence of incisional hernia during 2 years of follow-up, analysed by intention to treat. Adjusted odds ratios (ORs) were estimated by logistic regression. This trial is registered at ClinicalTrials.gov, number NCT00761475. Findings Between March, 2009, and December, 2012, 498 patients were enrolled to the study, of whom 18 were excluded before randomisation. Therefore, we included 480 patients in the primary analysis: 107 were assigned primary suture only, 188 were allocated onlay mesh reinforcement, and 185 were assigned sublay mesh reinforcement. 92 patients were identified with an incisional hernia, 33 (30%) who were allocated primary suture only, 25 (13%) who were assigned onlay mesh reinforcement, and 34 (18%) who were assigned sublay mesh reinforcement (onlay mesh reinforcement vs primary suture, OR 0·37, 95% CI 0·20–0·69; p=0·0016; sublay mesh reinforcement vs primary suture, 0·55, 0·30–1·00; p=0·05). Seromas were more frequent in patients allocated onlay mesh reinforcement (34 of 188) than in those assigned primary suture (five of 107; p=0·002) or sublay mesh reinforcement (13 of 185; p=0·002). The incidence of wound infection did not differ between treatment groups (14 of 107 primary suture; 25 of 188 onlay mesh reinforcement; and 19 of 185 sublay mesh reinforcement). Interpretation A significant reduction in incidence of incisional hernia was achieved with onlay mesh reinforcement compared with sublay mesh reinforcement and primary suture only. Onlay mesh reinforcement has the potential to become the standard treatment for high-risk patients undergoing midline laparotomy. Funding Baxter; B Braun Surgical SA.
- Published
- 2017
4. The value of combining anterior segment fluorescein angiography with indocyanine green angiography in scleral inflammation
- Author
-
Katinka Emmanouilidis-van der Spek, Peter G Watson, Jeroen Nieuwenhuizen, Martine J. Jager, and J. E. E. Keunen
- Subjects
Adult ,Indocyanine Green ,Male ,medicine.medical_specialty ,genetic structures ,Eye disease ,Fluorophotometry ,chemistry.chemical_compound ,Anterior Eye Segment ,medicine ,Humans ,Fluorescein Angiography ,Fluorescein ,Coloring Agents ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Middle Aged ,medicine.disease ,Fluorescein angiography ,eye diseases ,Sclera ,Ophthalmology ,medicine.anatomical_structure ,chemistry ,Angiography ,Female ,Radiology ,business ,Indocyanine green ,Scleritis - Abstract
Purpose To determine the value of anterior segment indocyanine green (ICG) angiography combined with anterior segment fluorescein angiography in scleral inflammation. Design Comparative observational case series. Participants The study included 18 patients with various forms of scleral and episcleral disease and a single normal subject. Methods Anterior segment angiography using both ICG and fluorescein was performed to identify any vascular abnormalities and pathologic changes in the anterior segment. Main outcome measure The pathologic criteria for anterior segment fluorescein angiography described by Watson and Bovey (1995) were used to compare and contrast the results of the angiograms. Results Fluorescein angiography and ICG angiography provide different and complementary information. Both dyes have different leakage patterns caused by their difference in optical and chemical properties. Areas of slow flow are more readily determined with fluorescein angiography. ICG angiography determines damage to and patency of individual vessels. Conclusion Fluorescein angiography and ICG angiography detect areas of damage not clinically visible and can be useful in the differential diagnosis, the selection of appropriate medication, and monitoring and regulation of treatment in scleritis. To obtain the most information both investigations should be performed sequentially.
- Published
- 2003
5. Small stitches with small suture distances increase laparotomy closure strength
- Author
-
Hans Jeekel, Jeroen Nieuwenhuizen, Johan F. Lange, Joost G. ten Brinke, Gert-Jan Kleinrensink, Wim C.J. Hop, Gabrielle H. van Ramshorst, Joris J. Harlaar, Surgery, Erasmus MC other, Epidemiology, and Neurosciences
- Subjects
medicine.medical_specialty ,Hernia ,Incisional hernia ,Swine ,medicine.medical_treatment ,Abdominal wall ,Polydioxanone ,chemistry.chemical_compound ,Postoperative Complications ,Suture (anatomy) ,Laparotomy ,Tensile Strength ,Surgical Wound Dehiscence ,Medicine ,Animals ,business.industry ,Abdominal Wall ,Suture Techniques ,General Medicine ,Fascia ,Anatomy ,medicine.disease ,Surgery ,medicine.anatomical_structure ,chemistry ,Abdomen ,business - Abstract
BACKGROUND: There is no conclusive evidence which size of suture stitches and suture distance should be used to prevent burst abdomen and incisional hernia. METHODS: Thirty-eight porcine abdominal walls were removed immediately after death and divided into 2 groups: A and B (N = 19 each). Two suturing methods using double-loop polydioxanone were tested in 14-cm midline incisions: group A consisted of large stitches (1 cm) with a large suture distance (1 cm), and group B consisted of small stitches (.5 cm) with a small suture distance (.5 cm). RESULTS: The geometric mean tensile force in group B was significantly higher than in group A (787 N vs 534 N; P = .006). CONCLUSIONS: Small stitches with small suture distances achieve higher tensile forces than large stitches with large suture distances. Therefore, small stitches may be useful to prevent the development of a burst abdomen or an incisional hernia after midline incisions. (C) 2009 Elsevier Inc. All rights reserved.
- Published
- 2009
6. Natural course of incisional hernia and indications for repair
- Author
-
Jens A. Halm, Johannes Jeekel, J. F. Lange, and Jeroen Nieuwenhuizen
- Subjects
Natural course ,medicine.medical_specialty ,Laparotomy ,business.industry ,Incisional hernia ,General surgery ,Incidence ,030231 tropical medicine ,Incisional hernia repair ,Suture Techniques ,Plastic Surgery Procedures ,medicine.disease ,Prognosis ,Hernia, Ventral ,Surgery ,Conservative treatment ,03 medical and health sciences ,surgical procedures, operative ,0302 clinical medicine ,030220 oncology & carcinogenesis ,medicine ,Humans ,Hernia ,business - Abstract
Background: Incisional hernias and incisional hernia repair can be a significant challenge for both surgeon and patient. Despite the growing amount of literature describing various methods of surgical techniques, little has been published the natural course of an incisional hernia and regarding indications for incisional hernia repair. Methods: An internet database search was performed to identify articles describing symptoms presented by patients and indications for incisional hernia repair. Results: Various symptoms and indications regarding incisional hernia repair and the natural course of an incisional hernia are mentioned in the literature. Nevertheless, published data accurately describing these symptoms and indications are rare. Conclusion: A prospective trial monitoring incisional hernias as well as comparing conservative treatment with repair should be performed.
- Published
- 2008
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.