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24 results on '"Karthaus, E.G."'

1. Treatment and survival of locally recurrent rectal cancer: A cross-sectional population study 15 years after the Dutch TME trial

Author

Aalbers, A.G.J., Acherman, Y., Algie, G.D., Alting von Geusau, B., Amelung, F., Aukema, T.S., Bakker, I.S., Bartels, S.A., Basha, S., Bastiaansen, A.J.N.M., Belgers, E., Bleeker, W., Blok, J., Bosker, R.J.I., Bosmans, J.W., Boute, M.C., Bouvy, N.D., Bouwman, H., Brandt-Kerkhof, A., Brinkman, D.J., Bruin, S., Bruns, E.R.J., Burbach, J.P.M., Burger, J.W.A., Buskens, C.J., Clermonts, S., Coene, P.P.L.O., Compaan, C., Consten, E.C.J., Darbyshire, T., de Mik, S.M.L., de Graaf, E.J.R., de Groot, I., tot Nederveen Cappel, RJ de Vos, de Wilt, J.H.W., van der Wolde, J., Boer, FC den, Dekker, J.W.T., Demirkiran, A., Derkx-Hendriksen, M., Dijkstra, F.R., van Duijvendijk, P., Dunker, M.S., Eijsbouts, Q.E., Fabry, H., Ferenschild, F., Foppen, J.W., Furnee, E.J.B., Gerhards, M.F., Gerven, P., Gooszen, J.A.H., Govaert, J.A., Van Grevenstein, W.M.U., Haen, R., Harlaar, J.J., van der Harst, E., Havenga, K., Heemskerk, J., Heeren, J.F., Heijnen, B., Heres, P., Hoff, C., Hogendoorn, W., Hoogland, P., Huijbers, A., Janssen, P., Jongen, A.C., Jonker, F.H., Karthaus, E.G., Keijzer, A., Ketel, J.M.A., Klaase, J., Kloppenberg, F.W.H., Kool, M.E., Kortekaas, R., Kruyt, P.M., Kuiper, J.T., Lamme, B., Lange, J.F., Lettinga, T., Lips, D.J., Logeman, F., Lutke Holzik, M.F., Madsen, E., Mamound, A., Marres, C.C., Masselink, I., Meerdink, M., Menon, A.G., Mieog, J.S., Mierlo, D., Musters, G.D., Nieuwenhuijzen, G.A.P., Neijenhuis, P.A., Nonner, J., Oostdijk, M., Oosterling, S.J., Paul, P.M.P., Peeters, K.C.M.J., Pereboom, I.T.A., Polat, F., Poortman, P., Raber, M., Reiber, B.M.M., Renger, R.J., van Rossem, C.C., Rutten, H.J., Rutten, A., Schaapman, R., Scheer, M., Schoonderwoerd, L., Schouten, N., Schreuder, A.M., Schreurs, W.H., Simkens, G.A., Slooter, G.D., Sluijmer, H.C.E., Smakman, N., Smeenk, R., Snijders, H.S., Sonneveld, D.J.A., Spaansen, B., Bilgen, EJ Spillenaar, Steller, E., Steup, W.H., Steur, C., Stortelder, E., Straatman, J., Swank, H.A., Sietses, C., Groen, H.A., Hoeve, HG ten, Riele, WW ter, Thorensen, I.M., Tip-Pluijm, B., Toorenvliet, B.R., Tseng, L., Tuynman, J.B., van Bastelaar, J., van Beek, S.C., van de Ven, A.W.H., van de Weijer, M.A.J., van den Berg, C., van den Bosch, I., van der Bilt, J.D.W., van der Hagen, S.J., van der Hul, R., van der Schelling, G., van der Spek, A., van der Wielen, N., van Duyn, E., van Eekelen, C., van Essen, J.A., van Gangelt, K., van Geloven, A.A.W., van Kessel, C., van Loon, Y.T., van Rijswijk, A., van Rooijen, S.J., van Sprundel, T., van Steensel, L., van Tets, W.F., van Westreenen, H.L., Veltkamp, S., Verhaak, T., Verheijen, P.M., Versluis-Ossenwaarde, L., Vijfhuize, S., Vles, W.J., Voeten, S.C., Vogelaar, F.J., Vrijland, W.W., Westerduin, E., Westerterp, M.E., Wetzel, M., Wevers, K.P., Wiering, B., Witjes, C.D.M., Wouters, M.W., Yauw, S.T.K., van der Zaag, E.S., Zeestraten, E.C., Zimmerman, D.D.E., Zwieten, T., Detering, Robin, Karthaus, Eleonora G., Borstlap, Wernard A.A., Marijnen, Corrie A.M., van de Velde, Cornelis J.H., Bemelman, Willem A., Beets, Geerard L., Tanis, Pieter J., and Aalbers, Arend G.J.

Published
2019
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2. Evaluating abdominal aortic aneurysm and carotid artery surgery in the Netherlands: variations in indication, treatment and outcomes measures

Author

Karthaus, E.G., Hamming, J.F., Borst, G.J. de, Vahl, A.C., Hage, J.A. van der, Geelkerken, R.H., Verhagen, H.J.M., Putter, H., Schepers, A., and Leiden University

Subjects
Carotid endarterectomy, Quality Measures, Clinical Auditing, Dutch Surgical Aneurysm Audit, Abdominal Aortic Aneurysm Surgery, Dutch Audit for Carotid Interventions
Abstract

Clinical audits are used to measure and improve quality of care. Since 2013 all patients undergoing aortic abdominal aneurysm (AAA) surgery in the Netherlands are registered Dutch Surgical Aneurysm Audit (DSAA). Where postoperative mortality was originally the primary outcome measure of this audit, due to low event rates this turned out to be indistinguishable between hospitals and did not provide any leads for quality improvement. With the aim of improving the quality of AAA surgery, new quality measures regarding the indication for surgery, choice of treatment and surgical outcomes were investigated in this thesis.Following the example of the DSAA, the Dutch Audit for Carotid Interventions (DACI) was initiated to monitor quality of care in patients undergoing carotid interventions. In this thesis the results of patients with a symptomatic carotid artery stenosis undergoing surgery during the first years of auditing are described.

Published
2022

3. Treatment Outcome Trends for Non-Ruptured Abdominal Aortic Aneurysms: A Nationwide Prospective Cohort Study

Author

Alberga, A.J., Karthaus, E.G., Wilschut, Janneke, Bruin, J.L. De, Akkersdijk, G.P., Geelkerken, R.H., Hamming, J.F., Warle, M.C., Wever, J.J., Verhagen, H.J., Alberga, A.J., Karthaus, E.G., Wilschut, Janneke, Bruin, J.L. De, Akkersdijk, G.P., Geelkerken, R.H., Hamming, J.F., Warle, M.C., Wever, J.J., and Verhagen, H.J.

Abstract

Contains fulltext : 251573.pdf (Publisher’s version ) (Open Access), OBJECTIVE: The Dutch Surgical Aneurysm Audit (DSAA) initiative was established in 2013 to monitor and improve nationwide outcomes of aortic aneurysm surgery. The objective of this study was to examine whether outcomes of surgery for intact abdominal aortic aneurysms (iAAA) have improved over time. METHODS: Patients who underwent primary repair of an iAAA by standard endovascular (EVAR) or open surgical repair (OSR) between 2014 and 2019 were selected from the DSAA for inclusion. The primary outcome was peri-operative mortality trend per year, stratified by OSR and EVAR. Secondary outcomes were trends per year in major complications, textbook outcome (TbO), and characteristics of treated patients. The trends per year were evaluated and reported in odds ratios per year. RESULTS: In this study, 11 624 patients (74.8%) underwent EVAR and 3 908 patients (25.2%) underwent OSR. For EVAR, after adjustment for confounding factors, there was no improvement in peri-operative mortality (aOR [adjusted odds ratio] 1.06, 95% CI 0.94 - 1.20), while major complications decreased (2014: 10.1%, 2019: 7.0%; aOR 0.91, 95% CI 0.88 - 0.95) and the TbO rate increased (2014: 68.1%, 2019: 80.9%; aOR 1.13, 95% CI 1.10 - 1.16). For OSR, the peri-operative mortality decreased (2014: 6.1%, 2019: 4.6%; aOR 0.89, 95% CI 0.82 - 0.98), as well as major complications (2014: 28.6%, 2019: 23.3%; aOR 0.95, 95% CI 0.91 - 0.99). Furthermore, the proportion of TbO increased (2014: 49.1%, 2019: 58.3%; aOR 1.05, 95% CI 1.01 - 1.10). In both the EVAR and OSR group, the proportion of patients with cardiac comorbidity increased. CONCLUSION: Since the establishment of this nationwide quality improvement initiative (DSAA), all outcomes of iAAA repair following EVAR and OSR have improved, except for peri-operative mortality following EVAR which remained unchanged.

Published
2022

5. Effects of hospital preference for endovascular repair on postoperative mortality after elective abdominal aortic aneurysm repair: analysis of the Dutch Surgical Aneurysm Audit

Author

Lijftogt, N., Vahl, A.C., Karthaus, E.G., Willik, E.M. van der, Amodio, S., Zwet, E.W. van, Hamming, J.F., Dutch Soc Vasc Surg, Dutch Surg Aneurysm Audit, and Dutch Inst Clinical Auditing

Abstract

Background: Increased use of endovascular aneurysm repair (EVAR) and reduced open surgical repair (OSR), has decreased postoperative mortality after elective repair of abdominal aortic aneurysms (AAAs). The choice between EVAR or OSR depends on aneurysm anatomy, and the experience and preference of the vascular surgeon, and therefore differs between hospitals. The aim of this study was to investigate the current mortality risk difference (RD) between EVAR and OSR, and the effect of hospital preference for EVAR on overall mortality.Methods: Primary elective infrarenal or juxtarenal aneurysm repairs registered in the Dutch Surgical Aneurysm Audit (2013-2017) were analysed. First, mortality in hospitals with a higher preference for EVAR (high-EVAR group) was compared with that in hospitals with a lower EVAR preference (low-EVAR group), divided by the median percentage of EVAR. Second, the mortality RD between EVAR and OSR was determined by unadjusted and adjusted linear regression and propensity-score (PS) analysis and then by instrumental-variable (IV) analysis, adjusting for unobserved confounders; percentage EVAR by hospital was used as the IV.Results: A total of 11 997 patients were included. The median hospital rate of EVAR was 76.6 per cent. The overall mortality RD between high- and low-EVAR hospitals was 0.1 (95 per cent -0.5 to 0.4) per cent. The OSR mortality rate was significantly higher among high-EVAR hospitals than low-EVAR hospitals: 7.3 versus 4.0 per cent (RD 3.3 (1.4 to 5.3) per cent). The EVAR mortality rate was also higher in high-EVAR hospitals: 0.9 versus 0.7 per cent (RD 0.2 (-0.0 to 0.6) per cent). The RD following unadjusted, adjusted, and PS analysis was 4.2 (3.7 to 4.8), 4.4 (3.8 to 5.0), and 4.7 (4.1 to 5.3) per cent in favour of EVAR over OSR. However, the RD after IV analysis was not significant: 1.3 (-0.9 to 3.6) per cent.Conclusion: Even though EVAR has a lower mortality rate than OSR, the overall effect is offset by the high mortality rate after OSR in hospitals with a strong focus on EVAR.

Published
2021

7. Outcomes in Octogenarians and the Effect of Comorbidities After Intact Abdominal Aortic Aneurysm Repair in the Netherlands: A Nationwide Cohort Study

Author

Alberga, A.J., Karthaus, E.G., Zwet, E.W. van, Bruin, J.L. De, Herwaarden, J.A. van, Warle, M.C., Wever, J.J., Verhagen, H.J., Alberga, A.J., Karthaus, E.G., Zwet, E.W. van, Bruin, J.L. De, Herwaarden, J.A. van, Warle, M.C., Wever, J.J., and Verhagen, H.J.

Abstract

Contains fulltext : 239384.pdf (Publisher’s version ) (Open Access), OBJECTIVE: Age is an independent risk factor for mortality after both elective open surgical repair (OSR) and endovascular aneurysm repair (EVAR). As a result of an ageing population, and the less invasive nature of EVAR, the number of patients over 80 years (octogenarians) being treated is increasing. The mortality and morbidity following aneurysm surgery are increased for octogenarians. However, the mortality for octogenarians who have either low or high peri-operative risks remains unclear. The aim of this study was to provide peri-operative outcomes of octogenarians vs. non-octogenarians after OSR and EVAR for intact aneurysms, including separate subanalyses for elective and urgent intact repair, based on a nationwide cohort. Furthermore, the influence of comorbidities on peri-operative mortality was examined. METHODS: All patients registered in the Dutch Surgical Aneurysm Audit (DSAA) undergoing intact AAA repair between 2013 and 2018, were included. Patient characteristics and peri-operative outcomes (peri-operative mortality, and major complications) of octogenarians vs. non-octogenarians for both OSR and EVAR were compared using descriptive statistics. Multivariable logistic regression analyses were used to examine whether age and the presence of cardiac, pulmonary, or renal comorbidities were associated with mortality. RESULTS: This study included 12 054 EVAR patients (3 015 octogenarians), and 3 815 OSR patients (425 octogenarians). Octogenarians in both the EVAR and OSR treatment groups were more often female and had more comorbidities. In both treatment groups, octogenarians had significantly higher mortality rates following intact repair as well as higher major complication rates. Mortality rates of octogenarians were 1.9% after EVAR and 11.8% after OSR. Age ≥ 80 and presence of cardiac, pulmonary, and renal comorbidities were associated with mortality after EVAR and OSR. CONCLUSION: Because of the high peri-operative mortality rates of octogenarians, a

Published
2021

8. National Numbers of Secondary Aortic Reinterventions after Primary Abdominal Aortic Aneurysm Surgery from the Dutch Surgical Aneurysm Audit

Author

Karthaus, E.G., Vahl, A., Elsman, B.H.P., Wouters, M., Borst, G.J. de, Warle, M.C., Hamming, J.F., Karthaus, E.G., Vahl, A., Elsman, B.H.P., Wouters, M., Borst, G.J. de, Warle, M.C., and Hamming, J.F.

Abstract

Contains fulltext : 226469.pdf (Publisher’s version ) (Open Access), BACKGROUND: Long-term secondary aortic reinterventions (SARs) can be a sign of (lack of) effectiveness of abdominal aortic aneurysm (AAA) surgery. This study provides insight into the national number of SARs after primary AAA repair by endovascular aneurysm repair (EVAR) or by open surgical repair in the Netherlands. METHODS: Observational study included all patients undergoing SAR between 2016 and 2017, registered in the compulsory Dutch Surgical Aneurysm Audit (DSAA). The DSAA started in 2013, SARs are registered from 2016. Characteristics of SAR and postoperative outcomes (mortality/complications) were analyzed, stratified by urgency of SAR. Data of SARs were merged with data of their preceded primary AAA repair, registered in the DSAA after January 2013. In these patients undergoing SAR, treatment characteristics of the preceded primary AAA repair were additionally described, with focus on differences between stent grafts. RESULTS: Between 2016 and 2017, 691 patients underwent SAR, this concerned 9.3% of all AAA procedures (infrarenal/juxtarenal/suprarenal) in the Netherlands (77% elective/11% acute symptomatic/12% ruptured). Endoleak (60%) was the most frequent indication for SAR. SARs were performed with EVAR in 66%. Postoperative mortalities after SAR were 3.4%, 11%, and 29% in elective, acute symptomatic, and ruptured patients, respectively. In 26% (n = 181) of the patients undergoing SAR their primary AAA repair was performed after January 2013 and data of primary and SAR procedures could be merged. In 93% (n = 136), primary AAA repair was EVAR. Endografts primarily used were nitinol/polyester (62%), nitinol/polytetrafluoroethylene (8%), endovascular sealing (21%), and others (9%), compared with their national market share of 76% (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.38-0.71), 15% (OR, 0.50; CI, 0.29-0.89), 4.9% (OR, 5.04; CI, 3.44-7.38), and 4.1% (OR, 2.81; CI, 1.66-4.74), respectively. CONCLUSIONS: In the Netherlands, about one-tenth of

Published
2020

9. Patients with a Ruptured Abdominal Aortic Aneurysm Are Better Informed in Hospitals with an 'EVAR-preferred' Strategy: An Instrumental Variable Analysis of the Dutch Surgical Aneurysm Audit

Author

Karthaus, E.G., Lijftogt, N., Vahl, A., Willik, E.M. van der, Amodio, S., Warlé, M.C., Zwet, E.W. van, Hamming, J.F., Karthaus, E.G., Lijftogt, N., Vahl, A., Willik, E.M. van der, Amodio, S., Warlé, M.C., Zwet, E.W. van, and Hamming, J.F.

Abstract

Contains fulltext : 229914.pdf (Publisher’s version ) (Open Access), BACKGROUND: While several observational studies suggested a lower postoperative mortality after minimal invasive endovascular aneurysm repair (EVAR) in patients with a ruptured abdominal aortic aneurysm (RAAA) compared to conventional open surgical repair (OSR), landmark randomized controlled trials have not been able to prove the superiority of EVAR over OSR. Randomized controlled trials contain a selected, homogeneous population, influencing external validity. Observational studies are biased and adjustment of confounders can be incomplete. Instrumental variable (IV) analysis (pseudorandomization) may help to answer the question if patients with an RAAA have lower postoperative mortality when undergoing EVAR compared to OSR. METHODS: This is an observational study including all patients with an RAAA, registered in the Dutch Surgical Aneurysm Audit between 2013 and 2017. The risk difference (RD) in postoperative mortality (30 days/in-hospital) between patients undergoing EVAR and OSR was estimated, in which adjustment for confounding was performed in 3 ways: linear model adjusted for observed confounders, propensity score model (multivariable logistic regression analysis), and IV analysis (two-stage least square regression), adjusting for observed and unobserved confounders, with the variation in percentage of EVAR per hospital as the IV instrument. RESULTS: 2419 patients with an RAAA (1489 OSR and 930 EVAR) were included. Unadjusted postoperative mortality was 34.9% after OSR and 22.6% after EVAR (RD 12.3%, 95% CI 8.5-16%). The RD adjusted for observed confounders using linear regression analysis and propensity score analysis was, respectively, 12.3% (95% CI 9.6-16.7%) and 13.2% (95%CI 9.3-17.1%) in favor of EVAR. Using IV analysis, adjusting for observed and unobserved confounders, RD was 8.9% (95% CI -1.1-18.9%) in favor of EVAR. CONCLUSIONS: Adjusting for observed confounders, patients with an RAAA undergoing EVAR had a significant better survival than OSR in a

Published
2020

10. A Composite Measure for Quality of Care in Patients with Symptomatic Carotid Stenosis Using Textbook Outcome

Author

Kuhrij, L.S., Karthaus, E.G., Vahl, A.C., Willems, M.C.M., Elshof, J.W., Warle, M.C., Borst, G.J. de, Kuhrij, L.S., Karthaus, E.G., Vahl, A.C., Willems, M.C.M., Elshof, J.W., Warle, M.C., and Borst, G.J. de

Abstract

Contains fulltext : 226467.pdf (Publisher’s version ) (Closed access), OBJECTIVE: Composite measures may better objectify hospital performance than individual outcome measures (IOM). Textbook outcome (TO) is an outcome measure achieved for an individual patient when all undesirable outcomes are absent. The aim of this study was to assess TO as an additional outcome measure to evaluate quality of care in symptomatic patients treated by carotid endarterectomy (CEA). METHODS: All symptomatic patients treated by CEA in 2018, registered in the Dutch Audit for Carotid Interventions, were included. TO was defined as a composite of the absence of 30 day mortality, neurological events (any stroke or transient ischaemic attack [TIA]), cranial nerve deficit, haemorrhage, 30 day readmission, prolonged length of stay (LOS; > 5 days) and any other surgical complication. Multivariable logistic regression was used to identify covariables associated with achieving TO, which were used for casemix adjustment for hospital comparison. For each hospital, an observed vs. expected number of events ratio (O/E ratio) was calculated and plotted in a funnel plot with 95% control limits. RESULTS: In total, 70.7% of patients had a desired outcome within 30 days after CEA and therefore achieved TO. Prolonged LOS was the most common parameter (85%) and mortality the least common (1.1%) for not achieving TO. Covariates associated with achieving TO were younger age, the absence of pulmonary comorbidity, higher haemoglobin levels, and TIA as index event. In the case mix adjusted funnel plot, the O/E ratios between hospitals ranged between 0.63 and 1.27, with two hospitals revealing a statistically significantly lower rate of TO (with O/E ratios of 0.63 and 0.66). CONCLUSION: In the Netherlands, most patients treated by CEA achieve TO. Variation between hospitals in achieving TO might imply differences in performance. TO may be used as an additive to the pre-existing IOM, especially in surgical care with low baseline risk such as CEA.

Published
2020

11. Saccular Abdominal Aortic Aneurysms Patient Characteristics, Clinical Presentation, Treatment, and Outcomes in the Netherlands

Author

Karthaus, E.G., Tong, T.M.L., Vahl, A., Hamming, J.F., Akker, L.H. van den, Akker, P.J. van den, Akkersdijk, G.J., Akkersdijk, G.P., Akkersdijk, W.L., Kempenaer, M.G.V. de, Arts, C.H., Avontuur, J.A., Baal, J.G., Bakker, O.J., Balm, R., Barendregt, W.B., Bender, M.H., Bendermacher, B.L., Berg, M. van den, Berger, P., Beuk, R.J., Blankensteijn, J.D., Bleker, R.J., Bockel, J.H., Bodegom, M.E., Bogt, K.E., Boll, A.P., Booster, M.H., Burg, B.L.B. van der, Borst, G.J. de, Bos-van Rossum, W.T., Bosma, J., Botman, J.M., Bouwman, L.H., Breek, J.C., Brehm, V., Brinckman, M.J., Broek, T.H. van den, Brom, H.L., Bruijn, M.T. de, Bruin, J.L. de, Brummel, P., Brussel, J.P. van, Buijk, S.E., Buimer, M.G., Burger, D.H., Buscher, H.C., Butter, G. den, Cancrinus, E., Castenmiller, P.H., Cazander, G., Coveliers, H.M., Cuypers, P.H., Daemen, J.H., Dawson, I., Derom, A.F., Dijkema, A.R., Diks, J., Dinkelman, M.K., Dirven, M., Dolmans, D.E., Doorn R, C. van, Dortmont, L.M. van, Eb, M.M. van der, Eefting, D., Eijck, G.J. van, Elshof, J.W., Elsman, B.H., Elst, A. van der, Engeland, M.I. van, Eps, R.G. van, Faber, M.J., Fijter, W.M. de, Fioole, B., Fritschy, W.M., Geelkerken, R.H., Gent, W.B. van, Glade, G.J., Govaert, B., Groenendijk, R.P., Groot, H.G. de, Haak, R.F. van den, Haan, E.F. de, Hajer, G.F., Hattum, E.S. van, Hazenberg, C.E., Joosten, P.P.H.M., Helleman, J.N., Hem, L.G. van der, Hendriks, J.M., Herwaarden, J.A. van, Heyligers, J.M., Hinnen, J.W., Hissink, R.J., Ho, G.H., Hoed, P.T. den, Hoedt, M.T., Hoek, F. van, Hoencamp, R., Hoffmann, W.H., Hoksbergen, A.W., Hollander, E.J., Huisman, L.C., Hulsebos, R.G., Hunt-Jens, K.M., Idu, M.M., Jacobs, M.J., Jagt, M.F. van der, Jansbeken, J.R., Janssen, R.J., Jiang, H.H., Jong, S.C. de, Jongkind, V., Kapma, M.R., Keller, B.P., Jahrome, A.K., Kievit, J.K., Klemm, P.L., Klinkert, P., Knippenberg, B., Koedam, N.A., Koelemaij, M.J., Kolkert, J.L., Koning, G.G., Koning, O.H., Krasznai, A.G., Krol, R.M., Kropman, R.H., Kruse, R.R., Laan, L. van der, Laan, M.J. van der, Laanen, J.H. van, Lardenoye, J.H., Lawson, J.A., Legemate, D.A., Leijdekkers, V.J., Lemson, M.S., Lensvelt, M.M., Lijkwan, M.A., Lind, R.C., Linden, F.T. van der, Lung, P.F.L., Loos, M.J., Loubert, M.C., Mahmoud, D.E., Manshanden, C.G., Mattens, E.C., Meerwaldt, R., Mees, B.M., Metz, R., Minnee, R.C., Mol van Otterloo , J.C. de, Moll, F.L., Swijndregt, Y.C.M. van, Morak, M.J., Mortel, R.H. van de, Mulder, W., Nagesser, S.K., Naves, C.C., Nederhoed, J.H., Nevenzel-Putters, A.M., Nie, A.J. de, Nieuwenhuis, D.H., Nieuwen-Huizen, J., Nieuwenhuizen, R.C. van, Nio, D., Oomen, A.P., Oranen, B.I., Oskam, J., Palamba, H.W., Peppelenbosch, A.G., Petersen, A.S. van, Peterson, T.F., Petri, B.J., Pierie, M.E., Ploeg, A.J., Pol, R.A., Ponfoort, E.D., Poyck, P.P., Prent, A., Raa, S. ten, Raymakers, J.T., Reichart, M., Reichmann, B.L., Reijnen, M.M., Rijbroek, A., Rijn, M.J. van, Roo, R.A. de, Rouwet, E.V., Rupert, C.G., Saleem, B.R., Sambeek, M.R. van, Samyn, M.G., Sant, H.P. van 't, Schaik, J. van, Schaik, P.M. van, Scharn, D.M., Scheltinga, M.R., Schepers, A., Schlejen, P.M., Schlosser, F.J., Schol, F.P., Schouten, O., Schreinemacher, M.H., Schreve, M.A., Schurink, G.W., Sikkink, C.J., Siroen, M.P., Slaa, A. te, Smeets, H.J., Smeets, L., Smet, A.A. de, Smit, P. de, Smit, P.C., Smits, T.M., Snoeijs, M.G., Sondakh, A.O., Steenhoven, T.J. van der, Sterkenburg, S.M. van, Stigter, D.A., Stigter, H., Strating, R.P., Stultiens, G.N., Sybrandy, J.E., Teijink, J.A., Telgenkamp, B.J., Testroote, M.J., The, R.M., Thijsse, W.J., Tielliu, I.F., Tongeren, R.B. van, Toorop, R.J., Tordoir, J.H., Tournoij, E., Truijers, M., Turkean, K., Nolthenius, R.P.T., Unlu, C., Vafi, A.A., Vahl, A.C., Veen, E.J., Veger, H.T., Veldman, M.G., Verhagen, H.J., Verhoeven, B.A., Vermeulen, C.F., Vermeulen, E.G., Vierhout, B.P., Visser, M.J., Vliet, J.A. van der, Vlijmen-van Kuelen, C.J., Voesten, H.G., Voorhoeve, R., and Vos

Subjects
Male, medicine.medical_specialty, Aortic Rupture, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Treatment outcome, Patient characteristics, Hospital mortality, 030204 cardiovascular system & hematology, Dutch Surgical Aneurysm Audit (DSAA), Risk Assessment, Blood Vessel Prosthesis Implantation, 03 medical and health sciences, Aortic aneurysm, 0302 clinical medicine, Intervention (counseling), medicine, Humans, Hospital Mortality, Registries, 030212 general & internal medicine, cardiovascular diseases, threshold for elective surgery, Aged, Netherlands, Retrospective Studies, business.industry, General surgery, Follow up studies, Retrospective cohort study, Middle Aged, Saccular abdominal aortic aneurysm, medicine.disease, Survival Analysis, Surgery, Treatment Outcome, Elective Surgical Procedures, 030220 oncology & carcinogenesis, cardiovascular system, Female, 030211 gastroenterology & hepatology, Emergencies, Presentation (obstetrics), Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine, business, Aortic Aneurysm, Abdominal, Follow-Up Studies, Abdominal surgery
Abstract

Objective: The aim of this was to analyze differences between saccularshaped abdominal aortic aneurysms (SaAAAs) and fusiform abdominal aortic aneurysms (FuAAAs) regarding patient characteristics, treatment, and outcome, to advise a threshold for intervention for SaAAAs.Background: Based on the assumption that SaAAAs are more prone to rupture, guidelines suggest early elective treatment. However, little is known about the natural history of SaAAAs and the threshold for intervention is not substantiated.Methods: Observational study including primary repairs of degenerative AAAs in the Netherlands between 2016 and 2018 in which the shape was registered, registered in the Dutch Surgical Aneurysm Audit (DSAA). Patients were stratified by urgency of surgery; elective versus acute (symptomatic/ruptured). Patient characteristics, treatment, and outcome were compared between SaAAAs and FuAAAs.Results: A total of 7659 primary AAA-patients were included, 6.1% (n = 471) SaAAAs and 93.9% (n = 7188) FuAAAs. There were 5945 elective patients (6.5% SaAAA) and 1714 acute (4.8% SaAAA). Acute SaAAApatients were more often female (28.9% vs 17.2%, P = 0.007) compared with acute FuAAA-patients. SaAAAs had smaller diameters than FuAAAs, in elective (53.0mm vs 61 mm, P = 0.000) and acute (68mm vs 75 mm, P = 0.002) patients, even after adjusting for sex. In addition, 25.2% of acute SaAAA-patients presented with diameters

Published
2019

13. Treatment and survival of locally recurrent rectal cancer: A cross-sectional population study 15 years after the Dutch TME trial

Author

Detering, Robin, primary, Karthaus, Eleonora G., additional, Borstlap, Wernard A.A., additional, Marijnen, Corrie A.M., additional, van de Velde, Cornelis J.H., additional, Bemelman, Willem A., additional, Beets, Geerard L., additional, Tanis, Pieter J., additional, Aalbers, Arend G.J., additional, Aalbers, A.G.J., additional, Acherman, Y., additional, Algie, G.D., additional, Alting von Geusau, B., additional, Amelung, F., additional, Aukema, T.S., additional, Bakker, I.S., additional, Bartels, S.A., additional, Basha, S., additional, Bastiaansen, A.J.N.M., additional, Belgers, E., additional, Bleeker, W., additional, Blok, J., additional, Bosker, R.J.I., additional, Bosmans, J.W., additional, Boute, M.C., additional, Bouvy, N.D., additional, Bouwman, H., additional, Brandt-Kerkhof, A., additional, Brinkman, D.J., additional, Bruin, S., additional, Bruns, E.R.J., additional, Burbach, J.P.M., additional, Burger, J.W.A., additional, Buskens, C.J., additional, Clermonts, S., additional, Coene, P.P.L.O., additional, Compaan, C., additional, Consten, E.C.J., additional, Darbyshire, T., additional, de Mik, S.M.L., additional, de Graaf, E.J.R., additional, de Groot, I., additional, tot Nederveen Cappel, RJ de Vos, additional, de Wilt, J.H.W., additional, van der Wolde, J., additional, Boer, FC den, additional, Dekker, J.W.T., additional, Demirkiran, A., additional, Derkx-Hendriksen, M., additional, Dijkstra, F.R., additional, van Duijvendijk, P., additional, Dunker, M.S., additional, Eijsbouts, Q.E., additional, Fabry, H., additional, Ferenschild, F., additional, Foppen, J.W., additional, Furnee, E.J.B., additional, Gerhards, M.F., additional, Gerven, P., additional, Gooszen, J.A.H., additional, Govaert, J.A., additional, Van Grevenstein, W.M.U., additional, Haen, R., additional, Harlaar, J.J., additional, van der Harst, E., additional, Havenga, K., additional, Heemskerk, J., additional, Heeren, J.F., additional, Heijnen, B., additional, Heres, P., additional, Hoff, C., additional, Hogendoorn, W., additional, Hoogland, P., additional, Huijbers, A., additional, Janssen, P., additional, Jongen, A.C., additional, Jonker, F.H., additional, Karthaus, E.G., additional, Keijzer, A., additional, Ketel, J.M.A., additional, Klaase, J., additional, Kloppenberg, F.W.H., additional, Kool, M.E., additional, Kortekaas, R., additional, Kruyt, P.M., additional, Kuiper, J.T., additional, Lamme, B., additional, Lange, J.F., additional, Lettinga, T., additional, Lips, D.J., additional, Logeman, F., additional, Lutke Holzik, M.F., additional, Madsen, E., additional, Mamound, A., additional, Marres, C.C., additional, Masselink, I., additional, Meerdink, M., additional, Menon, A.G., additional, Mieog, J.S., additional, Mierlo, D., additional, Musters, G.D., additional, Nieuwenhuijzen, G.A.P., additional, Neijenhuis, P.A., additional, Nonner, J., additional, Oostdijk, M., additional, Oosterling, S.J., additional, Paul, P.M.P., additional, Peeters, K.C.M.J., additional, Pereboom, I.T.A., additional, Polat, F., additional, Poortman, P., additional, Raber, M., additional, Reiber, B.M.M., additional, Renger, R.J., additional, van Rossem, C.C., additional, Rutten, H.J., additional, Rutten, A., additional, Schaapman, R., additional, Scheer, M., additional, Schoonderwoerd, L., additional, Schouten, N., additional, Schreuder, A.M., additional, Schreurs, W.H., additional, Simkens, G.A., additional, Slooter, G.D., additional, Sluijmer, H.C.E., additional, Smakman, N., additional, Smeenk, R., additional, Snijders, H.S., additional, Sonneveld, D.J.A., additional, Spaansen, B., additional, Bilgen, EJ Spillenaar, additional, Steller, E., additional, Steup, W.H., additional, Steur, C., additional, Stortelder, E., additional, Straatman, J., additional, Swank, H.A., additional, Sietses, C., additional, Groen, H.A., additional, Hoeve, HG ten, additional, Riele, WW ter, additional, Thorensen, I.M., additional, Tip-Pluijm, B., additional, Toorenvliet, B.R., additional, Tseng, L., additional, Tuynman, J.B., additional, van Bastelaar, J., additional, van Beek, S.C., additional, van de Ven, A.W.H., additional, van de Weijer, M.A.J., additional, van den Berg, C., additional, van den Bosch, I., additional, van der Bilt, J.D.W., additional, van der Hagen, S.J., additional, van der Hul, R., additional, van der Schelling, G., additional, van der Spek, A., additional, van der Wielen, N., additional, van Duyn, E., additional, van Eekelen, C., additional, van Essen, J.A., additional, van Gangelt, K., additional, van Geloven, A.A.W., additional, van Kessel, C., additional, van Loon, Y.T., additional, van Rijswijk, A., additional, van Rooijen, S.J., additional, van Sprundel, T., additional, van Steensel, L., additional, van Tets, W.F., additional, van Westreenen, H.L., additional, Veltkamp, S., additional, Verhaak, T., additional, Verheijen, P.M., additional, Versluis-Ossenwaarde, L., additional, Vijfhuize, S., additional, Vles, W.J., additional, Voeten, S.C., additional, Vogelaar, F.J., additional, Vrijland, W.W., additional, Westerduin, E., additional, Westerterp, M.E., additional, Wetzel, M., additional, Wevers, K.P., additional, Wiering, B., additional, Witjes, C.D.M., additional, Wouters, M.W., additional, Yauw, S.T.K., additional, van der Zaag, E.S., additional, Zeestraten, E.C., additional, Zimmerman, D.D.E., additional, and Zwieten, T., additional

Published
2019
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15. Influence of Conversion and Anastomotic Leakage on Survival in Rectal Cancer Surgery; Retrospective Cross-sectional Study

Author

Furnee, E.J.B., Aukema, T.S., Oosterling, S.J., Borstlap, W.A.A., Bemelman, W.A., Tanis, P.J., Aalbers, A., Acherman, Y., Algie, G.D., Geusau, B.A. von, Amelung, F., Bartels, S.A., Basha, S., Bastiaansen, A.J.N.M., Belgers, E., Bleeker, W., Blok, J., Bosker, R.J.I., Bosmans, J.W., Boute, M.C., Bouvy, N.D., Bouwman, H., Brandt-Kerkhof, A., Brinkman, D.J., Bruin, S., Bruns, E.R.J., Burbach, J.P.M., Burger, J.W.A., Buskens, C.J., Clermonts, S., Coene, P.P.L.O., Compaan, C., Consten, E.C.J., Darbyshire, T., Mik, S.M.L. de, Graaf, E.J.R. de, Groot, I. de, Cappel, R.J.L.D.N., Wilt, J.H.W. de, Wolde, J. van der, Boer, F.C. den, Dekker, J.W.T., Demirkiran, A., Derkx-Hendriksen, M., Dijkstra, F.R., Duijvendijk, P. van, Dunker, M.S., Eijsbouts, Q.E., Fabry, H., Ferenschild, F., Foppen, J.W., Gerhards, M.F., Gerven, P., Gooszen, J.A.H., Govaert, J.A., Grevenstein, W.M.U. van, Haen, R., Harlaar, J.J., Harst, E., Havenga, K., Heemskerk, J., Heeren, J.F., Heijnen, B., Heres, P., Hoff, C., Hogendoorn, W., Hoogland, P., Huijbers, A., Janssen, P., Jongen, A.C., Jonker, F.H., Karthaus, E.G., Keijzer, A., Ketel, J.M.A., Klaase, J., Kloppenberg, F.W.H., Kool, M.E., Kortekaas, R., Kruyt, P.M., Kuiper, J.T., Lamme, B., Lange, J.F., Lettinga, T., Lips, D.J., Logeman, F., Holzik, M.F.L., Madsen, E., Mamound, A., Marres, C.C., Masselink, I., Meerdink, M., Menon, A.G., Mieog, J.S., Mierlo, D., Musters, G.D., Nieuwenhuijzen, G.A.P., Neijenhuis, P.A., Nonner, J., Oostdijk, M., Paul, P.M.P., Peeters, K.C.M.J., Pereboom, I.T.A., Polat, F., Poortman, P., Raber, M., Reiber, B.M.M., Renger, R.J., Rossem, C.C. van, Rutten, H.J., Rutten, A., Schaapman, R., Scheer, M., Schoonderwoerd, L., Schouten, N., Schreuder, A.M., Schreurs, W.H., Simkens, G.A., Slooter, G.D., Sluijmer, H.C.E., Smakman, N., Smeenk, R., Snijders, H.S., Sonneveld, D.J.A., Spaansen, B., Bilgen, E.J.S., Steller, E., Steup, W.H., Steur, C., Stortelder, E., Straatman, J., Swank, H.A., Sietses, C., Berge, H.A. ten, Hoeve, H.G. ten, Riele, W.W. ter, Thorensen, I.M., Tip-Pluijm, B., Toorenvliet, B.R., Tseng, L., Tuynman, J.B., Bastelaar, J. van, Beek, S.C. van, Ven, A.W.H. van de, Weijer, M.A.J. van de, Berg, C. van den, Bosch, I. van den, Bilt, J.D.W. van der, Hagen, S.J. van der, Hul, R. van der, Schelling, G. van der, Spek, A. van der, Wielen, N. van der, Duyn, E. van, Eekelen, C. van, Essen, J.A. van, Gangelt, K. van, Geloven, A.A.W. van, Kessel, C. van, Loon, Y.T. van, Rijswijk, A. van, Rooijen, S.J. van, Sprundel, T. van, Steensel, L. van, Tets, W.F. van, Westreenen, H.L. van, Veltkamp, S., Verhaak, T., Verheijen, P.M., Versluis-Ossenwaarde, L., Vijfhuize, S., Vles, W.J., Voeten, S., Vogelaar, F.J., Vrijland, W.W., Westerduin, E., Westerterp, M.E., Wetzel, M., Wevers, K.P., Wiering, B., Witjes, C.D.M., Wouters, M.W., Yauw, S.T.K., Zaag, E.S. van der, Zeestraten, E.C., Zimmerman, D.D., Zwieten, T., and Dutch Snapshot Res Grp

Subjects
Survival, Anastomosis, Laparoscopy, Conversion, Rectal cancer
Published
2019

16. Cross-Sectional Study on MRI Restaging After Chemoradiotherapy and Interval to Surgery in Rectal Cancer: Influence on Short- and Long-Term Outcomes

Author

Detering, R., Borstlap, W.A.A., Broeders, L., Hermus, L., Marijnen, C.A.M., Beets-Tan, R.G.H., Bemelman, W.A., Westreenen, H.L. van, Tanis, P.J., Aalbers, A., Acherman, Y., Algie, G.D., Geusau, B.A. von, Amelung, F., Bartels, S.A., Basha, S., Bastiaansen, A.J.N.M., Belgers, E., Bleeker, W., Blok, J., Bosker, R.J.I., Bosmans, J.W., Boute, M.C., Bouvy, N.D., Bouwman, H., Brandt-Kerkhof, A., Brinkman, D.J., Bruin, S., Bruns, E.R.J., Burbach, J.P.M., Burger, J.W.A., Buskens, C.J., Clermonts, S., Coene, P.P.L.O., Compaan, C., Consten, E.C.J., Darbyshire, T., Mik, S.M.L. de, Graaf, E.J.R. de, Groot, I. de, Cappel, R.J.L.D.T.N., Wilt, J.H.W. de, Wolde, J. van der, Boer, F.C. den, Dekker, J.W.T., Demirkiran, A., Derkx-Hendriksen, M., Dijkstra, F.R., Duijvendijk, P. van, Dunker, M.S., Eijsbouts, Q.E., Fabry, H., Ferenschild, F., Foppen, J.W., Gerhards, M.F., Gerven, P., Gooszen, J.A.H., Govaert, J.A., Grevenstein, W.M.U. van, Haen, R., Harlaar, J.J., Harst, E., Havenga, K., Heemskerk, J., Heeren, J.F., Heijnen, B., Heres, P., Hoff, C., Hogendoorn, W., Hoogland, P., Huijbers, A., Janssen, P., Jongen, A.C., Jonker, F.H., Karthaus, E.G., Keijzer, A., Ketel, J.M.A., Klaase, J., Wit, F., Kloppenberg, H., Kool, M.E., Kortekaas, R., Kruyt, P.M., Kuiper, J.T., Lamme, B., Lange, J.F., Lettinga, T., Lips, D.J., Logeman, F., Holzik, M.F.L., Madsen, E., Mamound, A., Marres, C.C., Masselink, I., Meerdink, M., Menon, A.G., Mieog, J.S., Mierlo, D., Musters, G.D., Nieuwenhuijzen, G.A.P., Neijenhuis, P.A., Nonner, J., Oostdijk, M., Paul, P.M.P., Peeters, K.C.M.J., Pereboom, I.T.A., Polat, F., Poortman, P., Raber, M., Reiber, B.M.M., Renger, R.J., Rossem, C.C. van, Rutten, H.J., Rutten, A., Schaapman, R., Scheer, M., Schoonderwoerd, L., Schouten, N., Schreuder, A.M., Schreurs, W.H., Simkens, G.A., Slooter, G.D., Sluijmer, H.C.E., Smakman, N., Smeenk, R., Snijders, H.S., Sonneveld, D.J.A., Spaansen, B., Bilgen, E.J.S., Steller, E., Steup, W.H., Steur, C., Stortelder, E., Straatman, J., Swank, H.A., Sietses, C., Berge, H.A. ten, Hoeve, H.G. ten, Riele, W.W. ter, Thorensen, I.M., Tip-Pluijm, B., Toorenvliet, B.R., Tseng, L., Tuynman, J.B., Bastelaar, J. van, Beek, S.C. van, Ven, A.W.H. van de, Weijer, M.A.J. van de, Berg, C. van den, Bosch, I. van den, Bilt, J.D.W. van der, Hagen, S.J. van der, Hul, R. van der, Schelling, G. van der, Spek, A. van der, Wielen, N. van der, Duyn, E. van, Eekelen, C. van, Essen, J.A. van, Gangelt, K. van, Geloven, A.A.W. van, Kessel, C. van, Loon, Y.T. van, Rijswijk, A. van, Rooijen, S.J. van, Sprundel, T. van, Steensel, L. van, Tets, W.F. van, Veltkamp, S., Verhaak, T., Verheijen, P.M., Versluis-Ossenwaarde, L., Vijfhuize, S., Vles, W.J., Voeten, S.C., Vogelaar, F.J., Vrijland, W.W., Westerduin, E., Westerterp, M.E., Wetzel, M., Wevers, K.P., Wiering, B., Witjes, C.D.M., Wouters, M.W., Yauw, S.T.K., Zaag, E.S. van der, Zeestraten, E.C., Zimmerman, D.D., Zwieten, T., Dutch Snapshot Res Grp, Groningen Institute for Organ Transplantation (GIOT), Value, Affordability and Sustainability (VALUE), ​Robotics and image-guided minimally-invasive surgery (ROBOTICS), CCA - Cancer Treatment and quality of life, Surgery, Amsterdam Reproduction & Development (AR&D), and Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Male, IMPACT, medicine.medical_treatment, THERAPY, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], CHEMORADIATION, 0302 clinical medicine, ADJUVANT CHEMOTHERAPY, Interquartile range, Medicine, PATHOLOGICAL COMPLETE RESPONSE, Stage (cooking), Neoadjuvant therapy, Netherlands, Aged, 80 and over, medicine.diagnostic_test, Incidence, ASO Author Reflections, Chemoradiotherapy, Middle Aged, Magnetic Resonance Imaging, Neoadjuvant Therapy, Survival Rate, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, Surgical Procedures, Operative, SURVIVAL, 030211 gastroenterology & hepatology, Female, TIME-INTERVAL, RADIOTHERAPY, medicine.medical_specialty, RESECTION, Preoperative care, Time-to-Treatment, 03 medical and health sciences, Preoperative Care, Humans, Survival rate, Aged, Neoplasm Staging, Retrospective Studies, business.industry, Rectal Neoplasms, Magnetic resonance imaging, Retrospective cohort study, NEOADJUVANT CHEMORADIOTHERAPY, Surgery, Cross-Sectional Studies, Neoplasm Recurrence, Local, business, Follow-Up Studies
Abstract

Contains fulltext : 215772.pdf (Publisher’s version ) (Open Access) BACKGROUND: The time interval between CRT and surgery in rectal cancer patients is still the subject of debate. The aim of this study was to first evaluate the nationwide use of restaging magnetic resonance imaging (MRI) and its impact on timing of surgery, and, second, to evaluate the impact of timing of surgery after chemoradiotherapy (CRT) on short- and long-term outcomes. METHODS: Patients were selected from a collaborative rectal cancer research project including 71 Dutch centres, and were subdivided into two groups according to time interval from the start of preoperative CRT to surgery (< 14 and >/= 14 weeks). RESULTS: From 2095 registered patients, 475 patients received preoperative CRT. MRI restaging was performed in 79.4% of patients, with a median CRT-MRI interval of 10 weeks (interquartile range [IQR] 8-11) and a median MRI-surgery interval of 4 weeks (IQR 2-5). The CRT-surgery interval groups consisted of 224 (< 14 weeks) and 251 patients (>/= 14 weeks), and the long-interval group included a higher proportion of cT4 stage and multivisceral resection patients. Pathological complete response rate (n = 34 [15.2%] vs. n = 47 [18.7%], p = 0.305) and CRM involvement (9.7% vs. 15.9%, p = 0.145) did not significantly differ. Thirty-day surgical complications were similar (20.1% vs. 23.1%, p = 0.943), however no significant differences were found for local and distant recurrence rates, disease-free survival, and overall survival. CONCLUSIONS: These real-life data, reflecting routine daily practice in The Netherlands, showed substantial variability in the use and timing of restaging MRI after preoperative CRT for rectal cancer, as well as time interval to surgery. Surgery before or after 14 weeks from the start of CRT resulted in similar short- and long-term outcomes.

Published
2019

17. Treatment and survival of locally recurrent rectal cancer: A cross-sectional population study 15 years after the Dutch TME trial

Author

Detering, R., Karthaus, E.G., Borstlap, W.A.A., Marijnen, C.A., Velde, C.J. van de, Bemelman, W.A., Beets, G.L., Wilt, J.H.W. de, Tanis, P.J., Aalbers, A.G., Detering, R., Karthaus, E.G., Borstlap, W.A.A., Marijnen, C.A., Velde, C.J. van de, Bemelman, W.A., Beets, G.L., Wilt, J.H.W. de, Tanis, P.J., and Aalbers, A.G.

Abstract

Contains fulltext : 215738.pdf (publisher's version ) (Closed access), INTRODUCTION: Optimized treatment of primary rectal cancer might have influenced treatment characteristics and outcome of locally recurrent rectal cancer (LRRC). Subgroup analysis of the Dutch TME trial showed that preoperative radiotherapy (PRT) for the primary tumour was an independent poor prognostic factor after diagnosis of LRRC. This cross-sectional population study aimed to evaluate treatment and overall survival (OS) of LRRC patients, stratified for prior preoperative radiotherapy (PRT) and intention of treatment of LRRC. METHODS: All patients developing LRRC were selected from a collaborative Snapshot study on 2095 surgically treated rectal cancer patients from 71 Dutch hospitals in the year 2011. Cox proportional hazard analysis was performed to determine predictors for OS. RESULTS: A total of 107 LRRC patients (5.1%) were included, of whom 88 (82%) underwent PRT for their primary tumour. LRRC was treated with initial curative intent in 31 patients (29%), with eventual resection in 20 patients (19%). Median OS was 22 and 8 months after curative and palliative intent treatment, respectively (p<0.001). Initial CRM positivity and palliative intent treatment were associated with worse OS after LRRC, while prior PRT was not. CONCLUSIONS: This cross-sectional study revealed that rectal cancer patients, who underwent curative resection in the Netherlands in 2011 and subsequently developed local recurrence, were amenable for again curative intent treatment in 29%, with a corresponding median survival of 22 months. Prior PRT was not significantly associated with survival after diagnosis of LRRC.

Published
2019

18. Data verification of nationwide clinical quality registries

Author

Werf, L.R. (Leonie) van der, Voeten, S.C. (S. C.), van Loe, C.M.M. (C. M.M.), Karthaus, E.G. (E. G.), Wouters, M.W.J.M. (Michel), Prins, H.A. (H. A.), Werf, L.R. (Leonie) van der, Voeten, S.C. (S. C.), van Loe, C.M.M. (C. M.M.), Karthaus, E.G. (E. G.), Wouters, M.W.J.M. (Michel), and Prins, H.A. (H. A.)

Abstract

Background: Clinical auditing is an emerging instrument for quality assessment and improvement. Moreover, clinical registries facilitate medical research as they provide 'real world' data. It is important that entered data are robust and reliable. The aim of this study was to describe the evolving procedure and results of data verification within the Dutch Institute for Clinical Auditing (DICA). Methods: Data verification performed on several (disease-specific) clinical registries between 2013 and 2015 was evaluated. Sign-up, sample size and process of verification were described. For each procedure, hospitals were visited by external data managers to verify registered data. Outcomes of data verification were completeness and accuracy. An assessment of the quality of data was given per registry, for each participating hospital. Using descriptive statistics, analyses were performed for different sections within the individual registries. Results: Seven of the 21 registries were verified, involving 174 visits to hospital departments. A step-by-step description of the data verification process was provided. Completeness of data in the registries varied from 97·2 to 99·4 per cent. Accuracy of data ranged from 88·2 to 100 per cent. Most discrepancies were observed for postoperative complications (0·7-7·5 per cent) and ASA classification (8·5-11·4 per cent). Data quality was assessed as 'sufficient' for 145 of the 174 hospital departments (83·3 per cent). Conclusion: Data verification revealed that the data entered in the observed DICA registries were complete and accurate.Antecedentes: La auditoría clínica es un instrumento emergente para la evaluación y mejora de la calidad. Además, los registros clínicos facilitan la investigación médica ya que proporcionan datos de la “vida real”. Es importante que los datos introducidos sean completos y fiables. El objetivo de este estudio fue describir la evolución y los resultados del procedimiento de verificación de datos en el se

Published
2019
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19. Textbook Outcome A Composite Measure for Quality of Elective Aneurysm Surgery

Author

Karthaus, E.G., Lijftogt, N., Busweiler, L.A.D., Elsman, B.H.P., Wouters, M.W.J.M., Vahl, A.C., Hamming, J.F., Collaboration Dutch Soc, Steering Comm Dutch, and Dutch Inst Clinical Auditing

Subjects
Adult, Male, medicine.medical_specialty, Quality Assurance, Health Care, media_common.quotation_subject, MEDLINE, 030230 surgery, Outcome (game theory), 03 medical and health sciences, Aortic aneurysm, 0302 clinical medicine, medicine, Humans, Quality (business), Registries, media_common, Aged, Netherlands, Quality Indicators, Health Care, Aged, 80 and over, business.industry, General surgery, Endovascular Procedures, Vascular surgery, Middle Aged, medicine.disease, elective aortic aneurysm surgery, Surgery, Treatment Outcome, textbook outcome, Elective Surgical Procedures, 030220 oncology & carcinogenesis, Multivariate Analysis, composite quality measure, Female, Risk Adjustment, Elective Surgical Procedure, business, Quality assurance, Vascular Surgical Procedures, Abdominal surgery, Aortic Aneurysm, Abdominal
Abstract

To investigate a new composite quality measurement, which comprises a desirable outcome for elective aneurysm surgery, called "Textbook Outcome" (TO).Single-quality indicators in vascular surgery are often not distinctive and insufficiently reflect the quality of care.All patients undergoing elective abdominal aortic aneurysm repair, registered in the Dutch Surgical Aneurysm Audit between 2014 and 2015 were included. TO was defined as the percentage of patients who had abdominal aortic aneurysm-repair without intraoperative complications, postoperative surgical complications, reinterventions, prolonged hospital stay [endovascular aneurysm repair (EVAR) ≤4 d, open surgical repair (OSR) ≤10 d], readmissions, and postoperative mortality (≤30 d after surgery/at discharge). Case-mix adjusted TO rates were used to compare hospitals and to compare individual hospital results for different procedures.Five thousand one hundred seventy patients were included, of whom 4039 were treated with EVAR and 1131 with OSR. TO was achieved in 71% of EVAR and 53% of OSR. Important obstacles for achieving TO were a prolonged hospital stay, postoperative complications, and readmissions. Adjusted TO rates varied from 38% to 89% (EVAR) and from 0% to 97% (OSR) between individual hospitals. Hospitals with a high TO for OSR also had a high TO for EVAR; however, a high TO for EVAR did not implicate a high TO for OSR.TO generates additional information to evaluate the overall quality of the care of elective aneurysm surgery, which subsequently can be used by hospitals to improve the quality of their care.

Published
2017

21. Failure to Rescue - a Closer Look at Mortality Rates Has No Added Value for Hospital Comparisons but Is Useful for Team Quality Assessment in Abdominal Aortic Aneurysm Surgery in The Netherlands

Author

Lijftogt, N., Karthaus, E.G., Vahl, A., Zwet, E.W. van, Willik, E.M. van der, Tollenaar, R., Warlé, M.C., Hamming, J.F., Wouters, M., Lijftogt, N., Karthaus, E.G., Vahl, A., Zwet, E.W. van, Willik, E.M. van der, Tollenaar, R., Warlé, M.C., Hamming, J.F., and Wouters, M.

Abstract

Item does not contain fulltext, OBJECTIVES: Failure to rescue (FTR) is a composite quality indicator, defined as the proportion of deceased patients following major complications. The aims of this study were to compare FTR with mortality for hospital comparisons in abdominal aortic aneurysm (AAA) surgery in The Netherlands and investigate hospital volume and associated factors. METHODS: Patients prospectively registered between 2013 and 2015 in the Dutch Surgical Aneurysm Audit (DSAA) were analysed. FTR was analysed for AAA patients and subgroups elective (EAAA) and acute (AAAA; symptomatic or ruptured) aneurysms. Variables and hospital volume were analysed by uni- and multivariable regression analysis. Adjusted hospital comparisons for mortality, major complications, and FTR were presented in funnel plots. Isomortality lines were constructed when presenting FTR and major complication rates. RESULTS: A total of 9258 patients were analysed in 61 hospitals: 7149 EAAA patients (77.2%) and 2109 AAAA patients (22.8%). There were 2785 (30.1%) patients with complications (unadjusted range 5-65% per hospital): 2161 (77.6%) with major and 624 (28.4%) patients with minor complications. Overall mortality was 6.6% (adjusted range 0-16% per hospital) and FTR was 28.4% (n = 613) (adjusted range 0-60% per hospital). Glasgow Coma Scale, age, pulse, creatinine, electrocardiography, and operative setting were independently associated with FTR. Hospital volume was not associated with FTR. In AAAA patients hospital volume was significantly associated with a lower adjusted major complication and mortality rate (OR 0.62, 95% CI 0.49-0.78; and 0.64, 95% CI 0.48-0.87). Four hospitals had a significant lower adjusted FTR with different major complication rates on different isomortality lines. CONCLUSIONS: There was more variation in FTR than in mortality between hospitals. FTR identified the same best performing hospitals as for mortality and therefore was of limited additional value in measuring quality of care for AAA s

Published
2018

22. The Dutch Audit of Carotid Interventions: Transparency in Quality of Carotid Endarterectomy in Symptomatic Patients in the Netherlands

Author

Karthaus, E.G., Vahl, A., Kuhrij, L.S., Elsman, B.H.P., Geelkerken, R.H., Wouters, M., Warle, M.C., Hamming, J.F., Borst, G.J. de, Karthaus, E.G., Vahl, A., Kuhrij, L.S., Elsman, B.H.P., Geelkerken, R.H., Wouters, M., Warle, M.C., Hamming, J.F., and Borst, G.J. de

Abstract

Item does not contain fulltext, BACKGROUND: The Dutch Audit for Carotid Interventions (DACI) registers all patients undergoing interventions for carotid artery stenosis in the Netherlands. This study describes the design of the DACI and results of patients with a symptomatic stenosis undergoing carotid endarterectomy (CEA). It aimed to evaluate variation between hospitals in process of care and (adjusted) outcomes, as well as predictors of major stroke/death after CEA. METHODS: All patients with a symptomatic stenosis, who underwent CEA and were registered in the DACI between 2014 and 2016 were included in this cohort. Descriptive analyses of patient characteristics, process of care, and outcomes were performed. Casemix adjusted hospital procedural outcomes as (30 day/in hospital) mortality, stroke/death, and major stroke/death, were compared with the national mean. A multivariable logistic regression model (backward elimination at p > 0.10) was used to identify predictors of major stroke/death. RESULTS: A total of 6459 patients, registered by 52 hospitals, were included. The majority (4,832, 75%) were treated <2 weeks after their first hospital consultation, varying from 40% to 93% between hospitals. Mortality, stroke/death, and major stroke/death were, respectively, 1.1%, 3.6%, and 1.8%. Adjusted major stroke/death rates for hospital comparison varied between 0 and 6.5%. Nine hospitals performed significantly better, none performed significantly worse. Predictors of major stroke/death were sex, age, pulmonary disease, presenting neurological symptoms, and peri-operative shunt. CONCLUSION: CEA in The Netherlands is associated with an overall low mortality and (major) stroke/death rate. Whereas the indicator time to intervention varied between hospitals, mortality and (major) stroke/death were not significantly distinctive enough to identify worse practices and therefore were unsuitable for hospital comparison in the Dutch setting. Additionally, predictors of major stroke/death at population level

Published
2018

23. Benchmarking recent national practice in rectal cancer treatment with landmark randomized controlled trials

Author

Borstlap, W.A., Deijen, C.L., Dulk, M. den, Bonjer, H.J., Velde, C.J. van de, Bemelman, W.A., Tanis, P.J., Aalbers, A., Acherman, Y., Algie, G.D., Geu-sau, B. von, Amelung, F., Aukema, T.S., Bakker, I.S., Bartels, S.A., Basha, S., Bastiaansen, A.J., Belgers, E.H.J., Bleeker, W., Blok, J., Bosker, R.J.I., Bosmans, J.W., Boute, M.C., Bouvy, N.D., Bouwman, H., Brandt-Kerkhof, A., Brinkman, D.J., Bruin, S., Bruns, E.R.J., Burbach, J.P.M., Burger, J.W., Buskens, C.J., Clermonts, S., Coene, P.P.L.O., Compaan, C., Consten, E.C., Darbyshire, T., Mik, S.M.L. de, Graaf, E.J. de, Groot, I de, Cappel de Vos Tot Nederveen, R.J.L., Wilt, J.H.W. de, Wolde, J. van der, Boer, F.C. den, Dekker, J.W.T., Demirkiran, A., Derkx-Hendriksen, M., Dijkstra, F.R., Duijvendijk, P. van, Dunker, M.S., Eijsbouts, Q.E., Fabry, H., Ferenschild, F.T.J., Foppen, J.W., Furnee, E.J.B., Gerhards, M.F., Gerven, P, Gooszen, J.A.H., Govaert, J.A., Grevenstein, W.M. van, Haen, R., Harlaar, J.J., Harst, E, Havenga, K., Heemskerk, J., Heeren, J.F., Heijnen, B., Heres, P., Hoff, C., Hogendoorn, W., Hoogland, P., Huijbers, A, Janssen, P., Jongen, A.C., Jonker, F.H., Karthaus, E.G., Keijzer, A, Ketel, J.M.A., Klaase, J., Kloppenberg, F.W.H., Kool, M.E., Kortekaas, R., Kruyt, P.M., Kuiper, J.T., Lamme, B., Lange, J.F., Lettinga, T., Lips, D.J., Logeman, F., Holzik, M.F., Madsen, E., Mamound, A., Marres, C.C., Masselink, I., Meerdink, M., Menon, A.G., Mieog, J.S., Mierlo, D. van, Musters, G.D., Neijenhuis, P.A., Nonner, J., Oostdijk, M, Oosterling, S.J., Paul, P.M.P., Peeters, K.C., Pereboom, I.T.A., Polat, F., Poortman, P., Raber, M., Reiber, B.M.M., Renger, R.J., Rossem, C.C. van, Rutten, H.J., Rutten, A., Schaapman, R., Scheer, M.G.W., Schoonderwoerd, L., Schouten, N., Schreuder, A.M., Schreurs, W.H., Simkens, G.A., Slooter, G.D., Sluijmer, H.C.E., Smakman, N., Smeenk, R., Snijders, H.S., Sonneveld, D.J.A., Spaansen, B., Spillenaar Bilgen, E.J., Steller, E., Steup, W.H., Steur, C., Stortelder, E., Straatman, J., Swank, H.A., Sietses, C., Berge, H.A. ten, Hoeve, H.G. ten, Riele, W.W. ter, Thorensen, I.M., Tip-Pluijm, B., Toorenvliet, B.R., Tseng, L., Tuynman, J.B., Bastelaar, J. van, Beek, S.V. van, Ven, A.W.H. van de, Weijer, M.A.J. van de, Berg, C. van den, Bosch, I. van den, Bilt, J.D.W. van der, Hagen, S.J. van der, Hul, R. van der, Schelling, G.P. van der, Spek, A van der, Wielen, N. van der, Duyn, E. van, Eekelen, C. van, Essen, J.A. van, Gangelt, K. van, Geloven, A.A. van, Kessel, C. Van, Loon, Y.T. van, Rijswijk, A. van, Rooijen, S.J. van, Sprundel, T. van, Steensel, L. van, Tets, W.F van, Westreenen, H.L. van, Veltkamp, S., Verhaak, T., Verheijen, P.M., Versluis-Ossenwaarde, L., Vijfhuize, S., Vles, W.J., Voeten, S., Vogelaar, F.J., Vrijland, W.W., Westerduin, E., Westerterp, M., Wetzel, M., Wevers, K., Wiering, B., Witjes, A.C., Wouters, M.W., Yauw, S.T.K., Zeestraten, E.C., Zimmerman, D., Zwieten, T., Groningen Institute for Organ Transplantation (GIOT), Value, Affordability and Sustainability (VALUE), ​Robotics and image-guided minimally-invasive surgery (ROBOTICS), Surgery, CCA - Cancer Treatment and quality of life, APH - Quality of Care, APH - Global Health, Anatomy and neurosciences, VU University medical center, AGEM - Re-generation and cancer of the digestive system, AGEM - Digestive immunity, Neurology, Internal medicine, ACS - Microcirculation, MUMC+: MA Heelkunde (9), RS: MHeNs - R2 - Mental Health, Psychiatrie & Neuropsychologie, Promovendi MHN, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: NUTRIM - R1 - Metabolic Syndrome, RS: NUTRIM - R2 - Liver and digestive health, Revalidatie, RS: CARIM - R1.03 - Cell biochemistry of thrombosis and haemostasis, Biochemie, Promovendi CD, Ondersteunend personeel NTM, Promovendi NTM, Promovendi PHPC, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA AIOS Heelkunde (9), Promovendi ODB, MUMC+: MA AIOS Anesthesiologie (9), Pathologie, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA - Cancer Treatment and Quality of Life, Graduate School, and Other departments

Subjects
Male, Transanal Endoscopic Microsurgery, Colorectal cancer, medicine.medical_treatment, NETHERLANDS, law.invention, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, ADJUVANT CHEMOTHERAPY, Randomized controlled trial, law, Interquartile range, Prospective Studies, Registries, Rectal cancer, Intersectoral Collaboration, Randomized Controlled Trials as Topic, Aged, 80 and over, Medical Audit, Gastroenterology, Margins of Excision, Chemoradiotherapy, Benchmarking, Middle Aged, Total mesorectal excision, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], Treatment Outcome, snapshot study, 030220 oncology & carcinogenesis, OPEN SURGERY, Cohort, Female, 030211 gastroenterology & hepatology, RADIOTHERAPY, medicine.medical_specialty, Disease-Free Survival, 03 medical and health sciences, ANTERIOR RESECTION, medicine, Humans, Aged, Retrospective Studies, oncologic outcomes, Rectal Neoplasms, business.industry, General surgery, TOTAL MESORECTAL EXCISION, medicine.disease, Surgery, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Radiation therapy, Cross-Sectional Studies, Circumferential resection margin, Neoplasm Recurrence, Local, business
Abstract

Aim A Snapshot study design eliminates changes in treatment and outcome over time. This population based Snapshot study aimed to determine current practice and outcome of rectal cancer treatment with published landmark randomized controlled trials as a benchmark.Method In this collaborative research project, the dataset of the Dutch Surgical Colorectal Audit was extended with additional treatment and long-term outcome data. All registered patients who underwent resection for rectal cancer in 2011 were eligible. Baseline characteristics and outcome were evaluated against the results of the Dutch TME trial and the COLOR II trial from which the original datasets were obtained.Results A total of 71 hospitals participated, and data were completed for 2102 out of the potential 2633 patients (79.8%). Median follow-up was 41 (interquartile range 25-47) months. Overall circumferential resection margin (CRM) involvement was 9.3% in the Snapshot cohort and 18.5% in the Dutch TME trial. CRM positivity after laparoscopic resection was 7.8% in the Snapshot and 9.5% in the COLOR II trial. Three-year overall local recurrence rate in the Snapshot was 5.9%, with a disease-free survival of 67.1% and overall survival of 79.5%. Benchmarking with the randomized controlled trials revealed an overall favourable long-term outcome of the Snapshot cohort.Conclusion This study showed that current rectal cancer care in a large unselected Dutch population is of high quality, with less positive CRM since the TME trial and oncologically safe implementation of minimally invasive surgery after the COLOR II trial.

Published
2017

24. Benchmarking recent national practice in rectal cancer treatment with landmark randomized controlled trials

Author

Borstlap, W.A.A., Deijen, C.L., Dulk, M. den, Bonjer, H.J., Velde, C.J. van de, Bemelman, W.A., Tanis, P.J., Aalbers, A., Acherman, Y., Algie, G.D., Geu-sau, B.A. von, Amelung, F., Aukema, T.S., Bakker, I.S., Bartels, S.A., Basha, S., Bastiaansen, A.J.N.M., Belgers, E., Bleeker, W., Blok, J., Bosker, R.J.I., Bosmans, J.W., Boute, M.C., Bouvy, N.D., Bouwman, H., Brandt-Kerkhof, A., Brinkman, D.J., Bruin, S., Bruns, E.R.J., Burbach, J.P.M., Burger, J.W.A., Buskens, C.J., Clermonts, S., Coene, P.P.L.O., Compaan, C., Consten, E.C.J., Darbyshire, T., Mik, S.M.L. de, Graaf, E.J.R. de, Groot, I. de, Cappel, R.J.L.D.T.N., Wilt, J.H.W. de, Wolde, J. van der, Boer, F.C. den, Dekker, J.W.T., Demirkiran, A., Derkx-Hendriksen, M., Dijkstra, F.R., Duijvendijk, P. van, Dunker, M.S., Eijsbouts, Q.E., Fabry, H., Ferenschild, F., Foppen, J.W., Furnee, E.J.B., Gerhards, M.F., Gerven, P., Gooszen, J.A.H., Govaert, J.A., Grevenstein, W.M.U. van, Haen, R., Harlaar, J.J., Harst, E., Havenga, K., Heemskerk, J., Heeren, J.F., Heijnen, B., Heres, P., Hoff, C., Hogendoorn, W., Hoogland, P., Huijbers, A., Janssen, P., Jongen, A.C., Jonker, F.H., Karthaus, E.G., Keijzer, A., Ketel, J.M.A., Klaase, J., Kloppenberg, F.W.H., Kool, M.E., Kortekaas, R., Kruyt, P.M., Kuiper, J.T., Lamme, B., Lange, J.F., Lettinga, T., Lips, D.J., Logeman, F., Holzik, M.F.L., Madsen, E., Mamound, A., Marres, C.C., Masselink, I., Meerdink, M., Menon, A.G., Mieog, J.S., Mierlo, D., Musters, G.D., Neijenhuis, P.A., Nonner, J., Oostdijk, M., Oosterling, S.J., Paul, P.M.P., Peeters, K.C.M.J.C., Pereboom, I.T.A., Polat, F., Poortman, P., Raber, M., Reiber, B.M.M., Renger, R.J., Rossem, C.C. van, Rutten, H.J., Rutten, A., Schaapman, R., Scheer, M., Schoonderwoerd, L., Schouten, N., Schreuder, A.M., Schreurs, W.H., Simkens, G.A., Slooter, G.D., Sluijmer, H.C.E., Smakman, N., Smeenk, R., Snijders, H.S., Sonneveld, D.J.A., Spaansen, B., Bilgen, E.J.S., Steller, E., Steup, W.H., Steur, C., Stortelder, E., Straatman, J., Swank, H.A., Sietses, C., Berge, H.A. ten, Hoeve, H.G. ten, Riele, W.W. ter, Thorensen, I.M., Tip-Pluijm, B., Toorenvliet, B.R., Tseng, L., Tuynman, J.B., Bastelaar, J. van, Beek, S.V. van, Ven, A.W.H. van de, Weijer, M.A.J. van de, Berg, C. van den, Bosch, I. van den, Bilt, J.D.W. van der, Hagen, S.J. van der, Hul, R. van der, Schelling, G. van der, Spek, A. van der, Wielen, N. van der, Duyn, E. van, Eekelen, C. van, Essen, J.A. van, Gangelt, K. van, Geloven, A.A.W. van, Kessel, C. van, Loon, Y.T. van, Rijswijk, A. van, Rooijen, S.J. van, Sprundel, T. van, Steensel, L. van, Tets, W.F. van, Westreenen, H.L. van, Veltkamp, S., Verhaak, T., Verheijen, P.M., Versluis-Ossenwaarde, L., Vijfhuize, S., Vles, W.J., Voeten, S., Vogelaar, F.J., Vrijland, W.W., Westerduin, E., Westerterp, M.E., Wetzel, M., Wevers, K., Wiering, B., Witjes, A.C., Wouters, M.W., Yauw, S.T.K., Zeestraten, E.C., Zimmerman, D.D., Zwieten, T., and Dutch Snapshot Res Grp

Subjects
oncologic outcomes, snapshot study, Rectal cancer
Abstract

Aim A Snapshot study design eliminates changes in treatment and outcome over time. This population based Snapshot study aimed to determine current practice and outcome of rectal cancer treatment with published landmark randomized controlled trials as a benchmark.Method In this collaborative research project, the dataset of the Dutch Surgical Colorectal Audit was extended with additional treatment and long-term outcome data. All registered patients who underwent resection for rectal cancer in 2011 were eligible. Baseline characteristics and outcome were evaluated against the results of the Dutch TME trial and the COLOR II trial from which the original datasets were obtained.Results A total of 71 hospitals participated, and data were completed for 2102 out of the potential 2633 patients (79.8%). Median follow-up was 41 (interquartile range 25-47) months. Overall circumferential resection margin (CRM) involvement was 9.3% in the Snapshot cohort and 18.5% in the Dutch TME trial. CRM positivity after laparoscopic resection was 7.8% in the Snapshot and 9.5% in the COLOR II trial. Three-year overall local recurrence rate in the Snapshot was 5.9%, with a disease-free survival of 67.1% and overall survival of 79.5%. Benchmarking with the randomized controlled trials revealed an overall favourable long-term outcome of the Snapshot cohort.Conclusion This study showed that current rectal cancer care in a large unselected Dutch population is of high quality, with less positive CRM since the TME trial and oncologically safe implementation of minimally invasive surgery after the COLOR II trial.

Published
2017

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