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6. Perioperative Systemic Therapy Versus Cytoreductive Surgery and HIPEC Alone for Resectable Colorectal Peritoneal Metastases: Patient-Reported Outcomes of a Randomized Phase II Trial

Author

Bakkers, C., Rovers, K. P., Rijken, A., Simkens, G. A. A. M., Bonhof, C. S., Nienhuijs, S. W., Burger, J. W. A., Creemers, G. J. M., Brandt-Kerkhof, A. R. M., Tuynman, J. B., Aalbers, A. G. J., Wiezer, M. J., de Reuver, P. R., van Grevenstein, W. M. U., Hemmer, P. H. J., Punt, C. J. A., Tanis, P. J., Mols, F., and de Hingh, I. H. J. T.

Published
2023
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12. The Impact of Longer Biliopancreatic Limb Length on Weight Loss and Comorbidity Improvement at 5 Years After Primary Roux-en-Y Gastric Bypass Surgery: A Population-Based Matched Cohort Study.

Author

Bruinsma, Floris F. E., Nienhuijs, Simon W., Liem, Ronald S. L., Greve, Jan Willem M., Marang-van de Mheen, Perla J., van Acker, G. J. D., Apers, J., de Brauw, L. M., de Castro, S. M. M., Damen, S. L., Faneyte, I. F., van' t Hof, G., Jonker, F. H. W., Klaassen, R. A., Lagae, E. A. G. L., Langenhoff, B. S., Liem, R. S. L., Luijten, A. A. P. M., Nienhuijs, S. W., and Smeenk, R. M.

Subjects
PROPENSITY score matching, WEIGHT loss, GASTRIC bypass, ODDS ratio, LOGISTIC regression analysis, CONFIDENCE intervals
Abstract

Introduction: Different limb lengths are used in Roux-en-Y gastric bypass (RYGB) surgery, as there is no consensus which limb length strategy has the best outcomes. The biliopancreatic limb (BPL) is thought to play an important role in achieving weight loss and associated comorbidity resolution. The objective of this study was to assess the impact of a longer BPL on weight loss and comorbidity improvement at 5 years after primary RYGB. Methods: All patients aged ≥ 18 years undergoing primary RYGB between 2014–2017 with registered follow-up 5 years after surgery were included. Long BPL was defined as BPL ≥ 100 cm and short BPL as BPL < 100 cm. The primary outcome was achieving at least 25% total weight loss (TWL) at 5 years. Secondary outcomes included absolute %TWL and improvement of comorbidities. A propensity score matched logistic and linear regression was used to estimate the difference in outcomes between patients with long and short BPL. Results: At 5 years, long BPL had higher odds to achieve ≥ 25% TWL (odds ratio (OR) 1.19, 95% confidence interval (CI) [1.01 – 1.41]) and was associated with 1.26% higher absolute TWL (β = 1.26, 95% CI [0.53 – 1.99]). Furthermore, long BPL was more likely to result in improved diabetes mellitus (OR = 2.17, 95% CI [1.31 – 3.60]) and hypertension (OR = 1.45, 95% CI [1.06 – 1.99]). Conclusion: Patients undergoing RYGB with longer BPL achieved higher weight loss and were more likely to achieve improvement of comorbidities at 5 years. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Optimizing Hospital Performance Evaluation in Total Weight Loss Outcomes After Bariatric Surgery: A Retrospective Analysis to Guide Further Improvement in Dutch Hospitals.

Author

Bruinsma, Floris F. E., Liem, Ronald S. L., Nienhuijs, Simon W., Greve, Jan Willem M., de Mheen, Perla J. Marang-van, van Acker, G. J. D., Apers, J., Bruin, S. C., de Castro, S. M. M., Damen, S. L., Faneyte, I. F., Greve, J. W. M., van 't Hof, G., Jonker, F. H. W., Klaassen, R. A., Lagae, E. A. G. L., Langenhoff, B. S., Liem, R. S. L., Luijten, A. A. P. M., and Nienhuijs, S. W.

Abstract

Introduction: Bariatric surgery aims for optimal patient outcomes, often evaluated through the percentage total weight loss (%TWL). Quality registries employ funnel plots for outcome comparisons between hospitals. However, funnel plots are traditionally used for dichotomous outcomes, requiring %TWL to be dichotomized, potentially limiting feedback quality. This study evaluates whether a funnel plot around the median %TWL has better discriminatory performance than binary funnel plots for achieving at least 20% and 25% TWL. Methods: All hospitals performing bariatric surgery were included from the Dutch Audit for Treatment of Obesity. A funnel plot around the median was constructed using 5-year %TWL data. Hospitals positioned above the 95% control limit were colored green and those below red. The same hospitals were plotted in the binary funnel plots for 20% and 25% TWL and colored according to their performance in the funnel plot around the median. We explored the hospital's procedural mix in relation to %TWL performance as possible explanatory factors. Results: The median-based funnel plot identified four underperforming and four outperforming hospitals, while only one underperforming and no outperforming hospitals were found with the binary funnel plot for 20% TWL. The 25% TWL binary funnel plot identified two underperforming and three outperforming hospitals. The proportion of sleeve gastrectomies performed per hospital may explain part of these results as it was negatively associated with median %TWL (β = − 0.09, 95% confidence interval [− 0.13 to − 0.04]). Conclusion: The funnel plot around the median discriminated better between hospitals with significantly worse and better performance than funnel plots for dichotomized %TWL outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Perioperative Systemic Therapy Versus Cytoreductive Surgery and HIPEC Alone for Resectable Colorectal Peritoneal Metastases:Patient-Reported Outcomes of a Randomized Phase II Trial

Author

Bakkers, C., Rovers, K. P., Rijken, A., Simkens, G. A.A.M., Bonhof, C. S., Nienhuijs, S. W., Burger, J. W.A., Creemers, G. J.M., Brandt-Kerkhof, A. R.M., Tuynman, J. B., Aalbers, A. G.J., Wiezer, M. J., de Reuver, P. R., van Grevenstein, W. M.U., Hemmer, P. H.J., Punt, C. J.A., Tanis, P. J., Mols, F., de Hingh, I. H.J.T., Bakkers, C., Rovers, K. P., Rijken, A., Simkens, G. A.A.M., Bonhof, C. S., Nienhuijs, S. W., Burger, J. W.A., Creemers, G. J.M., Brandt-Kerkhof, A. R.M., Tuynman, J. B., Aalbers, A. G.J., Wiezer, M. J., de Reuver, P. R., van Grevenstein, W. M.U., Hemmer, P. H.J., Punt, C. J.A., Tanis, P. J., Mols, F., and de Hingh, I. H.J.T.

Abstract

Background: As part of a randomized phase II trial in patients with isolated resectable colorectal peritoneal metastases (CPMs), the present study compared patient-reported outcomes (PROs) of patients treated with perioperative systemic therapy versus cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS–HIPEC) alone. Also, PROs of patients receiving perioperative systemic therapy were explored. Patients and Methods: Eligible patients were randomized to perioperative systemic therapy (experimental) or CRS–HIPEC alone (control). PROs were assessed using EORTC QLQ-C30, QLQ-CR29, and EQ-5D-5L questionnaires at baseline, after neoadjuvant treatment (experimental), and at 3 and 6 months postoperatively. Linear mixed modeling was used to compare five predefined PROs (visual analog scale, global health status, physical functioning, fatigue, C30 summary score) between arms and to longitudinally analyze PROs in the experimental arm. Results: Of 79 analyzed patients, 37 (47%) received perioperative systemic therapy. All predefined PROs were comparable between arms at all timepoints and returned to baseline at 3 or 6 months postoperatively. The experimental arm had worsening of fatigue [mean difference (MD) + 14, p = 0.001], loss of appetite (MD + 15, p = 0.003), hair loss (MD + 18, p < 0.001), and loss of taste (MD + 27, p < 0.001) after neoadjuvant treatment. Except for loss of appetite, these PROs returned to baseline at 3 or 6 months postoperatively. Conclusions: In patients with resectable CPM randomized to perioperative systemic therapy or CRS–HIPEC alone, PROs were comparable between arms and returned to baseline postoperatively. Together with the trial’s previously reported feasibility and safety data, these findings show acceptable tolerability of perioperative systemic therapy in this setting.

Published
2023

21. Laparoscopic peritoneal lavage or sigmoidectomy for perforated diverticulitis with purulent peritonitis: a multicentre, parallel-group, randomised, open-label trial

Author

Hop, W C, Opmeer, B C, Reitsma, J B, Scholte, R A, Waltmann, E W H, Legemate, D A, Bartelsman, J F, Meijer, D W, de Brouwer, M, van Dalen, J, Durbridge, M, Geerdink, M, Ilbrink, G J, Mehmedovic, S, Middelhoek, P, Di Saverio, Salomone, Boom, M J, Consten, E C J, van der Bilt, J D W, van Olden, G D J, Stam, M A W, Verweij, M S, Busch, O R C, Buskens, C J, El-Massoudi, Y, Kluit, A B, van Rossem, C C, Schijven, M P, Tanis, P J, Unlu, C, Gerhards, M F, Karsten, T M, de Nes, L C, Rijna, H, van Wagensveld, B A, Koffeman, G I, Steller, E P, Tuynman, J B, Bruin, S C, van der Peet, D L, Blanken-Peeters, C F J M, Cense, H A, Jutte, E, Crolla, R M P H, van der Schelling, G P, van Zeeland, M, de Graaf, E J R, Groenendijk, R P R, Vermaas, M, Schouten, O, de Vries, M R, Prins, H A, Lips, D J, Bosker, R J I, van der Hoeven, J A B, Diks, J, Plaisier, P W, Kruyt, P M, Sietses, C, Stommel, M W J, Nienhuijs, S W, de Hingh, I H J T, Luyer, M D P, van Montfort, G, Ponten, E H, Smulders, J F, van Duyn, E B, Klaase, J M, Swank, D J, Ottow, R T, Stockmann, H B A C, Vermeulen, J, Vuylsteke, R J C L M, Belgers, H J, Fransen, S, von Meijenfeldt, E M, Sosef, M N, van Geloven, A A W, Hendriks, E R, ter Horst, B, Leeuwenburgh, M M N, van Ruler, O, Vogten, J M, Vriens, E J C, Westerterp, M, Eijsbouts, Q A J, Bentohami, A, Bijlsma, T S, de Korte, N, Nio, D, Govaert, M J P M, Joosten, J J A, Tollenaar, R A E M, Stassen, L P S, Wiezer, M J, Hazebroek, E J, Smits, A B, van Westreenen, H L, Lange, J F, Brandt, A, Nijboer, W N, Toorenvliet, B R, Weidema, W F, Coene, P P L O, Mannaerts, G H H, den Hartog, D, de Vos, R J, Zengerink, J F, Hoofwijk, A G M, Hulsewé, K W E, Melenhorst, J, Stoot, J H M B, Steup, W H, Huijstee, P J, Merkus, J W S, Wever, J J, Maring, J K, Heisterkamp, J, van Grevenstein, W M U, Vriens, M R, Besselink, M G H, Borel Rinkes, I H M, Witkamp, A J, Slooter, G D, Konsten, J L M, Engel, A F, Pierik, E G J M, Frakking, T G, van Geldere, D, Patijn, G A, D'Hoore, A J L, de Buck van Overstraeten, A, Miserez, M, Terrasson, I, Wolthuis, A, De Blasiis, M G, Vennix, Sandra, Musters, Gijsbert D, Mulder, Irene M, Swank, Hilko A, Consten, Esther C, Belgers, Eric H, van Geloven, Anna A, Gerhards, Michael F, Govaert, Marc J, van Grevenstein, Wilhelmina M, Hoofwijk, Anton G, Kruyt, Philip M, Nienhuijs, Simon W, Boermeester, Marja A, Vermeulen, Jefrey, van Dieren, Susan, Lange, Johan F, and Bemelman, Willem A

Published
2015
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22. Quality of life and bariatric surgery: a systematic review of short- and long-term results and comparison with community norms

Author

Raaijmakers, L C H, Pouwels, S, Thomassen, S E M, and Nienhuijs, S W

Subjects
Obesity -- Surgery, Quality of life -- Health aspects, Food/cooking/nutrition, Health
Abstract

Currently the effects of bariatric surgery are generally expressed in excess weight loss or comorbidity reduction. Therefore the aim of this review was to provide insight in the available prospective evidence regarding the short and long-term effects of bariatric surgery on Quality of Life (QoL) and a comparison with community norms. A systematic multi-database search was conducted for 'QoL' and 'Bariatric surgery'. Only prospective studies with QoL before and after bariatric surgery were included. The 'Quality Assessment Tool for Before-After Studies with No Control Group' was used to assess the methodological quality. Thirty-six studies met the inclusion criteria. Most studies were assessed to be of 'fair' to 'good' methodological quality. Ten different questionnaires were used to measure QoL. Follow-up ranged from 6 months to 10 years, sample sizes from 26 to 1276 and follow-up rates from 45 to 100%. A significant increase in QoL after bariatric surgery was found in all studies (P[[less-than or slanted equal to]0.05), however, mostly these outcomes stay below community norms. Only outcomes of the IWQoL, SF-36 and OWQoL show QoL outcomes that exceed community norms. The QoL is increased after bariatric surgery on both the short and long term. However, due to the heterogeneity of the studies and the generality of the questionnaires is it hard to make a distinction between different surgeries and difficult to see a relation with medical profit. Therefore, tailoring QoL measurements to the bariatric population is recommended as the focus of future studies., Author(s): L C H Raaijmakers [sup.1] , S Pouwels [sup.1] , S E M Thomassen [sup.1] , S W Nienhuijs [sup.1] Author Affiliations: (1) Department of Surgery, Catharina Hospital, Eindhoven, [...]

Published
2017
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32. Hiatal Hernia

Author

Castelijns, B., Ponten, J. E. H., Van de Poll, M. C. G., Nienhuijs, S. W., Smulders, J. F., Hu, Z. W., Wu, J. M., Wang, Z. G., Idani, H., Asami, S., Nakano, K., Miyake, S., Harano, M., Miyoshi, H., Araki, H., Ogawa, T., Takahashi, K., Shiozaki, S., Ninomiya, M., Prasad, A., Todkar, J., Asti, E., Lovece, A., Sironi, A., Bonavina, L., Wright, R., Wurst, H., Zhang, C., Li, H. L., Ke, L. M., Loi, K., Hua, R., Yao, Q. Y., Chen, H., Okinyi, W., Odende, K., Ndungu, B., Ndonga, A., Kiragu, P., Kelimu, A., Alimujiang, M., Tian, W., and Bing, M.

Published
2015
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39. Treatment Strategies and Prognosis of Patients With Synchronous or Metachronous Colorectal Peritoneal Metastases:A Population-Based Study

Author

Bakkers, C., Lurvink, R. J., Rijken, A., Nienhuijs, S. W., Kok, N. F., Creemers, G. J., Verhoef, C., Lemmens, V. E., van Erning, F. N., De Hingh, I. H., Bakkers, C., Lurvink, R. J., Rijken, A., Nienhuijs, S. W., Kok, N. F., Creemers, G. J., Verhoef, C., Lemmens, V. E., van Erning, F. N., and De Hingh, I. H.

Abstract

Background: This study aimed to compare treatment strategies and survival of patients with synchronous colorectal peritoneal metastases (CPM) and patients with metachronous CPM in a nationwide cohort. Methods: All patients from the Netherlands Cancer Registry with synchronous or metachronous CPM whose primary colorectal cancer (CRC) was diagnosed between 1 January and 30 June 2015 were included in the study. Treatments were categorized as (A) cytoreductive surgery and hyperthermic intraperitoneal chemotherapy [CRS-HIPEC]; (B) palliative treatment; or (C) best supportive care. Overall survival (OS) for all the patients and disease-free survival (DFS) for those who underwent CRS-HIPEC were compared between the two groups. Results: Of 7233 patients, 743 had a diagnosis of CPM, including 409 patients with synchronous CPM and 334 patients with metachronous CPM. The median OS was 8.1 months for the patients with synchronous CPM versus 12 months for the patients with metachronous CPM (p = 0.003). After multivariable correction, OS no longer differed between the patients with synchronous CPM and those with metachronous CPM (HR 1.03 [0.83–1.27]). The patients with metachronous CPM more often underwent CRS-HIPEC than the patients with synchronous CPM (16 % vs 8 %; p = 0.001). The two groups did not differ statistically in terms of DFS and OS (median DFS, 21.5 vs 14.1 months, respectively; p = 0.094; median OS, 37.8 vs. 35.8 months, respectively; p = 0.553). Conclusion: This population-based study showed that survival for the patients with synchronous CPM and patients with metachronous CPM did not significantly differ. This suggests that a similar prognosis may be expected for patients selected for treatment regardless of the onset of CPM.

Published
2021

48. Long-term survival after hyperthermic intraperitoneal chemotherapy using mitomycin C or oxaliplatin in colorectal cancer patients with synchronous peritoneal metastases: A nationwide comparative study

Author

MS CGO, Cancer, Bakkers, C, van Erning, F N, Rovers, K P, Nienhuijs, S W, Burger, J W, Lemmens, V E, Aalbers, A G, Kok, N F, Boerma, D, Brandt, A R, Hemmer, P H, van Grevenstein, W M, de Reuver, P R, Tanis, P J, Tuynman, J B, de Hingh, I H, MS CGO, Cancer, Bakkers, C, van Erning, F N, Rovers, K P, Nienhuijs, S W, Burger, J W, Lemmens, V E, Aalbers, A G, Kok, N F, Boerma, D, Brandt, A R, Hemmer, P H, van Grevenstein, W M, de Reuver, P R, Tanis, P J, Tuynman, J B, and de Hingh, I H

Published
2020

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