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3. In-hospital Delay of Appendectomy in Acute, Complicated Appendicitis

Author

Bolmers, M. D. M., de Jonge, J., Bom, W. J., van Rossem, C. C., van Geloven, A. A. W., Bemelman, W. A., van Acker, G. J., Akkermans, B., Akkersdijk, G. J., Algie, G. D., Allema, J. H., Andeweg, C. S., Appeldoorn, N., van Baal, J. G., Bakker, C. M. den, Bartels, S. A., van den Berg, C., Boekestijn, B., Boer, F. C. den, Boerma, D., van den Boom, A. L., Boute, M. C., Bouwense, S. A., Bransen, J., van Brussel, F. A., Busch, O. R., de Castro, S. M., Cense, H. A., Croese, C., van dalen, T., Dawson, I., van Dessel, E., Dettmers, R., Dhar, N., Dohmen, F. Y., van Dongen, K. W., van Duijvendijk, P., Dulfer, R. R., Dwars, B. J., Eerenberg, J. P., van der Elst, M., van den Ende, E., Fassaert, L. M., Fikkers, J. T., Foppen, J. W., Furnee, E. J., Garssen, F. P., Gerhards, M. F., van Goor, H., de Graaf, J. S., Graat, L. J., Grootr, J., van der Ham, A. C., Hamming, J. F., Hamminga, J. T., van der Harst, E., Heemskerk, J., Heijne, A., Heikens, J. T., Heineman, E., Hertogs, R., van Heurn, E., van den Hil, L. C., Hooftwijk, A. G., Hulsker, C. C., Hunen, D. R., Ibelings, M. S., Klaase, J. M., Klicks, R., Knaapen, L., Kortekaas, R. T., Kruyt, F., Kwant, S., Lases, S. S., Lettinga, T., Loupatty, A., Matthijsen, R. A., Minnee, R. C., Mirck, B., Mitalas, L., Moes, D., Moorman, A. M., Nieuwenhuijs, V. B., Nieuwenhuizen, G. A., Nijk, P. D., Omloo, J. M., Ottenhof, A. G., Palamba, H. W., van der Peet, D. L., Pereboom, I. T., Plaisier, P. W., van der Ploeg, A. P., Raber, M. H., Reijen, M. M., Rijna, H., Rosman, C., Roumen, R. M., Scmitz, R. F., Schouten van der Velden, A. P., Scheurs, W. H., Sigterman, T. A., Smeets, H. J., Sonnevled, D. J., Sosef, M. N., Spoor, S. F., Stassen, L. P., van Steensel, L., Stortelder, E., Straatman, J., van Susante, H. J., Suykerbuyk de Hoog, D. E., Terwisscha van Scheltinga, C., Toorenvliet, B. R., Verbeek, P. C., Verseveld, M., Volders, J. H., Vriens, M. R., Vriens, P. W., Vrouenraets, B. C., van de wall, B. J., Wegdam, J. A., Westerduin, E., Wever, J. J., Wijfels, N. A., Wijnhoven, B. P., Winkel, T. A., van der Zee, D. C., Zeillemaker, A. M., Zietse, C., Amsterdam Reproduction & Development (AR&D), Pediatrics, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and quality of life, Other Research, Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Graduate School, AII - Infectious diseases, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Paediatric Surgery, and ARD - Amsterdam Reproduction and Development

Subjects
Delay in surgery, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], Gastroenterology, Surgery, Appendicitis, Complicated
Abstract

Item does not contain fulltext BACKGROUND: Present theory is that uncomplicated and complicated appendicitis are different entities. Recent studies suggest it is safe to delay surgery in patients with uncomplicated appendicitis. We hypothesize that patients with complicated appendicitis are at higher risk for postoperative complications when surgery is delayed. METHODS: Data was used from the multicenter, prospective SNAPSHOT appendicitis study of 1975 patients undergoing surgery for suspected appendicitis. Adult patients (≥ 18 years) who underwent appendectomy for appendicitis were included in this study. The primary outcome was the difference in postoperative complications between patients with complicated appendicitis who were operated within and after 8 h after hospital presentation. Secondary outcomes were the incidence of both uncomplicated and complicated appendicitis in relationship to delay of appendectomy. Follow-up was 30 days. A multivariable analysis was performed. RESULTS: Of 1341 adult patients with appendicitis, 34.3% had complicated appendicitis. In patients with complicated appendicitis, 22.8% developed a postoperative complication compared to 8.2% for uncomplicated appendicitis (P 8 h) increased the complication rate in patients with complicated appendicitis (28.1%) compared to surgery within 8 h (18.3%; P = 0.01). Multivariate analysis showed a delay in surgery as an independent predictor for a postoperative complication in patients with complicated appendicitis (OR 1.71; 95%CI 1.01-2.68, P = 0.02). CONCLUSION: In-hospital delay of surgery (> 8 h) in patients with complicated appendicitis is associated with a higher risk of a postoperative complication. It is important that we recognize and treat these patients early.

Published
2022
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4. Functional Outcomes after Surgery for Total Colonic, Long-Segment, Versus Rectosigmoid Segment Hirschsprung Disease

Author

Verkuijl, S. J., Meinds, R. J., Van Der Steeg, A. F. W., Van Gemert, W. G., De Blaauw, I., Witvliet, M. J., Sloots, C. E. J., Van Heurn, E., Vermeulen, K. M., Trzpis, M., Broens, P. M. A., Verkuijl, S. J., Meinds, R. J., Van Der Steeg, A. F. W., Van Gemert, W. G., De Blaauw, I., Witvliet, M. J., Sloots, C. E. J., Van Heurn, E., Vermeulen, K. M., Trzpis, M., and Broens, P. M. A.

Abstract

Objectives:Knowledge on long-term outcomes in patients with Hirschsprung disease is progressing. Nevertheless, differences in outcomes according to aganglionic lengths are unclear. We compared long-term bowel function and generic quality of life in Hirschsprung patients with total colonic or long-segment versus rectosigmoid aganglionosis.Methods:In this nationwide, cross-sectional study participants with proven Hirschsprung disease received the Defecation and Fecal Continence questionnaire, and the Child Health Questionnaire Child Form-87, or the WHO Quality of Life-100. We excluded deceased patients, patients who were younger than 8 years, lived abroad, had a permanent enterostomy, or were intellectually impaired.Results:The study population (n = 334) was operated for rectosigmoid (83.9%), long-segment (8.7%), or total colonic aganglionosis (7.5%). Fecal incontinence in general was not significantly different between the three groups, but liquid fecal incontinence was significantly associated with total colonic aganglionosis (odds ratio [OR] = 6.00, 95% confidence interval [CI] 2.07-17.38, P = 0.001). Regarding constipation, patients with total colonic or long-segment aganglionosis were less likely to suffer from constipation than the rectosigmoid group (OR = 0.21, 95% CI, 0.05-0.91, P = 0.038 and OR = 0.11, 95% CI, 0.01-0.83, P = 0.032). Quality of life was comparable between the three groups, except for a lower physical score in children with total colonic aganglionosis (P = 0.016).Conclusions:Over time Hirschsprung patients with total colonic or long-segment aganglionosis do not suffer from worse fecal incontinence in general. A difference in stool consistency may underlie the association between liquid fecal incontinence and total colonic aganglionosis and constipation in patients with rectosigmoid aganglionosis. Despite these differences, generic quality of life is comparable on reaching adulthood.

Published
2022

5. Familial Experience With Hirschsprung's Disease Improves the Patient's Ability to Cope

Author

Verkuijl, S. J., Meinds, R. J., van der Steeg, A. F. W., Sloots, C. E. J., van Heurn, E., de Blaauw, I., van Gemert, W. G., Witvliet, M. J., Vermeulen, K. M., Trzpis, M., Broens, P. M. A., Verkuijl, S. J., Meinds, R. J., van der Steeg, A. F. W., Sloots, C. E. J., van Heurn, E., de Blaauw, I., van Gemert, W. G., Witvliet, M. J., Vermeulen, K. M., Trzpis, M., and Broens, P. M. A.

Abstract

Introduction: Familial occurrence of Hirschsprung's disease may have a positive effect on patients' ability to cope with the disease. The aim was to compare long-term bowel function and generic quality of life between patients with familial and non-familial Hirschsprung's disease. Methods: This was a nationwide, cross-sectional study in which we included all 830 Hirschsprung patients of 8 years and older who had undergone surgery between 1957 and 2015. We excluded patients with a permanent stoma, intellectual disability, or an unknown or foreign address. We requested patients to complete the validated pediatric or adult Defecation and Fecal Continence questionnaire and the Child Health Questionnaire Child Form-87, or the World Health Organization Quality of Life-100 Assessment Instrument. Results: We analyzed 336 Hirschsprung patients, 15.8% of whom were familial cases and 84.2% were non-familial cases. After adjusting for aganglionic length, sex, and age, patients with familial Hirschsprung's disease were twice more likely to suffer from constipation (OR = 2.47, 95% CI, 1.21–5.05, p = 0.013). The quality of life of the pediatric patients was comparable, but in adult patients the energy/fatigue, thinking/learning/concentration, and work capacity facets showed better scores in the familial patients with Hirschsprung's disease of the rectosigmoid (p = 0.029, p = 0.024, p = 0.036, respectively). Conclusions: Different facets of generic quality of life are better in adult patients with familial Hirschsprung's disease of the rectosigmoid. It seems that familial experience with the disease influences patients' coping abilities positively.

Published
2022

7. Prospective nationwide outcome audit of surgery for suspected acute appendicitis

Author

van Rossem, C. C., Bolmers, M. D. M., Schreinemacher, M. H. F., van Geloven, A. A. W., Bemelman, W. A., van Acker, G. J. D., Akkermans, B., Akkersdijk, G. J. M., Algie, G. D., Allema, J. H., Andeweg, C. S., Appeldorn, N., van Baal, J. G., den Bakker, C. M., Bartels, S. A. L., van den Berg, C., Boekestijn, B., den Boer, F. C., Boerma, D., van den Boom, A. L., Boute, M. C., Bouwense, S. A. W., Bransen, J., van Brussel, F. A., Busch, O. R. C., de Castro, S. M. M., Cense, H. A., Croese, C., van Dalen, T., Dawson, I., van Dessel, E., Dettmers, R., Dhar, N., Dohmen, F. Y. M., van Dongen, K. W., van Duijvendijk, P., Dulfer, R. R., Dwars, B. J., Eerenberg, J. P., van der Elst, M., van den Ende, E., Fassaert, L. M. M., Fikkers, J. T., Foppen, J. W., Furnee, E. J. B., Garssen, F. P., Gerhards, M. F., van Goor, H., Gorter, R. R., de Graaf, J. S., Graat, L. J., Groote, J., van der Ham, A. C., Hamming, J. F., Hamminga, J. T. H., van der Harst, E., Heemskerk, J., Heij, H. A., Heijne, A., Heikens, J. T., Heineman, E., Hertogs, R., van Heurn, E., van den Hil, L. C. L., Hoofwijk, A. G. M., Hulsker, C. C. C., Hunen, D. R. M., Ibelings, M. S., Klaase, J. M., Klicks, R., Knaapen, L., Kortekaas, R. T. J., Kruyt, F., Kwant, S., Lases, S. S., Lettinga, T., Loupatty, A., Matthijsen, R. A., Minnee, R. C., Mirck, B., Mitalas, L., Moes, D., Moorman, A. M., Nieuwenhuijs, V. B., Nieuwenhuijzen, G. A. P., Nijk, P. D., Omloo, J. M. T., Ottenhof, A. G., Palamba, H. W., van der Peet, D. L., Pereboom, I. T. A., Plaisier, P. W., van der Ploeg, A. P. T., Raber, M. H., Reijnen, M. M. P. J., Rijna, H., Rosman, C., Roumen, R. M. H., Schmitz, R. F., van der Velden, Schouten A. P., Schreurs, W. H., Sigterman, T. A., Smeets, H. J., Sonneveld, D. J. A., Sosef, M. N., Spoor, S. F., Stassen, L. P. S., van Steensel, L., Stortelder, E., Straatman, J., van Susante, H. J., de Hoog, Suykerbuyk D. E. N. M., van Scheltinga, Terwisscha C., Toorenvliet, B. R., Verbeek, B. M., Verbeek, P. C. M., Verseveld, M., Volders, J. H., Vriens, M. R., Vriens, P. W. H. E., Vrouenraets, B. C., van de Wall, B. J. M., Wegdam, J. A., Westerduin, E., Wever, J. J., Wijffels, N. A. T., Wijnhoven, B. P. L., Winkel, T. A., van der Zee, D. C., Zeillemaker, A. M., and Zietse, C.

Published
2016
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8. Normal inflammatory markers and acute appendicitis: a national multicentre prospective cohort analysis

Author

de Jonge, J., Scheijmans, J. C. G., van Rossem, C. C., van Geloven, A. A. W., Boermeester, M. A., Bemelman, W. A., van Acker, G. J., Akkermans, B., Akkersdijk, G. J., Algie, G. D., Allema, J. H., Andeweg, C. S., Appeldoorn, N., van Baal, J. G., den Bakker, C. M., Bartels, S. A., van den Berg, C., Boekestijn, B., den Boer, F. C., Boerma, D., van den Boom, A. L., Boute, M. C., Bouwense, S. A., Bransen, J., van Brussel, F. A., Busch, O. R., de Castro, S. M., Cense, H. A., Croese, C., van Dalen, T., Dawson, I., van Dessel, E., Dettmers, R., Dhar, N., Dohmen, F. Y., van Dongen, K. W., van Duijvendijk, P., Dulfer, R. R., Dwars, B. J., Eerenberg, J. P., van der Elst, M., van den Ende, E., Fassaert, L. M., Groot, J., van Heurn, E., Lases, S. S., Mirck, B., van der Peet, D. L., Terwisscha van Scheltinga, C., Westerduin, E., Graduate School, Surgery, AII - Inflammatory diseases, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Paediatric Surgery, and ARD - Amsterdam Reproduction and Development

Subjects
Adult, medicine.medical_specialty, Inflammatory markers, Peritonitis, 030230 surgery, Gastroenterology, Sensitivity and Specificity, C-reactive protein, Cohort Studies, 03 medical and health sciences, Leukocyte Count, 0302 clinical medicine, Internal medicine, White blood cell, medicine, Humans, Prospective Studies, Prospective cohort study, Retrospective Studies, Complicated appendicitis, biology, business.industry, Incidence (epidemiology), Hepatology, medicine.disease, Appendicitis, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], medicine.anatomical_structure, 030220 oncology & carcinogenesis, Acute Disease, biology.protein, Original Article, business, Biomarkers, Cohort study
Abstract

Purpose For the diagnosis of acute appendicitis, the combination of clinical and laboratory variables achieves high diagnostic accuracy. Nevertheless, appendicitis can present with normal laboratory tests of inflammation. The aim of this study was to investigate the incidence of normal inflammatory markers in patients operated for acute appendicitis. Methods This is an analysis of data from a prospective, multicentre SNAPSHOT cohort study of patients with suspected acute appendicitis. Only patients with histopathologically proven acute appendicitis were included. Adult patients with acute appendicitis and normal preoperative inflammatory markers were explored further in terms of abdominal complaints, preoperative imaging results and intraoperative assessment of the degree of inflammation and compared to those with elevated inflammatory markers. Results Between June and July 2014, 1303 adult patients with histopathologically proven acute appendicitis were included. In only 23 of 1303 patients (1.8%) with proven appendicitis, both preoperative white blood cell count and C-reactive protein levels were normal. Migration of pain was reported less frequently in patients with normal inflammatory markers compared to those with elevated inflammatory marker levels (17.4% versus 43.0%, p = 0.01). Characteristics like fever, duration of symptoms and localized peritonitis were comparable. Only 4 patients with normal inflammatory markers (0.3% overall) had complicated appendicitis at histopathological evaluation. Conclusion Combined normal WBC and CRP levels are seen in about 2 per 100 patients with confirmed acute appendicitis and can, although rarely, be found in patients with complicated appendicitis.

Published
2021

10. Appendicular neoplasms and consequences in patients undergoing surgery for suspected acute appendicitis

Author

Bolmers, M. D. M., de Jonge, J., van Rossem, C. C., van Geloven, A. A. W., Bemelman, W. A., van Acker, G. J., Akkermans, B., Akkersdijk, G. J., Algie, G. D., Allema, J. H., Andeweg, C. S., Appeldoorn, N., van Baal, J. G., den Bakker, C. M., Bartels, S. A., van den Berg, C., Boekestijn, B., den Boer, F. C., Boerma, D., van den Boom, A. L., Boute, M. C., Bouwense, S. A., Bransen, J., van Brussel, F. A., Busch, O. R., de Castro, S. M., Cense, H. A., Croese, C., van Dalen, T., Dawson, I., van Dessel, E., Dettmers, R., Dhar, N., Dohmen, F. Y., van Dongen, K. W., van Duijvendijk, P., Dulfer, R. R., Dwars, B. J., Eerenberg, J. P., van der Elst, M., van den Ende, E., Fassaert, L. M., Fikkers, J. T., Foppen, J. W., van Heurn, E., Lases, S. S., Mirck, B., van der Peet, D. L., Terwisscha van Scheltinga, C., Westerduin, E., Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Paediatric Surgery, and Amsterdam Reproduction & Development (AR&D)

Subjects
medicine.medical_specialty, Neuroendocrine tumors, Appendix, Malignancy, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], Internal medicine, medicine, Appendectomy, Humans, Neoplasm, Prospective Studies, Acute appendicitis, business.industry, Incidence (epidemiology), Gastroenterology, Hepatology, Appendicitis, medicine.disease, musculoskeletal system, Surgery, Neuroendocrine Tumors, medicine.anatomical_structure, Acute Disease, embryonic structures, Laparoscopy, Original Article, business, Neuroendocrine tumors (NET), Cohort study
Abstract

Introduction In patients treated with an appendectomy for acute appendicitis, the specimen is generally sent for histological evaluation. In an era of increasing non-operative treatment for acute appendicitis, it is important to know the incidence, the diagnostic accuracy, and treatment consequences of appendicular neoplasms that are found in acute appendicitis. We hypothesize that pre- and intra-operative parameters might predict an appendicular neoplasm. Methods Data was used from our previous prospective observational cohort study. All patients undergoing surgery for suspected acute appendicitis were included. The primary outcome was the incidence of appendicular neoplasms in patients operated for acute appendicitis. Secondary outcomes were pre-operative diagnostics and imaging outcomes, intra-operative surgical judgment, and postoperative management and outcome. Possible predictors of an appendicular neoplasm were identified and used in multivariable logistic regression. Patients with an appendicular neoplasm were followed for 3 years after initial appendectomy. Results A total of 1975 patients underwent surgery for suspected acute appendicitis and in 98.3% (1941/1975) the appendix was removed. In 1.5% (30/1941) of these patients, an appendicular neoplasm was found. Among the malignant neoplasms, the majority were grade 1 neuroendocrine tumors (NET) in 65% (13/20). On pre-operative imaging, there was no suspicion of malignancy. In three cases, there was an intra-operative suspicion of malignancy. Multivariable analysis showed only age as an independent predictor for appendicular neoplasms. No recurrent or new malignancy was found during follow-up. Discussion The incidence of appendicular neoplasm in patients undergoing an acute appendectomy is very low and clinical risk factors could not be identified.

Published
2020
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17. Orgaandonatie na euthanasie

Author

van Smaalen, T. (Tim), Smaalen, A.H.-V. (Annelieke Hof-van), van Smaalen-Croes, M. (Monique), de Jongh, W., Bollen, J., van Heurn, E., Mook, W.N.K.A. (Walther) van, van Smaalen, T. (Tim), Smaalen, A.H.-V. (Annelieke Hof-van), van Smaalen-Croes, M. (Monique), de Jongh, W., Bollen, J., van Heurn, E., and Mook, W.N.K.A. (Walther) van

Published
2018
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19. OP12.09: Ultrasound markers predicting complex gastroschisis and adverse outcome: a longitudinal prospective nationwide cohort study

Author

Lap, C.C., primary, Hijkoop, A., additional, Pistorius, L., additional, Mulder, E.J., additional, Cohen-Overbeek, T.E., additional, Aliasi, M., additional, Kramer, W., additional, Bax, C., additional, van Baren, R., additional, Bilardo, C.M., additional, Brouwers, H., additional, Dijk, P., additional, Pajkrt, E., additional, van Kaam, A., additional, Sikkel, E., additional, van Heijst, A., additional, van der Hoeven, M., additional, van Heurn, E., additional, Sleeboom, C., additional, Tibboel, D., additional, Weissenbruch, M., additional, Wijnen, R., additional, Willekes, C., additional, Visser, G., additional, and Manten, G., additional

Published
2017
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23. Kidney preservation: from 'do no further harm' to 'opportunity to recover'

Author

van Heurn E, Surgery, and RS: NUTRIM - R1 - Metabolic Syndrome

Subjects
medicine.medical_specialty, medicine.medical_treatment, Nephrectomy, Extracorporeal Membrane Oxygenation, medicine, Extracorporeal membrane oxygenation, Immunology and Allergy, Humans, Warm Ischemia, Cold ischemia, Kidney transplantation, Transplantation, Kidney preservation, business.industry, Cold Ischemia, Graft Survival, Organ Preservation, medicine.disease, Warm ischemia, Kidney Transplantation, Tissue Donors, Surgery, Harm, Reperfusion Injury, business, Reperfusion injury
Published
2011

24. Machine perfusion versus cold storage for preservation of kidneys from expanded criteria donors after brain death

Author

Treckmann, J, Moers, C, Smits, J, Gallinat, A, Maathuis, M, van Kasterop-Kutz, M, Jochmans, I, Homan van der Heide, J, Squifflet, J, van Heurn, E, Kirste, G, Rahmel, A, Leuvenink, H, Pirenne, J, Ploeg, R, Paul, A, Surgery, RS: NUTRIM - R1 - Metabolic Syndrome, Groningen Institute for Organ Transplantation (GIOT), Amsterdam institute for Infection and Immunity, Nephrology, and Paediatric Surgery

Subjects
DELAYED GRAFT FUNCTION, kidney, RENAL-TRANSPLANTATION, organ preservation and procurement, Medizin, donation, outcome, SURVIVAL, PULSATILE PRESERVATION, ACUTE REJECTION, expanded donor pool, COSTS
Abstract

P>The purpose of this study was to analyze the possible effects of machine perfusion (MP) versus cold storage (CS) on delayed graft function (DGF) and early graft survival in expanded criteria donor kidneys (ECD). As part of the previously reported international randomized controlled trial 91 consecutive heart-beating deceased ECDs - defined according to the United Network of Organ Sharing definition - were included in the study. From each donor one kidney was randomized to MP and the contralateral kidney to CS. All recipients were followed for 1 year. The primary endpoint was DGF. Secondary endpoints included primary nonfunction and graft survival. DGF occurred in 27 patients in the CS group (29.7%) and in 20 patients in the MP group (22%). Using the logistic regression model MP significantly reduced the risk of DGF compared with CS (OR 0.460, P = 0.047). The incidence of nonfunction in the CS group (12%) was four times higher than in the MP group (3%) (P = 0.04). One-year graft survival was significantly higher in machine perfused kidneys compared with cold stored kidneys (92.3% vs. 80.2%, P = 0.02). In the present study, MP preservation clearly reduced the risk of DGF and improved 1-year graft survival and function in ECD kidneys. (Current Controlled Trials number: ISRCTN83876362).

Published
2011

25. The renal biopsy in non-heart-beating organ transplantation

Author

Snoeijs, M.G., Matthijsen, R.A., Christiaans, M.H., van Hooff, J.P., van Heurn, E., Buurman, W.A., van Suylen, R.J., Peutz-Kootstra, C.J., Talbot, David, D'Alessandro, Anthony M., Algemene Heelkunde, Interne Geneeskunde, Pathologie, RS: NUTRIM - R2 - Gut-liver homeostasis, and RS: NUTRIM - R1 - Metabolic Syndrome

Published
2009

30. Machine perfusion versus cold storage for the preservation of kidneys from donors >=65 years allocated in the Eurotransplant Senior Programme

Author

Gallinat, A., primary, Moers, C., additional, Treckmann, J., additional, Smits, J. M., additional, Leuvenink, H. G. D., additional, Lefering, R., additional, van Heurn, E., additional, Kirste, G. R., additional, Squifflet, J.-P., additional, Rahmel, A., additional, Pirenne, J., additional, Ploeg, R. J., additional, and Paul, A., additional

Published
2012
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32. MACHINE PERFUSION VERSUS COLD STORAGE PRESERVATION IN NON-HEART-BEATING KIDNEY DONATION AND TRANSPLANTATION: FIRST RESULTS OF A MULTICENTRE TRIAL IN EUROTRANSPLANT.

Author

Gelder, F Van, primary, Moers, C, additional, Smits, J M., additional, Maathuis, M H.J., additional, Treckmann, J, additional, Napieralski, B P., additional, van Kasterop-Kutz, M, additional, van der Heide, J J. Homan, additional, van Heurn, E, additional, Kirste, G R., additional, Rahmel, A, additional, Leuvenink, H G.D., additional, Paul, A, additional, Malaise, J, additional, Randon, C, additional, Ysebaert, D, additional, Squifflet, J P., additional, Ploeg, R J., additional, and Pirenne, J, additional

Published
2008
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37. 37th International Symposium on Intensive Care and Emergency Medicine (part 3 of 3)

Author

Von Seth, M., Hillered, L., Otterbeck, A., Hanslin, K., Larsson, A., Sjölin, J., Lipcsey, M., Cove, ME, Chew, N. S., Vu, L. H., Lim, R. Z., Puthucheary, Z., Wilske, F., Skorup, P., Tano, E., Derese, I., Thiessen, S., Derde, S., Dufour, T., Pauwels, L., Bekhuis, Y., Van den Berghe, G., Vanhorebeek, I., Khan, M., Dwivedi, D., Zhou, J., Prat, A., Seidah, N. G., Liaw, P. C., Fox-Robichaud, A. E., Correa, T., Pereira, J, Takala, J, Jakob, S, Maudsdotter, L., Castegren, M., Sjölin, J, Xue, M., Xu, J. Y., Liu, L., Huang, Y. Z., Guo, F. M., Yang, Y., Qiu, H. B., Kuzovlev, A., Moroz, V., Goloubev, A., Myazin, A., Chumachenko, A., Pisarev, V., Takeyama, N., Tsuda, M., Kanou, H., Aoki, R., Kajita, Y., Hashiba, M., Terashima, T., Tomino, A., Davies, R., O’Dea, K. P., Soni, S., Ward, J. K., O’Callaghan, D. J., Takata, M., Gordon, A. C., Wilson, J., Zhao, Y., Singer, M., Spencer, J., Shankar-Hari, M., Genga, K. Roveran, Lo, C., Cirstea, M. S., Walley, K. R., Russell, J. A., Linder, A., Boyd, J. H., Sedlag, A., Riedel, C., Georgieff, M., Barth, E., Bracht, H., Essig, A., Henne-Bruns, D., Gebhard, F., Orend, K., Halatsch, M., Weiss, M., Chase, M., Freinkman, E., Uber, A., Liu, X., Cocchi, M. N., Donnino, M. W., Peetermans, M., Liesenborghs, L., Claes, J., Vanassche, T., Hoylaerts, M., Jacquemin, M., Vanhoorelbeke, K., De Meyer, S., Verhamme, P., Vögeli, A., Ottiger, M., Meier, M., Steuer, C., Bernasconi, L., Huber, A., Christ-Crain, M., Henzen, C., Hoess, C., Thomann, R., Zimmerli, W., Müller, B., Schütz, P., Hoppensteadt, D., Walborn, A., Rondina, M., Tsuruta, K., Fareed, J., Tachyla, S., Ikeda, T., Ono, S., Ueno, T., Suda, S., Nagura, T., Damiani, E., Domizi, R., Scorcella, C., Tondi, S., Pierantozzi, S., Ciucani, S., Mininno, N., Adrario, E., Pelaia, P., Donati, A., Andersen, M. Schou, Lu, S., Lopez, G, Lassen, AT, Ghiran, I., Shapiro, N. I., Trahtemberg, U., Sviri, S., Beil, M., Agur, Z., Van Heerden, P., Jahaj, E., Vassiliou, A., Mastora, Z., Orfanos, S. E., Kotanidou, A., Wirz, Y., Sager, R., Amin, D., Amin, A., Haubitz, S., Hausfater, P., Kutz, A., Mueller, B., Schuetz, P., Sager, R. S., Wirz, Y. W., Amin, D. A., Amin, A. A., Hausfater, P. H., Huber, A. H., Mueller, B, Schuetz, P, Gottin, L., Dell’amore, C., Stringari, G., Cogo, G., Ceolagraziadei, M., Sommavilla, M., Soldani, F., Polati, E., Baumgartner, T., Zurauskaité, G., Gupta, S., Devendra, A., Mandaci, D., Eren, G., Ozturk, F., Emir, N., Hergunsel, O., Azaiez, S., Khedher, S., Maaoui, A., Salem, M., Chernevskaya, E., Beloborodova, N., Bedova, A., Sarshor, Y. U., Pautova, A., Gusarov, V., Öveges, N., László, I., Forgács, M., Kiss, T., Hankovszky, P., Palágyi, P., Bebes, A., Gubán, B., Földesi, I., Araczki, Á., Telkes, M., Ondrik, Z., Helyes, Z., Kemény, Á., Molnár, Z., Spanuth, E., Ebelt, H., Ivandic, B., Thomae, R., Werdan, K., El-Shafie, M., Taema, K., El-Hallag, M., Kandeel, A., Tayeh, O., Eldesouky, M., Omara, A., Winkler, M. S., Holzmann, M., Nierhaus, A., Mudersbach, E., Schwedhelm, E., Daum, G., Kluge, S., Zoellner, C., Greiwe, G., Sawari, H., Kubitz, J., Jung, R., Reichenspurner, H., Groznik, M., Ihan, A., Andersen, L. W., Holmberg, M. J., Wulff, A., Balci, C., Haliloglu, M., Bilgili, B., Bilgin, H., Kasapoglu, U., Sayan, I., Süzer, M., Mulazımoglu, L., Cinel, I., Patel, V., Shah, S., Parulekar, P., Minton, C., Patel, J., Ejimofo, C., Choi, H., Costa, R., Caruso, P., Nassar, P., Fu, J., Jin, J., Xu, Y., Kong, J., Wu, D., Yaguchi, A., Klonis, A., Ganguly, S., Kollef, M., Burnham, C., Fuller, B., Mavrommati, A., Chatzilia, D., Salla, E., Papadaki, E., Kamariotis, S., Christodoulatos, S., Stylianakis, A., Alamanos, G., Simoes, M., Trigo, E., Silva, N., Martins, P., Pimentel, J., Baily, D., Curran, L. A., Ahmadnia, E., Patel, B. V., Adukauskiene, D., Cyziute, J, Adukauskaite, A., Pentiokiniene, D., Righetti, F., Colombaroli, E., Castellano, G., Man, M., Shum, H. P., Chan, Y. H., Chan, K. C., Yan, W. W., Lee, R. A., Lau, S. K., Dilokpattanamongkol, P., Thirapakpoomanunt, P., Anakkamaetee, R., Montakantikul, P., Tangsujaritvijit, V., Sinha, S., Pati, J., Sahu, S., Valanciene, D., Dambrauskiene, A., Hernandez, K., Lopez, T., Saca, D., Bello, M., Mahmood, W., Hamed, K., Al Badi, N., AlThawadi, S., Al Hosaini, S., Salahuddin, N., Cilloniz, C. C., Ceccato, A. C., Bassi, G. L. Li, Ferrer, M. F., Gabarrus, A. G., Ranzani, O. R., Jose, A. S. San, Vidal, C. G. Garcia, de la Bella Casa, J. P. Puig, Blasi, F. B., Torres, AT, Ciginskiene, A., Simoliuniene, R., Giuliano, G., Triunfio, D., Sozio, E., Taddei, E., Brogi, E., Sbrana, F., Ripoli, A., Bertolino, G., Tascini, C., Forfori, F., Fleischmann, C., Goldfarb, D., Schlattmann, P., Schlapbach, L., Kissoon, N., Baykara, N., Akalin, H., Arslantas, M. Kemal, Gavrilovic, S. G., Vukoja, M. V., Hache, M. H., Kashyap, R. K., Dong, Y. D., Gajic, O. G., Ranzani, O., Harrison, D., Rabello, L., Rowan, K., Salluh, J., Soares, M., Markota, A. M., Fluher, J. F., Kogler, D. K., Borovšak, Z. B., Sinkovic, A. S., Siddiqui, Z, Aggarwal, P., Iqbal, O., Lewis, M., Wasmund, R., Abro, S., Raghuvir, S., Barie, P. S., Fineberg, D., Radford, A., Casazza, A., Vilardo, A., Bellazzi, E., Boschi, R., Ciprandi, D., Gigliuto, C., Preda, R., Vanzino, R., Vetere, M., Carnevale, L., Kyriazopoulou, E., Pistiki, A., Routsi, C., Tsangaris, I., Giamarellos-Bourboulis, E., Pnevmatikos, I., Vlachogiannis, G., Antoniadou, E., Mandragos, K., Armaganidis, A., Allan, P., Oehmen, R., Luo, J., Ellis, C., Latham, P., Newman, J., Pritchett, C., Pandya, D., Cripps, A., Harris, S., Jadav, M., Langford, R., Ko, B., Park, H., Beumer, C. M., Koch, R., Beuningen, D. V., Oudelashof, A. M., Vd Veerdonk, F. L., Kolwijck, E., VanderHoeven, J. G., Bergmans, D. C., Hoedemaekers, C., Brandt, J. B., Golej, J., Burda, G., Mostafa, G., Schneider, A., Vargha, R., Hermon, M., Levin, P., Broyer, C, Assous, M., Wiener-Well, Y., Dahan, M., Benenson, S., Ben-Chetrit, E, Faux, A., Sherazi, R., Sethi, A., Saha, S., Kiselevskiy, M., Gromova, E., Loginov, S., Tchikileva, I., Dolzhikova, Y., Krotenko, N., Vlasenko, R., Anisimova, N., Spadaro, S., Fogagnolo, A., Remelli, F., Alvisi, V., Romanello, A., Marangoni, E., Volta, C., Degrassi, A., Mearelli, F., Casarsa, C., Fiotti, N., Biolo, G., Cariqueo, M., Luengo, C., Galvez, R., Romero, C., Cornejo, R., Llanos, O., Estuardo, N., Alarcon, P., Magazi, B., Khan, S., Pasipanodya, J., Eriksson, M., Strandberg, G., Lipsey, M., Rajput, Z., Hiscock, F., Karadag, T., Uwagwu, J., Jain, S., Molokhia, A., Barrasa, H., Soraluce, A., Uson, E., Rodriguez, A., Isla, A., Martin, A., Fernández, B., Fonseca, F., Sánchez-Izquierdo, J. A., Maynar, F. J., Kaffarnik, M., Alraish, R., Frey, O., Roehr, A., Stockmann, M., Wicha, S., Shortridge, D., Castanheira, M., Sader, H. S., Streit, J. M., Flamm, R. K., Falsetta, K., Lam, T., Reidt, S., Jancik, J., Kinoshita, T., Yoshimura, J., Yamakawa, K., Fujimi, S., Torres, A., Zakynthinos, S., Mandragos, C., Ramirez, P., De la Torre-Prados, M., Dale, G., Wach, A., Beni, L., Hooftman, L., Zwingelstein, C., François, B., Colin, G., Dequin, P. F., Laterre, P. F., Perez, A., Welte, R., Lorenz, I., Eller, P., Joannidis, M., Bellmann, R., Lim, S., Chana, S., Patel, S., Higuera, J., Cabestrero, D., Rey, L., Narváez, G., Blandino, A., Aroca, M., Saéz, S., De Pablo, R, Albert, C. Nadège, Langouche, L., Goossens, C., Peersman, N., Vermeersch, P., Vander Perre, S., Holst, J., Wouters, P., Uber, A. U., Holmberg, M., Konanki, V., McNaughton, M., Zhang, J., Demirkiran, O., Byelyalov, A., Guerrero, J., Cariqueo, M, Rossini, N., Falanga, U., Monaldi, V., Cole, O., Scawn, N., Balciunas, M., Blascovics, I., Vuylsteke, A., Salaunkey, K., Omar, A., Salama, A., Allam, M., Alkhulaifi, A., Verstraete, S., Van Puffelen, E., Ingels, C., Verbruggen, S., Joosten, K., Hanot, J., Guerra, G., Vlasselaers, D., Lin, J., Haines, R., Zolfaghari, P., Hewson, R., Offiah, C., Prowle, J., Buter, H., Veenstra, J. A., Koopmans, M., Boerma, E. C., Taha, A., Shafie, A., Hallaj, S., Gharaibeh, D., Hon, H., Bizrane, M., El Khattate, A. A., Madani, N., Abouqal, R., Belayachi, J., Kongpolprom, N., Sanguanwong, N., Sanaie, S., Mahmoodpoor, A., Hamishehkar, H., Biderman, P., Avitzur, Y., Solomon, S., Iakobishvili, Z., Carmi, U., Gorfil, D, Singer, P., Paisley, C., Patrick-Heselton, J., Mogk, M., Humphreys, J., Welters, I., Casarotta, E., Bolognini, S., Moskowitz, A., Patel, P., Grossestreuer, A., Malinverni, S., Goedeme, D., Mols, P., Langlois, P. L., Szwec, C., D’Aragon, F., Heyland, D. K., Manzanares, W., Langlois, P., Aramendi, I., Heyland, D., Stankovic, N., Nadler, J., Sanchez, L., Wolfe, R., Donnino, M., Cocchi, M., Atalan, H. K., Gucyetmez, B., Kavlak, M. E., Aslan, S., Kargi, A., Yazici, S., Donmez, R., Polat, K. Y., Piechota, M, Piechota, A., Misztal, M., Bernas, S., Pietraszek-Grzywaczewska, I., Saleh, M., Hamdy, A., Elhallag, M., Atar, F., Kundakci, A., Gedik, E., Sahinturk, H., Zeyneloglu, P., Pirat, A., Popescu, M., Tomescu, D., Van Gassel, R., Baggerman, M., Schaap, F., Bol, M., Nicolaes, G., Beurskens, D., Damink, S. Olde, Van de Poll, M., Horibe, M., Sasaki, M., Sanui, M., Iwasaki, E., Sawano, H., Goto, T., Ikeura, T., Hamada, T., Oda, T., Mayumi, T., Kanai, T., Kjøsen, G., Horneland, R., Rydenfelt, K., Aandahl, E., Tønnessen, T., Haugaa, H., Lockett, P., Evans, L., Somerset, L., Ker-Reid, F., Laver, S., Courtney, E., Dalton, S., Georgiou, A., Robinson, K., Haas, B., Bartlett, K., Bigwood, M., Hanley, R., Morgan, P., Marouli, D., Chatzimichali, A., Kolyvaki, S., Panteli, A., Diamantaki, E., Pediaditis, E., Sirogianni, P., Ginos, P., Kondili, E., Georgopoulos, D., Askitopoulou, H., Zampieri, F. G., Liborio, A. B., Besen, B. A., Cavalcanti, A. B., Dominedò, C., Dell’Anna, A. M., Monayer, A., Grieco, D. L., Barelli, R., Cutuli, S. L., Maddalena, A. Ionescu, Picconi, E., Sonnino, C., Sandroni, C., Antonelli, M., Tuzuner, F., Cakar, N., Jacob, M., Sahu, S, Singh, Y. P., Mehta, Y., Yang, K. Y., Kuo, S., Rai, V., Cheng, T., Ertmer, C., Czempik, P, Hutchings, S., Watts, S., Wilson, C., Burton, C., Kirkman, E., Drennan, D., O’Prey, A., MacKay, A., Forrest, R., Oglinda, A., Ciobanu, G., Casian, M., Oglinda, C., Lun, C. T., Yuen, H. J., Ng, G., Leung, A., So, S. O., Chan, H. S., Lai, K. Y., Sanguanwit, P., Charoensuk, W., Phakdeekitcharoen, B., Batres-Baires, G., Kammerzell, I., Lahmer, T., Mayr, U., Schmid, R., Huber, W., Bomberg, H., Klingele, M., Groesdonk, H., Piechota, M., Mirkiewicz, K., Pérez, A. González, Silva, J., Ramos, A., Acharta, F., Perezlindo, M., Lovesio, L., Antonelli, P. Gauna, Dogliotti, A., Lovesio, C., Baron, J., Schiefer, J., Baron, D. M., Faybik, P., Chan, T. M., Ginos, P, Vicka, V., Gineityte, D., Ringaitiene, D., Sipylaite, J., Pekarskiene, J., Beurskens, D. M., Van Smaalen, T. C., Hoogland, P., Winkens, B., Christiaans, M. H., Reutelingsperger, C. P., Van Heurn, E., Nicolaes, G. A., Schmitt, F. S., Salgado, E. S., Friebe, J. F., Fleming, T. F., Zemva, J. Z., Schmoch, T. S., Uhle, F. U., Kihm, L. K., Morath, C. M., Nusshag, C. N., Zeier, M. Z., Bruckner, T. B., Mehrabi, A. M., Nawroth, P. N., Weigand, M. W., Hofer, S. H., Brenner, T. B., Fotopoulou, G., Poularas, I., Kokkoris, S., Brountzos, E., Elghonemi, M., Nilsson, K. F., Sandin, J., Gustafsson, L., Frithiof, R., Skorniakov, I., Varaksin, A., Vikulova, D., Shaikh, O., Whiteley, C., Ostermann, M., Di Lascio, G., Anicetti, L., Bonizzoli, M., Fulceri, G., Migliaccio, M. L., Sentina, P., Cozzolino, M., Peris, A., Khadzhynov, D., Halleck, F., Staeck, O., Lehner, L., Budde, K., Slowinski, T., Kindgen-Milles, D., Huysmans, N., Laenen, M. Vander, Helmschrodt, A., Boer, W., Debain, A., Jonckheer, J., Moeyersons, W., Van zwam, K., Puis, L., Staessens, K., Honoré, P. M., Spapen, H. D., De Waele, E., de Garibay, A. Perez Ruiz, Ende-Schneider, B., Schreiber, C., Kreymann, B., Bini, A., Votino, E., Steinberg, I., Vetrugno, L., Trunfio, D., Sidoti, A., Conroy, M., Marsh, B., and O’Flynn, J

Subjects
Critical Care and Intensive Care Medicine, Meeting Abstracts
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39. Ernica Clinical Consensus Statements on Total Colonic and Intestinal Aganglionosis.

Author

Granström AL, Irvine W, Hoel AT, Tabbers M, Kyrklund K, Fascetti-Leon F, Fusaro F, Thapar N, Dariel A, Sloots CEJ, Miserez M, Lemli A, Alexander S, Lambe C, Crétolle C, Qvist N, Schukfeh N, Lacher M, Cavalieri D, van Heurn E, Sfeir R, Pakarinen MP, Bjørnland K, and Wester T

Subjects
Humans, Delphi Technique, Consensus, Europe, Infant, Newborn, Hirschsprung Disease surgery
Abstract

Background: Hirschsprung disease is a congenital intestinal motility disorder characterized by an absence of enteric ganglion cells. Total colonic aganglionosis and near total or total intestinal aganglionosis, defined as absence of ganglion cells in the entire colon and with variable length of small bowel involved, are life-threatening conditions which affect less than 10 % of all patients with Hirschsprung disease. The aim of this project was to develop clinical consensus statements within ERNICA, the European Reference Network for rare congenital digestive diseases, on four major topics: Surgical treatment of total colonic aganglionosis, surgical treatment of total intestinal aganglionosis, management of poor bowel function in total colonic and/or intestinal aganglionosis and long-term management in total colonic and or intestinal aganglionosis., Methods: A multidisciplinary panel of representatives from ERNICA centers was invited to participate. Literature was searched, using specified search terms, in Medline (ALL), Embase and Google Scholar. Abstracts were screened and full text publications were selected. The panel was divided in four groups that extracted data from the full text publications and suggested draft statements for each of the major topics. A modified Delphi process was used to refine and agree on the statements., Results: The consensus statement was conducted by a multidisciplinary panel of 24 participants from 10 European countries, 45 statements reached consensus after 3 Delphi-rounds. The availability of high-quality clinical evidence was limited, and most statements were based on expert opinion. Another 25 statements did not reach consensus., Conclusions: Total colonic and total intestinal aganglionosis are rare variants of Hirschsprung disease, with very limited availability of high-quality clinical evidence. This consensus statement provides statements on the surgical treatment, management of poor bowel function and long-term management for these rare patients. The expert panel agreed that patients benefit from multidisciplinary and personalized care, preferably in an expert center., Type of Study: Clinical consensus statement., Level of Evidence: 3a., Competing Interests: Declaration of competing interest All contributing authors have submitted a declaration of interest form. No competing interests were noticed, all declarations are available on request., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2024
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40. Transition Zone Pull-through in Patients with Hirschsprung Disease: Is Redo Surgery Beneficial for the Long-term Outcomes?

Author

Beltman L, Labib H, Ahmed H, Benninga M, Roelofs J, van der Voorn P, van Schuppen J, Oosterlaan J, van Heurn E, and Derikx J

Subjects
Humans, Infant, Retrospective Studies, Quality of Life, Administration, Rectal, Postoperative Complications epidemiology, Postoperative Complications etiology, Hirschsprung Disease surgery, Enterocolitis etiology, Enterocolitis surgery
Abstract

Introduction: Transition zone pull-through (TZPT) is incomplete removal of the aganglionic bowel/transition zone (TZ) in patients with Hirschsprung disease (HD). Evidence on which treatment generates the best long-term outcomes is lacking. The aim of this study was to compare the long-term occurrence of Hirschsprung associated enterocolitis (HAEC), requirement of interventions, functional outcomes and quality of life between patients with TZPT treated conservatively to patients with TZPT treated with redo surgery to non-TZPT patients., Methods: We retrospectively studied patients with TZPT operated between 2000 and 2021. TZPT patients were matched to two control patients with complete removal of the aganglionic/hypoganglionic bowel. Functional outcomes and quality of life was assessed using Hirschsprung/Anorectal Malformation Quality of Life questionnaire and items of Groningen Defecation & Continence together with occurrence of Hirschsprung associated enterocolitis (HAEC) and requirement of interventions. Scores between the groups were compared using One-Way ANOVA. The follow-up duration lasted from time at operation until follow-up., Results: Fifteen TZPT-patients (six treated conservatively, nine receiving redo surgery) were matched with 30 control-patients. Median duration of follow-up was 76 months (range 12-260). No significant differences between groups were found in the occurrence of HAEC (p = 0.65), laxatives use (p = 0.33), rectal irrigation use (p = 0.11), botulinum toxin injections (p = 0.06), functional outcomes (p = 0.67) and quality of life (p = 0.63)., Conclusion: Our findings suggest that there are no differences in the long-term occurrence of HAEC, requirement of interventions, functional outcomes and quality of life between patients with TZPT treated conservatively or with redo surgery and non-TZPT patients. Therefore, we suggest to consider conservative treatment in case of TZPT., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Published
2023
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41. Training in minimally invasive surgery: experience of paediatric surgery trainees in Europe.

Author

Markel M, Lacher M, Hall NJ, Martynov I, Siles Hinojosa A, de Augustin Asensio JC, Fortmann C, Hukkinen M, Mutanen A, Ford K, Glenisson M, Bonnard A, Dimitrios G, Zavras N, Malowiecka M, Patkowski D, Zambaiti E, Pelizzo G, Salo M, Wester T, Hoel AT, Bjornland K, Arni D, Wildhaber BE, Karagöz A, Topuzlu Tekant G, Barroso C, Correia-Pinto J, Gorter R, van Heurn E, Reusens H, Steyaert H, Dagilyte R, Strumila A, Arneitz C, Till H, Dotlaci V, Rygl M, Jukic M, Pogorelic Z, Enache T, Balanescu L, Cascio S, Zani A, and Pio L

Subjects
Child, Humans, Minimally Invasive Surgical Procedures education, Europe, Clinical Competence, Specialties, Surgical education
Published
2023
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42. Dynamic Compression Therapy for Pectus Carinatum in Children and Adolescents: Factors for Success.

Author

de Beer S, Volcklandt S, de Jong J, Oomen M, Zwaveling S, and van Heurn E

Subjects
Humans, Child, Adolescent, Treatment Outcome, Braces, Pectus Carinatum etiology, Medically Unexplained Symptoms, Thoracic Wall
Abstract

Background: Pectus carinatum (PC) is a congenital chest wall deformity. In childhood, it is increasingly treated with dynamic compression therapy. Factors for success for dynamic brace therapy are relatively unknown., Methods: Between 2013 and 2020, 740 patients treated with the Dynamic Compression System (DCS), were studied. This included the effect of age, gender, pectus height, symmetry and pectus rigidity on treatment time and symptoms with linear multiple regression analyses., Results: Carinatum height and high pressure of initial correction at the start of treatment were associated with a prolonged duration of treatment. For each cm increase in carinatum height, the total treatment duration increased with 1.9 months (p-value= 0.002, 95% CI: 0.70-3.13). An initial correction pressure of ≥7.6 pounds per square inch (psi), increased the treatment duration with 3.5 months (p-value 0.006, 95% CI: 1.04-6.01) compared to an initial correction pressure of ≤5.0 psi. A high initial pressure of correction of ≥7.6 psi increased the odds of having somatic symptoms with 1.19 (p-value= 0.012, 95% CI: 1.04-1.45) and psychosocial symptoms with 1.13 (p-value= 0.04, 95% CI: 1.01-1.27) compared to a low initial pressure of correction of ≤5.0 psi. An initial pressure of correction of 5.1-7.5 psi increased the odds of having somatic symptoms with 1.14 (p-value 0.046, 95% CI: 1.00-1.29) compared to an initial pressure of correction of ≤5.0 psi. Patients with asymmetric chests were more likely to abandon therapy CONCLUSIONS: High carinatum height and high initial pressure of correction are associated with prolonged bracing treatment and a higher failure rate., Level of Evidence: III., (Copyright © 2022. Published by Elsevier Inc.)

Published
2023
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43. Determining the Correct Resection Level in Patients with Hirschsprung Disease Using Contrast Enema and Full Thickness Biopsies: Can the Diagnostic Accuracy be Improved by Examining Submucosal Nerve Fiber Thickness?

Author

Beltman L, Shirinskiy I, Donner N, Backes M, Benninga M, Roelofs J, van der Voorn P, van Schuppen J, Oosterlaan J, van Heurn E, and Derikx J

Subjects
Male, Humans, Infant, Retrospective Studies, Enema methods, Biopsy, Rectum pathology, Hirschsprung Disease diagnostic imaging, Hirschsprung Disease surgery
Abstract

Background: Intraoperative resection level in patients with Hirschsprung disease (HD) is determined by contrast enema, surgeon's intraoperative judgement and full thickness biopsy (FTB) identifying ganglia. This study aims to evaluate diagnostic accuracy of contrast enema and FTB in determination of resection level and whether this can be improved by measuring submucosal nerve fiber diameter., Methods: We retrospectively analyzed contrast enema and intraoperative FTBs obtained in our center, determining diagnostic accuracy for level of resection. Gold standard was pathological examination of resection specimen. Secondly, we matched transition zone pull-through (TZPT) patients with non-TZPT patients, based on age and length of resected bowel, to blindly compare nerve fibers diameters between two groups using group comparison., Results: From 2000-2021, 209 patients underwent HD surgery of whom 180 patients (138 males; median age at surgery: 13 weeks) with 18 TZPTs (10%) were included. Positive predictive value of contrast enema was 65.1%. No caliber change was found in patients with total colon aganglionosis (TCA). Negative predictive value of surgeon's intraoperative judgement and FTB in determining resection level was 79.0% and 90.0% (91.2% single-stage, 84.4% two-stage surgery) respectively. Mean nerve fiber diameter in TZPT was 25.01 µm (SD= 5.63) and in non-TZPT 24.35 µm (SD= 6.75) (p = 0.813)., Conclusion: Determination of resection level with combination of contrast enema, surgeon's intraoperative judgement and FTB results in sufficient diagnostic accuracy in patients with HD. If no caliber change is seen with contrast enema, TCA should be considered. Resection level or transition zone cannot be determined by assessment of submucosal nerve fiber diameter in FTB., Type of Study: clinical research paper., Competing Interests: Declarations of competing interest None of the authors have any conflicts-of-interest to disclose., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Published
2023
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44. Additional Anomalies in Children with Gastroschisis and Omphalocele: A Retrospective Cohort Study.

Author

Pijpers AGH, de Beaufort CMC, Maat SC, Broers CJM, Straver B, van Heurn E, Gorter RR, and Derikx JPM

Abstract

Background: Congenital abdominal wall defects might be associated with other anomalies, such as atresia in gastroschisis and cardiac anomalies in omphalocele patients. However, in the current literature, an overview of these additional anomalies and potential patient-specific risk factors is missing. Therefore, we aimed to assess the prevalence of associated anomalies and their patient-specific risk factors in patients with gastroschisis and omphalocele., Methods: A mono-center retrospective cohort study between 1997 and 2023 was performed. Outcomes were the presence of any additional anomalies. Risk factors were analyzed via logistic regression analysis., Results: In total, 122 patients were included, of whom 82 (67.2%) had gastroschisis, and 40 (32.8%) had omphalocele. Additional anomalies were identified in 26 gastroschisis patients (31.7%) and in 27 omphalocele patients (67.5%). In patients with gastroschisis, intestinal anomalies were most identified (n = 13, 15.9%), whereas, in patients with omphalocele, cardiac anomalies were most identified (n = 15, 37.5%). Logistic regression showed that cardiac anomalies were associated with complex gastroschisis (OR: 8.5; CI-95%: 1.4-49.5)., Conclusions: In patients with gastroschisis and omphalocele, intestinal and cardiac anomalies were most identified, respectively. Cardiac anomalies were found to be a risk factor for patients with complex gastroschisis. Therefore, regardless of the type of gastroschisis and/or omphalocele, postnatal cardiac screening remains important.

Published
2023
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45. Risk factors for complications in patients with Hirschsprung disease while awaiting surgery: Beware of bowel perforation.

Author

Beltman L, Labib H, Oosterlaan J, van Heurn E, and Derikx J

Subjects
Humans, Infant, Laxatives, Postoperative Complications epidemiology, Postoperative Complications etiology, Retrospective Studies, Risk Factors, Enterocolitis epidemiology, Enterocolitis etiology, Hirschsprung Disease complications, Hirschsprung Disease surgery, Intestinal Perforation epidemiology, Intestinal Perforation etiology, Intestinal Perforation surgery
Abstract

Background: Patients with Hirschsprung disease (HD) mostly undergo surgery around the age of three to six months. While awaiting surgery, therapy to treat the obstruction such as transanal irrigation (TAI) or laxatives is applied. The aim of this study was to gain insight in the prevalence and severity of complications occurring while awaiting surgery and to identify patient characteristics associated with the development of these complications., Methods: This study retrospectively analyzed data of patients with HD operated in our center between 2000 and 2021. Complications emerging while awaiting surgery were graded using Clavien-Dindo (CD). Patient characteristics as predictor of a complication were tested using logistic regression analysis., Results: Twenty-two of 132 (17%) included patients (preoperative treatment: 94% TAI; 2% laxatives; 2% other therapy) developed 45 complications while awaiting surgery, including predominantly major complications (91%). Bowel perforation occurred most frequently (n = 9, 7%) wherefrom six caused by TAI (5%), including three patients with total colon aganglionosis (TCA) (2%) counting one life-threatening and one lethal perforation. The other perforations were caused by meconium ileus (n = 2) and Hirschsprung associated enterocolitis (HAEC) (n = 1). Other frequent complications were: sepsis (5%), ileus (4%) and persistent obstruction (4%). Predictive factor for developing complication was TCA (OR 9.905, CI 2.994-32.772, p < 0.001)., Conclusion: We found a complication rate of 17% in patients while awaiting surgery, reporting bowel perforation most frequently. We found this complication in patients with TCA being highly dangerous causing one life-threatening and one lethal perforation. Therefore, we advise in patients with (suspected) TCA to limit the time awaiting surgery., Level of Evidence: level III., Competing Interests: Declaration of Competing Interest None of the authors have any conflicts-of-interest to disclose., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Published
2022
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46. Major stoma related morbidity in young children following stoma formation and closure: A retrospective cohort study.

Author

Vogel I, Eeftinck Schattenkerk LD, Venema E, Pandey K, de Jong JR, Tanis PJ, Gorter R, van Heurn E, Musters GD, and Derikx JPM

Subjects
Child, Child, Preschool, Colostomy adverse effects, Constriction, Pathologic etiology, Humans, Ileostomy adverse effects, Morbidity, Postoperative Complications epidemiology, Postoperative Complications etiology, Postoperative Complications surgery, Retrospective Studies, Surgical Stomas adverse effects
Abstract

Background: Little is known about stoma related morbidity in young children. Therefore, the aim of this study is to assess major morbidity after stoma formation and stoma closure and its associated risk factors., Methods: All consecutive young children (age ≤ three years) who received a stoma between 1998 and 2018 at our tertiary referral center were retrospectively included. The incidence of major stoma related morbidity (Clavien-Dindo grade ≥III) was the primary outcome. This was separately analysed for stoma formation alone, stoma closure alone and all stoma interventions combined. Non-stoma related morbidity was excluded. Risk factors for major morbidity were identified using multivariable logistic regression analysis., Results: In total 336 young children were included with a median follow-up of 6 (IQR:2-11) years. Of these young children, 5% (n = 17/336) received a jejunostomy, 57% (n = 192/336) an ileostomy, and 38% (n = 127/336) a colostomy. Following stoma formation, 27% (n = 92/336) of the young children experienced major stoma related morbidity, mainly consisting of high output stoma, prolapse and stoma stenosis. The major morbidity rate was 23% (n = 66/292) following stoma closure, most commonly comprising anastomotic leakage/stenosis, incisional hernia and adhesive obstructions. For combined stoma interventions, major stoma related morbidity was 39% (n = 130/336). Ileostomy was independently associated with a higher risk of developing major morbidity following stoma formation (OR:2.5; 95%-CI:1.3-4.7) as well as following closure (OR:2.7; 95%-CI:1.3-5.8)., Conclusions: Major stoma related morbidity is a frequent and severe clinical problem in young children, both after stoma formation and closure. The risk of morbidity should be considered when deliberating a stoma., (Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.)

Published
2022
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47. Familial Experience With Hirschsprung's Disease Improves the Patient's Ability to Cope.

Author

Verkuijl SJ, Meinds RJ, van der Steeg AFW, Sloots CEJ, van Heurn E, de Blaauw I, van Gemert WG, Witvliet MJ, Vermeulen KM, Trzpis M, and Broens PMA

Abstract

Introduction: Familial occurrence of Hirschsprung's disease may have a positive effect on patients' ability to cope with the disease. The aim was to compare long-term bowel function and generic quality of life between patients with familial and non-familial Hirschsprung's disease., Methods: This was a nationwide, cross-sectional study in which we included all 830 Hirschsprung patients of 8 years and older who had undergone surgery between 1957 and 2015. We excluded patients with a permanent stoma, intellectual disability, or an unknown or foreign address. We requested patients to complete the validated pediatric or adult Defecation and Fecal Continence questionnaire and the Child Health Questionnaire Child Form-87, or the World Health Organization Quality of Life-100 Assessment Instrument., Results: We analyzed 336 Hirschsprung patients, 15.8% of whom were familial cases and 84.2% were non-familial cases. After adjusting for aganglionic length, sex, and age, patients with familial Hirschsprung's disease were twice more likely to suffer from constipation (OR = 2.47, 95% CI, 1.21-5.05, p = 0.013). The quality of life of the pediatric patients was comparable, but in adult patients the energy/fatigue, thinking/learning/concentration, and work capacity facets showed better scores in the familial patients with Hirschsprung's disease of the rectosigmoid ( p = 0.029, p = 0.024, p = 0.036, respectively)., Conclusions: Different facets of generic quality of life are better in adult patients with familial Hirschsprung's disease of the rectosigmoid. It seems that familial experience with the disease influences patients' coping abilities positively., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Verkuijl, Meinds, van der Steeg, Sloots, van Heurn, de Blaauw, van Gemert, Witvliet, Vermeulen, Trzpis and Broens.)

Published
2022
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48. Functional Outcomes After Surgery for Total Colonic, Long-Segment, Versus Rectosigmoid Segment Hirschsprung Disease.

Author

Verkuijl SJ, Meinds RJ, van der Steeg AFW, van Gemert WG, de Blaauw I, Witvliet MJ, Sloots CEJ, van Heurn E, Vermeulen KM, Trzpis M, and Broens PMA

Subjects
Adult, Child, Constipation epidemiology, Cross-Sectional Studies, Humans, Quality of Life, Fecal Incontinence complications, Fecal Incontinence etiology, Hirschsprung Disease complications, Hirschsprung Disease surgery
Abstract

Objectives: Knowledge on long-term outcomes in patients with Hirschsprung disease is progressing. Nevertheless, differences in outcomes according to aganglionic lengths are unclear. We compared long-term bowel function and generic quality of life in Hirschsprung patients with total colonic or long-segment versus rectosigmoid aganglionosis., Methods: In this nationwide, cross-sectional study participants with proven Hirschsprung disease received the Defecation and Fecal Continence questionnaire, and the Child Health Questionnaire Child Form-87, or the WHO Quality of Life-100. We excluded deceased patients, patients who were younger than 8 years, lived abroad, had a permanent enterostomy, or were intellectually impaired., Results: The study population (n = 334) was operated for rectosigmoid (83.9%), long-segment (8.7%), or total colonic aganglionosis (7.5%). Fecal incontinence in general was not significantly different between the three groups, but liquid fecal incontinence was significantly associated with total colonic aganglionosis (odds ratio [OR] = 6.00, 95% confidence interval [CI] 2.07-17.38, P = 0.001). Regarding constipation, patients with total colonic or long-segment aganglionosis were less likely to suffer from constipation than the rectosigmoid group (OR = 0.21, 95% CI, 0.05-0.91, P = 0.038 and OR = 0.11, 95% CI, 0.01-0.83, P = 0.032). Quality of life was comparable between the three groups, except for a lower physical score in children with total colonic aganglionosis (P = 0.016)., Conclusions: Over time Hirschsprung patients with total colonic or long-segment aganglionosis do not suffer from worse fecal incontinence in general. A difference in stool consistency may underlie the association between liquid fecal incontinence and total colonic aganglionosis and constipation in patients with rectosigmoid aganglionosis. Despite these differences, generic quality of life is comparable on reaching adulthood., Competing Interests: The authors report no conflicts of interest., (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)

Published
2022
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49. Neurodevelopmental outcome of patients with congenital gastrointestinal malformations: a systematic review and meta-analysis.

Author

Roorda D, Königs M, Eeftinck Schattenkerk L, van der Steeg L, van Heurn E, and Oosterlaan J

Subjects
Child, Child Development, Humans, Risk Assessment, Digestive System Abnormalities classification, Digestive System Abnormalities complications, Digestive System Abnormalities epidemiology, Digestive System Abnormalities psychology, Gastrointestinal Tract abnormalities, Neurodevelopmental Disorders classification, Neurodevelopmental Disorders diagnosis, Neurodevelopmental Disorders epidemiology, Neurodevelopmental Disorders etiology
Abstract

Aim: Children with congenital gastrointestinal malformations may be at risk of neurodevelopmental impairment due to challenges to the developing brain, including perioperative haemodynamic changes, exposure to anaesthetics and postoperative inflammatory influences. This study aggregates existing evidence on neurodevelopmental outcome in these patients using meta-analysis., Method: PubMed, Embase and Web of Science were searched for peer-reviewed articles published until October 2019. Out of the 5316 unique articles that were identified, 47 studies met the inclusion criteria and were included. Standardised mean differences (Cohen's d) between cognitive, motor and language outcome of patients with congenital gastrointestinal malformations and normative data (39 studies) or the studies' control group (8 studies) were aggregated across studies using random-effects meta-analysis. The value of (clinical) moderators was studied using meta-regression and diagnostic subgroups were compared., Results: The 47 included studies encompassed 62 cohorts, representing 2312 patients. Children with congenital gastrointestinal malformations had small-sized cognitive impairment (d=-0.435, p<0.001; 95% CI -0.567 to -0.302), medium-sized motor impairment (d=-0.610, p<0.001; 95% CI -0.769 to -0.451) and medium-sized language impairment (d=-0.670, p<0.001; 95% CI -0.914 to -0.425). Patients with short bowel syndrome had worse motor outcome. Neurodevelopmental outcome was related to the number of surgeries and length of total hospital stay, while no relations were observed with gestational age, birth weight, age and sex., Interpretation: This study shows that children with congenital gastrointestinal malformations exhibit impairments in neurodevelopmental outcome, highlighting the need for routine screening of neurodevelopment during follow-up., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)

Published
2021
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50. Risk factors for enterocolitis in patients with Hirschsprung disease: A retrospective observational study.

Author

Roorda D, Oosterlaan J, van Heurn E, and Derikx JPM

Subjects
Humans, Postoperative Complications epidemiology, Postoperative Complications etiology, Retrospective Studies, Risk Factors, Enterocolitis epidemiology, Enterocolitis etiology, Hirschsprung Disease complications, Hirschsprung Disease epidemiology, Hirschsprung Disease surgery
Abstract

Introduction: Hirschsprung-associated enterocolitis (HAEC) accounts for substantial morbidity and mortality in patients with Hirschsprung disease (HD). The aim of this study was to identify incidence of pre- and postoperative HAEC in our consecutive cohort and to identify patient and clinical characteristics that are associated with developing postoperative HAEC and HAEC-free interval., Material and Methods: A retrospective cohort study was performed with all 146 HD patients treated between 2000 and 2017. Data were retrieved from the medical records. HAEC was defined as presence of clinical signs of bowel inflammation, that required treatment with intravenous antibiotics and admittance to the hospital during at least two days. To identify risk factor for HAEC, patients with and without a history of postoperative HAEC were compared. Kaplan-Meier and Cox-regression were used to assess HAEC free intervals before and after surgery., Results: Out of 146 patients, 12 patients had pre-operative HAEC (8%) and 31 patients had postoperative HAEC (21%). Median preoperative HAEC free interval was 112 days (IQR 182 days). Length of hospital stay due to readmissions was longer for patients with a history of postoperative HAEC compared to patients without a history of postoperative HAEC (9.5 vs 16 days, U = 1872.5, p = 0.047). Median postoperative HAEC free interval was 226 days. Of the patients who had postoperative HAEC, 66% had their first episode within the first year after surgery and that the incidence of HAEC declined over follow-up., Conclusions: HAEC incidence was relatively low in our population. No patient or clinical characteristics were associated with the risk of postoperative HAEC., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2021
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