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2. Human and Planetary Health

Author

van laarhoven, Kees

Subjects
Global population overgrowth, Economic drivers of disease, Environmental drivers of disease, Prevention and integrative health, One health, Human and planetary health, bic Book Industry Communication::J Society & social sciences::JH Sociology & anthropology::JHM Anthropology, bic Book Industry Communication::K Economics, finance, business & management::KC Economics::KCQ Health economics, bic Book Industry Communication::M Medicine::MB Medicine: general issues::MBP Health systems & services, bic Book Industry Communication::V Health & personal development, bic Book Industry Communication::M Medicine, bic Book Industry Communication::M Medicine::MB Medicine: general issues::MBN Public health & preventive medicine
Abstract

In his professional journey, travelling through an upcoming field of surgery with apparently unlimited possibilities, Kees van Laarhoven witnessed major milestones and breakthroughs. Already as a medical student, he was amazed by surgical courage. During residency, he experienced hard work, diligence and perseverance of surgical professionals. Today as a surgeon with over 25 years of clinical experience he now looks at pieces of art in surgery with professionals compassionately bringing hope to patients.But he also sees inconvenient truths in our healthcare system, with patients evolving from one predictable and preventable disease to the next and with professionals following disease trends rather than applying their knowledge to redirect disease into health. The modern disease-oriented care system becomes undesirable and unsustainable. And there are more inconvenient truths that have progressed rather than diminished in time. Healthcare is not easily accessible to the major half of the global population and for those who have access, with a growing global population, healthcare may become unaffordable in the future. Moreover, from an environmental perspective, both human and planetary health are compromised and ask for a ‘One Health’ approach. Being fascinated by the questions of how and why did this all happen, Kees van Laarhoven took up a scientific survey to comprehend and learn how things still can be changed. He found that clear solutions are there! Please join him on his journey.

Published
2023
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6. Qualitative flow metabolic phenotype of pancreatic cancer. A new prognostic biomarker?

Author

Pathologie Pathologen staf, Cancer, Riviere, Deniece, Aarntzen, Erik, van Geenen, Erwin, Chang, David, de Geus-Oei, Lioe-Fee, Brosens, Lodewijk, van Laarhoven, Kees, Gotthardt, Martin, Hermans, John, Pathologie Pathologen staf, Cancer, Riviere, Deniece, Aarntzen, Erik, van Geenen, Erwin, Chang, David, de Geus-Oei, Lioe-Fee, Brosens, Lodewijk, van Laarhoven, Kees, Gotthardt, Martin, and Hermans, John

Published
2024

7. Multimodal prehabilitation (Fit4Surgery) in high-impact surgery to enhance surgical outcomes: Study protocol of F4S PREHAB, a single center stepped wedge trial.

Author

Strijker, Dieuwke, Drager, Luuk, van Asseldonk, Monique, Atsma, Femke, van den Berg, Manon, van Daal, Elke, van Heusden-Scholtalbers, Linda, Meijerink, Jeroen, Servaes, Petra, Teerenstra, Steven, Verlaan, Sjors, van den Heuvel, Baukje, and van Laarhoven, Kees

Subjects
PREHABILITATION, PREOPERATIVE risk factors, PREOPERATIVE care, SURGICAL complications, ABDOMINAL surgery, SPECIALTY hospitals, GYMNASIUMS, MULTIMODAL user interfaces
Abstract

Background: High-impact surgery imposes a significant physiological and functional burden and is associated with substantial postoperative morbidity. Multimodal prehabilitation has demonstrated a reduction in postoperative complications and enhanced functional recovery, mainly in abdominal cancer surgery. Common preoperative risk factors shared among patients undergoing high-impact surgery, extending beyond abdominal cancer surgery procedures, suggest the relevance of multimodal prehabilitation to a broader patient population. This stepped wedge trial primarily aims to examine the hospital-wide effect of multimodal prehabilitation, compared to standard preoperative care, on the occurrence and severity of postoperative complications. Secondary and tertiary endpoints include length of hospital stay, physical fitness, nutritional status, mental health, intoxications, and cost-effectiveness of the intervention. Methods: The Fit4Surgery (F4S) PREHAB trial is a monocenter stepped wedge trial in an academic hospital. Adult patients, divided into 20 health clusters based on specific diagnoses, will be assessed for eligibility and receive usual preoperative care or multimodal prehabilitation. Patient enrollment commenced in March 2021 and continues up to and including April 2024. The intervention consists of a high-intensity exercise program, a nutritional intervention, psychological support, and smoking and alcohol cessation. The primary outcome will be measured by the Clavien-Dindo classification (grade II or higher) and the Comprehensive Complication Index (CCI). Discussion: Multimodal prehabilitation potentially reduces postoperative complications and enhances functional recovery. This is the first study to determine the hospital-wide effect and cost-effectiveness of multimodal prehabilitation in patients across various surgical specialties. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Impact of network treatment in patients with resected pancreatic cancer on use and timing of chemotherapy and survival

Author

Hopstaken, Jana S, primary, Vissers, Pauline A J, additional, Quispel, Rutger, additional, de Vos-Geelen, Judith, additional, Brosens, Lodewijk A A, additional, de Hingh, Ignace H J T, additional, van der Geest, Lydia G, additional, Besselink, Marc G, additional, van Laarhoven, Kees J H M, additional, and Stommel, Martijn W J, additional

Published
2023
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13. Self-efficacy and application of skills in the workplace after multidisciplinary trauma masterclass participation:a mixed methods survey and interview study

Author

Haverkamp, Frederike J.C., Rahim, Idris, Hoencamp, Rigo, Fluit, Cornelia R.M.G., Van Laarhoven, Kees J.H.M., Tan, Edward C.T.H., Haverkamp, Frederike J.C., Rahim, Idris, Hoencamp, Rigo, Fluit, Cornelia R.M.G., Van Laarhoven, Kees J.H.M., and Tan, Edward C.T.H.

Abstract

Purpose: The most complex injuries are usually least often encountered by trauma team members, limiting learning opportunities at work. Identifying teaching formats that enhance trauma skills can guide future curricula. This study evaluates self-assessed technical and nontechnical trauma skills and their integration into novel work situations for multidisciplinary trauma masterclass participants. Methods: This mixed methods study included participants of a multidisciplinary 3-day trauma masterclass. Ratings of trauma skills were collected through pre- and postcourse questionnaires with 1-year follow-up. Qualitative semi-structured interviews 9 months postcourse focused on the course format and self-perceived association with technical and nontechnical skills applied at work. Results: Response rates of pre- and postcourse questionnaires after 1 day, 3 months, and 1 year were respectively 72% (51/71), 85% (60/71), 34% (24/71), and 14% (10/71). Respondents were surgeons (58%), anesthesiologists (31%), and scrub nurses (11%). Self-efficacy in nontechnical (mean 3.4, SD 0.6 vs. mean 3.8, SD 0.5) and technical (mean 2.9, SD 0.6 vs. mean 3.6, SD 0.6) skills significantly increased postcourse (n = 40, p < 0.001). Qualitative interviews (n = 11) demonstrated that increased self-efficacy in trauma skills was the greatest benefit experienced at work. Innovative application of skills and enhanced reflection demonstrate adaptive expertise. Small-group case discussions and the operative porcine laboratory were considered the most educational working formats. The experienced faculty and unique focus on multidisciplinary teamwork were highly valued. Conclusion: Course participants’ self-assessed work performance mostly benefited from greater self-efficacy and nontechnical skills. Future trauma curricula should consider aligning the teaching strategies accordingly.

Published
2023

14. Impact of network treatment in patients with resected pancreatic cancer on use and timing of chemotherapy and survival

Author

Pathologie Pathologen staf, Cancer, Hopstaken, Jana S, Vissers, Pauline A J, Quispel, Rutger, de Vos-Geelen, Judith, Brosens, Lodewijk A A, de Hingh, Ignace H J T, van der Geest, Lydia G, Besselink, Marc G, van Laarhoven, Kees J H M, Stommel, Martijn W J, Pathologie Pathologen staf, Cancer, Hopstaken, Jana S, Vissers, Pauline A J, Quispel, Rutger, de Vos-Geelen, Judith, Brosens, Lodewijk A A, de Hingh, Ignace H J T, van der Geest, Lydia G, Besselink, Marc G, van Laarhoven, Kees J H M, and Stommel, Martijn W J

Published
2023

15. Nationwide Outcome after Pancreatoduodenectomy in Patients at very High Risk (ISGPS-D) for Postoperative Pancreatic Fistula

Author

Theijse, Rutger T, Stoop, Thomas F, Hendriks, Tessa E, Suurmeijer, J Annelie, Smits, F Jasmijn, Bonsing, Bert A, Lips, Daan J, Manusama, Eric, van der Harst, Erwin, Patijn, Gijs A, Wijsman, Jan H, Meerdink, Mark, den Dulk, Marcel, van Dam, Ronald, Stommel, Martijn W J, van Laarhoven, Kees, de Wilde, Roeland F, Festen, Sebastiaan, Draaisma, Werner A, Bosscha, Koop, van Eijck, Casper H J, Busch, Olivier R, Molenaar, I Quintus, Groot Koerkamp, Bas, van Santvoort, Hjalmar C, Besselink, Marc G, Theijse, Rutger T, Stoop, Thomas F, Hendriks, Tessa E, Suurmeijer, J Annelie, Smits, F Jasmijn, Bonsing, Bert A, Lips, Daan J, Manusama, Eric, van der Harst, Erwin, Patijn, Gijs A, Wijsman, Jan H, Meerdink, Mark, den Dulk, Marcel, van Dam, Ronald, Stommel, Martijn W J, van Laarhoven, Kees, de Wilde, Roeland F, Festen, Sebastiaan, Draaisma, Werner A, Bosscha, Koop, van Eijck, Casper H J, Busch, Olivier R, Molenaar, I Quintus, Groot Koerkamp, Bas, van Santvoort, Hjalmar C, and Besselink, Marc G

Abstract

OBJECTIVE: To assess nationwide surgical outcome after pancreatoduodenectomy (PD) in patients at very high risk for postoperative pancreatic fistula (POPF), categorized as ISGPS-D.SUMMARY BACKGROUND DATA: Morbidity and mortality after ISGPS-D PD is perceived so high that a recent randomized trial advocated prophylactic total pancreatectomy (TP) as alternative aiming to lower this risk. However, current outcomes of ISGPS-D PD remain unknown as large nationwide series are lacking.METHODS: Nationwide retrospective analysis including consecutive patients undergoing ISGPS-D PD (i.e., soft texture and pancreatic duct ≤3 mm), using the mandatory Dutch Pancreatic Cancer Audit (2014-2021). Primary outcome was in-hospital mortality and secondary outcomes included major morbidity (i.e., Clavien-Dindo grade ≥IIIa) and POPF (ISGPS grade B/C). The use of prophylactic TP to avoid POPF during the study period was assessed.RESULTS: Overall, 1402 patients were included. In-hospital mortality was 4.1% (n=57), which decreased to 3.7% (n=20/536) in the last 2 years. Major morbidity occurred in 642 patients (45.9%) and POPF in 410 (30.0%), which corresponded with failure to rescue in 8.9% (n=57/642). Patients with POPF had increased rates of major morbidity (88.0% vs. 28.3%; P<0.001) and mortality (6.3% vs. 3.5%; P=0.016), compared to patients without POPF. Among 190 patients undergoing TP, prophylactic TP to prevent POPF was performed in 4 (2.1%).CONCLUSION: This nationwide series found a 4.1% in-hospital mortality after ISGPS-D PD with 45.9% major morbidity, leaving little room for improvement through prophylactic TP. Nevertheless, given the outcomes in 30% of patients who develop POPF, future randomized trials should aim to prevent and mitigate POPF in this high-risk category.

Published
2023

17. Multimodal Prehabilitation in Patients Undergoing Complex Colorectal Surgery, Liver Resection, and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): A Pilot Study on Feasibility and Potential Efficacy

Author

Strijker, Dieuwke, primary, Meijerink, Wilhelmus J. H. J., additional, van Heusden-Schotalbers, Linda A. G., additional, van den Berg, Manon G. A., additional, van Asseldonk, Monique J. M. D., additional, Drager, Luuk D., additional, de Wilt, Johannes H. W., additional, van Laarhoven, Kees J. H. M., additional, and van den Heuvel, Baukje, additional

Published
2023
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18. Impact of multicentre network treatment in pancreatic cancer patients on time-to-chemotherapy, completion of adjuvant chemotherapy, and survival

Author

Hopstaken, Jana, primary, Vissers, Pauline, additional, Quispel, Rutger, additional, de Vos-Geelen, Judith, additional, Brosens, Lodewijk, additional, de Hingh, Ignace, additional, van der Geest, Lydia, additional, Besselink, Marc, additional, van Laarhoven, Kees, additional, and Stommel, Martijn, additional

Published
2023
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20. Feasibility and effectiveness of a multimodal rehabilitation program (Fit4Chemo) in patients with stage 3 colon carcinoma prior to and during adjuvant chemotherapy

Author

Strijker, Dieuwke, primary, van den Heuvel, Baukje, additional, van Laarhoven, Kees CJHM., additional, Meijerink, Jeroen WJHJ., additional, Hoogeboom, Thomas TJ., additional, van Heusden-Schotalbers, Linda LAG., additional, Schreurs, Hermien WH., additional, and Geurts, Yvonne, additional

Published
2023
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22. REMBRANDT trial:The effectiveness of adding Braun anastomosis to standard Child reconstruction to reduce delayed gastric emptying after pancreatoduodenectomy: a multicenter randomized-controlled trial

Author

Hopstaken, Jana, primary, Endo, Chikako, additional, de Vries, Marjan, additional, Atsma, Femke, additional, Adang, Eddy, additional, van der Wees, Philip, additional, van Santvoort, Hjalmar, additional, Den Dulk, Marcel, additional, Koerkamp, Bas Groot, additional, Mieog, Sven, additional, Besselink, Marc, additional, Stommel, Martijn, additional, and van Laarhoven, Kees, additional

Published
2023
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27. Impact of multicentre diagnostic workup in patients with pancreatic cancer on repeated diagnostic investigations, time-to-diagnosis and time-to-treatment: A nationwide analysis

Author

Hopstaken, Jana S, Vissers, Pauline A J, Quispel, Rutger, de Vos-Geelen, Judith, Brosens, Lodewijk A A, de Hingh, Ignace H J T, van der Geest, Lydia G, Besselink, Marc G, van Laarhoven, Kees J H M, Stommel, Martijn W J, Dutch Pancreatic Cancer Group, Hopstaken, Jana S, Vissers, Pauline A J, Quispel, Rutger, de Vos-Geelen, Judith, Brosens, Lodewijk A A, de Hingh, Ignace H J T, van der Geest, Lydia G, Besselink, Marc G, van Laarhoven, Kees J H M, Stommel, Martijn W J, and Dutch Pancreatic Cancer Group

Abstract

BACKGROUND: Due to the centralization of pancreatic surgery, patients with suspected pancreatic cancer may undergo diagnostic workup in both a non-pancreatic centre and a pancreatic centre, i.e. multicentre workup. This retrospective study assessed whether multicentre diagnostic workup is associated with repeated diagnostics, delayed time-to-diagnosis, delayed time-to-treatment, survival and whether variation existed among pancreatic cancer networks.METHODS: This nationwide study included all patients diagnosed with non-metastatic pancreatic ductal adenocarcinoma (PDAC) in 2015, registered by the Netherlands Cancer Registry. A delayed time-to-diagnosis was defined as ≥3 weeks from initial hospital visit to final diagnosis. A delayed time-to-treatment was defined as ≥6 weeks from the first hospital visit to start of first tumour treatment. Multilevel logistic regression analyses and survival analyses were performed.RESULTS: In total, 931 patients with non-metastatic PDAC were included. Overall, 175 patients (19%) underwent a multicentre diagnostic workup, which was significantly associated with repeated diagnostic investigations (OR = 6.31, 95% CI 4.13-9.64, P < 0.0001), a delayed time-to-diagnosis (OR = 2.66 95% CI 1.74-4.06, P < 0.001), and a delayed time-to-treatment (OR = 1.93 95% CI 1.12-3.31, P = 0.02), but not with decreased survival (HR = 1.09 95% CI 0.83-1.44; P = 0.532). Variation in outcomes per network was observed, especially for time-to-treatment, though the ICC was not statistically significant (P = 0.065).CONCLUSION: Multicentre diagnostic workup for patients with PDAC is associated with repeated diagnostic investigations, a delayed time-to-diagnosis and delayed time-to-treatment compared to patients with monocentre workup. To reduce costs and improve treatment times, efforts should be made to improve network coordination, for example via network care pathways.

Published
2022

30. Impact of multicenter diagnostic workup on time-to-diagnosis and time-to-treatment in patients with pancreatic ductal adenocarcinoma: a nationwide analysis.

Author

Hopstaken, Jana, primary, Vissers, Pauline, additional, Quispel, Rutger, additional, de Vos-Geelen, Judith, additional, Brosens, Lodewijk, additional, de Hingh, Ignace, additional, van der Geest, Lydia, additional, Besselink, Marc, additional, van Laarhoven, Kees, additional, and Stommel, Martijn, additional

Published
2022
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34. Clinical relevance assessment of animal preclinical research (RAA) tool: development and explanation

Author

Gurusamy, Kurinchi S., primary, Moher, David, additional, Loizidou, Marilena, additional, Ahmed, Irfan, additional, Avey, Marc T., additional, Barron, Carly C., additional, Davidson, Brian, additional, Dwek, Miriam, additional, Gluud, Christian, additional, Jell, Gavin, additional, Katakam, Kiran, additional, Montroy, Joshua, additional, McHugh, Timothy D., additional, Osborne, Nicola J., additional, Ritskes-Hoitinga, Merel, additional, van Laarhoven, Kees, additional, Vollert, Jan, additional, and Lalu, Manoj, additional

Published
2021
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37. The Tilburg double blind randomised controlled trial comparing inguinal hernia repair according to Lichtenstein and the transinguinal preperitoneal technique

Author

Gerritsen Pieter G, Verhofstad Michiel HJ, Oostvogel Henk JM, de Schipper Hans JP, Koning Giel G, van Laarhoven Kees CJHM, and Vriens Patrick WHE

Subjects
Medicine (General), R5-920
Abstract

Abstract Background Anterior open treatment of the inguinal hernia with a tension free mesh has reduced the incidence of recurrence and direct postoperative pain. The Lichtenstein procedure rules nowadays as reference technique for hernia treatment. Not recurrences but chronic pain is the main postoperative complication in inguinal hernia repair after Lichtenstein's technique. Preliminary experiences with a soft mesh placed in the preperitoneal space showed good results and less chronic pain. Methods The TULIP is a double-blind randomised controlled trial in which 300 patients will be randomly allocated to anterior inguinal hernia repair according to Lichtenstein or the transinguinal preperitoneal technique with soft mesh. All unilateral primary inguinal hernia patients eligible for operation who meet inclusion criteria will be invited to participate in this trial. The primary endpoint will be direct postoperative- and chronic pain. Secondary endpoints are operation time, postoperative complications, hospital stay, costs, return to daily activities (e.g. work) and recurrence. Both groups will be evaluated. Success rate of hernia repair and complications will be measured as safeguard for quality. To demonstrate that inguinal hernia repair according to the transinguinal preperitoneal (TIPP) technique reduces postoperative pain to Discussion The TULIP trial is aimed to show a reduction in postoperative chronic pain after anterior hernia repair according to the transinguinal preperitoneal (TIPP) technique, compared to Lichtenstein. In our hypothesis the TIPP technique reduces chronic pain compared to Lichtenstein. Trial registration ISRCTN 93798494

Published
2009
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39. Optimization of Vitamin Suppletion After Roux-En-Y Gastric Bypass Surgery Can Lower Postoperative Deficiencies

Author

Dogan, Kemal, Aarts, Edo O., Koehestanie, Parweez, Betzel, Bark, Ploeger, Nadine, de Boer, Hans, Aufenacker, Theo J., van Laarhoven, Kees J.H.M., Janssen, Ignace M.C., and Berends, Frits J.

Subjects
Hematologic Tests, Iron, Gastric Bypass, Avitaminosis, Vitamin B 12 Deficiency, Clinical Trial/Experimental Study, Folic Acid Deficiency, Vitamin D Deficiency, Article, Vitamin B 12, Folic Acid, Dietary Supplements, Humans, Netherlands
Abstract

Iron, vitamin B12, and folic acid deficiencies are among the most common deficiencies occurring after laparoscopic Roux-en-Y gastric bypass (LRYGB). The present study evaluates the effectiveness of a specially designed multivitamin supplement (WLS Forte, FitForMe, Rotterdam, the Netherlands) specifically developed for LRYGB patients. A triple-blind, randomized, 12-month study was conducted comparing WLS forte with a standard multivitamin supplement (sMVS) containing approximately 100% of the recommended daily allowance (RDA) for iron, vitamin B12, and folic acid. WLS Forte contains vitamin B12 14000% RDA, iron 500% RDA, and folic acid 300% RDA. In total, 148 patients (74 in each group) underwent a LRYGB procedure. Baseline characteristics were similar for both groups. Per protocol analysis demonstrated that sMVS treatment was associated with a decline in ferritin (−24.4 ± 70.1 μg/L) and vitamin B12 (−45.9 ± 150.3 pmol/L) over 12 months, whereas in WLS Forte patients, ferritin remained stable (+3.2 ± 93.2 μg/L) and vitamin B12 increased significantly (+55.1 ± 144.2 pmol/L). The number of patients developing ferritin or vitamin B12 deficiency was significantly lower with WLS Forte compared with sMVS (P

Published
2014

44. Comparison of the effectiveness of low pressure pneumoperitoneum with profound muscle relaxation during laparoscopic donor nephrectomy to optimize the quality of recovery during the early post-operative phase: study protocol for a randomized controlled clinical trial

Author

Özdemir-van Brunschot, Denise M. D., primary, Scheffer, Gert J., additional, Dahan, Albert, additional, Mulder, Janneke E. E. A., additional, Willems, Simone A. A., additional, Hilbrands, Luuk B., additional, d’Ancona, Frank C. H., additional, Donders, Rogier A. R. T., additional, van Laarhoven, Kees J. H. M., additional, and Warlé, Michiel C., additional

Published
2015
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47. Implementation and Evaluation of a Clinical Pathway for Pancreaticoduodenectomy Procedures: a Prospective Cohort Study.

Author

Kolk, Marion, Boogaard, Mark, Becking-Verhaar, Femke, Custers, Hettie, Hoeven, Hans, Pickkers, Peter, Laarhoven, Kees, van der Kolk, Marion, van den Boogaard, Mark, van der Hoeven, Hans, and van Laarhoven, Kees

Subjects
PANCREATICODUODENECTOMY, PERIOPERATIVE care, HEALTH outcome assessment, MEDICAL care, LENGTH of stay in hospitals, HEALTH care teams, INTERPROFESSIONAL relations, LONGITUDINAL method, EVALUATION of medical care, MEDICAL protocols
Abstract

Introduction: Medical and nursing protocols in perioperative care for pancreaticoduodenectomy are mainly mono-disciplinary, limiting their integration and transparency in a continuous health care system. The aims of this study were to evaluate adherence to a multidisciplinary clinical pathway for all pancreaticoduodenectomy patients during their entire hospital stay and to determine if the use of this clinical pathway is associated with beneficial effects on clinical end points.Materials and Methods: A prospective cohort study was conducted in 95 pancreaticoduodenectomy patients treated according to a clinical pathway, including a variance report, compared to a historical control group (n = 52) with a traditional treatment regime.Results: Process evaluation of the clinical pathway group revealed that protocol adherence throughout all units was above 80%. Major complications according to Clavien-Dindo classification grade ≥3 decreased from 27 to 13%; p = 0.02. Hospital length of stay was significantly shorter in the clinical pathway group, median 10 days [IQR 8-15], compared with the control group, median 13 days [IQR 10-18]; p = 0.02.Conclusion: The use of a clinical pathway in pancreaticoduodenectomy patients was associated with high protocol adherence, improved outcome and shorter hospital length of stay. Variance report analysis and protocol adherence with a Prepare-Act-Reflect Cycle are essential in surveillance of outcome. [ABSTRACT FROM AUTHOR]

Published
2017
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