Acute pilonidal abscess: Prospective nationwide audit in the Netherlands.

Aim: The aim of this study was to assess Dutch surgical practice and outcomes for acute pilonidal abscess.

Method: Patients with pilonidal sinus disease (PSD) who underwent surgical treatment between 1 March 2020 and 1 March 2021 at 36 participating hospitals were included in a prospective observational cohort study. For the present study, only patients with an acute abscess were included for analysis.

A nationwide snapshot study on outcomes one year after surgery for chronic pilonidal sinus disease.

Aim: Managing pilonidal sinus disease (PSD) remains challenging due to high recurrence rates and morbidity associated with treatment. The aim of this study was to evaluate the outcomes one year after surgical treatment for chronic PSD in the Netherlands.

Method: Patients with PSD who underwent surgical treatment between March 1, 2020, and March 1, 2021, at 36 participating hospitals were included in a prospective observational cohort study.

Best Evidence for Each Surgical Step in Minimally Invasive Right Hemicolectomy: A Systematic Review.

Objective: The aim of this study was to systematically review the literature for each surgical step of the minimally invasive right hemicolectomy (MIRH) for non-locally advanced colon cancer, to define the most optimal procedure with the highest level of evidence.

Background: High variability exists in the way MIRH is performed between surgeons and hospitals, which could affect patients' postoperative and oncological outcomes.

Methods: A systematic search using PubMed was performed to first identify systematic reviews and meta-analyses, and if there were none then landmark papers and consensus statements were systematically searched for each key step of MIRH.

Nationwide standardization of minimally invasive right hemicolectomy for colon cancer and development and validation of a video-based competency assessment tool (the Right study).

Background: Substantial variation exists when performing a minimally invasive right hemicolectomy (MIRH) due to disparities in training, expertise and differences in implementation of innovations. This study aimed to achieve national consensus on an optimal and standardized MIRH technique for colon cancer and to develop and validate a video-based competency assessment tool (CAT) for MIRH.

Method: Statements covering all elements of MIRH were formulated.

Two Days Versus Five Days of Postoperative Antibiotics for Complex Appendicitis: Cost Analysis of a Randomized, Noninferiority Trial.

Objective: To compare costs for 2 days versus 5 days of postoperative antibiotics within the antibiotics after an aPPendectomy In Complex appendicitis trial.Background:Recent studies suggest that restrictive antibiotic use leads to a significant reduction in hospital stays without compromising patient safety. Its potential effect on societal costs remains underexplored.

Video-based tools for surgical quality assessment of technical skills in laparoscopic procedures: a systematic review.

Background: Quality of surgery has substantial impact on both short- and long-term clinical outcomes. This stresses the need for objective surgical quality assessment (SQA) for education, clinical practice and research purposes. The aim of this systematic review was to provide a comprehensive overview of all video-based objective SQA tools in laparoscopic procedures and their validity to objectively assess surgical performance.

National implementation of an optimal standardised technique for right-sided colon cancer: protocol of an interventional sequential cohort study (Right study).

Purpose: Minimally invasive right hemicolectomy (MIRH) is the cornerstone of treatment for patients with right-sided colon cancer. This operation has evolved during recent decades, with many innovations and improvements but this has also resulted in high variability of uptake with subsequent substantial variableness. The aim of this ongoing study is to identify current surgical variations, determine the most optimal and standardised MIRH and nationally train and implement that technique to improve short-term clinical and long-term oncological outcomes.

2 days versus 5 days of postoperative antibiotics for complex appendicitis: a pragmatic, open-label, multicentre, non-inferiority randomised trial.

Background: The appropriate duration of postoperative antibiotics for complex appendicitis is unclear. The increasing global threat of antimicrobial resistance warrants restrictive antibiotic use, which could also reduce side-effects, length of hospital stay, and costs.

Methods: In this pragmatic, open-label, non-inferiority trial in 15 hospitals in the Netherlands, patients with complex appendicitis (aged ≥8 years) were randomly assigned (1:1) to receive 2 days or 5 days of intravenous antibiotics after appendicectomy.

Postoperative Antibiotics and Time to Reach Discharge Criteria after Appendectomy for Complex Appendicitis.

Introduction: Postoperative antibiotic treatment is indicated for 3-5 days following appendectomy for complex appendicitis. However, meeting discharge criteria may allow for safe discontinuation of antibiotics and discharge. This study assessed the association between time to reach discharge criteria and duration of postoperative antibiotic use and length of stay.

Multicenter cohort study on the presentation and treatment of acute appendicitis during the COVID-19 pandemic.

Purpose: Current studies have demonstrated conflicting results regarding surgical care for acute appendicitis during the COVID-19 pandemic. This study aimed to assess trends in diagnosis as well as treatment of acute appendicitis in the Netherlands during the first and second COVID-19 infection wave.

Methods: All consecutive patients that had an appendectomy for acute appendicitis in nine hospitals from January 2019 to December 2020 were included.

[Acute colonic pseudo-obstruction after caesarean section; Ogilvie's syndrome].

Background: Acute pseudo-obstruction of the colon - also known as Ogilvie's syndrome - is a rare clinical presentation in obstetrics. The syndrome is seen more often following caesarean section than vaginal delivery.

Case Description: We present a 38-year-old primigravida who developed Ogilvie's syndrome following secondary caesarean section.

[A late complication of cholecystitis].

A 75-year-old man developed a cholecystocutaneous fistula after conservative treatment for cholecystitis. Six months later, clinical and radiological examination revealed an abscess at the site of the fistula. Upon incision there was minimal pus, but a large gallstone was extracted.

Two versus five days of antibiotics after appendectomy for complex acute appendicitis (APPIC): study protocol for a randomized controlled trial.

Background: Acute appendicitis is one of the most common indications for emergency surgery. In patients with a complex appendicitis, prolonged antibiotic prophylaxis is recommended after appendectomy. There is no consensus regarding the optimum duration of antibiotics.

Surgery versus conservative management for recurrent and ongoing left-sided diverticulitis (DIRECT trial): an open-label, multicentre, randomised controlled trial.

Background: Patients with recurrent or persisting complaints after an episode of left-sided diverticulitis are managed with either conservative measures or elective sigmoidectomy. To date, there are no data from randomised trials. We aimed to establish which treatment leads to a better quality of life for patients with diverticulitis.

Accuracy of White Blood Cell Count and C-reactive Protein Levels Related to Duration of Symptoms in Patients Suspected of Acute Appendicitis.

Objectives: Low levels of white blood cell (WBC) count and C-reactive protein (CRP) have been suggested to sufficiently rule out acute appendicitis. The diagnostic value of these tests is likely to depend on the duration of complaints. The aim of this study was to evaluate the accuracy of these inflammatory markers in relation to duration of symptoms in patients suspected of acute appendicitis.

C-reactive protein and white blood cell count as triage test between urgent and nonurgent conditions in 2961 patients with acute abdominal pain.

The purpose of this article is to assess the diagnostic accuracy of C-reactive protein (CRP) and white blood cell (WBC) count to discriminate between urgent and nonurgent conditions in patients with acute abdominal pain at the emergency department, thereby guiding the selection of patients for immediate diagnostic imaging.Data from 3 large published prospective cohort studies of patients with acute abdominal pain were combined in an individual patient data meta-analysis. CRP levels and WBC counts were compared between patients with urgent and nonurgent final diagnoses.

Routine ultrasound and limited computed tomography for the diagnosis of acute appendicitis.

Background: Acute appendicitis continues to be a challenging diagnosis. Preoperative radiological imaging using ultrasound (US) or computed tomography (CT) has gained popularity as it may offer a more accurate diagnosis than classic clinical evaluation. The optimal implementation of these diagnostic modalities has yet to be established.

Standard outpatient re-evaluation for patients not admitted to the hospital after emergency department evaluation for acute abdominal pain.

Background: The aim of the present study was to investigate the efficacy and safety of standard outpatient re-evaluation for patients who are not admitted to the hospital after emergency department surgical consultation for acute abdominal pain.

Methods: All patients seen at the emergency department between June 2005 and July 2006 for acute abdominal pain were included in a prospective study using a structured diagnosis and management flowchart. Patients not admitted to the hospital were given appointments for re-evaluation at the outpatient clinic within 24 h.

Acute abdominal pain in women at an emergency department: predictors of chronicity.

Background: Persistence of pain after acute abdominal pain has been encountered but predictors of chronicity are insufficiently known.

Aims: To assess the course of acute abdominal pain and to explore whether chronicity is predicted by baseline demographic and clinical variables.

Methods: A follow-up study was conducted on all consecutive women who had visited an emergency department of a secondary care teaching hospital for acute abdominal pain.