Addition of prophylactic compression garments to standard care to prevent irreversible lower limb lymphoedema after gynaeco-oncological therapy (Gynolymph): protocol for a randomised controlled trial embedded within an observation cohort study.

Introduction: In female patients diagnosed with gynaecological cancer, the main priority is treating cancer itself. However, a significant number of these patients develop lower limb lymphoedema (LLL), with its incidence strongly influenced by the diagnostic cut-off (a difference in leg circumference between both legs of 5% or 10%). LLL significantly impacts patients' quality of life (QoL) due to functional impairment, the daily time investment required for treatment, financial costs and affected body image.

Literature review on management of prosthetic graft infections after supra-aortic bypass surgery, based on a case report.

Background: Graft infections of supra-aortic bypasses are rare, but often life-threatening. Guidelines for treatment of graft infections recommend systemic antibiotics and complete graft removal, followed by in-situ or extra-anatomic revascularisation.

Methods: Based on case report, literature search was performed on Medline, Google Scholar and Web of Science databases, focussing on infected supra-aortic bypass reconstructions.

Dutch Translation of the Yost Self-Report Lower Extremity Lymphedema Screening Questionnaire in Women.

Background: Validated questionnaires of self-reported LEL are important in the assessment and diagnosis of LEL. The aim of this study was to validate and translate a Dutch version of the screening questionnaire, the LELSQ developed and validated by Yost et al. Methods: We tested the questionnaire on a group of healthy women and a group of patients diagnosed with LEL.

Optimizing anticoagulation therapy for in-hospital patients on direct oral anticoagulants: a single-centre modified Delphi study.

Aims: The management of patients treated with direct oral anticoagulants (DOACs) during hospitalization is a common challenge in clinical practice. Although bridging is generally not recommended, too often DOACs are switched to parenteral therapy with low molecular weight heparins. Our objectives were to update a local guideline for perioperative DOAC management and to develop a guideline for the anticoagulation management in non-surgical patients regarding temporary DOAC discontinuation.

Risk Factors for Mortality and Promoting Factors for Ambulation After Major Lower Limb Amputation for End-Stage Arterial Disease: A Multicenter Study.

Background: Around 1%-2% of patients with peripheral arterial disease will require a lower limb amputation at some point. Despite advancements in prevention and treatment, mortality after major amputation remains high. The aim of this study was to investigate the risk factors related to mortality and promoting factors for ambulation postamputation.

SurLym trial: study protocol for a multicentre pragmatic randomised controlled trial on the added value of reconstructive lymphatic surgery to decongestive lymphatic therapy for the treatment of lymphoedema.

Introduction: Lymphoedema is a chronic condition caused by lymphatic insufficiency. It leads to swelling of the limb/midline region and an increased risk of infection. Lymphoedema is often associated with mental and physical problems limiting quality of life.

Spontaneous Ilio-Iliac Arteriovenous Fistula from Rupture of an Iliac Aneurysm: A Systematic Review.

Background: Spontaneous arteriovenous fistulas (AVF) caused by iliac aneurysms are a rare condition with possible dramatic complications due to secondary hemodynamic changes. Diagnosis can be challenging because patients may present with progressive cardiac failure or even hemodynamic shock as primary symptom. Due to the rarity of the condition, data are scarce and treatment decisions are challenging.

Clinical presentation of sporadic and hereditary pheochromocytoma/paraganglioma.

Pheochromocytomas (PHEO) and paragangliomas (PGL) can occur sporadic or within genetic predisposition syndromes. Despite shared embryology, there are important differences between PHEO and PGL. The aim of this study was to describe the clinical presentation and disease characteristics of PHEO/PGL.

Endovenous Iliocaval Revascularization for Transplant Kidney Salvage.

Purpose: We report the case of a venous iliocaval recanalization to preserve a transplant kidney.

Case Report: A young patient with a nephrotic syndrome caused by focal segmental glomerulosclerosis (FSGS) underwent a robot-assisted living-donor kidney transplant. The postoperative course was uneventful; serum creatinine at discharge was 1.

Angiosarcoma after endovascular aneurysm repair: case report and literature review.

Introduction: Epithelioid angiosarcoma is a rare soft tissue sarcoma with a poor prognosis. We report two cases of patients who presented with a history of lower back pain, inflammatory signs and weight loss 5 and 6 years after endovascular aortic repair (EVAR) of an elective infrarenal abdominal aortic aneurysm (AAA). Imaging suggested graft infection but tissue samples revealed an epithelioid angiosarcoma.

The impact of an angiosome-targeted revascularization on healing rate, limb salvage and survival in critical limb threatening ischemia.

Objective: According to the angiosome concept ulcer healing and limb salvage should be superior if direct arterial flow to the source vessel of an affected angiosome is established compared to indirect flow where the angiosome is perfused by means of collaterals. The objective of this study was to evaluate the impact of direct versus indirect revascularization (DR/IR) in endovascular versus bypass surgery on ulcer healing, limb salvage and mortality.

Materials And Methods: A retrospective analysis of both endovascular and bypass distal (below the knee) lower limb revascularizations for chronic limb-threatening ischemia (CLTI) between 1993 and 2014 was performed.

Impact of Angiosome Targeted Femorodistal Bypass Surgery on Healing Rate and Outcome in Chronic Limb Threatening Ischaemia.

Objective: In the presence of long lesions, in patients with chronic limb threatening ischaemia, a femorodistal bypass is often the only option to avoid major amputation. This study investigated whether targeted bypass to the affected angiosome, according to the angiosome concept definition of direct (DR) and indirect revascularisation (IR), has an impact on wound healing, major amputation rate, and mortality.

Methods: A retrospective analysis was performed at Ghent University Hospital of 201 non-healing ischaemic wounds (Rutherford categories 5 and 6) requiring femorodistal bypass surgery in 177 patients (61% male, median age 69 years) with a follow up of 36 months.

Single-setting robot-assisted kidney transplantation consecutive to single-port laparoscopic nephrectomy in a child and robot-assisted living-related donor nephrectomy: initial Ghent experience.

Introduction: Kidney transplantation (KT) is the gold-standard treatment for end-stage renal disease (ESRD) in children. Robot-assisted kidney transplantation (RAKT) in adults is becoming increasingly common with potentially improved morbidity compared with open KT. The study objective was to evaluate feasibility and outcomes of RAKT in children.

Robot-assisted Kidney Autotransplantation: A Minimally Invasive Way to Salvage Kidneys.

Background: Kidney autotransplantation (KAT) is the ultimate way to salvage kidneys with complex renovascular, ureteral, or malignant pathologies that are not amenable to in situ reconstruction. A minimally invasive approach could broaden its adoption.

Objective: To describe operative technique, perioperative complications, and early functional outcomes of robot-assisted kidney autotransplantation (RAKAT).

Robot-assisted Kidney Transplantation with Regional Hypothermia Using Grafts with Multiple Vessels After Extracorporeal Vascular Reconstruction: Results from the European Association of Urology Robotic Urology Section Working Group.

Background: Kidney transplantation using grafts with multiple vessels (GMVs) is technically demanding and may be associated with increased risk of complications or suboptimal graft function. To date, no studies have reported on robot-assisted kidney transplantation (RAKT) using GMVs.

Objective: To report our experience with RAKT using GMVs from living donors, focusing on technical feasibility and early postoperative outcomes.

Magnesium and infection risk after kidney transplantation: An observational cohort study.

Objectives: Magnesium is a co-factor in natural killer and T cell reactivity and may modify the course of infections. We examined the association between baseline serum magnesium concentration and infections requiring admission the first year after kidney transplantation.

Methods: Inclusion of adults transplant recipients between January 2003 and 31 December 2013.

Implementation of a quality improvement initiative in Belgian diabetic foot clinics: feasibility and initial results.

Background: This article aims to describe the implementation and initial results of an audit-feedback quality improvement initiative in Belgian diabetic foot clinics.

Methods: Using self-developed software and questionnaires, diabetic foot clinics collected data in 2005, 2008 and 2011, covering characteristics, history and ulcer severity, management and outcome of the first 52 patients presenting with a Wagner grade ≥ 2 diabetic foot ulcer or acute neuropathic osteoarthropathy that year. Quality improvement was encouraged by meetings and by anonymous benchmarking of diabetic foot clinics.

Kidney donation after circulatory death in a country with a high number of brain dead donors: 10-year experience in Belgium.

Worldwide shortage of standard brain dead donors (DBD) has revived the use of kidneys donated after circulatory death (DCD). We reviewed the Belgian DCD kidney transplant (KT) experience since its reintroduction in 2000. Risk factors for delayed graft function (DGF) were identified using multivariate analysis.

Fifteen years of infrapopliteal arterial reconstructions with cryopreserved venous allografts for limb salvage.

Objective: The availability of autologous vein grafts remains the limiting factor in infragenual bypass surgery in many patients with critical limb ischemia (CLI). Alternatives such as prosthetic conduits are known to have a poor outcome and most are not resistant to infection. Based on previous experimental work, we started to use cryopreserved saphenous vein allografts for this indication 15 years ago.

Outcome of arterial reconstruction and free-flap coverage in diabetic foot ulcers: long-term results.

Background: Major amputation for advanced soft tissue loss with bone and tendon exposure, can be prevented in diabetes patients with a combined arterial reconstruction and free-flap transfer. We reviewed our 15-year outcome and evaluated the feasibility to save diabetic feet by means of this aggressive strategy.

Methods: A total of 55 type II diabetes patients (42-80 years of age), hospitalized between January 1992 and December 2006 for a combined arterial reconstruction and free-flap transfer, were followed until December 2007.