Efficacy of oral compared with intramuscular vitamin B-12 supplementation after Roux-en-Y gastric bypass: a randomized controlled trial.

Background: After Roux-en-Y gastric bypass (RYGB), patients often develop a vitamin B-12 deficiency.

Objective: Our objective was to investigate whether oral supplementation increases and normalizes low vitamin B-12 concentrations (vitamin B-12 > 200 pmol/L) in RYGB patients as compared to intramuscular injections.

Design: A randomized controlled trial in RYGB patients with subnormal serum B-12 concentrations was performed.

A short or a long Roux limb in gastric bypass surgery: does it matter?

Background: The Roux-en-Y gastric bypass (RYGB) still remains the gold standard in bariatric surgery. However, no consensus exists on the optimal limb lengths to induce maximum weight reduction. The aim of the present study was to assess the effect of a longer alimentary limb (AL) length on weight reduction after RYGB.

Gallstones.

Gallstones grow inside the gallbladder or biliary tract. These stones can be asymptomatic or symptomatic; only gallstones with symptoms or complications are defined as gallstone disease. Based on their composition, gallstones are classified into cholesterol gallstones, which represent the predominant entity, and bilirubin ('pigment') stones.

Nighttime kidney transplantation is associated with less pure technical graft failure.

Purpose: To minimize cold ischemia time, transplantations with kidneys from deceased donors are frequently performed during the night. However, sleep deprivation of those who perform the transplantation may have adverse effects on cognitive and psychomotor performance and may cause reduced cognitive flexibility. We hypothesize that renal transplantations performed during the night are associated with an increased incidence of pure technical graft failure.

Is the Reluctance for the Implantation of Right Donor Kidneys Justified?

Background: The lengths of right renal veins are shorter when compared to their left counterparts. Since the implantation of kidneys with short renal veins is considered more challenging, many surgeons prefer left kidneys for transplantation. Therefore, our hypothesis is that the implantation of right kidneys from living and deceased donors is associated with more technical graft failures as compared to left kidneys.

Effectiveness and Safety of Sleeve Gastrectomy, Gastric Bypass, and Adjustable Gastric Banding in Morbidly Obese Patients: a Multicenter, Retrospective, Matched Cohort Study.

Background: Laparoscopic adjustable gastric band (LAGB), laparoscopic sleeve gastrectomy (LSG), and laparoscopic Roux-en-Y gastric bypass (LRYGB) are the most performed procedures worldwide (92 %) nowadays. However, comparative clinical trials are scarce in literature. The objective of this study was to compare the effectiveness and safety of the three most performed bariatric procedures.

Fast-track bariatric surgery improves perioperative care and logistics compared to conventional care.

Background: Due to the increased incidence of morbid obesity, the demand for bariatric surgery is increasing. Therefore, the methods for optimising perioperative care for the improvement of surgical outcome and to increase efficacy are necessary. The aim of this prospective matched cohort study is to objectify the effect of the fast-track surgery (FTS) programme in patients undergoing primary Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) surgery compared to conventional perioperative care (CPC).

Study protocol for a randomized controlled trial for anterior inguinal hernia repair: transrectus sheath preperitoneal mesh repair compared to transinguinal preperitoneal procedure.

Background: Anterior open treatment of the inguinal hernia with a tension-free mesh has reduced the incidence of hernia recurrence. The Lichtenstein procedure is the current reference technique for inguinal hernia treatment. Chronic pain has become the main postoperative complication after surgical inguinal hernia repair, especially following Lichtenstein.

Carprofen for perioperative analgesia causes early anastomotic leakage in the rat ileum.

Background: There is increasing evidence that perioperative use of NSAIDs may compromise the integrity of intestinal anastomoses. This study aims to characterize the negative effects of carprofen on early anastomotic healing in the rat ileum.

Results: In 159 male Wistar rats an anastomosis was constructed in the ileum.

Stages and evaluation of surgical innovation: a clinical example of the ileo neorectal anastomosis after ulcerative colitis and familial adenomatous polyposis.

Aim: So far, not many clinical examples that follow the IDEAL (Idea, Development, Evaluation, Assessment, and Long-term study) recommendations for evaluating and reporting surgical innovation and adoption are available.

Methods: In this article, all IDEAL stages will be described for a recent surgical innovation, the ileo neorectal anastomosis (INRA), a procedure restoring intestinal continuity after colectomy.

Results: INRA showed that the technique of small-bowel transposition with a vascular pedicle is feasible, with good long-term results.

[Increasing healthcare costs in the Netherlands: the doctor's role].

The sharply increasing costs of healthcare in the Netherlands are a huge problem and pose a serious threat for the sustainability of care in this country. The question is whether all treatments really do add value. Many of the treatments now provided are not indicated, or are even contraindicated.

Paracetamol does not compromise early wound repair in the intestine or abdominal wall in the rat.

Background: Paracetamol is a cornerstone for perioperative pain relief. Its mechanism of action may include a local anti-inflammatory effect with inhibition of cyclooxygenase isoenzymes. The scarce literature available on its effects on wound healing consists of preclinical studies into the effect of paracetamol on healing of the musculoskeletal system.

The ileo neo rectal anastomosis: long-term results of surgical innovation in patients after ulcerative colitis and familial adenomatous polyposis.

Purpose: Restorative proctocolectomy with ileo neo rectal anastomosis (INRA) combines cure of ulcerative colitis (UC) or familial adenomatous polyposis (FAP) with restoration of intestinal continuity. Evaluation of long-term results was needed to determine if there is a place for INRA in the armamentarium of a surgeon besides the ileal pouch anal anastomosis (IPAA).

Methods: All patients with INRA were included in the analysis.

A methodological systematic review on surgical site infections following spinal surgery: part 2: prophylactic treatments.

Study Design: A methodological systematic review.

Objective: To critically appraise the validity of preventive effects attributed to prophylactic treatments for surgical site infection (SSI) after spinal surgery.

Summary Of Background Data: As a result of a rapidly increasing number of spinal procedures, health care expenditure is expected to increase substantially in the foreseeable future.

A methodological systematic review on surgical site infections following spinal surgery: part 1: risk factors.

Study Design: A methodological systematic review.

Objective: To critically appraise the validity of risk factors for surgical site infection (SSI) after spinal surgery.

Summary Of Background Data: SSIs lead to higher morbidity, mortality, and increased health care costs.

The effect of fibrin glue on the early healing phase of intestinal anastomoses in the rat.

Purpose: Protecting the anastomotic integrity using suture or staple line reinforcement remains an important goal for ongoing research. The present comprehensive study aims to establish the effects of fibrin glue on the early phase of anastomotic healing in the rat intestine.

Methods: One hundred and eight young adult male Wistar rats underwent resection and anastomosis of both the ileum and colon.

Update of complications and functional outcome of the ileo-pouch anal anastomosis: overview of evidence and meta-analysis of 96 observational studies.

Objective: The objective of this study is to provide a comprehensive update of the outcome of the ileo-pouch anal anastomosis (IPAA).

Data Sources: An extensive search in PubMed, EMBASE, and The Cochrane Library was conducted.

Study Selection And Data Extraction: All studies published after 2000 reporting on complications or functional outcome after a primary open IPAA procedure for UC or FAP were selected.

Twenty-two-year follow-up of pronation external rotation type III-IV (OTA type C) ankle fractures: a retrospective cohort study.

Objective: Long-term evaluation protocolled treatment of pronation external rotation (PER) type III-IV (OTA type C) ankle fractures.

Design: Level III retrospective cohort study.

Setting: Level I trauma center.

Twenty-one-year follow-up of supination-external rotation type II-IV (OTA type B) ankle fractures: a retrospective cohort study.

Objective: To evaluate long-term results after protocoled treatment of supination-external rotation (SER) Type II-IV ankle injuries.

Design: Retrospective cohort study.

Setting: Level I trauma center.

Use of an acrylic mold for mortise view improvement in ankle fractures: a feasibility study.

We investigated an acrylic mold for use in obtaining ankle radiographs in 31 consecutive patients with ankle fracture. The radiologic examination consisted of routine lateral and mortise views, with the same views procured with the use of the acrylic mold to position the ankle. Radiographic evidence of ankle displacement was ascertained using both sets of radiographs, and 3 radiographic spaces (lateral talofibular, central talotibial, and medial talotibial) were considered identifiable on the mortise view.

Misdiagnosis of OTA type B (Weber B) ankle fractures leading to nonunion.

Little is known about the specific etiology of nonunion of stable Orthopaedic Trauma Association (OTA) type B fractures. In the present retrospective cohort study, we investigated all patients with a nonunion in a level 1 trauma center during an 8.5-year period.

A prospective cohort study to investigate cost-minimisation, of Traditional open, open fAst track recovery and laParoscopic fASt track multimodal management, for surgical patients with colon carcinomas (TAPAS study).

Background: The present developments in colon surgery are characterized by two innovations: the introduction of the laparoscopic operation technique and fast recovery programs such as the Enhanced Recovery After Surgery (ERAS) recovery program. The Tapas-study was conceived to determine which of the three treatment programs: open conventional surgery, open 'ERAS' surgery or laparoscopic 'ERAS' surgery for patients with colon carcinomas is most cost minimizing?

Method/design: The Tapas-study is a three-arm multicenter prospective cohort study. All patients with colon carcinoma, eligible for surgical treatment within the study period in four general teaching hospitals and one university hospital will be included.

The presentation, incidence, etiology, and treatment of surgical site infections after spinal surgery.

Study Design: Descriptive, retrospective cohort analysis.

Objective: To evaluate the presentation, etiology, and treatment of surgical site infections (SSI) after spinal surgery.

Summary Of Background Data: SSI after spine surgery is frequently seen.

Influence of perioperative resuscitation status on postoperative spine surgery complications.

Background Context: Restrictive transfusion criteria have led to decreased morbidity and mortality in critically ill patients. Their use has been extended to other patient groups. In adult spine surgery, ongoing postoperative blood losses and soft-tissue trauma may make these patients not appropriate for restrictive transfusion practices.