Publications by authors named "Dieren S"
Objective: To compare nationwide outcomes of robotic liver resection (RLR) with laparoscopic liver resection (LLR).
Background: Minimally invasive liver resection is increasingly performed using the robotic approach as this could help overcome inherent technical limitations of laparoscopy. It is unknown if this translates to improved patient outcomes.
Aims: To provide insights into postdischarge patients' experiences and preferences regarding surgical wound care education at discharge in the Netherlands.
Background: Patient involvement in wound care practices postdischarge is beneficial for the prevention of surgical site infections and has become an essential component in reducing the burden on healthcare systems. Surgical wound care discharge education is crucial to achieve this.
Background: Pancreatoduodenectomy in elderly patients may be associated with increased postoperative mortality, but studies in minimally invasive pancreatoduodenectomy (MIPD) are scarce.
Methods: International multicenter retrospective study including patients aged >60 years undergoing MIPD (robot-assisted and laparoscopic) and open pancreatoduodenectomy (OPD), were categorized by age: 60-69, 70-79, and 80+ years. In each category, propensity score matching (PSM) was performed (1:1 ratio) between MIPD and OPD.
Background: This multicentre retrospective cohort study assessed whether functional outcomes after primary reverse shoulder arthroplasty (RSA) are favourable compared to secondary placement in elderly patients with displaced proximal humerus fractures (PHFs).
Methods: Fifty-three patients with primary and 32 with secondary RSA were included. Patient-reported outcome measures (PROMs) were assessed: Constant-Murley Score (CMS), Oxford Shoulder Score (OSS), Disabilities of the Arm, Shoulder and Hand (DASH) score, and Visual Analogue Scale (VAS).
Article Synopsis
- Inadequate treatment of enlarged lateral lymph nodes (LLNs) in rectal cancer patients leads to higher local recurrence rates, but LLN dissection (LLND) may help reduce this risk.
- This study will evaluate the outcomes of a standardized treatment approach after multidisciplinary training, aiming for a 50% reduction in local recurrence rates among patients with rectal cancer and enlarged LLNs.
- The trial involves 200 patients and will assess important outcomes such as local recurrence rates, morbidity, disease-free survival, and quality of life over three years post-surgery, with ethical approval from a Dutch medical ethics board.
Article Synopsis
- * Out of 3,530 patients, 11.6% required conversion, with robotic procedures having a lower conversion rate compared to laparoscopic ones, and conversion associated with various complications, like increased blood loss and longer hospital stays.
- * Emergency conversions showed even more severe outcomes, such as significantly higher blood loss and increased rates of intensive care admissions compared to non-emergency cases.
Background: Colorectal cancer screening programmes have led to a shift towards early-stage colorectal cancer, which, in selected cases, can be treated using local excision. However, local excision followed by completion total mesorectal excision (two-stage approach) may be associated with less favourable outcomes than primary total mesorectal excision (one-stage approach). The aim of this population study was to determine the distribution of treatment strategies for early rectal cancer in the Netherlands and to compare the short-term outcomes of primary total mesorectal excision with those of local excision followed by completion total mesorectal excision.
View Article and Find Full Text PDF: Incidences of perianal fistulas (PAFs) as a first manifestation of Crohn's disease (CD) vary widely in the literature. Aim: To analyse the percentage of patients with a PAF preceding CD diagnosis and assess the time to diagnosis. : A systematic literature search was conducted.
View Article and Find Full Text PDFObjective: To determine the interobserver variability for complications of pancreatoduodenectomy as defined by the International Study Group for Pancreatic Surgery (ISGPS) and others.
Background: Good interobserver variability for the definitions of surgical complications is of major importance in comparing surgical outcomes between and within centers. However, data on interobserver variability for pancreatoduodenectomy-specific complications are lacking.
Background: The use of surgery in patients with locally advanced pancreatic cancer (LAPC) following induction chemotherapy is increasing. However, most series do not report on the total cohort of patients undergoing surgical exploration; therefore, this single-center study investigates outcomes among all consecutive patients with LAPC who underwent surgical exploration.
Methods: We conducted a retrospective, single-center analysis including all consecutive patients with LAPC (Dutch Pancreatic Cancer Group criteria) who underwent surgical exploration with curative intent (January 2014-June 2023) after induction therapy.
Article Synopsis
- The study evaluated the prognostic significance of total tumor volume (TTV) in predicting early recurrence and overall survival in patients with colorectal liver metastases (CRLM) who received systemic therapy followed by local treatment.
- Results showed that both baseline TTV and changes in TTV after treatment were significantly associated with early recurrence and overall survival, while conventional measures like RECIST1.1 did not show predictive value.
- Findings were validated in an external patient cohort, confirming that TTV provides important prognostic information beyond traditional clinical factors for patients with initially unresectable CRLM.
Background: There is a lack of evidence regarding the relationship between family involvement and outcomes in gastrointestinal oncology patients after surgery. To evaluate the effect of a family involvement program for patients undergoing oncologic gastrointestinal surgery on unplanned readmissions within 30 days after surgery.
Methods: A multicenter patient-preference cohort study compared 2 groups: patients who participated in the family involvement program versus usual care.
Objective: Guidelines advise to perform endoscopic surveillance following ileocolic resection (ICR) in Crohn disease (CD) for timely diagnosis of recurrence. This study aims to assess the variation in endoscopic recurrence (ER) rates in patients after ICR for CD using the most commonly used classification systems, the Rutgeerts score (RS) and modified Rutgeerts score (mRS) classifications.
Methods: A systematic literature search using MEDLINE, Embase, and the Cochrane Library was performed.
Background: Engaging families in postsurgical care is potentially beneficial for improving cancer patient outcomes and quality of care. The authors developed a family involvement program (FIP) and in this study, the authors aim to evaluate the impact of the FIP on family caregiver burden and well-being. Moreover, the authors aim to assess the fidelity of the program.
View Article and Find Full Text PDFArticle Synopsis
- - The study compares the outcomes of robot-assisted and laparoscopic pancreatoduodenectomy across 50 European centers, focusing on major morbidity and mortality rates among patients from 2009 to 2020.
- - The results show no significant differences in major morbidity and 30-day mortality rates between the two surgical methods, but robot-assisted surgery had lower conversion rates and better lymph node retrieval.
- - Laparoscopic pancreatoduodenectomy had advantages like shorter operation times and lower rates of postoperative pancreatic complications, suggesting it may be the preferable approach in certain aspects.
Article Synopsis
- In the Netherlands, the use of neoadjuvant radiotherapy for rectal cancer decreased significantly from 2011 to 2016 following a guideline revision, raising concerns about the treatment of locally recurrent rectal cancer (LRRC).
- A study compared two national cohorts from 2011 and 2016, analyzing outcomes such as time to LRRC, metastasis presence, treatment intent, and survival rates.
- Despite the decline in neoadjuvant treatment, the rates of LRRC remained similar, but patients in 2016 had a greater chance of receiving curative treatments and showed improved two-year survival rates after developing LRRC.
Article Synopsis
- A nationwide study in the Netherlands aimed to compare the outcomes of robotic pancreatoduodenectomy and open pancreatoduodenectomy, focusing on safety and effectiveness across various centers from 2014 to 2021.
- The research included data from 701 patients who underwent robotic procedures and 4447 who had open surgery, with a focus on major complications and mortality rates.
- While robotic surgery had a longer operating time, it resulted in less blood loss, fewer infections, and shorter hospital stays, but it did not show significant differences in major complications or mortality compared to open surgery after matching the patient groups.
Background: Patients with rectal cancer who have enlarged lateral lymph nodes (LLNs) have an increased risk of lateral local recurrence (LLR). However, little is known about prognostic implications of malignant features (internal heterogeneity, irregular margins, loss of fatty hilum, and round shape) on MRI and number of enlarged LLNs, in addition to LLN size.
Methods: Of the 3,057 patients with rectal cancer included in this national, retrospective, cross-sectional cohort study, 284 with a cT3-4 tumor located ≤8 cm from the anorectal junction who received neoadjuvant treatment and who had visible LLNs on MRI were selected.
Introduction: About 25% of patients with localized pancreatic adenocarcinoma have non-elevated serum carbohydrate antigen (CA) 19-9 levels at baseline, hampering evaluation of response to preoperative treatment. Serum carcinoembryonic antigen (CEA) is a potential alternative.
Methods: This retrospective cohort study from five referral centers included consecutive patients with localized pancreatic adenocarcinoma (2012-2019), treated with one or more cycles of (m)FOLFIRINOX, and non-elevated CA19-9 levels (i.
Importance: Neoadjuvant short-course radiotherapy was routinely applied for nonlocally advanced rectal cancer (cT1-3N0-1M0 with >1 mm distance to the mesorectal fascia) in the Netherlands following the Dutch total mesorectal excision trial. This policy has shifted toward selective application after guideline revision in 2014.
Objective: To determine the association of decreased use of neoadjuvant radiotherapy with cancer-related outcomes and overall survival at a national level.
Background: Several international high-volume centers have reported good outcomes after resection of locally advanced pancreatic cancer (LAPC) following chemo(radio)therapy, but it is unclear how this translates to nationwide clinical practice and outcome. This study aims to assess the nationwide use and outcome of resection of LAPC following induction chemo(radio)therapy.
Patients And Methods: A multicenter retrospective study including all patients who underwent resection for LAPC following chemo(radio)therapy in all 16 Dutch pancreatic surgery centers (2014-2020), registered in the mandatory Dutch Pancreatic Cancer Audit.
For patients with colorectal cancer liver metastases (CRLM), the genetic mutation status is important in treatment selection and prognostication for survival outcomes. This study aims to investigate the relationship between radiomics imaging features and the genetic mutation status (KRAS mutation versus no mutation) in a large multicenter dataset of patients with CRLM and validate these findings in an external dataset. Patients with initially unresectable CRLM treated with systemic therapy of the randomized controlled CAIRO5 trial (NCT02162563) were included.
View Article and Find Full Text PDFBackground And Aims: An appendectomy for appendiceal inflammation has been suggested to ameliorate the clinical course of patients with ulcerative colitis [UC]. In contrast, for Crohn's disease [CD] an inverse association has been suggested with a higher incidence of CD and worse prognosis after appendectomy. The aim of this study was to analyse the clinical relevance of an inflamed appendix in CD patients undergoing ileocaecal resection [ICR].
View Article and Find Full Text PDFArticle Synopsis
- Researchers developed deep learning models to automate the segmentation of tumors and assess total tumor volume (TTV) in patients with colorectal liver metastases (CRLM).
- The study used CT scans from 259 patients, dividing them into training, validation, and testing sets, resulting in highly accurate segmentation models with a global Dice similarity coefficient of 0.86 for CRLM.
- The findings suggest that these models can significantly reduce the workload for radiologists by allowing for quick and reliable TTV assessments in patients with CRLM.