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.
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.
Aim: The purpose of this Dutch retrospective population-based study was to evaluate how short-term outcomes and inter-hospital variability after right hemicolectomy for colon cancer have evolved between 2012 and 2020.
Method: Patients who underwent right hemicolectomy for primary solitary colon cancer between 1 January 2012 and 31 December 2020 and were registered in the Dutch Colorectal Audit were included. Surgical characteristics and outcomes were assessed during three time periods (2012-2014, 2015-2017, 2018-2020).
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.
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.
Non-excisional techniques for pilonidal sinus disease (PSD) have gained popularity over the last years. The aim of this study was to review short and long-term outcomes for non-excisional techniques with special focus on the additive effect of treatment of the inner lining of the sinus cavity and the difference between primary and recurrent PSD. A systematic search was conducted in Embase, Medline, Web of Science Core Collection, Cochrane and Google Scholar databases for studies on non-excisional techniques for PSD including pit picking techniques with or without additional laser or phenol treatment, unroofing, endoscopic techniques and thrombin gelatin matrix application.
View Article and Find Full Text PDFObjective: 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.
View Article and Find Full Text PDFBackground: 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.
View Article and Find Full Text PDFPurpose: 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.
View Article and Find Full Text PDFBackground: 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.
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.
View Article and Find Full Text PDFPurpose: 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.
Ned Tijdschr Geneeskd
February 2019
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 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.
View Article and Find Full Text PDFBackground: 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.
View Article and Find Full Text PDFBackground: The intraoperative classification of appendicitis dictates the patient's postoperative management. Prolonged antibiotic prophylaxis is recommended for complex appendicitis (gangrenous, perforated, abscess), whereas preoperative prophylaxis suffices for simple appendicitis. Distinguishing these two conditions can be challenging.
View Article and Find Full Text PDFBackground: 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.
View Article and Find Full Text PDFObjectives: 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.
View Article and Find Full Text PDFThe 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.
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