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Article ; Online: Safety of Antenatal Predniso(lo)ne and Dexamethasone on Fetal, Neonatal and Childhood Outcomes: A Systematic Review.

Slob, Elise M A / Termote, Jacqueline U M / Nijkamp, Janna W / van der Kamp, Hetty J / van den Akker, Erica L T

The Journal of clinical endocrinology and metabolism

2023 Volume 109, Issue 4, Page(s) e1328–e1335

Abstract: Context: Due to ethical considerations, antenatal dose finding for prednisolone and dexamethasone in pregnant women is limited, leading to a knowledge gap.: Objective: In order to guide the clinician in weighing benefits vs risks, the aim is to ... ...

Abstract	Context: Due to ethical considerations, antenatal dose finding for prednisolone and dexamethasone in pregnant women is limited, leading to a knowledge gap. Objective: In order to guide the clinician in weighing benefits vs risks, the aim is to systematically review the current literature on the side effects of antenatal predniso(lo)ne and dexamethasone use on the fetus, newborn, and (pre)pubertal child. Evidence acquisition: The search was performed in PubMed/MEDLINE and Embase using prespecified keywords and Medical Subject Headings. This systematic review investigated studies published until August 2022, with the following inclusion criteria: studies were conducted in humans and assessed side effects of long-term antenatal predniso(lo)ne and dexamethasone use during at least one of the trimesters on the child during the fetal period, neonatal phase, and during childhood. Evidence synthesis: In total, 328 papers in PubMed and 193 in Embase were identified. Fifteen studies were eligible for inclusion. Seven records were added through references. Antenatal predniso(lo)ne use may be associated with lower gestational age, but was not associated with miscarriages and stillbirths, congenital abnormalities, differences in blood pressure or low blood glucose levels at birth, or with low bone mass, long-term elevated cortisol and cortisone, or high blood pressure at prepubertal age. Increased risks of antenatal dexamethasone use include association with miscarriages and stillbirths, and from age 16 years, associations with disturbed insulin secretion and higher glucose and cholesterol levels. Conclusions: Based on the limited evidence found, predniso(lo)ne may have less side effects compared with dexamethasone in short- and long-term outcomes. Current literature shows minimal risk of side effects in the newborn from administration of a prenatal predniso(lo)ne dose of up to 10 mg per day.
MeSH term(s)	Infant, Newborn ; Child ; Pregnancy ; Female ; Humans ; Adolescent ; Stillbirth ; Abortion, Spontaneous ; Prenatal Care ; Dexamethasone/adverse effects ; Fetus
Chemical Substances	Dexamethasone (7S5I7G3JQL)
Language	English
Publishing date	2023-09-14
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgad547
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Article ; Online: The Efficacy, Safety, and Side Effects of Intrapericardial Triamcinolone Treatment in Children with Post-surgical Pericardial Effusion: A Case Series.

van der Werff, Manon H / van der Kamp, Hetty J / Breur, Johannes M P J

Pediatric cardiology

2021 Volume 43, Issue 1, Page(s) 142–146

Abstract: Intrapericardial triamcinolone can be used to treat chronic pericardial effusion (PE) in adults; however, pediatric data are lacking. In this case series we aim to evaluate the efficacy, safety, and side effects of intrapericardial triamcinolone in ... ...

Abstract	Intrapericardial triamcinolone can be used to treat chronic pericardial effusion (PE) in adults; however, pediatric data are lacking. In this case series we aim to evaluate the efficacy, safety, and side effects of intrapericardial triamcinolone in children with PE. The incidence and treatment of post-surgical PE from 2009 to 2019 were determined using the institutional surgical database and electronic patient records. Furthermore, a retrospective analysis of efficacy, safety, and side effects of intrapericardial triamcinolone treatment for chronic post-surgical PE was performed. The incidence of postoperative PE requiring treatment was highest after atrial septal defect (ASD) closure when compared to other types of cardiac surgery (9.7% vs 4.3%). Intrapericardial treatment with triamcinolone resolved pericardial effusion in 3 out of 4 patients. All patients developed significant systemic side effects. Surgical ASD closure is associated with an increased risk of development of PE requiring treatment. Intrapericardial triamcinolone is an effective treatment for chronic postoperative PE in children, but is always associated with significant systemic side effects. Close monitoring and treatment of adrenal insufficiency are mandatory in these cases.
MeSH term(s)	Adult ; Child ; Heart Septal Defects, Atrial ; Humans ; Pericardial Effusion/chemically induced ; Pericardial Effusion/drug therapy ; Pericarditis ; Retrospective Studies ; Triamcinolone/adverse effects
Chemical Substances	Triamcinolone (1ZK20VI6TY)
Language	English
Publishing date	2021-08-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	800857-7
ISSN	1432-1971 ; 0172-0643
ISSN (online)	1432-1971
ISSN	0172-0643
DOI	10.1007/s00246-021-02704-z
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Zs.A 1528: Show issues

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Article ; Online: Rapid early increase in BMI is associated with impaired longitudinal growth in children with cystic fibrosis.

Hak, Sarah F / Arets, Hubertus G M / van der Ent, Cornelis K / van der Kamp, Hetty J

Pediatric pulmonology

2019 Volume 54, Issue 8, Page(s) 1209–1215

Abstract: Background: We aimed to assess whether final height in children with cystic fibrosis (CF) is affected by body mass index (BMI), BMI increase, pulmonary function, and cystic fibrosis-related diabetes (CFRD).: Study design: A longitudinal, ... ...

Abstract	Background: We aimed to assess whether final height in children with cystic fibrosis (CF) is affected by body mass index (BMI), BMI increase, pulmonary function, and cystic fibrosis-related diabetes (CFRD). Study design: A longitudinal, retrospective study was performed in a cohort of 57 patients with CF (30 boys, 27 girls) born between 1997 and 2001. Height and weight were recorded annually from ages 0.5 to 10 years and biannually up to the age of 18. Measurements were converted to height-for-age-adjusted-for-target-height (HFA-TH) and BMI-for-age z-scores. Analyses were performed using the independent t tests and the Pearson's correlation. Results: For both boys and girls, HFA-TH and BMI-for-age z-scores were significantly lower in the first year of life, these scores increased rapidly until the age of 11 and 8 years, respectively. In boys, HFA-TH z-scores declined during puberty, with subsequently significantly impaired final height (z-score, -0.56, n = 30, standard deviation [SD] = 0.81, P = 0.001). In girls, HFA-TH z-scores briefly declined after the age of 8 years, but then increased to a z-score of -0.21 (n = 27, SD = 0.87) at age 18, which is not significantly lower than the national average (P = 0.22). Pulmonary function and the presence of CFRD were not associated with final height. However, rapid BMI increase between ages 1 and 6 was negatively associated with final height in boys (n = 29, r =-0.420; P = 0.023) and girls (n = 25, r =-0.466; P = 0.019). Conclusions: In boys and girls, early BMI increase was associated with impaired final height. We suggest that early childhood serves as a "window" in which nutritional variations may program subsequent growth. Further refinement of nutritional strategies could be needed.
MeSH term(s)	Adolescent ; Adolescent Development ; Body Height ; Body Mass Index ; Body Weight ; Child ; Child Development ; Child, Preschool ; Cystic Fibrosis/complications ; Diabetes Mellitus/etiology ; Female ; Humans ; Infant ; Longitudinal Studies ; Male ; Nutritional Status ; Retrospective Studies
Language	English
Publishing date	2019-04-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	632784-9
ISSN	1099-0496 ; 8755-6863
ISSN (online)	1099-0496
ISSN	8755-6863
DOI	10.1002/ppul.24343
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Zs.A 2143: Show issues

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Article ; Online: Optimizing the Timing of Highest Hydrocortisone Dose in Children and Adolescents With 21-Hydroxylase Deficiency.

Schröder, Mariska A M / van Herwaarden, Antonius E / Span, Paul N / van den Akker, Erica L T / Bocca, Gianni / Hannema, Sabine E / van der Kamp, Hetty J / de Kort, Sandra W K / Mooij, Christiaan F / Schott, Dina A / Straetemans, Saartje / van Tellingen, Vera / van der Velden, Janiëlle A / Sweep, Fred C G J / Claahsen-van der Grinten, Hedi L

The Journal of clinical endocrinology and metabolism

2021 Volume 107, Issue 4, Page(s) e1661–e1672

Abstract: Context: Hydrocortisone treatment of young patients with 21-hydroxylase deficiency (21OHD) is given thrice daily, but there is debate about the optimal timing of the highest hydrocortisone dose, either mimicking the physiological diurnal rhythm (morning) ...

Abstract	Context: Hydrocortisone treatment of young patients with 21-hydroxylase deficiency (21OHD) is given thrice daily, but there is debate about the optimal timing of the highest hydrocortisone dose, either mimicking the physiological diurnal rhythm (morning), or optimally suppressing androgen activity (evening). Objective: We aimed to compare 2 standard hydrocortisone timing strategies, either highest dosage in the morning or evening, with respect to hormonal status throughout the day, nocturnal blood pressure (BP), and sleep and activity scores. Methods: This 6-week crossover study included 39 patients (aged 4-19 years) with 21OHD. Patients were treated for 3 weeks with the highest hydrocortisone dose in the morning, followed by 3 weeks with the highest dose in the evening (n = 21), or vice versa (n = 18). Androstenedione (A4) and 17-hydroxyprogesterone (17OHP) levels were quantified in saliva collected at 5 am; 7 am; 3 pm; and 11 pm during the last 2 days of each treatment period. The main outcome measure was comparison of saliva 17OHP and A4 levels between the 2 treatment strategies. Results: Administration of the highest dose in the evening resulted in significantly lower 17OHP levels at 5 am, whereas the highest dose in the morning resulted in significantly lower 17OHP and A4 levels in the afternoon. The 2 treatment dose regimens were comparable with respect to averaged daily hormone levels, nocturnal BP, and activity and sleep scores. Conclusion: No clear benefit for either treatment schedule was established. Given the variation in individual responses, we recommend individually optimizing dose distribution and monitoring disease control at multiple time points.
MeSH term(s)	17-alpha-Hydroxyprogesterone ; Adolescent ; Adrenal Hyperplasia, Congenital/drug therapy ; Androgens/therapeutic use ; Child ; Child, Preschool ; Cross-Over Studies ; Female ; Humans ; Hydrocortisone ; Male ; Young Adult
Chemical Substances	Androgens ; 17-alpha-Hydroxyprogesterone (68-96-2) ; Hydrocortisone (WI4X0X7BPJ)
Language	English
Publishing date	2021-11-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgab826
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Article ; Online: Extreme phenotypic variability of a novel GLI2 mutation in a large family with panhypopituitarism and polydactyly: clinical implications.

Kremer Hovinga, Idske C L / Giltay, Jacques C / van der Crabben, Saskia N / Steyls, Anja / van der Kamp, Hetty J / Paulussen, Aimee D C

Clinical endocrinology

2018 Volume 89, Issue 3, Page(s) 378–380

MeSH term(s)	Child ; Female ; Genotype ; Humans ; Hypopituitarism/genetics ; Male ; Mutation/genetics ; Nuclear Proteins/genetics ; Phenotype ; Polydactyly/genetics ; Zinc Finger Protein Gli2/genetics
Chemical Substances	GLI2 protein, human ; Nuclear Proteins ; Zinc Finger Protein Gli2
Language	English
Publishing date	2018-07-03
Publishing country	England
Document type	Letter
ZDB-ID	121745-8
ISSN	1365-2265 ; 0300-0664
ISSN (online)	1365-2265
ISSN	0300-0664
DOI	10.1111/cen.13760
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Zs.A 814: Show issues

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Article ; Online: Analysis of therapy monitoring in the International Congenital Adrenal Hyperplasia Registry.

Lawrence, Neil / Bacila, Irina / Dawson, Jeremy / Bryce, Jillian / Ali, Salma R / van den Akker, Erica L T / Bachega, Tânia A S S / Baronio, Federico / Birkebaek, Niels H / Bonfig, Walter / van der Grinten, Hedi C / Costa, Eduardo C / de Vries, Liat / Elsedfy, Heba / Güven, Ayla / Hannema, Sabine / Iotova, Violeta / van der Kamp, Hetty J / Clemente, María /

Lichiardopol, Corina R / Milenkovic, Tatjana / Neumann, Uta / Nordenström, Ana / Poyrazoğlu, Şukran / Probst-Scheidegger, Ursina / De Sanctis, Luisa / Tadokoro-Cuccaro, Rieko / Thankamony, Ajay / Vieites, Ana / Yavaş, Zehra / Faisal Ahmed, Syed / Krone, Nils

Clinical endocrinology

2022 Volume 97, Issue 5, Page(s) 551–561

Abstract: Objective: Congenital adrenal hyperplasia (CAH) requires exogenous steroid replacement. Treatment is commonly monitored by measuring 17-OH progesterone (17OHP) and androstenedione (D4).: Design: Retrospective cohort study using real-world data to ... ...

Abstract	Objective: Congenital adrenal hyperplasia (CAH) requires exogenous steroid replacement. Treatment is commonly monitored by measuring 17-OH progesterone (17OHP) and androstenedione (D4). Design: Retrospective cohort study using real-world data to evaluate 17OHP and D4 in relation to hydrocortisone (HC) dose in CAH patients treated in 14 countries. Patients: Pseudonymized data from children with 21-hydroxylase deficiency (21OHD) recorded in the International CAH Registry. Measurements: Assessments between January 2000 and October 2020 in patients prescribed HC were reviewed to summarise biomarkers 17OHP and D4 and HC dose. Longitudinal assessment of measures was carried out using linear mixed-effects models (LMEM). Results: Cohort of 345 patients, 52.2% female, median age 4.3 years (interquartile range: 3.1-9.2) were taking a median 11.3 mg/m Discussion: Registry data show large variability in 17OHP and D4 between centres. 17OHP correlates with D4 well when accounting for age. Prescribed HC dose per body surface area decreased with weight gain.
MeSH term(s)	17-alpha-Hydroxyprogesterone ; Adrenal Hyperplasia, Congenital/drug therapy ; Androstenedione ; Child ; Child, Preschool ; Female ; Humans ; Hydrocortisone/therapeutic use ; Male ; Progesterone ; Registries ; Retrospective Studies
Chemical Substances	Androstenedione (409J2J96VR) ; Progesterone (4G7DS2Q64Y) ; 17-alpha-Hydroxyprogesterone (68-96-2) ; Hydrocortisone (WI4X0X7BPJ)
Language	English
Publishing date	2022-07-11
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	121745-8
ISSN	1365-2265 ; 0300-0664
ISSN (online)	1365-2265
ISSN	0300-0664
DOI	10.1111/cen.14796
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Article ; Online: Leptin receptor deficiency: a systematic literature review and prevalence estimation based on population genetics.

Kleinendorst, Lotte / Abawi, Ozair / van der Kamp, Hetty J / Alders, Mariëlle / Meijers-Heijboer, Hanne E J / van Rossum, Elisabeth F C / van den Akker, Erica L T / van Haelst, Mieke M

European journal of endocrinology

2019 Volume 182, Issue 1, Page(s) 47–56

Abstract: Objective: Leptin receptor (LepR) deficiency is an autosomal-recessive endocrine disorder causing early-onset severe obesity, hyperphagia and pituitary hormone deficiencies. As effective pharmacological treatment has recently been developed, diagnosing ... ...

Abstract	Objective: Leptin receptor (LepR) deficiency is an autosomal-recessive endocrine disorder causing early-onset severe obesity, hyperphagia and pituitary hormone deficiencies. As effective pharmacological treatment has recently been developed, diagnosing LepR deficiency is urgent. However, recognition is challenging and prevalence is unknown. We aim to elucidate the clinical spectrum and to estimate the prevalence of LepR deficiency in Europe. Design: Comprehensive epidemiologic analysis and systematic literature review. Methods: We curated a list of LEPR variants described in patients and elaborately evaluated their phenotypes. Subsequently, we extracted allele frequencies from the Genome Aggregation Database (gnomAD), consisting of sequencing data of 77 165 European individuals. We then calculated the number of individuals with biallelic disease-causing LEPR variants. Results: Worldwide, 86 patients with LepR deficiency are published. We add two new patients, bringing the total of published patients to 88, of which 21 are European. All patients had early-onset obesity; 96% had hyperphagia; 34% had one or more pituitary hormone deficiencies. Our calculation results in 998 predicted patients in Europe, corresponding to a prevalence of 1.34 per 1 million people (95% CI: 0.95-1.72). Conclusions: This study shows that LepR deficiency is more prevalent in Europe (n = 998 predicted patients) than currently known (n = 21 patients), suggesting that LepR deficiency is underdiagnosed. An important cause for this could be lack of access to genetic testing. Another possible explanation is insufficient recognition, as only one-third of patients has pituitary hormone deficiencies. With novel highly effective treatment emerging, diagnosing LepR deficiency is more important than ever.
MeSH term(s)	Female ; Genetics, Population/methods ; Humans ; Male ; Prevalence ; Receptors, Leptin/deficiency ; Receptors, Leptin/genetics
Chemical Substances	LEPR protein, human ; Receptors, Leptin
Language	English
Publishing date	2019-11-28
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1183856-5
ISSN	1479-683X ; 0804-4643
ISSN (online)	1479-683X
ISSN	0804-4643
DOI	10.1530/EJE-19-0678
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Uh III Zs.147: Show issues

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Article ; Online: Second-tier Testing for 21-Hydroxylase Deficiency in the Netherlands: A Newborn Screening Pilot Study.

Stroek, Kevin / Ruiter, An / van der Linde, Annelieke / Ackermans, Mariette / Bouva, Marelle J / Engel, Henk / Jakobs, Bernadette / Kemper, Evelien A / van den Akker, Erica L T / van Albada, Mirjam E / Bocca, Gianni / Finken, Martijn J J / Hannema, Sabine E / Mieke Houdijk, E C A / van der Kamp, Hetty J / van Tellingen, Vera / Paul van Trotsenburg, A S / Zwaveling-Soonawala, Nitash / Bosch, Annet M /

de Jonge, Robert / Heijboer, Annemieke C / Claahsen-van der Grinten, Hedi L / Boelen, Anita

The Journal of clinical endocrinology and metabolism

2021 Volume 106, Issue 11, Page(s) e4487–e4496

Abstract: Context: Newborn screening (NBS) for classic congenital adrenal hyperplasia (CAH) consists of 17-hydroxyprogesterone (17-OHP) measurement with gestational age-adjusted cutoffs. A second heel puncture (HP) is performed in newborns with inconclusive ... ...

Abstract	Context: Newborn screening (NBS) for classic congenital adrenal hyperplasia (CAH) consists of 17-hydroxyprogesterone (17-OHP) measurement with gestational age-adjusted cutoffs. A second heel puncture (HP) is performed in newborns with inconclusive results to reduce false positives. Objective: We assessed the accuracy and turnaround time of the current CAH NBS algorithm in comparison with alternative algorithms by performing a second-tier 21-deoxycortisol (21-DF) pilot study. Methods: Dried blood spots (DBS) of newborns with inconclusive and positive 17-OHP (immunoassay) first HP results were sent from regional NBS laboratories to the Amsterdam UMC Endocrine Laboratory. In 2017-2019, 21-DF concentrations were analyzed by LC-MS/MS in parallel with routine NBS. Diagnoses were confirmed by mutation analysis. Results: A total of 328 DBS were analyzed; 37 newborns had confirmed classic CAH, 33 were false-positive and 258 were categorized as negative in the second HP following the current algorithm. With second-tier testing, all 37 confirmed CAH had elevated 21-DF, while all 33 false positives and 253/258 second-HP negatives had undetectable 21-DF. The elevated 21-DF of the other 5 newborns may be NBS false negatives or second-tier false positives. Adding the second-tier results to inconclusive first HPs reduced the number of false positives to 11 and prevented all 286 second HPs. Adding the second tier to both positive and inconclusive first HPs eliminated all false positives but delayed referral for 31 CAH patients (1-4 days). Conclusion: Application of the second-tier 21-DF measurement to inconclusive first HPs improved our CAH NBS by reducing false positives, abolishing the second HP, and thereby shortening referral time.
MeSH term(s)	17-alpha-Hydroxyprogesterone/blood ; Adrenal Hyperplasia, Congenital/blood ; Adrenal Hyperplasia, Congenital/diagnosis ; Algorithms ; Cortodoxone/blood ; False Positive Reactions ; Humans ; Infant, Newborn ; Neonatal Screening/methods ; Netherlands ; Pilot Projects ; Sensitivity and Specificity
Chemical Substances	21-deoxycortisol (641-77-0) ; 17-alpha-Hydroxyprogesterone (68-96-2) ; Cortodoxone (WDT5SLP0HQ)
Language	English
Publishing date	2021-06-25
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgab464
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Article ; Online: Evaluation of the Dutch neonatal screening for congenital adrenal hyperplasia.

van der Linde, Annelieke A A / Schönbeck, Yvonne / van der Kamp, Hetty J / van den Akker, Erica L T / van Albada, Mirjam E / Boelen, Anita / Finken, Martijn J J / Hannema, Sabine E / Hoorweg-Nijman, Gera / Odink, Roelof J / Schielen, Peter C J I / Straetemans, Saartje / van Trotsenburg, Paul S / Claahsen-van der Grinten, Hedi L / Verkerk, Paul H

Archives of disease in childhood

2019 Volume 104, Issue 7, Page(s) 653–657

Abstract: Background: In 2002, a nationwide screening for congenital adrenal hyperplasia (CAH) was introduced in the Netherlands. The aim of our study is to evaluate the validity of the neonatal screening for CAH and to assess how many newborns with salt-wasting ( ...

Abstract	Background: In 2002, a nationwide screening for congenital adrenal hyperplasia (CAH) was introduced in the Netherlands. The aim of our study is to evaluate the validity of the neonatal screening for CAH and to assess how many newborns with salt-wasting (SW) CAH have already been clinically diagnosed before the screening result was known. Methods: Retrospective, descriptive study. The following data of patients with positive screening results since implementation of the screening programme were collected (1 January 2002 up until 31 December 2013): gestational age, sex, diagnosis, clinical presentation and contribution of screening to the diagnosis. Results: In the evaluated period, 2 235 931 newborns were screened. 479 children had an abnormal screening result, 133 children were diagnosed with CAH (114 SW, 14 simple virilizing (SV)), five non-classic CAH. During this period, no patients with SW CAH were missed by neonatal screening (sensitivity was 100%). After exclusion of 17 cases with missing information on diagnosis, specificity was 99.98% and positive predictive value was 24.7%. Most false positives (30%) were attributable to prematurity. Of patients with SW CAH, 68% (71/104) patients were detected by neonatal screening and 33 (33/104) were clinically diagnosed. Of girls with SW CAH, 38% (14/37) were detected by neonatal screening and 62% (23/37) were clinically diagnosed. Conclusion: The Dutch neonatal screening has an excellent sensitivity and high specificity. Both boys and girls can benefit from neonatal screening.
MeSH term(s)	Adrenal Hyperplasia, Congenital/diagnosis ; Adrenal Hyperplasia, Congenital/epidemiology ; Adrenal Hyperplasia, Congenital/pathology ; Female ; Humans ; Incidence ; Infant, Newborn ; Male ; Neonatal Screening/standards ; Netherlands/epidemiology ; Retrospective Studies ; Sensitivity and Specificity
Language	English
Publishing date	2019-02-02
Publishing country	England
Document type	Evaluation Study ; Journal Article
ZDB-ID	524-1
ISSN	1468-2044 ; 0003-9888 ; 1359-2998
ISSN (online)	1468-2044
ISSN	0003-9888 ; 1359-2998
DOI	10.1136/archdischild-2018-315972
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Article ; Online: Relocation of inadequate resection margins in the wound bed during oral cavity oncological surgery: A feasibility study.

van Lanschot, Cornelia G F / Mast, Hetty / Hardillo, Jose A / Monserez, Dominiek / Ten Hove, Ivo / Barroso, Elisa M / Cals, Froukje L J / Smits, Roeland W H / van der Kamp, Martine F / Meeuwis, Cees A / Sewnaik, Aniel / Verdijk, Rob / van Leenders, Geert J L H / Noordhoek Hegt, Vincent / Bakker Schut, Tom C / Baatenburg de Jong, Robert J / Puppels, Gerwin J / Koljenović, Senada

Head & neck

2019 Volume 41, Issue 7, Page(s) 2159–2166

Abstract: Background: Specimen-driven intraoperative assessment of the resection margins provides immediate feedback if an additional excision is needed. However, relocation of an inadequate margin in the wound bed has shown to be difficult. The objective of this ...

Abstract	Background: Specimen-driven intraoperative assessment of the resection margins provides immediate feedback if an additional excision is needed. However, relocation of an inadequate margin in the wound bed has shown to be difficult. The objective of this study is to assess a reliable method for accurate relocation of inadequate tumor resection margins in the wound bed after intraoperative assessment of the specimen. Methods: During oral cavity cancer surgery, the surgeon placed numbered tags on both sides of the resection line in a pair-wise manner. After resection, one tag of each pair remained on the specimen and the other tag in the wound bed. Upon detection of an inadequate margin in the specimen, the tags were used to relocate this margin in the wound bed. Results: The method was applied during 80 resections for oral cavity cancer. In 31 resections an inadequate margin was detected, and based on the paired tagging an accurate additional resection was achieved. Conclusion: Paired tagging facilitates a reliable relocation of inadequate margins, enabling an accurate additional resection during the initial surgery.
MeSH term(s)	Carcinoma/pathology ; Carcinoma/surgery ; Feasibility Studies ; Frozen Sections ; Humans ; Intraoperative Care/methods ; Margins of Excision ; Mouth Neoplasms/pathology ; Mouth Neoplasms/surgery
Language	English
Publishing date	2019-02-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	645165-2
ISSN	1097-0347 ; 0148-6403 ; 1043-3074
ISSN (online)	1097-0347
ISSN	0148-6403 ; 1043-3074
DOI	10.1002/hed.25690
Database	MEDical Literature Analysis and Retrieval System OnLINE

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