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Article ; Online: Reply To: Incisional Hernias After Open Abdominal Aortic Aneurysm Repair: More Attention Needed at Start and Finish.

Dewulf, Maxime / Bouvy, Nicole D / Van Herzeele, Isabelle

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

2022 Volume 64, Issue 2-3, Page(s) 282–283

MeSH term(s)	Humans ; Incisional Hernia/etiology ; Incisional Hernia/surgery ; Aortic Aneurysm, Abdominal/surgery ; Vascular Surgical Procedures/adverse effects ; Abdominal Wound Closure Techniques ; Hernia, Ventral/surgery
Language	English
Publishing date	2022-06-11
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	1225869-6
ISSN	1532-2165 ; 1078-5884
ISSN (online)	1532-2165
ISSN	1078-5884
DOI	10.1016/j.ejvs.2022.06.003
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Article ; Online: Evaluation of a New Elastic Ostomy Appliance to Decrease Skin Complications: Results of a Pilot Study.

Bloemen, Arthur / Aarts, Frits / Bouvy, Nicole / Nijhuis, Paul

Wound management & prevention

2020 Volume 66, Issue 5, Page(s) 30–36

Abstract: Peristomal skin complications due to appliance leakage frequently occur in all types of ostomies, resulting in great emotional, social, and financial impact for patients.: Purpose: This pilot study was conducted to evaluate the safety and use of a new, ...

Abstract	Peristomal skin complications due to appliance leakage frequently occur in all types of ostomies, resulting in great emotional, social, and financial impact for patients. Purpose: This pilot study was conducted to evaluate the safety and use of a new, reusable, nonadherent, elastic device. Method: A convenience sample of nonhospitalized patients with ileostomies and colostomies was recruited through the Dutch ostomy patient association. Participant inclusion criteria stipulated the presence of ileostomy or colostomy, a body mass index (BMI) between 18 and 30, and presence of an osto-my for at least 1 month. Patients with existing prolapse or necrosis of the ostomy, inability to give consent, or concurrent usage of other aids to prevent leakage or skin problems were excluded. Participants were fitted with and asked to wear the appliance continuously for 4 weeks and report experiences in a structured diary. Patient charts were reviewed for baseline demographic characteristics that included age, gender, American Society of Anaesthesiologists classification, and BMI. Study nurses performed structured weekly interviews and inspections of the ostomies and peristomal skin. The primary outcome measure was occurrence of serious adverse events such as ostomy necrosis or perforation. Secondary outcome measures were patient reported incidents of leakage and satisfaction during wear and changing of the appli-ance. Peristomal skin complications also were recorded. Descriptive statistics were used to analyze results. In addition, subgroup analysis of patients with a parastomal hernia was performed because of the potential benefits of the device design in these cases. Results: Participants included 23 patients (16 with colostomies, 7 with ileostomies); 13 participants (57%) were female. Mean age and BMI were 64 years and 28.3, respectively. Six (6) patients had a parastomal hernia. Due to shifting or discomfort while wearing the appliance, 16 participants discontinued use before the end of the study and were excluded from analysis from the point they left the study. Mean duration of participation was 12.8 days. No adverse events occurred. Mean number of incidents of leakage/week decreased from 3.5 ± 4.9 at start of the study to 1.8 ± 1.3 at week 4. The mean number of pouches used/week decreased from 10.5 ± 5.4 to 8 ± 2.6. Peristomal skin reactions present in 15 patients at start of the study decreased to 1 patient at the end of the study. Patient satisfaction did not change over the course of the study. Patients with parastomal hernias had similar results. Conclusion: No serious adverse events were reported and leakage and skin irritation were found to improve, but participant dropout rate was high and average usage time was only 12.8 days, which limited interpretation of the results. The data suggest that the appliance may offer an (intermittent) alternative to existing ostomy materials for patients experiencing troublesome leakages, peristomal skin problems, or parastomal hernias, but further research is needed to explore these outcomes.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Equipment Design/standards ; Female ; Humans ; Male ; Middle Aged ; Netherlands ; Ostomy/adverse effects ; Ostomy/methods ; Ostomy/statistics & numerical data ; Pilot Projects ; Prospective Studies ; Skin Care/methods ; Skin Diseases/physiopathology ; Skin Diseases/prevention & control
Language	English
Publishing date	2020-05-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2964376-4
ISSN	2640-5245 ; 2640-5237
ISSN (online)	2640-5245
ISSN	2640-5237
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Article ; Online: Enhancing intestinal anastomotic healing using butyrate: Systematic review and meta-analysis of experimental animal studies.

Wildeboer, Aurelia C L / van Helsdingen, Claire P M / Gallé, Camille G / de Vries, Rob B M / Derikx, Joep P M / Bouvy, Nicole D

PloS one

2023 Volume 18, Issue 6, Page(s) e0286716

Abstract: Background: Despite advancements in surgical technique and perioperative care, intestinal anastomoses still have a 10-15 per cent risk of leakage, which results in considerable morbidity and/or mortality. Recent animal studies have suggested that ... ...

Abstract	Background: Despite advancements in surgical technique and perioperative care, intestinal anastomoses still have a 10-15 per cent risk of leakage, which results in considerable morbidity and/or mortality. Recent animal studies have suggested that administration of butyrate to the anastomotic site results in enhanced anastomotic strength, which may prevent leakage. This systematic review and meta-analysis summarises current evidence concerning the effect of butyrate administration on anastomotic healing and will form a scientific basis for the development of new research into this subject. Methods: Animal studies on the effect of butyrate-based interventions in models of intestinal anastomotic healing were systematically retrieved from online databases. Bibliographical data, study characteristics and outcome data were extracted, and internal validity of the studies was assessed. Outcomes studied through meta-analysis concerned: anastomotic strength, anastomotic leakage, collagen metabolism and general histologic parameters of wound healing. Results: A comprehensive search and selection identified 19 relevant studies containing 41 individual comparisons. Design and conduct of most experiments were poorly reported resulting in an unclear risk of bias. Meta-analyses showed that butyrate administration significantly increases anastomotic strength (SMD 1.24, 0.88 to 1.61), collagen synthesis (SMD 1.44, 0.72 to 2.15) and collagen maturation, making anastomoses less prone to leakage in the early postoperative period (OR 0.37, 0.15 to 0.93). Conclusion: This systematic review and meta-analysis shows that there is potential ground to investigate the use of butyrate in clinical trials to prevent anastomotic leakage in intestinal surgery. However, more research is necessary to define the best application form, dosage and administration route.
MeSH term(s)	Animals ; Humans ; Anastomotic Leak/prevention & control ; Butyrates ; Anastomosis, Surgical/adverse effects ; Digestive System Surgical Procedures ; Wound Healing ; Animals, Laboratory
Chemical Substances	Butyrates
Language	English
Publishing date	2023-06-13
Publishing country	United States
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0286716
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Article: Near-Infrared Spectral Similarity between Ex Vivo Porcine and In Vivo Human Tissue.

Vries, Eva de / Alic, Lejla / Schols, Rutger M / Emanuel, Kaj S / Wieringa, Fokko P / Bouvy, Nicole D / Tuijthof, Gabriëlle J M

Life (Basel, Switzerland)

2023 Volume 13, Issue 2

Abstract: Background: In vivo diffuse reflectance spectroscopy provides additional contrast in discriminating nerves embedded in adipose tissue during surgery. However, large datasets are required to achieve clinically acceptable classification levels. This study ...

Abstract	Background: In vivo diffuse reflectance spectroscopy provides additional contrast in discriminating nerves embedded in adipose tissue during surgery. However, large datasets are required to achieve clinically acceptable classification levels. This study assesses the spectral similarity between ex vivo porcine and in vivo human spectral data of nerve and adipose tissue, as porcine tissue could contribute to generate large datasets. Methods: Porcine diffuse reflectance spectra were measured at 124 nerve and 151 adipose locations. A previously recorded dataset of 32 in vivo human nerve and 23 adipose tissue locations was used for comparison. In total, 36 features were extracted from the raw porcine to generate binary logistic regression models for all combinations of two, three, four and five features. Feature selection was performed by assessing similar means between normalized features of nerve and of adipose tissue (Kruskal-Wallis test, Results: The binary logistic regression models with selected features showed an accuracy of 60% on the test set. Conclusions: Spectral similarity between ex vivo porcine and in vivo human adipose and nerve tissue was present, but further research is required.
Language	English
Publishing date	2023-01-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662250-6
ISSN	2075-1729
ISSN	2075-1729
DOI	10.3390/life13020357
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Article ; Online: A systematic review on the detection of volatile organic compounds in exhaled breath in experimental animals in the context of gastrointestinal and hepatic diseases.

Hintzen, Kim F H / Eussen, Myrthe M M / Neutel, Céline / Bouvy, Nicole D / van Schooten, Frederik-Jan / Hooijmans, Carlijn R / Lubbers, Tim

PloS one

2023 Volume 18, Issue 9, Page(s) e0291636

Abstract: Background: Analysis of volatile organic compounds (VOCs) in exhaled breath has the potential to serve as an accurate diagnostic tool for gastro-intestinal diseases. Animal studies could be instrumental as a preclinical base and subsequent clinical ... ...

Abstract	Background: Analysis of volatile organic compounds (VOCs) in exhaled breath has the potential to serve as an accurate diagnostic tool for gastro-intestinal diseases. Animal studies could be instrumental as a preclinical base and subsequent clinical translation to humans, as they are easier to standardize and better equipped to relate specific VOCs to metabolic and pathological processes. This review provides an overview of the study design, characteristics and methodological quality of previously published animal studies on analysis of exhaled breath in gastrointestinal and hepatic diseases. Guidelines are provided for standardization in study design and breath collection methods to improve comparability, avoid duplication of research and reduce discomfort of animals in future studies. Methods: PubMed and Embase database were searched for animal studies using exhaled breath analysis to detect gastro-intestinal diseases. Risk of bias was assessed using the SYRCLE's risk of bias tool for animal studies. Information on study design, standardization methods, animal models, breath collection methods and identified VOCs were extracted from the included studies. Results: 10 studies were included (acute liver failure n = 1, non-alcoholic steatohepatitis n = 1, hepatic ischemia n = 2, mesenteric ischemia n = 2, sepsis and peritonitis n = 3, colitis n = 1). Rats were used in most of the studies. Exhaled breath was mostly collected using invasive procedures as tracheal cannulation or tracheostomy. Poor reporting on standardization, breath collection methods, analytical techniques, as well as heterogeneity of the studies, complicate comparison of the different studies. Conclusion: Poor reporting of essential methodological details impaired comprehensive summarizing the various studies on exhaled breath in gastrointestinal and hepatic diseases. Potential pitfalls in study design, and suggestions for improvement of study design are discussed which, when applied, lead to consistent and generalizable results and a reduction in the use of laboratory animals. Refining the methodological quality of animal studies has the potential to improve subsequent clinical trial design.
MeSH term(s)	Humans ; Animals ; Rats ; Volatile Organic Compounds ; Animals, Laboratory ; Models, Animal ; Non-alcoholic Fatty Liver Disease ; Colitis
Chemical Substances	Volatile Organic Compounds
Language	English
Publishing date	2023-09-21
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0291636
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Article: Can virtual non-contrast imaging replace true non-contrast imaging in multiphase scanning of the neck region?

Al-Difaie, Zaid / Scheepers, Max Hmc / Bouvy, Nicole D / Engelen, Sanne / Havekes, Bas / Postma, Alida A

Acta radiologica open

2023 Volume 12, Issue 8, Page(s) 20584601231205159

Abstract: Background: Dual-energy computed tomography (DECT) is an advanced imaging method that enables reconstruction of virtual non-contrast (VNC) images from a contrast-enhanced acquisition. This has the potential to reduce radiation exposure by eliminating ... ...

Abstract	Background: Dual-energy computed tomography (DECT) is an advanced imaging method that enables reconstruction of virtual non-contrast (VNC) images from a contrast-enhanced acquisition. This has the potential to reduce radiation exposure by eliminating the need for a true non-contrast (TNC) phase. Purpose: The purpose is to evaluate the feasibility of VNC images in the neck region. Materials and methods: A total of 100 patients underwent a DECT scan as part of diagnostic workup of primary hyperparathyroidism. VNC images were reconstructed from 30 s (arterial) and 50 s (venous) post-contrast scans. Regions of interest (ROIs) were placed in thyroid tissue, lymph node, carotid artery, jugular vein, fat, and sternocleidomastoid muscle. Mean densities of all anatomical structures were compared between VNC and TNC images. Results: For all anatomical structures except the thyroid gland, the difference in mean density between TNC and VNC images was less than 15 HU. The mean difference in density between TNC and VNC images of the thyroid was 53.2 HU (95% CI 46.8; 59.6, Conclusion: This study demonstrated an acceptable agreement in density between true non-contrast and virtual non-contrast images for most anatomical structures in the neck region. Therefore, VNC images may have the potential to replace TNC images in the neck. However, due to significant differences in CT density of thyroid tissue, true non-contrast imaging cannot be directly substituted by virtual non-contrast imaging when examining the thyroid and its surrounding tissue.
Language	English
Publishing date	2023-09-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2818429-4
ISSN	2058-4601
ISSN	2058-4601
DOI	10.1177/20584601231205159
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Article: Diagnostic Value of Four-Dimensional Dynamic Computed Tomography for Primary Hyperparathyroidism in Patients with Low Baseline Parathyroid Hormone Levels.

Al-Difaie, Zaid / Scheepers, Max H M C / Engelen, Sanne M E / Havekes, Bastiaan / Bouvy, Nicole D / Postma, Alida A

Diagnostics (Basel, Switzerland)

2023 Volume 13, Issue 16

Abstract: Low baseline levels of parathyroid hormone (PTH) are associated with a higher rate of multiglandular disease, lower localization rates of preoperative imaging modalities, and a higher rate of unsuccessful minimally invasive parathyroidectomies. The ... ...

Abstract	Low baseline levels of parathyroid hormone (PTH) are associated with a higher rate of multiglandular disease, lower localization rates of preoperative imaging modalities, and a higher rate of unsuccessful minimally invasive parathyroidectomies. The objective of this study is to assess the diagnostic value of four-dimensional dynamic computed tomography (4D-CT) in localizing primary hyperparathyroidism (pHPT) in patients with low baseline PTH levels, compared to patients with high baseline PTH levels. Patients with pHPT who received a 4D-CT scan as part of their standard diagnostic evaluation were divided into two groups based on the following criteria: (1) preoperative PTH levels less than 100 pg/mL and (2) patients with preoperative PTH levels greater than 100 pg/mL. All patients underwent parathyroidectomy based on 4D-CT findings, with intraoperative parathyroid hormone monitoring. The lesion-based sensitivity of 4D-CT was 88% in patients with low baseline PTH levels and 94.7% in patients with high baseline PTH levels (
Language	English
Publishing date	2023-08-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics13162621
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Article ; Online: Quantitative analysis of intestinal perfusion with indocyanine green (ICG) and methylene blue (MB) using a single clinically approved fluorescence imaging system: a demonstration in a porcine model.

Heuvelings, Danique J I / Scheepers, Max H M C / Al-Difaie, Zaid / Okamoto, Nariaki / Diana, Michele / Stassen, Laurents P S / Bouvy, Nicole D / Al-Taher, Mahdi

Surgical endoscopy

2024

Abstract: Background: Near-infrared fluorescence (NIRF) angiography with intraoperative administration of indocyanine green (ICG) has rapidly disseminated in clinical practice. Another clinically approved, and widely available dye, methylene blue (MB), has up to ... ...

Abstract	Background: Near-infrared fluorescence (NIRF) angiography with intraoperative administration of indocyanine green (ICG) has rapidly disseminated in clinical practice. Another clinically approved, and widely available dye, methylene blue (MB), has up to now not been used for this purpose. Recently, we demonstrated promising results for the real-time evaluation of intestinal perfusion using this dye. The primary aim of this study was to perform a quantitative analysis of bowel perfusion assessment for both ICG and MB. Methods: Four mature female Landrace pigs underwent laparotomy under general anesthesia. An ischemic bowel loop with five regions of interest (ROIs) with varying levels of perfusion was created in each animal. An intravenous (IV) injection of 0.25 mg/kg-0.50 mg/kg MB was administered after 10 min, followed by NIRF imaging in MB mode and measurement of local lactate levels in all corresponding ROIs. This procedure was repeated in ICG mode (IV dose of 0.2 mg/kg) after 60 min. The quest spectrum fluorescence camera (Quest Medical Imaging, Middenmeer, The Netherlands) was used for NIRF imaging of both MB and ICG. Results: Intraoperative NIRF imaging of bowel perfusion assessment with MB and ICG was successful in all studied animals. Ingress (i/s) levels were calculated and correlated with local lactate levels. Both MB and ICG ingress values showed a significant negative correlation (r = - 0.7709; p = < 0.001; r = - 0.5367, p = 0.015, respectively) with local lactate levels. This correlation was stronger for MB compared to ICG, although ICG analysis showed higher absolute ingress values. Conclusion: Our fluorescence quantification analysis validates the potential to use MB for bowel perfusion assessment besides the well-known and widely used ICG. Further human studies are necessary to translate our findings to clinical applications.
Language	English
Publishing date	2024-05-10
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-024-10864-1
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Zs.A 2214: Show issues

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Article ; Online: Diagnostic Performance of Electronic Noses in Cancer Diagnoses Using Exhaled Breath: A Systematic Review and Meta-analysis.

Scheepers, Max H M C / Al-Difaie, Zaid / Brandts, Lloyd / Peeters, Andrea / van Grinsven, Bart / Bouvy, Nicole D

JAMA network open

2022 Volume 5, Issue 6, Page(s) e2219372

Abstract: Importance: There has been a growing interest in the use of electronic noses (e-noses) in detecting volatile organic compounds in exhaled breath for the diagnosis of cancer. However, no systematic evaluation has been performed of the overall diagnostic ... ...

Abstract	Importance: There has been a growing interest in the use of electronic noses (e-noses) in detecting volatile organic compounds in exhaled breath for the diagnosis of cancer. However, no systematic evaluation has been performed of the overall diagnostic accuracy and methodologic challenges of using e-noses for cancer detection in exhaled breath. Objective: To provide an overview of the diagnostic accuracy and methodologic challenges of using e-noses for the detection of cancer. Data sources: An electronic search was performed in the PubMed and Embase databases (January 1, 2000, to July 1, 2021). Study selection: Inclusion criteria were the following: (1) use of e-nose technology, (2) detection of cancer, and (3) analysis of exhaled breath. Exclusion criteria were (1) studies published before 2000; (2) studies not performed in humans; (3) studies not performed in adults; (4) studies that only analyzed biofluids; and (5) studies that exclusively used gas chromatography-mass spectrometry to analyze exhaled breath samples. Data extraction and synthesis: PRISMA guidelines were used for the identification, screening, eligibility, and selection process. Quality assessment was performed using Quality Assessment of Diagnostic Accuracy Studies 2. Generalized mixed-effects bivariate meta-analysis was performed. Main outcomes and measures: Main outcomes were sensitivity, specificity, and mean area under the receiver operating characteristic curve. Results: This review identified 52 articles with a total of 3677 patients with cancer. All studies were feasibility studies. The sensitivity of e-noses ranged from 48.3% to 95.8% and the specificity from 10.0% to 100.0%. Pooled analysis resulted in a mean (SE) area under the receiver operating characteristic curve of 94% (95% CI, 92%-96%), a sensitivity of 90% (95% CI, 88%-92%), and a specificity of 87% (95% CI, 81%-92%). Considerable heterogeneity existed among the studies because of differences in the selection of patients, endogenous and exogenous factors, and collection of exhaled breath. Conclusions and relevance: Results of this review indicate that e-noses have a high diagnostic accuracy for the detection of cancer in exhaled breath. However, most studies were feasibility studies with small sample sizes, a lack of standardization, and a high risk of bias. The lack of standardization and reproducibility of e-nose research should be addressed in future research.
MeSH term(s)	Adult ; Breath Tests/methods ; Electronic Nose ; Exhalation ; Humans ; Neoplasms/diagnosis ; Reproducibility of Results
Language	English
Publishing date	2022-06-01
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.19372
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Article: Laparoscopic Laser Speckle Contrast Imaging Can Visualize Anastomotic Perfusion: A Demonstration in a Porcine Model.

Wildeboer, Aurelia / Heeman, Wido / van der Bilt, Arne / Hoff, Christiaan / Calon, Joost / Boerma, E Christiaan / Al-Taher, Mahdi / Bouvy, Nicole

Life (Basel, Switzerland)

2022 Volume 12, Issue 8

Abstract: Background: Intestinal resection causes inevitable vascular damage, which cannot always be seen during an intraoperative clinical assessment of local intestinal perfusion. If left unaltered, impaired perfusion can lead to complications, such as ... ...

Abstract	Background: Intestinal resection causes inevitable vascular damage, which cannot always be seen during an intraoperative clinical assessment of local intestinal perfusion. If left unaltered, impaired perfusion can lead to complications, such as anastomotic leakage (AL). Therefore, we demonstrate the use of a novel laparoscopic laser speckle contrast imaging (LSCI)-based approach in order to assess local intestinal perfusion during the construction of intestinal anastomoses. Methods: Three segments were isolated from the small intestine of a pig, while the perfusion of each was compromised by coagulating 7-8 mesenteric arteries. Both clinical assessments and LSCI were used to detect the induced perfusion deficits and to subsequently guide a transection in either a well perfused, marginally perfused, or poorly perfused tissue area within the segment. Bowel ends were then utilized for the creation of three differently perfused anastomoses: well perfused/well perfused (anastomosis segment 1), well perfused/poorly perfused (anastomosis segment 2), and poorly perfused/poorly perfused (anastomosis segment 3). After construction of the anastomoses, a final perfusion assessment using both clinical assessment and LSCI was executed in order to evaluate the vascular viability of the anastomosis. Results: Laparoscopic LSCI enabled continuous assessment of local intestinal perfusion and allowed for detection of perfusion deficits in real time. The imaging feedback precisely guided the surgical procedure, and, when evaluating the final anastomotic perfusion, LSCI was able to visualize the varying degrees of perfusion, whereas standard clinical assessment yielded only minor differences in visual appearance of the tissue. Conclusions: In this technical note, we demonstrate a novel LSCI-based approach for intraoperative perfusion assessment. With its ability to continuously visualize perfusion in real time, laparoscopic LSCI has significant potential for the optimization of anastomotic surgery in the near future.
Language	English
Publishing date	2022-08-16
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662250-6
ISSN	2075-1729
ISSN	2075-1729
DOI	10.3390/life12081251
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