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Article ; Online: Hypovolemische shock enkele dagen na ribfracturen.

Schok, Thomas / Konsten, Joop L M

2013 Volume 157, Issue 2, Page(s) A4957

Abstract: Background: A quarter of all patients with rib fractures develop a haemothorax. A haemothorax usually occurs immediately following trauma, but it can also occur with considerable delay.: Case description: We describe two patients, aged 58 and 51 ... ...

Title translation	Hypovolaemic shock several days after rib fractures.
Abstract	Background: A quarter of all patients with rib fractures develop a haemothorax. A haemothorax usually occurs immediately following trauma, but it can also occur with considerable delay. Case description: We describe two patients, aged 58 and 51 years, who each had sustained thoracic trauma. After the initial assessment and additional diagnostic testing, the patients were admitted to hospital. On the 4th and 8th day after the trauma, respectively, they developed hypovolaemic shock resulting from a haemothorax. Both patients had multiple rib fractures. Conclusion: A delayed haemothorax is rare but in cases of hypovolaemic shock, this dangerous complication of rib fractures should be ruled out.
MeSH term(s)	Accidental Falls ; Accidents, Traffic ; Hemothorax/diagnosis ; Hemothorax/epidemiology ; Hemothorax/etiology ; Humans ; Male ; Middle Aged ; Rib Fractures/complications ; Shock/diagnosis ; Shock/epidemiology ; Shock/etiology ; Watchful Waiting
Language	Dutch
Publishing date	2013
Publishing country	Netherlands
Document type	Case Reports ; English Abstract ; Journal Article
ZDB-ID	82073-8
ISSN	1876-8784 ; 0028-2162
ISSN (online)	1876-8784
ISSN	0028-2162
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Article: Internal herniation of the abdominal wall.

Bloemen, Arthur / J Keijzers, Marlies / L M Konsten, Joop / Aarts, Frits / Vogelaar, F Jeroen

Clinical case reports

2019 Volume 7, Issue 3, Page(s) 575–576

Abstract: A symptomatic arcuate line hernia should be considered in patients with acute lower abdominal complaints. This rare internal herniation is caused by a sharp ending of the posterior aponeurotic sheath of the rectus muscle, rather than the more common ... ...

Abstract	A symptomatic arcuate line hernia should be considered in patients with acute lower abdominal complaints. This rare internal herniation is caused by a sharp ending of the posterior aponeurotic sheath of the rectus muscle, rather than the more common gradual delineation, and can cause strangulation or incarceration of abdominal contents.
Language	English
Publishing date	2019-01-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2740234-4
ISSN	2050-0904
ISSN	2050-0904
DOI	10.1002/ccr3.2008
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Article ; Online: Quality of Life and Bowel Dysfunction after Transanal Endoscopic Microsurgery for Rectal Cancer: One Third of Patients Experience Major Low Anterior Resection Syndrome.

van Heinsbergen, Maarten / Leijtens, Jeroen W / Slooter, Gerrit D / Janssen-Heijnen, Maryska L / Konsten, Joop L

Digestive surgery

2019 Volume 37, Issue 1, Page(s) 39–46

Abstract: Background/aims: The low anterior resection syndrome (LARS) severely affects quality of life (QoL) after rectal cancer surgery. Studies investigating LARS and the effect on QoL after transanal endoscopic microsurgery (TEM) for rectal cancer are scarce. ... ...

Abstract	Background/aims: The low anterior resection syndrome (LARS) severely affects quality of life (QoL) after rectal cancer surgery. Studies investigating LARS and the effect on QoL after transanal endoscopic microsurgery (TEM) for rectal cancer are scarce. The aim of our study was to assess bowel dysfunction and QoL after TEM. Methods: Seventy-three -patients who underwent TEM for stage I rectal cancer were included in this single-centre, cross-sectional study Bowel dysfunction was assessed by the LARS-Score, QoL by the -European Organization for the Research and Treatment of Cancer QLQ-C30 and -CR29 questionnaires. Results: Fifty-five respondents (75.3%) could be included for the analyses. The median interval since treatment was 4.3 years, and the median age at the follow-up point was 72 years. "Major LARS" was observed in 29% of patients and "minor LARS" in 26%. Female gender (OR 4.00; 95% CI 1.20-13.36), neo-adjuvant chemoradiotherapy (OR 3.63; 95% CI 1.08-12.17) and specimen thickness in millimetres (OR 1.10 for each mm increase in thickness; 95% CI 1.01-1.20) were associated with the development of major LARS. Patients with major LARS fared worse in most QoL domains. Conclusion: This is the first study demonstrating major LARS after TEM treatment for rectal cancer, with a negative effect on QoL, even years after treatment. Our data provides an adequate counselling before TEM in terms of postoperative bowel dysfunction and its effect on QoL.
MeSH term(s)	Aged ; Aged, 80 and over ; Colectomy/adverse effects ; Cross-Sectional Studies ; Female ; Humans ; Intestinal Diseases/etiology ; Intestinal Diseases/physiopathology ; Male ; Middle Aged ; Proctectomy/adverse effects ; Quality of Life ; Rectal Neoplasms/physiopathology ; Rectal Neoplasms/surgery ; Rectal Neoplasms/therapy ; Rectum/physiopathology ; Rectum/surgery ; Syndrome ; Transanal Endoscopic Microsurgery/adverse effects
Language	English
Publishing date	2019-06-11
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	605888-7
ISSN	1421-9883 ; 0253-4886
ISSN (online)	1421-9883
ISSN	0253-4886
DOI	10.1159/000496434
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Article: Functional Bowel Complaints and the Impact on Quality of Life After Colorectal Cancer Surgery in the Elderly.

Ketelaers, Stijn H J / van Heinsbergen, Maarten / Orsini, Ricardo G / Vogelaar, F Jeroen / Konsten, Joop L M / Nieuwenhuijzen, Grard A P / Rutten, Harm J T / Burger, Jacobus W A / Bloemen, Johanne G

Frontiers in oncology

2022 Volume 12, Page(s) 832377

Abstract: Background: The Low Anterior Resection Syndrome (LARS) is commonly reported after colorectal cancer surgery and significantly impairs quality of life. The prevalence and impact of LARS in the elderly after rectal cancer as well as colon cancer surgery ... ...

Abstract	Background: The Low Anterior Resection Syndrome (LARS) is commonly reported after colorectal cancer surgery and significantly impairs quality of life. The prevalence and impact of LARS in the elderly after rectal cancer as well as colon cancer surgery is unclear. We aimed to describe the prevalence of LARS complaints and the impact on quality of life in the elderly after colorectal cancer surgery. Materials and methods: Patients were included from seven Dutch hospitals if they were at least one year after they underwent colorectal cancer surgery between 2008 and 2015. Functional bowel complaints were assessed by the LARS score. Quality of life was assessed by the EORTC QLQ-C30 and EORTC QLQ-CR29 questionnaires. Outcomes in patients ≥70 years were compared to a reference group of patients <70 years. Results: In total 440 rectal cancer and 1183 colon cancer patients were eligible for analyses, of whom 133 (30.2%) rectal and 536 (45.3%) colon cancer patients were ≥70 years. Major LARS was reported by 40.6% of rectal cancer and 22.2% of colon cancer patients ≥70 years. In comparison, patients <70 years reported major LARS in 57.3% after rectal cancer surgery (p=0.001) and in 20.4% after colon cancer surgery (p=0.41). Age ≥70 years was independently associated with reduced rates of major LARS after rectal cancer surgery (OR 0.63, Conclusion: Elderly should not be withheld a restorative colorectal cancer resection based on age alone. However, a substantial part of the elderly colorectal cancer patients develops major LARS after surgery, which often severely impairs quality of life. Since elderly frequently consider quality of life and functional outcomes as one of the most important outcomes after treatment, major LARS and its impact on quality of life should be incorporated in the decision-making process.
Language	English
Publishing date	2022-02-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2022.832377
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Article ; Online: Een man met pijn in het been.

Rijpsma, Douwe / Konsten, Joop L M

Nederlands tijdschrift voor geneeskunde

2011 Volume 155, Page(s) A1702

Abstract: A 72-year-old man with a history of prostate cancer was seen with pain in the right leg and the left arm. He suffered from a clostridial myonecrosis. Physical examination showed typical findings of purple discoloration of the skin and hemorrhagic bullae. ...

Title translation	A man with a painful leg.
Abstract	A 72-year-old man with a history of prostate cancer was seen with pain in the right leg and the left arm. He suffered from a clostridial myonecrosis. Physical examination showed typical findings of purple discoloration of the skin and hemorrhagic bullae. The patient eventually died because of septic shock.
MeSH term(s)	Aged ; Clostridium Infections/complications ; Clostridium Infections/diagnosis ; Fatal Outcome ; Humans ; Leg/pathology ; Male ; Muscles/pathology ; Necrosis/diagnosis ; Necrosis/etiology ; Shock, Septic/etiology
Language	Dutch
Publishing date	2011
Publishing country	Netherlands
Document type	Case Reports ; English Abstract ; Journal Article
ZDB-ID	82073-8
ISSN	1876-8784 ; 0028-2162
ISSN (online)	1876-8784
ISSN	0028-2162
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Article: Is there a difference in laparoscopic cholecystectomy performed in a teaching hospital or a general hospital in The Netherlands?

Corten, Bartholomeus J G A / Leijtens, Jeroen W A / Janssen, Loes / Konsten, Joop L M

Acta chirurgica Belgica

2018 Volume 119, Issue 4, Page(s) 236–242

Abstract: Introduction: ...

Abstract	Introduction:
MeSH term(s)	Cholecystectomy, Laparoscopic ; Cohort Studies ; Female ; Hospitals, General ; Hospitals, Teaching ; Humans ; Male ; Middle Aged ; Netherlands ; Postoperative Complications/epidemiology ; Prospective Studies
Language	English
Publishing date	2018-09-26
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	210274-2
ISSN	0001-5458
ISSN	0001-5458
DOI	10.1080/00015458.2018.1502928
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Article ; Online: Mesh OR Patch for Hernia on Epigastric and Umbilical Sites (MORPHEUS-Trial): The Complete Two-year Follow-up.

Ponten, Jeroen E H / Leclercq, Wouter K G / Lettinga, Tanja / Heemskerk, Jeroen / Konsten, Joop L M / Bouvy, Nicole D / Nienhuijs, Simon W

Annals of surgery

2018 Volume 270, Issue 1, Page(s) 33–37

Abstract: Objective: The objective of this trial was to identify a superior method for umbilical and epigastric hernia repair in terms of complications. Complications such as an extended operation duration, additional use of painkillers, reoperation, infection, ... ...

Abstract	Objective: The objective of this trial was to identify a superior method for umbilical and epigastric hernia repair in terms of complications. Complications such as an extended operation duration, additional use of painkillers, reoperation, infection, seroma, extended wound care, extended hospitalization, and early recurrence were reported according to the Clavien-Dindo grading system. Summary background data: Over the years mesh repair is proven the gold standard for umbilical and epigastric hernias. The question remains, which mesh should be used? Methods: In this randomized controlled, multicenter trial, all patients ≥ 18 years with a single, symptomatic, and primary small umbilical or epigastric hernia qualified for inclusion. Flat preperitoneal polypropylene mesh repair was compared with patch repair (PROCEED Ventral Patch) (PVP). Results: A total of 352 patients were randomized; 348 patients received the intervention (n = 177 PVP vs n = 171 mesh). One out of 4 suffered from any kind of complication within 2 years postoperative (27.6%). A significant difference in complications was seen, in favor of polypropylene mesh repair (P = 0.044, 22.1% mesh vs 32.5% PVP). Reoperation was performed in 19 PVP operated patients (10.7%) versus 7 patients with polypropylene mesh repair (4.0%, P = 0.021).No significant differences were seen in recurrences (n = 13, 8.4% PVP vs n = 6, 4.1% mesh, P = 0.127). Conclusions: In small epigastric and small umbilical hernia repair a flat polypropylene mesh repair was associated with a lower complication rate than PVP repair. No differences in recurrence rates were seen. Combining all complications, the preperitoneal positioned flat polypropylene mesh performed better.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Hernia, Abdominal/surgery ; Hernia, Umbilical/surgery ; Herniorrhaphy/instrumentation ; Herniorrhaphy/methods ; Humans ; Male ; Middle Aged ; Polypropylenes ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control ; Recurrence ; Reoperation/statistics & numerical data ; Single-Blind Method ; Surgical Mesh ; Treatment Outcome ; Young Adult
Chemical Substances	Polypropylenes
Language	English
Publishing date	2018-10-19
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000003086
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Article ; Online: Awareness and management of low anterior resection syndrome: A Dutch national survey among colorectal surgeons and specialized nurses.

Thomas, Gwendolyn / van Heinsbergen, Maarten / van der Heijden, Joost / Slooter, Gerrit / Konsten, Joop / Maaskant, Sabrina

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2018 Volume 45, Issue 2, Page(s) 174–179

Abstract: Introduction: Substantial progress has been made in the treatment of rectal cancer in the past two decades. Low anterior resection is a cornerstone in current treatment, combined with neo-adjuvant (chemo-) radiation in selected cases. However, side ... ...

Abstract	Introduction: Substantial progress has been made in the treatment of rectal cancer in the past two decades. Low anterior resection is a cornerstone in current treatment, combined with neo-adjuvant (chemo-) radiation in selected cases. However, side effects such as increased frequency, urgency and incontinence are seen in a majority of patients postoperatively. These symptoms, referred to as low anterior resection syndrome (LARS), have a severe impact on quality of life. Management of LARS is complex, and surgeons seem to underestimate and misinterpret the impact of symptoms associated with LARS. Aim and methods: We investigated the awareness and management of LARS in The Netherlands, conducting a national survey in which colorectal surgeons and colorectal care nurses were asked for their views on this complex syndrome. Results: 242 health-care professionals participated in the survey. Most participants estimate the prevalence of major LARS is 20-40% after low anterior resection (LAR); a severe underestimation of actual prevalence - around 70%. Only 10% of surgeons use LARS screening tools in the preoperative period, and fewer than half of surgeons use LARS scores before or after a LAR. Although most surgeons inform their patients preoperatively about the changes in bowel function that they may experience after rectal cancer treatment, a majority of these surgeons indicate more information and patient counselling would improve the quality of life of their patients. Discussion: Impact and prevalence of LARS is underestimated by their physicians. Uniform clinical guidelines should be developed to guide physicians in adequate management of patients with LARS.
MeSH term(s)	Adult ; Attitude of Health Personnel ; Awareness ; Digestive System Surgical Procedures ; Female ; Humans ; Male ; Middle Aged ; Netherlands/epidemiology ; Postoperative Complications/epidemiology ; Postoperative Complications/therapy ; Prevalence ; Quality of Life ; Rectal Neoplasms/surgery ; Risk Factors ; Surveys and Questionnaires ; Syndrome
Language	English
Publishing date	2018-11-10
Publishing country	England
Document type	Journal Article
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2018.11.001
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Article ; Online: Frailty screening by Geriatric-8 and 4-meter gait speed test is feasible and predicts postoperative complications in elderly colorectal cancer patients.

Bessems, Stan A M / Konsten, Joop L M / Vogelaar, Jeroen F J / Csepán-Magyar, Reka / Maas, Huub A A M / van de Wouw, Yes A J / Janssen-Heijnen, Maryska L G

Journal of geriatric oncology

2020 Volume 12, Issue 4, Page(s) 592–598

Abstract: Introduction: Identification of frail older colorectal cancer patients might help to select those prone to adverse events and may lead to adjustment of treatment plans. However, the prognostic validity of screening for frailty is unknown.: Methods: ... ...

Abstract	Introduction: Identification of frail older colorectal cancer patients might help to select those prone to adverse events and may lead to adjustment of treatment plans. However, the prognostic validity of screening for frailty is unknown. Methods: This retrospective study evaluates colorectal cancer patients ≥70 years who underwent elective surgery between May 2016 and December 2018. The Geriatric-8 (G8) and 4-m gait speed test (4MGST) were used as frailty screening tools. According to hospital guidelines, patients were referred to a geriatrician when screening was indicative for frailty (G8 ≤ 14 and/or 4MGST < 1 m/s). Patients were categorized as fit, vulnerable or frail by comprehensive geriatric assessment (CGA). The clinical implications and prognostic validity of frailty screening and CGA were evaluated. Results: 149 patients were included, of whom 132 (89%) were screened for frailty. Frailty was suspected in 40% of screened patients (n = 53) of whom 89% (n = 47) was referred for CGA. A higher complication rate was seen in patients with G8 ≤ 14 and/or 4MGST < 1 m/s compared to those with G8 > 14 and 4MGST ≥1 m/s (respectively 62% versus 28%,p < 0.001). Pneumonia (21% versus 6%, p = 0.013) and cardiac complications (11% versus 4%, p = 0.093) were more prevalent in patients with G8 ≤ 14 and/or 4MGST < 1 m/s. CGA identified frail patients as a group with a high complication rate of 68%. Conclusion: Screening for frailty with subsequent referral for CGA is feasible in older colorectal cancer patients. Our study suggests that screening for frailty by G8 + 4MGST can identify patients with higher risk for postoperative complications.
Language	English
Publishing date	2020-11-04
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2556813-9
ISSN	1879-4076 ; 1879-4068
ISSN (online)	1879-4076
ISSN	1879-4068
DOI	10.1016/j.jgo.2020.10.012
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Article ; Online: Benefits of a well-structured diagnostic process in colon cancer.

Klemann, Victor M W T / Wolters, Frank L / Konsten, Joop L M

Digestive surgery

2011 Volume 28, Issue 1, Page(s) 15–21

Abstract: Introduction: Preoperative work-up in colorectal cancer is comprehensive and can be time consuming. In our institution, the preoperative track for colorectal patients was reorganized in order to reduce the therapeutic delay and the number of outpatient ... ...

Abstract	Introduction: Preoperative work-up in colorectal cancer is comprehensive and can be time consuming. In our institution, the preoperative track for colorectal patients was reorganized in order to reduce the therapeutic delay and the number of outpatient clinic visits. We assessed the impact upon the patient outcomes. Methods: All consecutive patients with colon cancer who entered the reorganized preoperative track between January 2008 and December 2009 (n = 87) were retrospectively compared with a consecutively diagnosed traditionally evaluated patient group diagnosed between January 2005 and December 2006 (n = 108). Time between diagnostic procedures and surgery as well as needed number of preoperative outpatient department visits were calculated. All rectal malignancies, patients who received preoperative chemotherapy and/or radiotherapy and patients who underwent emergency procedures were excluded from analysis. Results: Time between colonoscopy and surgery was reduced from [median (25-75%)] 44 (34-54) to 27 (21-34) days, p < 0.001. The number of outpatient department visits declined from 6 (5-7) to 3 (3-4), p < 0.001. Time between first diagnostic test and colonoscopy was reduced from 44 (11-68) to 9 days (0-30), p < 0.001. Time between first diagnostic test and operation was reduced from 85.5 (56-120.5) to 42 days (28-62), p < 0.001. Before the reorganizations, 7% of colonoscopies were ordered by GPs and went up afterwards to 60%. Conclusion: Reorganization of traditional logistic routes for patients diagnosed with colon cancer reduces therapeutic delay and improves care. Moreover, the surgeon, gastroenterologist and oncologist can focus on the oncologic patient and his/her family instead of having to perform administrative tasks.
MeSH term(s)	Aged ; Colonic Neoplasms/diagnosis ; Colonic Neoplasms/surgery ; Critical Pathways/organization & administration ; Humans ; Middle Aged ; Netherlands ; Office Visits ; Patient-Centered Care/organization & administration ; Referral and Consultation ; Retrospective Studies ; Sigmoidoscopy ; Time Factors
Language	English
Publishing date	2011
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	605888-7
ISSN	1421-9883 ; 0253-4886
ISSN (online)	1421-9883
ISSN	0253-4886
DOI	10.1159/000321894
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