Prof. dr. M. Boermeester
AMC, Chirurg, Amsterdam
Nederland
M.A. Boermeester is one of the AMC Principal Investigators. Research is focussed on clinical and basic aspects in (1) abdominal infections and (2) patient safety:
1) Abdominal infections
- peritonitis (acute surgical treatment, intestinal fistula, and late phase reconstructive surgery)
- acute and chronic pancreatitis.
- inflammatory responses in abdominal sepsis
A multicenter trial (OPTIMA trial) investigated the optimal and cost-effective use of diganostic imaging in patients with acute abdominal pain, and received the ZonMW Pearl Award for best cost-effectiveness research. (Lameris et al, BMJ 2009)
A multicenter randomized trial (RELAP trial) compared cost-effectiveness of a more aggressive surgical management strategy (planned relaparotomy) with a more conservative, 'watchful waiting' strategy (relaparotomy on demand) in patients with secondary peritonitis. (van Ruler, JAMA 2007) In peritonitis patients also compartimentalized activation of inflammatory responses are investigated. Inflammatory mediator systems such as coagulation, fibrinolysis, cytokines, and activated neutrophils have been examined and compared between compartments (blood, abdomen, lungs).
To gain insight in the role of the genetic make-up in the course of disease, several single nucleotide polymorphisms (SNPs) are investigated. Research is focussed on SNPs with an inherent higher risk for fungal superinfection in surgical ICU patients and for acute necrotizing pancreatitis.
The majority of patients (65-70%) need only one laparotomy for peritonitis, some undergo relaparotomy with positive findings. Logistic regression modelling searches for a clinical score to select patients who indeed will benefit from a relaparotomy.
Accuracy of clinical scores for diagnoses of appendicitis and diverticulitis is being compared to diagnostic imaging (AAP study).
Accuracy of MRI imaging in appenditis is compared to US with conditional CT (OPTIMAP study).
Cost-effectiveness of antibiotic treatment compared to liberal (expectant) treatment in a randomized pragmatic trial (DIABOLO trial).
Surgical and medical treatment of acute pancreatitis is investigated.
Clinical and animal studies in chronic pancreatis (CP) determine the role of surgery in treatment of CP-related pain (CARE prospective registry in CP, ESCAPE trial).
2) Patient safety
2a. SURPASS (Surgical Patient Safety System) peri-operative checklist; design, validation, effectiveness testing, digitalizing
2b. SUREPILL study examining cost-effectiveness of a ward-based pharmacy team compared to standard set-up for reduction of adverse drug events (ADEs).
Bron: AMC