Johannes Kurt Schultz

• Kachapila, Mwayi; Monahan, Mark; Ademuyiwa, Adesoji O.; Adinoyi, Yakubu Momohsani; Biccard, Bruce M. & George, Christina [Show all 1,785 contributors for this article] (2023). Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries. BJA Open. ISSN 2772-6096. 7. doi: 10.1016/j.bjao.2023.100207. Full text in Research Archive
• Greijdanus, Nynke G.; Wienholts, Kiedo; Ubels, Sander; Talboom, Kevin; Hannink, Gerjon & Wolthuis, Albert [Show all 725 contributors for this article] (2023). Stoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patients. British Journal of Surgery. ISSN 0007-1323. 110(12), p. 1863–1876. doi: 10.1093/bjs/znad311. Full text in Research Archive Show summary

  Background: The optimal treatment of anastomotic leak after rectal cancer resection is unclear. This worldwide cohort study aimed to provide an overview of four treatment strategies applied. Methods: Patients from 216 centres and 45 countries with anastomotic leak after rectal cancer resection between 2014 and 2018 were included. Treatment was categorized as salvage surgery, faecal diversion with passive or active (vacuum) drainage, and no primary/secondary faecal diversion. The primary outcome was 1-year stoma-free survival. In addition, passive and active drainage were compared using propensity score matching (2 : 1). Results: Of 2470 evaluable patients, 388 (16.0 per cent) underwent salvage surgery, 1524 (62.0 per cent) passive drainage, 278 (11.0 per cent) active drainage, and 280 (11.0 per cent) had no faecal diversion. One-year stoma-free survival rates were 13.7, 48.3, 48.2, and 65.4 per cent respectively. Propensity score matching resulted in 556 patients with passive and 278 with active drainage. There was no statistically significant difference between these groups in 1-year stoma-free survival (OR 0.95, 95 per cent c.i. 0.66 to 1.33), with a risk difference of -1.1 (95 per cent c.i. -9.0 to 7.0) per cent. After active drainage, more patients required secondary salvage surgery (OR 2.32, 1.49 to 3.59), prolonged hospital admission (an additional 6 (95 per cent c.i. 2 to 10) days), and ICU admission (OR 1.41, 1.02 to 1.94). Mean duration of leak healing did not differ significantly (an additional 12 (-28 to 52) days). Conclusion: Primary salvage surgery or omission of faecal diversion likely correspond to the most severe and least severe leaks respectively. In patients with diverted leaks, stoma-free survival did not differ statistically between passive and active drainage, although the increased risk of secondary salvage surgery and ICU admission suggests residual confounding.

• Malik, Yasir Gulzar; Saltyte Benth, Jurate; Hamre, Hanne Mari; Færden, Arne Engebreth; Ignjatovic, Dejan & Schultz, Johannes Kurt (2023). Chemotherapy reduces long-term quality of life in recurrence-free colon cancer survivors (LaTE study)—a nationwide inverse probability of treatment-weighted registry-based cohort study and survey. Colorectal Disease. ISSN 1462-8910. doi: 10.1111/codi.16807. Full text in Research Archive
• Azhar, Najia; Lambrichts, Daniël; Lange, Johan; Yakub, Sheraz; Øresland, Tom & Schultz, Johannes Kurt [Show all 8 contributors for this article] (2023). Laparoscopic lavage for Hinchey III perforated diverticulitis: factors for treatment failure in two randomized clinical trials. British Journal of Surgery. ISSN 0007-1323. 110(7), p. 846–851. doi: 10.1093/bjs/znad114. Full text in Research Archive
• Reuter, Anna; Rogge, Lisa; Monahan, Mark; Kachapila, Mwayi; Morton, Dion G & Davies, Justine I [Show all 50 contributors for this article] (2022). Global economic burden of unmet surgical need for appendicitis. British Journal of Surgery. ISSN 0007-1323. 109(10), p. 995–1003. doi: 10.1093/bjs/znac195. Full text in Research Archive
• Sahli, Hannah; Azhar, Najia; Lydrup, Marie-Louise; Jörgren, Fredrik; Schultz, Johannes Kurt & Buchwald, Pamela (2022). Risk factors for recurrence and complications in acute uncomplicated diverticulitis: A retrospective cohort study. International Journal of Surgery Open. ISSN 2405-8572. 43. doi: 10.1016/j.ijso.2022.100471.
• Azhar, Najia; Aref, Hager; Brorsson, Adam; Lydrup, Marie-Louise; Jörgren, Fredrik & Schultz, Johannes Kurt [Show all 7 contributors for this article] (2022). Management of acute uncomplicated diverticulitis without antibiotics: compliance and outcomes -a retrospective cohort study. BMC Emergency Medicine. ISSN 1471-227X. 22. doi: 10.1186/s12873-022-00584-x.
• Azhar, Najia; Buchwald, Pamela & Schultz, Johannes Kurt (2021). Long-term Outcomes of Laparoscopic Lavage for Perforated Diverticulitis Remain Unfavorable-Reply. . JAMA Surgery. ISSN 2168-6254. 156(11), p. 1071–1071. doi: 10.1001/jamasurg.2021.3306.
• Toresen, Åsmund Lokdam; Johanssen, Anette; Ansari, Omar Ben Afzal; Holmedal, Stein Harald & Schultz, Johannes Kurt (2021). Conservative treatment of perforated diverticulitis: following the latest guidelines pays dividends. . The Lancet. ISSN 0140-6736. doi: 10.1016/S0140-6736(21)02003-1.
• Kleive, Dyre; Aas, Eline; Angelsen, Jon-Helge; Bringeland, Erling Audun; Nesbakken, Arild & Nymo, Linn Såve [Show all 9 contributors for this article] (2021). Simultaneous Resection of Primary Colorectal Cancer and Synchronous Liver Metastases: Contemporary Practice, Evidence and Knowledge Gaps. Oncology and Therapy. ISSN 2366-1070. 9(1), p. 111–120. doi: 10.1007/s40487-021-00148-2. Full text in Research Archive
• Chabok, A.; Thorisson, A.; Nikberg, M.; Schultz, J.K. & Sallinen, Ville J. (2021). Changing Paradigms in the Management of Acute Uncomplicated Diverticulitis. Scandinavian Journal of Surgery. ISSN 1457-4969. 110(2), p. 180–186. doi: 10.1177/14574969211011032.
• Azhar, Najia; Buchwald, Pamela; Ansari, Hamza; Schyman, Tommy; Yaqub, Sheraz & Øresland, Tom [Show all 7 contributors for this article] (2020). Risk of colorectal cancer following CT-verified acute diverticulitis: a nationwide population-based cohort study. Colorectal Disease. ISSN 1462-8910. p. 1406–1414. doi: 10.1111/codi.15073. Full text in Research Archive
• Azhar, Najia; Johanssen, Anette; Sundström, Tove; Folkesson, Joakim; Wallon, Conny & Kørner, Hartwig [Show all 12 contributors for this article] (2020). Laparoscopic lavage vs primary resection for acute perforated diverticulitis: Long-term outcomes from the Scandinavian Diverticulitis (SCANDIV) randomized clinical trial. JAMA Surgery. ISSN 2168-6254. p. 1–7. doi: 10.1001/jamasurg.2020.5618.
• Drake, Thomas M.; Pata, Francesco; Ghosh, Dhruv; Ademuyiwa, Adesoji O; Arnaud, Alexis P & Bhangu, Aneel [Show all 56 contributors for this article] (2020). Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study. . BMJ Global Health. ISSN 2059-7908. doi: 10.1136/bmjgh-2020-003429. Show summary

  Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

• Malik, Yasir Gulzar; Lyckander, Lars Gustav; Lindstrøm, Jonas Christoffer; Holmquist, Olof Dan Sebastian; Sheikh, Ariba Ehsan & Schultz, Johannes Kurt [Show all 7 contributors for this article] (2020). Stratification of Stage III colon cancer may identify a patient group not requiring adjuvant chemotherapy. Journal of Cancer Research and Clinical Oncology. ISSN 0171-5216. p. 1–11. doi: 10.1007/s00432-020-03381-w. Full text in Research Archive
• Schultz, Johannes Kurt; Azhar, Najia; Binda, Gian Andrea; Barbara, Giovanni; Biondo, Sebastiano & Boermeester, Marja A. [Show all 22 contributors for this article] (2020). European Society of Coloproctology: guidelines for the management of diverticular disease of the colon. Colorectal Disease. ISSN 1462-8910. doi: 10.1111/codi.15140.
• Thomas, Hannah S.; Weiser, Thomas G.; Drake, Thomas M.; Knight, Stephen R.; Fairfield, Cameron & Ademuyiwa, Adesoji O. [Show all 50 contributors for this article] (2019). Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy. British Journal of Surgery. ISSN 0007-1323. 106(2), p. 103–112. doi: 10.1002/bjs.11051. Full text in Research Archive
• Glasbey, James C.; Adisa, Adewale O.; Costas-Chavarri, Ainhoa; Qureshi, Ahmad U.; Allen-Ingabire, Jean C. & Salem, Hosni Khairy [Show all 50 contributors for this article] (2019). Global variation in anastomosis and end colostomy formation following left-sided colorectal resection. BJS Open. ISSN 2474-9842. 3, p. 403–414. doi: 10.1002/bjs5.50138. Full text in Research Archive
• Azhar, Najia; Kulstad, Hanna; Pålsson, Birger; Schultz, Johannes Kurt; Lydrup, Marie-Louise & Buchwald, Pamela (2018). Acute uncomplicated diverticulitis managed without antibiotics?difficult to introduce a new treatment protocol but few complications. Scandinavian Journal of Gastroenterology. ISSN 0036-5521. doi: 10.1080/00365521.2018.1552987.
• Schultz, Johannes Kurt; Wallon, Conny; Blecic, Liljana; Forsmo, Håvard Mjørud; Folkesson, Joakim & Buchwald, Pamela [Show all 10 contributors for this article] (2017). One-year results of the SCANDIV randomized clinical trial of laparoscopic lavage versus primary resection for acute perforated diverticulitis. British Journal of Surgery. ISSN 0007-1323. 104(10), p. 1382–1392. doi: 10.1002/bjs.10567.
• Marshall, James R.; Buchwald, Pamela; Gandhi, Jamish; Schultz, Johannes Kurt; Hider, Phil N. & Frizelle, Frank A. [Show all 7 contributors for this article] (2016). Laparoscopic Lavage in the Management of Hinchey Grade III Diverticulitis. Annals of Surgery. ISSN 0003-4932. doi: 10.1097/sla.0000000000002005.
• Brochmann, Nina Dølvik; Schultz, Johannes Kurt; Jakobsen, Gunn Signe & Øresland, Tom (2016). Management of acute uncomplicated diverticulitis without antibiotics: a single-centre cohort study. Colorectal Disease. ISSN 1462-8910. 18(11), p. 1101–1107. doi: 10.1111/codi.13355.
• Schultz, Johannes Kurt; Yaqub, Sheraz & Øresland, Tom (2016). Management of diverticular disease in scandinavia. Journal of Clinical Gastroenterology. ISSN 0192-0790. 50, p. S50–S52. doi: 10.1097/MCG.0000000000000642.
• Schultz, Johannes Kurt; Yaqub, Sheraz; Wallon, Conny; Blecic, Liljana; Forsmo, Håvard Mjørud & Folkesson, Joakim [Show all 10 contributors for this article] (2015). Laparoscopic lavage vs primary resection for acute perforated diverticulitis: The SCANDIV randomized clinical trial. Journal of the American Medical Association (JAMA). ISSN 0098-7484. 314(13), p. 1364–1375. doi: 10.1001/jama.2015.12076. Show summary

  IMPORTANCE Perforated colonic diverticulitis usually requires surgical resection, which is associated with significant morbidity. Cohort studies have suggested that laparoscopic lavage may treat perforated diverticulitis with less morbidity than resection procedures. OBJECTIVE To compare the outcomes from laparoscopic lavage with those for colon resection for perforated diverticulitis. DESIGN, SETTING, AND PARTICIPANTS Multicenter, randomized clinical superiority trial recruiting participants from 21 centers in Sweden and Norway from February 2010to June 2014. The last patient follow-upwas in December 2014 and final review and verification of the medical records was assessed in March 2015. Patients with suspected perforated diverticulitis, a clinical indication for emergency surgery, and free air on an abdominal computed tomography scanwere eligible. Of 509 patients screened, 415were eligible and 199were enrolled. INTERVENTIONS Patients were assigned to undergo laparoscopic peritoneal lavage (n = 101) or colon resection (n = 98) based on a computer-generated, center-stratified block randomization. All patients with fecal peritonitis (15 patients in the laparoscopic peritoneal lavage group vs 13 in the colon resection group) underwent colon resection. Patients with a pathology requiring treatment beyond that necessary for perforated diverticulitis (12 in the laparoscopic lavage group vs 13 in the colon resection group) were also excluded from the protocol operations and treated as required for the pathology encountered. MAIN OUTCOMES AND MEASURES The primary outcomewas severe postoperative complications (Clavien-Dindo score >IIIa) within 90 days. Secondary outcomes included other postoperative complications, reoperations, length of operating time, length of postoperative hospital stay, and quality of life. RESULTS The primary outcome was observed in 31 of 101 patients (30.7%) in the laparoscopic lavage group and 25 of 96 patients (26.0%) in the colon resection group (difference, 4.7% [95%CI, −7.9%to 17.0%]; P = .53). Mortality at 90 days did not significantly differ between the laparoscopic lavage group (14 patients [13.9%]) and the colon resection group (11 patients [11.5%]; difference, 2.4%[95%CI, −7.2%to 11.9%]; P = .67). The reoperation rate was significantly higher in the laparoscopic lavage group (15 of 74 patients [20.3%]) than in the colon resection group (4 of 70 patients [5.7%]; difference, 14.6%[95%CI, 3.5%to 25.6%]; P = .01) for patients who did not have fecal peritonitis. The length of operating time was significantly shorter in the laparoscopic lavage group; whereas, length of postoperative hospital stay and quality of life did not differ significantly between groups. Four sigmoid carcinomas were missed with laparoscopic lavage. CONCLUSIONS AND RELEVANCE Among patients with likely perforated diverticulitis and undergoing emergency surgery, the use of laparoscopic lavage vs primary resection did not reduce severe postoperative complications and led toworse outcomes in secondary end points. These findings do not support laparoscopic lavage for treatment of perforated diverticulitis. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01047462

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• Schultz, Johannes Kurt; Augestad, Knut Magne & Saltyte Benth, Jurate (2023). Surgical site infections: does one glove fit all? The Lancet. ISSN 0140-6736. 401(10387). doi: 10.1016/S0140-6736(23)00398-7.
• Schultz, Johannes Kurt; Azhar, Najia & Buchwald, Pamela (2021). Comments and Concerns on the LASER Trial. JAMA Surgery. ISSN 2168-6254. doi: 10.1001/jamasurg.2021.2247.
• Marshall, James R.; Schultz, Johannes Kurt; Frizelle, Frank A. & Eglinton, Timothy W. (2018). Reply to: "laparoscopic Lavage for Perforated Diverticulitis". Annals of Surgery. ISSN 0003-4932. 267(4), p. e74–e75. doi: 10.1097/SLA.0000000000002160.
• Schultz, Johannes Kurt; Yaqub, Sheraz & Øresland, Tom (2016). Privacy policies of android diabetes apps and sharing of health information: In reply. Journal of the American Medical Association (JAMA). ISSN 0098-7484. 315(10), p. 1053–1054.

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