Zentralblatt fur Chirurgie最新文献

{"title":"[Giant Scrotal Liposarcoma as Intraoperative Finding During an Inguinal Hernioplasty - A Case Report with Literature Review].","authors":"Danai-Niki Giourgali, Martin Kruschewski, German Germanov","doi":"10.1055/a-2962-4294","DOIUrl":"https://doi.org/10.1055/a-2962-4294","url":null,"abstract":"<p><strong>Abstract: </strong>The case is presented of a 69-year-old male patient who underwent surgery for a giant inguinoscrotal hernia on the right side. Intraoperatively, a giant liposarcoma in the right scrotum was discovered. A complete (R0) resection of the tumour was performed. Two years postoperatively, the patient remains asymptomatic and without any signs of tumour recurrence. This case represents the very rare differential diagnosis of a giant inguinoscrotal hernia.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Standardised Minimally Invasive Ivor-Lewis Hybrid Oesophagectomy - Safe Anastomosis and Low Morbidity/Mortality].","authors":"Arnulf H Hölscher, Martin Hemmerich, Stefanie Albert, Javed Parvez, Christin Lenk, Stephan Johannsen, Peter M Markus","doi":"10.1055/a-2955-8048","DOIUrl":"https://doi.org/10.1055/a-2955-8048","url":null,"abstract":"<p><strong>Background: </strong>Real world data of unselected series with standardised management are important for the comparison of different techniques of minimally invasive oesophagectomy.</p><p><strong>Patients and methods: </strong>This is a retrospective study of a consecutive cohort of 193 minimally invasive hybrid oesophagectomies (laparoscopic/thoracotomy) including 9 conversions (4.6%) and 4 primary open oesophagectomies, in total with 195 gastric and 2 colonic interpositions (196 intrathoracic anastomoses and 1 cervical esophagogastrostomy). No patient had distant metastasis except 1 with hepatic lesions, who was resected, because of recurrent cancer bleeding during chemotherapy. 78% had adeno- and 20% squamous cell carcinomas. 65 of the tumours were cT3, 20 % cT2, 14% cT1. 77% of the patients underwent neoadjuvant chemotherapy with FLOT or radiochemotherapy with CROSS including 6 with definitive radiochemotherapy and salvage surgery.</p><p><strong>Results: </strong>The R0-resection rate was 99% and a median of 34 lymph nodes was resected. The rate of anastomotic leakage was 1.5%, (n = 3), pneumonia 11%, chylothorax 1.5%, postoperative bleeding 0,5% and revisional surgery 2%. The 30- and 90- day mortality rates were 1.5% or 4.6%, respectively. One of 3 patients with anastomotic leakage had a fatal outcome despite endoscopic therapy.</p><p><strong>Conclusion: </strong>The reported technique of hybrid minimally invasive oesophagectomy is safe, with a very low rate of anastomotic leakage. This benchmark is important for the comparison with the results of other types of minimally invasive Ivor-Lewis oesophagectomy.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prevention of Complications Following Surgical Procedures of the Upper Gastrointestinal Tract].","authors":"Richard Hummel, Maciej Patrzyk, Melanie Langheinrich, Stephan Kersting","doi":"10.1055/a-2952-6177","DOIUrl":"https://doi.org/10.1055/a-2952-6177","url":null,"abstract":"<p><strong>Abstract: </strong>Surgical procedures of the upper gastrointestinal tract remain associated with substantial perioperative morbidity, particularly after oesophagectomy and gastrectomy. This review outlines current evidence that prevention of complications should be understood as a phase-spanning concept integrating preoperative optimisation, intraoperative quality assurance, and postoperative standardisation. Prehabilitation, nutritional optimisation, and risk-adapted patient preparation may reduce overall and pulmonary complications and may also lower the risk of anastomotic leakage in selected settings. Intraoperatively, minimally invasive and robotic approaches can reduce morbidity, especially respiratory complications, while adjunctive measures such as perfusion assessment, leak testing, endoscopic control, and procedure-specific technical strategies, may further improve safety. Postoperatively, ERAS pathways, early oral or enteral nutrition, and structured rescue strategies contribute to faster recovery without increasing anastomosis-related complications. In addition, volume-outcome data indicate that hospital and surgeon caseload, together with the ability to rescue patients after complications, represent key system-level determinants of perioperative outcomes. Overall, the available evidence supports a comprehensive perioperative safety pathway rather than isolated individual measures for effective prevention of complications in upper gastrointestinal surgery.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Correction: The Reconstruction of Complex Thoracic Defects with Free Flaps and the Choice of the Appropriate Recipient Vessel].","authors":"Florian Falkner, Rebecca Luisa Schäfer, Simon Mayer, Nicolas Ewerbeck, Riccardo Giunta, Denis Ehrl, Nicholas Möllhoff, Wolfram Demmer, Vanessa Masalov, Emre Gazyakan, Julian Vogelpohl, Ulrich Kneser, Felix Hubertus Vollbach","doi":"10.1055/a-2697-8476","DOIUrl":"10.1055/a-2697-8476","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"e2"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145125819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician Assistance und die chirurgische Prozessqualität.","authors":"Dietmar Pennig","doi":"10.1055/a-2746-8923","DOIUrl":"10.1055/a-2746-8923","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"397-400"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BGH bestätigt: Ärztliche Aufklärung immer im persönlichen Gespräch.","authors":"Kim-Victoria Seibert","doi":"10.1055/a-2921-2163","DOIUrl":"https://doi.org/10.1055/a-2921-2163","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"151 5","pages":"405-406"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[AI-Assisted EVAR Planning - Experiences in Simple and Complex Cases with the Digital Twin Technology].","authors":"Paula R Keschenau, Mats-Niklas Doering, Johannes Kalder","doi":"10.1055/a-2773-0963","DOIUrl":"10.1055/a-2773-0963","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study is to present initial experiences with AI-assisted EVAR planning in cases of different complexity, and to discuss its potential clinical benefits, current limitations, and future development perspectives.</p><p><strong>Patients/materials and methods: </strong>Starting from March 2024, this single centre study included prospectively the first infrarenal and complex EVAR cases that were planned with additional preoperative simulation using the AI-based Digital Twin technology (Predisurge SAS, St. Etienne, France). The study assessed the concordance between simulation results, clinical planning, and postoperative outcomes, focusing on the occurrence of Type Ia endoleaks after infrarenal EVAR and target vessel complications during the implantation of fenestrated/branched endografts (F/BEVAR). Additionally, the potential impact of the simulation on therapeutic decision-making was evaluated.</p><p><strong>Results: </strong>9 infrarenal EVAR cases (all male, median age 74 [61-80] years) and 10 F/BEVAR cases (4 male, median age 73 [58-82] years) were included. 7/9 patients with infrarenal pathology were treated with Endurant IIs endografts (Medtronic, Dublin, Ireland), one patient with a Zenith Alpha endograft (Cook Medical, Australia Pty Ltd., Brisbane, Australia), and one patient with an Anaconda endograft (Terumo Aortic, Inchinnan, Scotland). In 2 cases, a larger main body was selected based on the simulation results. In 3 cases, the simulation indicated an elevated Endoleak Risk Index (ERI), although no Type Ia endoleak was observed during follow-up; in these cases, the simulation results differed from the surgeon's assessment. Among the F/BEVAR patients (7/10 Cook Medical, 3/10 Terumo Aortic), the simulation led to a change in graft design or fenestration position (1/10 each) and predicted target vessel complications in three cases.</p><p><strong>Conclusion: </strong>AI-assisted EVAR planning is still in its early stages but offers numerous opportunities for further development, which are eagerly anticipated. Initial clinical experiences are promising; however, larger studies are needed to confirm and validate these findings. It is expected that preoperative AI-assisted EVAR simulation will play a significant role in the future - not only in clinical decision-making for both simple and complex cases, but also in education and training.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"419-429"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146020091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Open Thoracoabdominal Aortic Replacement for Midaortic Syndrome and COL3A1 Variant].","authors":"Christos Tanasidis, Steffen Wolk, Albert Busch, Thomas Rössel, Heiner Nebelung, Norbert Weiss, Christian Reeps","doi":"10.1055/a-2773-1827","DOIUrl":"10.1055/a-2773-1827","url":null,"abstract":"<p><strong>Purpose: </strong>Midaortic syndrome (MAS) is a rare vascular disorder characterised by segmental hypoplasia or stenosis of the thoracoabdominal aorta and possible involvement of renovisceral branches.</p><p><strong>Patients/materials and methods: </strong>In the case presented here, a 19-year-old female patient with thoracoabdominal aortic hypoplasia combined with multiple aortic and visceral aneurysms and a genetically confirmed COL3A1 variant (vascular Ehlers-Danlos syndrome) underwent open surgical thoracoabdominal type II aortic replacement.</p><p><strong>Patients/materials and methods: </strong>Using a multimodal neuro- and organ-protective approach, including perioperative CSF drainage, MEP monitoring, mechanical selective and distal extremity and organ perfusion, and targeted blood product and volume management, a complication-free thoracoabdominal reconstruction was performed.</p><p><strong>Results: </strong>The postoperative course was normal but required subsequent interventional endovascular treatment of an anastomotic stenosis of the right renal artery.</p><p><strong>Conclusion: </strong>This case highlights the need for a tailored therapeutic approach for this complex, genetic aortic pathology. It demonstrates that not all aortic diseases are amenable to endovascular treatment and that open surgical treatment remains highly important, especially in younger patients with hereditary aortic diseases.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"434-438"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The Thoracoflo Graft for Hybrid TAAA Repair - Tips and Tricks After the First Clinical Experience].","authors":"Sabine Wipper, Florian K Enzmann, David Wippel, Julia Dumfarth, Tilo Kölbel, Sebastian Debus","doi":"10.1055/a-2773-6571","DOIUrl":"10.1055/a-2773-6571","url":null,"abstract":"<p><strong>Purpose: </strong>The Thoracoflo hybridgraft was developed for treatment of thoracoabdominal aortic pathologies in selective patients, avoiding thoracotomy, thoracic cross-clamping, and extracorporeal circulation (ECC). In the following manuscript, criteria for patient selection as well as pitfalls and bailouts after first clinical experience are summarised.</p><p><strong>Materials and methods: </strong>Since September 2021, worldwide a total of 50 Thoracoflo implantations have been performed in centres with high experience in open and endovascular treatment of thoracoabdominal aortic pathologies. All patients were selected by interdisciplinary board decision. Conventional open or solely endovascular repair was not feasible or at high risk due to comorbidities or for anatomical reasons. Simulator team training was performed prior to surgery and the procedure was supervised by a proctor. All procedures were evaluated postoperatively for technical and surgical pitfalls, and consecutive bailouts were elaborated and summarised.</p><p><strong>Results: </strong>Requirements for graft implantation are a safe landing zone in the descending thoracic aorta, which can also be created by TEVAR implantation, and possibility for retrograde visceral perfusion (access to visceral arteries in dissection, low thrombus load). The Thoracoflo hybridgraft was successfully implanted in 49 out of 50 patients, but in one procedure intraoperative conversion with thoracotomy and extracorporeal circulation was necessary. During debriefing pitfalls and bailouts were summarised.</p><p><strong>Conclusions: </strong>The Thoracoflo hybridgraft offers an alternative treatment option for complex aortic pathologies, if perioperative requirements are followed. Accurate patient selection and verification of treatment indication are mandatory.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"439-443"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Semibranches for Complex Aortic Repair].","authors":"Alexander Oberhuber, Miroslav Yordanov, Abdulhakim Ibrahim, Johannes Frederik Schäfers","doi":"10.1055/a-2699-9135","DOIUrl":"10.1055/a-2699-9135","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"430-433"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}