Zentralblatt fur Chirurgie最新文献_第10页

[Physical Strain after Abdominal Surgery - Results of a Patient Survey]. [腹部手术后的体力劳损-病人调查结果]。

IF 0.7 4区医学

Zentralblatt fur Chirurgie Pub Date : 2023-12-01 Epub Date: 2021-02-04 DOI: 10.1055/a-1346-0274

Sebastian Schaaf, Carsten Weber, Christoph Güsgen, Robert Schwab, Arnulf Willms

{"title":"[Physical Strain after Abdominal Surgery - Results of a Patient Survey].","authors":"Sebastian Schaaf, Carsten Weber, Christoph Güsgen, Robert Schwab, Arnulf Willms","doi":"10.1055/a-1346-0274","DOIUrl":"10.1055/a-1346-0274","url":null,"abstract":"Introduction: Incision hernias are common complications after abdominal surgery and affect the recommendations on postoperative physical strain, as it is thought that excessively early strain causes incisional hernias. However, there is no evidence to justify this. This study evaluates the effect of postoperative strain on the risk of incisional hernia.Materials and methods: Patients with a laparoscopy (LS) or laparotomy (LT) were asked to complete a questionnaire on postoperative strain, complaints and quality of life. Patients with hernia surgery, or open abdomen therapy for complicated courses (Clavien-Dindo > III) were excluded.Results: 393 patients completed the questionnaire (43.6%). 274 were LS and 128 LT. The incidence of incisional hernias was 5.2% (LS) and 18.0% (LT, p = 0.001). Incisional hernia patients were younger and more commonly males. 30.5% of incisional hernia patients did not return to normal physical strain postoperatively. Abdominal binders did not affect the hernia rate. The incisional hernia patients showed decreased quality of life scores in both mental and physical domains.Conclusion: Early postoperative physical strain was not a risk factor for incisional hernia development in this study. However, prospective studies are needed to create necessary evidence to recommend earlier postoperative return to normal physical strain.","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-1346-0274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25331439","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}

引用次数: 1

The Role of C-reactive Protein and Procalcitonin in Predicting the Occurrence of Pancreatic Fistula in Patients who Underwent Laparoscopic Pancreaticoduodenectomy: a Retrospective Study. C反应蛋白和降钙素原在腹腔镜胰十二指肠切除术患者预测胰瘘发生中的作用：一项回顾性研究。

IF 0.7 4区医学

Zentralblatt fur Chirurgie Pub Date : 2023-12-01 Epub Date: 2023-10-05 DOI: 10.1055/a-2157-7550

Maher Al Hussan, Shishi Qiao, Ezaldin M I Abuheit, Mohammed Awadh Abdun, Mohamad Al Mahamid, Huahu Guo, Fengyu Zheng, Ali Mansour Ali Mi Nobah

{"title":"The Role of C-reactive Protein and Procalcitonin in Predicting the Occurrence of Pancreatic Fistula in Patients who Underwent Laparoscopic Pancreaticoduodenectomy: a Retrospective Study.","authors":"Maher Al Hussan, Shishi Qiao, Ezaldin M I Abuheit, Mohammed Awadh Abdun, Mohamad Al Mahamid, Huahu Guo, Fengyu Zheng, Ali Mansour Ali Mi Nobah","doi":"10.1055/a-2157-7550","DOIUrl":"10.1055/a-2157-7550","url":null,"abstract":"The occurrence of postoperative pancreatic fistula following laparoscopic pancreaticoduodenectomy (LPD) is a significant concern, yet there is currently a lack of consensus on reliable predictive methods for this complication. Therefore, the aim of this study was to assess the clinical significance of C-reactive protein (CRP) and procalcitonin (PCT) values and their reliability in early predicting the development of clinically relevant pancreatic fistula (CRPF) following LPD.A retrospective analysis was conducted using data from 120 patients who had LPD between September 2019 and December 2021. Preoperative assessment data, standard patients' demographic and clinicopathological characteristics, intra- and postoperative evaluation, as well as postoperative laboratory values on postoperative days (PODs) 1, 3, and 7, including white blood cells (WBCs), CRP, and PCT, were prospectively recorded on a dedicated database. Two clinicians separately collected and cross-checked all of the data.Among 120 patients [77 men (64%), 43 women (36%], CRPF occurred in 15 patients (11 grade B and 4 grade C fistulas). The incidence rate of CRPF was 12.3%. A comparison of the median values of WBCs, PCT, and CRP across the two groups revealed that the CRPF group had higher values on most PODs than the non-CRPF group. Receiver operating characteristic (ROC) analysis was used to calculate the area under the curve (AUC) and cutoff values. It was discovered that POD 3 has the most accurate and significant values for WBCs, CRP, and PCT. According to the ROC plots, the AUC for WBCs was 0.842, whereas the AUC for PCT was 0.909. As for CRP, the AUC was 0.941 (95% CI 0.899-0.983, p < 0.01) with a cutoff value of 203.45, indicating a sensitivity of 93.3% and specificity of 91.4%.Both CRP and PCT can be used to predict the early onset of CRPF following LPD, with CRP being slightly superior on POD 3.","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41155628","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}

引用次数: 0

Das neue Ehegattennotvertretungsrecht: § 1358 BGB. 新Ehegattennotvertretungsrecht:§1358 BGB .

IF 0.7 4区医学

Zentralblatt fur Chirurgie Pub Date : 2023-12-01 Epub Date: 2023-11-23 DOI: 10.1055/a-2054-6525

Jörg Staatsmann

引用次数: 0

Smart und effizient – den OP-Saal von morgen gibt es schon heute. 智能和高效——明天的手术室已经在今天了。

IF 0.7 4区医学

Zentralblatt fur Chirurgie Pub Date : 2023-12-01 Epub Date: 2023-11-23 DOI: 10.1055/a-2164-2013

Jochen A Werner

引用次数: 0

[Indication and Surgical Procedures for MEN1-associated Duodenopancreatic Neuroendocrine Neoplasms]. 【men1相关十二指肠胰神经内分泌肿瘤的适应证和手术方法】。

IF 0.7 4区医学

Zentralblatt fur Chirurgie Pub Date : 2023-12-01 Epub Date: 2023-08-21 DOI: 10.1055/a-2103-3525

Jerena Manoharan, Max Albers, Detlef K Bartsch

引用次数: 0

Revaskularisation vor Defektdeckung – essenzielle Schnittstelle zwischen plastischer Chirurgie und Gefäßchirurgie 外科手术和血管手术的重要接口

4区医学

Zentralblatt fur Chirurgie Pub Date : 2023-11-13 DOI: 10.1055/a-2183-1770

Alexander Meyer, Ulrich Rother, Oliver C Thamm

{"title":"Revaskularisation vor Defektdeckung – essenzielle Schnittstelle zwischen plastischer Chirurgie und Gefäßchirurgie","authors":"Alexander Meyer, Ulrich Rother, Oliver C Thamm","doi":"10.1055/a-2183-1770","DOIUrl":"https://doi.org/10.1055/a-2183-1770","url":null,"abstract":"Zusammenfassung Komplexe, ischämische Wunden im Bereich der unteren Extremität mit freiliegenden tiefen Strukturen stellen große Herausforderungen an die behandelnden Fachdisziplinen dar. Als Alternative zur Majoramputation ergibt sich für ausgewählte Patienten die Möglichkeit eines kombinierten Verfahrens mittels arterieller Rekonstruktion und nachfolgender mikrochirurgischer Defektdeckung durch eine freie Lappentransplantation. Als arterielle Rekonstruktionsverfahren stehen endovaskuläre oder offen chirurgische Verfahren wie Bypassrekonstruktion oder Implantation eines arteriovenösen Loops als Vorbereitung für die Defektdeckung zur Verfügung. Ziel der arteriellen Rekonstruktion ist die Schaffung einer ausreichenden Perfusion zur Defektdeckung an der Extremität sowie die Schaffung von Anschlussgefäßen für die Lappentransplantation. Die Auswahl des Lappens richtet sich u. a. nach der Größe und Ausdehnung des Defektes sowie nach dem Vorhandensein einer Osteomyelitis. Dies kann ein- oder zweizeitig erfolgen. In Zentren ist dieses kombinierte Vorgehen als sichere Methode etabliert. Die Mikroperfusionsanalyse des Gewebes mittels Indocyaningrün erhöht nochmals die Sicherheit des Verfahrens und kann Perfusionsdefizite aufzeigen. Das kombinierte Verfahren mittels arterieller Rekonstruktion und freiem Gewebetransfer liefert gute Langzeitergebnisse im Hinblick auf amputationsfreies Überleben und postoperative Mobilität. Wichtig für die Indikationsstellung ist eine korrekte Patientenselektion unter Berücksichtigung der Kontraindikationen. Dieses Verfahren sollte für alle mobilen Patienten mit komplexen Weichteildefekten vor einer Majoramputation evaluiert werden.","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136351621","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}

引用次数: 0

Editorial. 社论

IF 0.7 4区医学

Zentralblatt fur Chirurgie Pub Date : 2023-10-01 Epub Date: 2023-10-16 DOI: 10.1055/a-2146-5273

Ralph Ingo Rückert

引用次数: 0

Stellenwert der Checkpoint Therapie bei viszeral-onkologischen Erkrankungen. 检查点治疗在内脏肿瘤疾病中的重要性。

IF 0.7 4区医学

Zentralblatt fur Chirurgie Pub Date : 2023-10-01 Epub Date: 2023-10-16 DOI: 10.1055/a-2148-1979

Hans Anton Schlößer, Thomas Schmidt

引用次数: 0

[The Usefulness of ERAS Concepts for Colorectal Resections - an Economic Analysis under DRG Conditions]. 【ERAS概念对结直肠癌切除术的有用性——DRG条件下的经济分析】。

IF 0.7 4区医学

Zentralblatt fur Chirurgie Pub Date : 2023-10-01 Epub Date: 2022-09-05 DOI: 10.1055/a-1880-1309

Franziska Koch, Melanie Dietrich, Martina Green, Lutz Moikow, Mareike Schmidt, Matthias Ristig, Andreas Meier-Hellmann, Jörg-Peter Ritz

{"title":"[The Usefulness of ERAS Concepts for Colorectal Resections - an Economic Analysis under DRG Conditions].","authors":"Franziska Koch, Melanie Dietrich, Martina Green, Lutz Moikow, Mareike Schmidt, Matthias Ristig, Andreas Meier-Hellmann, Jörg-Peter Ritz","doi":"10.1055/a-1880-1309","DOIUrl":"10.1055/a-1880-1309","url":null,"abstract":"Background: ERAS (Enhanced Recovery After Surgery) describes a multimodal, interdisciplinary and interprofessional treatment concept that optimizes the postoperative convalescence of the patient through the use of evidence-based measures.Goal of the work: The aim of this article is to examine the economic feasibility of the concept in the German DRG system.Material and methods: Since August 2019, patients have been treated in our clinic according to the later certified ERAS concept. The last 20 patients before ERAS implementation are compared below with 20 patients after ERAS implementation, who were identified using a matched pair analysis. In addition to the comparison of costs and revenues, the clinical outcome of the patients is also presented.Results: The cases of the patients in the pre-ERAS cohort caused median costs of € 7432.83. BWR of 3.38 were billable. The resulting DRG revenue for the patients in this group amounted to € 11325.78. The proceeds generated in the end amounted to € 4575.14. The cases of patients in the ERAS cohort resulted in costs of € 5582.96. BWR of 2.84 could be billed. The DRG proceeds for the patients in this group therefore amounted to € 10014.18. The profit generated was thus € 4993.84.Discussion: The cost reduction generated by ERAS was comparable to the \"loss\" caused by the BWR decrease. ERAS is therefore also possible to cover costs in the German DRG system.","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40351017","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}

引用次数: 0

Langzeitergebnisse einer Bewegungstherapie im Vergleich mit Revaskularisation bei Patienten mit Claudicatio intermittens 在运动治疗中对因克劳迪卡过世的病人的替换次数显示

4区医学

Zentralblatt fur Chirurgie Pub Date : 2023-10-01 DOI: 10.1055/a-2135-7796

引用次数: 0