Zentralblatt fur Chirurgie最新文献

{"title":"Editorial.","authors":"Michael Ghadimi, Jörg Kalff, Tobias Keck, Stefan Fischer","doi":"10.1055/a-2481-5843","DOIUrl":"https://doi.org/10.1055/a-2481-5843","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"150 1","pages":"26-27"},"PeriodicalIF":0.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256827","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":"[Resection of Solitary Lung Metastasis of Urinary Tract Transitional Cell Cancer Can Prolong Survival in Selected Patients].","authors":"Benjamin Ehle, Mohamed Hassan, Uyen-Thao Le, Bernward Passlick, Konstantinos Grapatsas","doi":"10.1055/a-2148-1207","DOIUrl":"10.1055/a-2148-1207","url":null,"abstract":"<p><p>There are only a few small published studies on pulmonary metastasectomy for urinary tract transitional cell carcinoma (TCC). In this study, we examined the long-term outcome and the prognostic survival factors associated with pulmonary metastasectomy of urinary tract TCC, as based on our centre's 20-year experience. Between 2000 and 2020, curative pulmonary metastasectomy was performed in 18 patients (14 males and 4 females). Clinical, demographical and surgical data were retrospectively analysed. The disease-free interval between treatment of the primary tumour and pulmonary metastasectomy ranged from one to 48 months. Survival analysis was conducted with the Kaplan-Meier method and log-rank test. The 3- and 5-year survival rates were 84.7% and 52.9%, respectively. Resection of solitary metastases was a positive and independent factor for survival (p = 0.04). Pulmonary metastasectomy of urinary tract TCC is associated with a favourable outcome and solitary metastasis is associated with long-term survival. Surgical resection of solitary pulmonary metastasis and repeated lung metastasectomy by pulmonary recurrence from a urinary tract TCC is feasible in selected patients.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"71-77"},"PeriodicalIF":0.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10515671","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":"Arztanmerkungen – Das Kleingedruckte (1. Teil).","authors":"Albrecht Wienke","doi":"10.1055/a-2445-0902","DOIUrl":"https://doi.org/10.1055/a-2445-0902","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"150 1","pages":"16-19"},"PeriodicalIF":0.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256825","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":"Intraoperative Schmerztherapie bei der minimalinvasiven Chirurgie.","authors":"Christine Reincke, Marco Niedergethmann","doi":"10.1055/a-2461-9187","DOIUrl":"https://doi.org/10.1055/a-2461-9187","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"150 1","pages":"5-8"},"PeriodicalIF":0.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256832","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":"[Scientific Activity in German Thoracic Surgery, as Measured in Publication Output].","authors":"Michael Ried, Luisa Marie Pfannschmidt, Hans-Stefan Hofmann","doi":"10.1055/a-2257-9739","DOIUrl":"10.1055/a-2257-9739","url":null,"abstract":"<p><p>Thoracic surgery in Germany is primarily provided in non-university centres with a clinical focus and less at university hospitals. The extent to which scientific activity can be achieved within these different structures is investigated on the basis of publication output.A PubMed analysis was carried out for selected authors (leader in thoracic surgery in Germany) between Jan 2012 to Dec 2021. University hospitals, DKG-certified lung cancer centres (DKG: German Cancer Society) and DGT-certified thoracic centres (DGT: German Society for Thoracic Surgery) were included.An analysis of n = 54 non-university centres (DKG certificate n = 50 and/or DGT certificate n = 22) and n = 36 university hospitals (n = 9 autonomous clinic/department) was performed. A total of n = 2414 publications were identified, with original papers (n = 1776; 74%) and publications focussing on thoracic surgery (n = 1501; 62%) being found most frequently. The publication performance of the non-university centres was n = 599 publications (11/centre) and thus significantly lower than that of the university hospitals (n = 902; 25/clinic; p ≤ 0.001). Significantly higher publication output was confirmed for autonomous (n = 560; 62/clinic) compared to non-autonomous university thoracic surgery (n = 342; 13/clinic; p = 0.003). A 10-year trend was recorded, with almost doubling of publication output from n = 105 (university: n = 63) to n = 203 (university: n = 124) publications/year. The cumulative impact factors (IF) resulted in 2845 IF (52.7 IF/clinic) for non-university centres, 6361 IF (235.6 IF/clinic) for non-autonomous and 2931 IF (325.7 IF/clinic) for autonomous university thoracic surgery.Scientific activities have increased in non-university centres, but above all in university thoracic surgery. These positive developments are in acute danger due to the upcoming political changes (Hospital Structure Act, minimum volumes). Structural changes such as independent university thoracic surgery or cooperation models with non-university centres could offer solutions.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"78-87"},"PeriodicalIF":0.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933106","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":"Modified Delphi Procedure to Achieve Consensus for the Concept of a National Curriculum for Minimally Invasive and Robot-assisted Surgery in Germany (GeRMIQ).","authors":"Tobias Huber, Julia Weber, Felix von Bechtolsheim, Sven Flemming, Hans Friedrich Fuchs, Marian Grade, Richard Hummel, Christian Krautz, Jessica Stockheim, Michael Thomaschewski, Dirk Wilhelm, Jörg C Kalff, Felix Nickel, Hanno Matthaei","doi":"10.1055/a-2386-9463","DOIUrl":"10.1055/a-2386-9463","url":null,"abstract":"<p><p>The rapid development of minimally invasive surgery (MIS) and robot-assisted surgery (RAS) requires standardized training to ensure high-quality patient care. In Germany, there is currently a lack of a standardized curriculum that teaches these specialized skills. The aim of this study is to find a consensus for the development of a nationwide curriculum for MIS and RAS with the subsequent implementation of the consented content.A modified Delphi process was used to reach consensus among national experts in MIS and RAS. The process included a literature review, an online survey and an expert conference.All 12 invited experts participated in the survey. They primarily achieved consensus on 73% and secondarily within the expert conference on 95 out of 122 questions (77.9%). The preference for a basic curriculum as a foundation on which specialized modules can build on was particularly clear. The results support the development of an integrated curriculum for MIS and RAS that includes step-by-step training from theoretical knowledge via e-learning modules to practical skills in dry lab simulations and in the OR. Emphasis was placed on the need to promote clinical judgment and decision making through targeted assessment during the learning curve to ensure effective application of learned skills in clinical practice. There was also a consensus that training content must be aligned with learners' skill acquisition using objective performance assessments in line with the principle of proficiency-based progression (PBP). The continuous updating of the curriculum to keep it up to date with the latest technology was considered essential.The study underlines the urgent need for a standardized training curriculum for MIS and RAS in Germany in order to increase patient safety and improve the quality of surgical care. There is broad expert consensus for the implementation of such a curriculum. It aims to ensure a contemporary and internationally competitive uniform quality of training and to increase the attractiveness of surgical training.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"35-49"},"PeriodicalIF":0.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11798644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[CA 19-9 Secreting Extralobar Sequestration Presenting as a Bifocal Posterior Mediastinal Tumour].","authors":"Ioannis Karampinis, Christian Galata, Eric Dominic Rößner, Davor Stamenovic","doi":"10.1055/a-2520-2848","DOIUrl":"https://doi.org/10.1055/a-2520-2848","url":null,"abstract":"<p><p>A 60-year-old female patient was referred for further diagnosis and treatment of a posterior mediastinal lesion. The lesion was incidentally discovered in a CT scan of the chest and abdomen, which had been performed due to an increased CA 19-9 in routine blood tests. At the time point of the referral, the lesion had already been biopsied twice (CT guided and through EUS) but the histopathology was inconclusive. Upon referral, we repeated the CT guided biopsy and the transoesophageal ultrasound. The latter did not reveal any invasion of the oesophagus. Both biopsies were inconclusive again. We discussed thoracoscopic exploration with the patient. The procedure began with a right uniportal VATS. The lesion originated in the right lower lobe. After dissection of the lesion from the right lower lobe and its adhesions to the diaphragm, the lesion was mobilised from the mediastinal adhesions. A supplying vessel from the descending aorta was ligated and the patient was turned in order to continue the procedure from the left side. During the left sided thoracoscopy, the lesion was dissected from the diaphragm and the descending aorta. There was no invasion of the lung on the left side. The lesion was pulled through the mediastinum between the aorta and the oesophagus and was successfully extracted through the left uniportal incision. The histopathological report revealed extralobar pulmonary sequestration.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067709","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":"[Ergonomic Load on the Surgical Team during Open, Laparoscopic and Robot-assisted Surgical Procedures].","authors":"Oliver Owen Koch, Karoline Leberbauer, Wolfgang Hitzl, Eva Wallner, Klaus Emmanuel","doi":"10.1055/a-2510-8669","DOIUrl":"https://doi.org/10.1055/a-2510-8669","url":null,"abstract":"<p><p>The aim of this work is to investigate the ergonomic load on the surgical team during open, laparoscopic and robot-assisted surgical procedures.Employees of the Salzburg State Hospitals (SALK) were invited to take part in a standardised online survey in December 2023. The extent and differences in psychophysical stress for the individual professional groups and specialists were examined for different surgical procedures.64/111 (57.7%) of all invited employees took part in the study, of whom 30 (46.9%) were male and 34 (53.1%) female. For the majority, working in the operating theatre (OT) was physically stressful, and more than 60.9% of those surveyed had to seek medical help or take painkillers. The most commonly affected areas of the body are the back and neck, and 17.2% of respondents believe they were likely to have to retire early. Despite the physical strain, the majority enjoyed working in the OT. For 61.9%, robotic surgery was perceived as being the least physically demanding. Significant differences in psychophysical stress and preferences for the different types of operations were evident in gender, age groups, professional groups, specialist areas, years of work in the operating theatre and biometric data.The results could be used to initiate targeted measures to promote health and employee satisfaction and to carry out appropriate training.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042528","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 6th Year of the Study of Human Medicine is Mainly Orientated to Practice: a Pilot Study with a Digital Logbook].","authors":"Max Wacker, George Awad, Maximilian Scherner, Bastian Fakundiny, Thorsten Walles, Lars Choritz, Michael Hansen, Hatice Cukaz, Tim Herrmann, André Helm, Frank Meyer, Jens Wippermann","doi":"10.1055/a-2505-2114","DOIUrl":"10.1055/a-2505-2114","url":null,"abstract":"<p><p>Digital learning resources are in increasing demand, especially in the light of the planned reform of the medical licensing regulations for 2028. In a pilot project, we digitised and evaluated a logbook for students in their practical year (PJ).The aim of this study is to evaluate the digital and non-digital PJ logbooks.Based on a printed PJ logbook, a digital PJ logbook was developed as a web app. The implementation was performed using the commercial enterprise knowledge management system Confluence (Atlassian Corporation, Sydney, Australia), which allows responsive design, integration with the university's user directory, and incorporation of corporate design. Student satisfaction (n = 34) was assessed using questionnaires and a 5-level Likert scale. Additionally, students self-assessed their skills at the beginning and end of the rotation before (n = 49) and after (n = 34) the introduction of the digital logbook by grade points.The majority of students found the digital logbook to be an intuitive and a valuable addition. In the stationary setting, the introduction of the digital logbook led to a significant improvement in self-assessed skills by 0.73 grade points at the beginning (p < 0.001) and 0.78 grade points at the end of the rotation (p < 0.001). In the operating theatre, there was only a significant improvement of 0.47 grade points at the beginning of the rotation (p = 0.027).The evaluation demonstrates that the digital PJ logbook is well-received by students and significantly improves their self-assessed skills. The observed increase in self-assessed skills could be attributed to the introduction of the digital logbook and its contents, although other factors, such as the engagement of the instructors, cannot be excluded. Future modifications are planned to make the logbook more appealing.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012874","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":"[Laparoscopic Roux-en-Y Gastric Bypass for Grade III Obesity].","authors":"Patrick Téoule, Mirko Otto, Susanne Blank","doi":"10.1055/a-2446-2362","DOIUrl":"https://doi.org/10.1055/a-2446-2362","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781149","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}