Zentralblatt fur Chirurgie最新文献

{"title":"Innovation, Ergonomie und Resilienz – drei wichtige Entwicklungen der modernen Chirurgie.","authors":"Tobias Keck","doi":"10.1055/a-2708-1312","DOIUrl":"https://doi.org/10.1055/a-2708-1312","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"151 2","pages":"142-143"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595010","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":"[What Must the (General/Abdominal) Surgeon Know about Novel and Current Aspects as Well as Trends in Interdisciplinary \"Emergency Room\" Divisions (Knowledge of the [General and Abdominal] Surgeon)].","authors":"Tobias Hofmann, Christian Breitling, Frank Meyer","doi":"10.1055/a-2557-4795","DOIUrl":"10.1055/a-2557-4795","url":null,"abstract":"<p><p>Based on 1) selective but relevant references from current subject-specific medical literature and 2) competent clinical experiences of the interdisciplinary, professional, and sectoral profile of emergency medicine specialists and general/abdominal surgeons, current contents and trends of emergency management with specific surgical relevance are to be outlined.Narrative review.In addition to acute inflammatory or tumour diseases of the GI tract (and neighbouring organs) including threatening or manifest perforation, adequate care of injured patients (by accidents, physical violence) as well as bleeding in abdominosurgical dimension belong to the general and abdominal surgery care profile in the emergency room. In case of emergency care, there is repeatedly an imbalance between the number and severity of the patients on one side and the available resources on the other side, due to considerable variations in case volume and range of patient's condition (extending from completely unaffected to vitally threatened patients). Beside the \"classical\" general and abdominosurgical clinical pictures and diseases, the surgical care spectrum extends increasingly to gunshot and stab wounds (penetrating injuries). While there are recommendations for traumatic injuries including the abdomen, in particular, for diagnostic, treatment and disposable personal resources, such standard care policy for general/abdominal surgery emergency patients does not exist. Standardisation of emergency diagnoses, registration and risk stratification based on existing findings (clinical, anatomical, radiological) as well as evidence-based clinical pathways and bundle of measures including the documentation of treatment results in a national register for quality assurance may lead to improvement in the care in general/abdominal surgery emergency patients.To fulfil adequately all the requirements in interdisciplinary emergency cases, stringent workflows, discipline-, finding- and diagnosis-related therapeutic standards, high and developing expertise of physicians and interprofessional collaboration are all essential. Clinical quality assurance with register-based documentation and periodic auditing may improve patient care.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"185-196"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812576","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":"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":"144-153"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","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":"Sektorenübergreifende Versorgung – Gamechanger für die Chirurgie?","authors":"Thomas Schmitz-Rixen","doi":"10.1055/a-2686-2567","DOIUrl":"10.1055/a-2686-2567","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"125-131"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107702","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":"Robotik in der Leberchirurgie.","authors":"Roland S Croner","doi":"10.1055/a-2739-5378","DOIUrl":"10.1055/a-2739-5378","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"137-138"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744913","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":"Aufklärungsbogen in der Praxis – ein kurzes Interview.","authors":"Armin Schwerdtfeger","doi":"10.1055/a-2766-6588","DOIUrl":"https://doi.org/10.1055/a-2766-6588","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"151 2","pages":"135-136"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594997","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":"168-173"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","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":"[Endoscopic Retrograde Cholangiopancreatography before Gallbladder Removal - an Unholy Alliance?]","authors":"Lars Fischer, Kiryl Halavach, Byulen Brahomov, Björn Huck, Gerd Kolb, Boris Huber, Carolin Erhardt, Cornelia Segendorf, Erika Fischer, Ronald Koschny, Manuel Feißt","doi":"10.1055/a-2557-4649","DOIUrl":"10.1055/a-2557-4649","url":null,"abstract":"<p><p>Endoscopic retrograde cholangiopancreaticography (ERCP) is, among other indications, performed in conjunction with cholecystectomy (CHE) for suspected bile duct stones. Due to its invasiveness, ERCP is an endoscopic examination with considerable morbidity and mortality and influence the perioperative outcome after CHE.In this retrospective and monocentric study, all patients who underwent CHE in Baden-Baden from 01.07.2018 to 31.12.2022 were consecutively examined. In this exploratory study, p values < 0.05 were assessed as statistically significant.942 patients with gallbladder surgery (CHE) were included. Of these, 158 patients (17%) had at least one preoperative ERCP (pre-ERCP). During this pre-ERCP, 89 patients (56.3%) had one or more stones removed or pus drained. Patients with pre-ERCP differed significantly from patients without pre-ERCP in terms of surgical procedure (laparoscopic, conversion, open), duration of surgery, hospital stay, need for conversion, surgical revision, morbidity, and mortality. However, a systematic bias was found, i.e. patients with pre-ERCP were significantly older, more often male and sicker (ASA classification). The multiple regression models showed that pre-ERCP was a significant factor for conversion or open cholecystectomy and for the occurrence of postoperative complications after CHE.In patients with cholecystectomy, pre-ERCP is associated with significantly more conversions, prolonged operating time and increased postoperative complication rates. Patients could therefore benefit from the \"surgery first\" mindset, i.e. primary cholecystectomy.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"161-167"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016839","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 Dynamics of the German Healthcare System Require Rapid Team Development - Colorectal Fast Track Implementation as a Prototype with a Steep Learning Curve].","authors":"Christoph W Strey, Sven Flemming, Montserrat Girona-Johannkemper, Wolfgang Wendt, Ibrahim Darwich, Hannes Neeff, Carolyn Bormann, Wolfgang Schwenk","doi":"10.1055/a-2698-6551","DOIUrl":"10.1055/a-2698-6551","url":null,"abstract":"<p><p>Restructuring of the German healthcare system necessitates adjustments in quality assurance, cost reduction, shortened length of stay, and professional staff retention. The structured Fast Track Implementation (FTI) for colorectal surgery meets these requirements through interprofessional team development.Fast Track was implemented in a structured procedure over the course of one year at the participating clinics. Fast Track adherence (= process quality) and data on functional recovery, morbidity, and mortality (= outcome quality) were reflected back to the teams for the periods before (preFTI), during (FTI), and after (postFTI) FT implementation, respectively.In 7 clinics, 1,550 elective colorectal resections were performed. Fast Track adherence increased from 52 % before (preFTI) to 83 % during (FTI) and 87 % after (postFTI) the structured Fast Track implementation (p < 0.01). Before the FT implementation, the recovery of patients' physical autonomy took 5 days, compared to 4 days during and only 3 days after the implementation (p < 0.001). The postoperative length of stay was reduced from 7 days (preFTI) to 6 days and then to 5 days (postFTI; p < 0.001). The rate of general complications simultaneously decreased from 12.6 % (preFTI) and 8.1 % (FTI) to 6.1 % (postFTI; p < 0.001).The structured Fast Track implementation for elective colorectal resections leads to improved process and outcome quality with a steep learning curve and can be considered as a template for project-oriented team development in other medical fields as well.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"174-184"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439275","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":"[First True Robotic Single-port Right Hepatectomy].","authors":"Philipp Anton Holzner, Magdalena Marei Menzel, Stefan Fichtner-Feigl, Christopher Berlin","doi":"10.1055/a-2732-6713","DOIUrl":"10.1055/a-2732-6713","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"139-141"},"PeriodicalIF":0.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744875","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}