Zentralblatt fur Chirurgie最新文献

{"title":"Mitteilungen der DGT im Zentralblatt für Chirurgie.","authors":"","doi":"10.1055/a-2650-2890","DOIUrl":"https://doi.org/10.1055/a-2650-2890","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"150 S 01","pages":"S58-S59"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971689","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":"[MRI Defecography - What is Important for Surgery of the Pelvic Floor?]","authors":"Christopher Kämpfer, Claus Christian Pieper","doi":"10.1055/a-2607-3789","DOIUrl":"10.1055/a-2607-3789","url":null,"abstract":"<p><p>MR-defecography plays a key role in imaging complex pelvic floor dysfunction. Simultaneous detection of multiple findings in a complex anatomical setting makes correct analysis and clinical interpretation challenging. Thorough understanding of this imaging technique is essential for pelvic floor surgeons in order to make proper use of its advantages in the diagnosis of pelvic floor pathologies. We have reviewed the scientific literature on MR-defecography from recent years to sum up the most important aspects concerning patients' selection and preparation, examination procedure, standardised reporting and the most important pathological findings for pelvic floor surgery. MR-defecography is performed using static as well as dynamic MR sequences of high spatial resolution with excellent soft tissue contrast. The detection of pathological findings (pelvic floor relaxation, pelvic floor descent, rectocele, enterocele, peritoneocele, intussusception, rectal prolapse, dyssynergistic defecation) must always be correlated with clinical symptoms. It can provide information that is missed by other imaging modalities and hence it can alter therapeutic strategies in the interdisciplinary cooperation of pelvic floor surgeons, urologists and gynaecologists.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"362-371"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318129","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":"[Update on Gastric Pacemaking: Relevance for Gastroparesis].","authors":"Johannes Riebeling, Robert Patejdl, David Zipf, Lena-Christin Conradi, Michael Ghadimi, Felix Gundling, Tobias Bruegmann","doi":"10.1055/a-2636-2851","DOIUrl":"https://doi.org/10.1055/a-2636-2851","url":null,"abstract":"<p><p>Gastroparesis is a disease in which gastric emptying is significantly decreased in the absence of a mechanical obstruction of the gastric outlet. In addition to conservative or pharmacological treatment options, gastric electrical stimulation (GES) is a possible alternative therapy for refractory courses of the disease. However, the available data from randomised controlled trials on efficacy do not permit an unqualified recommendation. The aim of this review is to introduce the clinical picture of gastroparesis, including the underlying pathophysiology, and to classify the therapeutic role of GES, based on the currently available literature. In particular, indications and limitations of the therapy are outlined that may lead to optimisation of the therapy, followed by an outlook on a potential new therapeutic procedure.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"150 4","pages":"337-345"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804998","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":"[Functional Outcome of Radiotherapy, Chemotherapy and Surgery in the Treatment of Rectal Cancer].","authors":"Philipp Rhode, Matthias Mehdorn, Undine Gabriele Lange, Sebastian Murad Rabe, Johannes Quart, Robert Nowotny, Patrick Sven Plum, Stefan Niebisch, Sigmar Stelzner","doi":"10.1055/a-2646-2695","DOIUrl":"https://doi.org/10.1055/a-2646-2695","url":null,"abstract":"<p><p>Treatment of rectal cancer is multimodal and based on tumour stage and location, as well as morphological and biological risk factors - using surgery, radiotherapy, and chemotherapy. In a large number of cases, there are several treatment options, some of which can cause similar and some of which can cause different functional limitations. Comparisons of functional outcomes between different treatment modalities are currently limited.This narrative review presents the functional outcomes of different treatment strategies for middle and lower third rectal cancer, as based on a literature search.This paper analyses the evidence on the functional outcomes of different treatment strategies, especially regarding fecal continence, urinary and sexual function. The functional outcome after organ-preserving strategies appears to be slightly better in terms of stool frequency compared to surgical therapy alone, but this has to be weighed up against chemotherapy-induced polyneuropathy and radiogenic toxicities such as cystitis, radionecrosis or fistula formation. In addition, the functional side effects of perioperative and surgical therapy accumulate in the event of incomplete remission. A few days of treatment during surgical therapy contrast with the significantly more protracted treatment of total neoadjuvant therapy. A conclusive evaluation based on the current evidence is only possible to a limited extent.This study emphasises the importance of providing patients with detailed information about the functional consequences, duration of treatment and possible complications and offers a decision-making aid for planning individual treatment, taking quality of life into account.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"150 4","pages":"353-361"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804995","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":"[Surgical Therapy Options for Fecal Incontinence].","authors":"Momoko Nagata, Dieter Bussen","doi":"10.1055/a-2636-2704","DOIUrl":"10.1055/a-2636-2704","url":null,"abstract":"<p><p>Incontinence - especially anal incontinence - poses a significant burden for those affected. It severely impacts the quality of life, leads to limitations in daily life, and can result in social isolation. The aetiology of anal incontinence is heterogeneous and often multifactorial. Depending on the specific genesis, the therapy requires both a high degree of personal responsibility and discipline from the patients, as well as acceptance of the condition and its causes. For the responsible professionals, it is essential to incorporate not only professional expertise but also empathy and patience into the care. It should be gently communicated to the affected individuals that a complete restoration of continence is not realistic in most cases. Anal incontinence can occur in the context of numerous systemic diseases, psychological disorders, as well as due to muscular, sensory, or neurogenic dysfunctions. It can also be a possible complication following surgical procedures. Therefore, a differentiated, interdisciplinary investigation of the causes and their interrelations is essential. Patients should be fully informed about the available therapeutic options as well as the possible limitations of treatment. The therapeutic focus remains on conservative measures. Surgical procedures should only be considered when a morphological correlate is present and the chances of success are deemed favourable. An exception is sacral nerve modulation, which can also be successfully applied in cases of idiopathic faecal incontinence. This article is intended as a practice-oriented review and is based on clinical experience as well as the analysis and summary of current scientific literature - taking into account valid guidelines.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"372-381"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555122","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":"Unverzichtbar für die Fort- und Weiterbildung.","authors":"","doi":"10.1055/a-2650-9393","DOIUrl":"10.1055/a-2650-9393","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"150 4","pages":"321-322"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805002","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":"[Perioperative Use of Antibiotics in Thoracic Surgery].","authors":"Jana Schroeder, Jan Haselmann","doi":"10.1055/a-2444-5127","DOIUrl":"https://doi.org/10.1055/a-2444-5127","url":null,"abstract":"<p><p>Postoperative wound infections are a serious complication in thoracic surgery. At the same time, excessive use of antibiotics poses the risk of multi-resistant pathogens. The article highlights evidence-based strategies for perioperative antibiotic prophylaxis (PAP) and provides specific recommendations for action.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"150 S 01","pages":"S60-S70"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971504","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":"[Modern Radiological Approaches to the Diagnosis and Staging of Pleural Mesothelioma].","authors":"Sabine Franckenberg, Olivia Theissen-Lauk, Thomas Frauenfelder","doi":"10.1055/a-2576-6585","DOIUrl":"10.1055/a-2576-6585","url":null,"abstract":"<p><p>Pleural mesothelioma (PM) is a highly aggressive tumour, mainly associated with prior asbestos exposure. Symptoms typically do not manifest until 20 to 50 years after exposure. Depending on the histological subtype of PM, the prognosis varies, though the median survival time is only 12-18 months. Imaging plays a central role in the management of PM patients, particularly in assessing operability and treatment response. However, PM presents a unique challenge for radiology due to its rarity, complex morphology, and tendency to invade multiple tissue layers simultaneously. Contrast-enhanced computed tomography (CT) is the central imaging modality in the diagnosis, preoperative planning and therapy monitoring of pleural mesothelioma (PM). Ideally, CT should include both the thorax and abdomen to capture the entire pleural space. Tumour thickness and volume, as determined by CT, are important prognostic factors for patient survival in PM. In addition, PET/CT, using radioactively labelled fluorodeoxyglucose (¹⁸F-FDG), offers additional valuable insights into tumour metabolism. Since PM is typically metabolically active, PET/CT is particularly effective in detecting smaller lesions, occult metastases, and assessing morphologically ambiguous lesions. Magnetic resonance imaging (MRI), on the other hand, offers distinct advantages over CT, due to its superior soft tissue contrast, particularly in visualizing tumour extent and infiltration of adjacent structures. Dynamic contrast-enhanced imaging, diffusion-weighted imaging, and 4D sequences provide valuable additional information. On the basis of the \"Best Practices\" of the expert panel from the International Mesothelioma Interest Group (iMig), we provide an overview of the common imaging modalities, including conventional X-ray, CT, MRI, and PET/CT. Additionally, we discuss staging based on the TNM classification (Tumour, Node, Metastasis), which evaluates the local invasion of the tumour (T), lymph node involvement (N), and the presence of metastases (M). We also present examples of assessing treatment response and highlight recent developments in diagnostic imaging.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"S39-S49"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102788","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":"[A Migrating Pulmonary Mass: a Rare Case of Thoracolithiasis].","authors":"Deborah D Wehde, Jan Reichelt, Jan Philipp Hering","doi":"10.1055/a-2566-6597","DOIUrl":"10.1055/a-2566-6597","url":null,"abstract":"<p><p>We report on an 70-year old male patient with progressive dyspnoea. For further differential diagnosis he underwent a CT thorax in the pulmonary arterial phase. This revealed a solid, pleural round lesion. The lesion was located paravertebrally in the area of the distal aortic arch. Initially the dignity of the round lesion was undetermined. A subsequent examination conducted three months later, utilising HRCT, revealed no alterations in the dimensions or configuration of the mass. A change in position was observed. In this case of idiopathic phrenic nerve paralysis with diaphragmatic atrophy, diaphragmatic elevation and chronic progressive exertional dyspnoea, the surgical intervention involved a diaphragmoplasty and the surgical removal of the voluminous thoracolith by means of a muscle-sparing limited lateral thoracotomy. The diagnosis of a thoracolith was confirmed on the basis of morphologic criteria and a change in position.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"S12-S15"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151882","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":"[Pelvic Intraoperative Neuromonitoring - Update and Pilot Study on Telementoring].","authors":"Werner Kneist, Daniel Wilhelm Kauff, Tobias Huber, Jonas Friedrich Schiemer, Markus Paschold","doi":"10.1055/a-2640-0212","DOIUrl":"10.1055/a-2640-0212","url":null,"abstract":"<p><p>Pelvic intraoperative neuromonitoring (pIONM) is emerging as a key tool to enhance functional outcomes following rectal cancer surgery. This paper synthesizes current evidence on pIONM, including findings from the multicenter, randomized NEUROS trial, which demonstrated significant benefits for urinary, sexual, and ano-(neo-)rectal functions. Additionally, the role of telementoring as a catalyst for standardized robotic assisted pIONM adoption is explored. Three case studies illustrate the low cognitive burden on surgeons during telemedicine-assisted monitoring, assessed via the NASA-TLX questionnaire (TLX-score varied from 5.0 to 24.3). The results highlight pIONM's potential to prevent nerve damage and improve patient quality of life, with telementoring poised to facilitate broader implementation.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"150 4","pages":"346-352"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12334264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804996","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}