Zentralblatt fur Chirurgie最新文献_第3页

[Value and Role of Obesity and Metabolic Surgery in the Study of Human Medicine, Academic Teaching and Advanced Training]. [肥胖症和代谢外科在人类医学研究、学术教学和高级培训中的价值和作用]。

IF 0.5 4区医学

Zentralblatt fur Chirurgie Pub Date : 2024-12-01 Epub Date: 2024-05-14 DOI: 10.1055/a-2294-0672

Christine Stroh, Frank Meyer

{"title":"[Value and Role of Obesity and Metabolic Surgery in the Study of Human Medicine, Academic Teaching and Advanced Training].","authors":"Christine Stroh, Frank Meyer","doi":"10.1055/a-2294-0672","DOIUrl":"10.1055/a-2294-0672","url":null,"abstract":"In teaching, obesity and metabolic surgery play only a limited role. However, due to the rapidly increasing number of surgical interventions, communication of knowledge in the study of human medicine as well as in gastroenterological and surgical residency (general and abdominal surgery) is required.Narrative review. · Currently, lectures on obesity and metabolic surgery do not belong to the current surgical curriculum of human medicine at all University Medical Schools, which needs to be absolutely established step by step - based on their topicality and importance in the clinical spectrum of clinical care.. · This rapidly developing special area of abdominal surgery is characterized by specific and diverse interdisciplinarity.. · Multimorbidity, changes in resorption mechanisms but also psychological changes have a substantial impact on the indication and patient outcome.. · The increase in endoscopic, surgical and also robotic interventions and surgical methods in this special field requires a broad knowledge of all surgical disciplines in intervention preparation, perioperative and follow-up management of obesity-associated basic diagnosis. This objective is important even in the study of human medicine and further advanced training.. The inclusion of such complex contents on obesity and metabolic surgery into surgical teaching and into residency of general and abdominal surgery is essential to be future-oriented and prepared for the development of the discipline.","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"546-551"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923511","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

[Impact of the Reflux Origin on the Clinical Stage and Surgical Decision in Primary Varicose Veins]. [反流起源对原发性静脉曲张临床阶段和手术决定的影响]。

IF 0.5 4区医学

Zentralblatt fur Chirurgie Pub Date : 2024-12-01 Epub Date: 2024-03-20 DOI: 10.1055/a-2251-1628

Christoph Wilmanns, Ulrich Zechner, Paul Karl Walter, Alicia Schulze

{"title":"[Impact of the Reflux Origin on the Clinical Stage and Surgical Decision in Primary Varicose Veins].","authors":"Christoph Wilmanns, Ulrich Zechner, Paul Karl Walter, Alicia Schulze","doi":"10.1055/a-2251-1628","DOIUrl":"10.1055/a-2251-1628","url":null,"abstract":"Reflux and recirculation in primary varicose veins are not yet completely understood, and the contribution of perforator veins is dual.Reflux origin was assessed as junctional (JP, reflux of the greater saphenous junction or groin recurrences) with/without suspect perforator veins (SPV), or perforator phenotype (PP, reflux from SPV only or for statistical purposes from the small saphenous vein). Flow direction and intensity were recorded under Valsalva (JP) or as spontaneous/under distal compression/decompression (SPV) and weighted with one/two points as reflux/reentry, respectively, in the case of SPV. We compared the origin and extent of axial reflux and diameter/flow direction of SPV with the clinical stage by multivariate analysis.Of 107 limbs, 68 presented with JP, 49 combined with SPV, and 39 with PP. CEAP C3-C6 was associated with the presence of SPV (JP and PP) in 45/65 (11/22) limbs with primaries (recurrences) or in 3/16 (0/4), p < 0.01 (p = 0.01), without SPV. C4-C6 at first manifestation, however, was more frequent in JP and axial reflux below the knee in 14/39 limbs (p = 0.01) or above the knee in 3/11 (p = 0.12) compared with PP (5/31). SPV flow at first manifestation was reentry in the case of JP and axial reflux below the knee (estimate -1.62, p = 0.02) or above the knee (0.29, p = 0.81) compared with PP, but diameter of the most dilated perforator vein was higher in the case of JP and axial reflux above the knee (estimate 0.20, p < 0.01) or below the knee (0.04, p = 0.30) compared with PP. Predominant SPV flow was reentry/reflux during peripheral compression/decompression, respectively (p = 0.009).The data suggest that the reflux origin and extent of axial reflux are associated with diameter/flow direction of SPV and clinical stage in primary varicose veins.","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"529-536"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176715","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

[Perioperative Management in Hernia Surgery]. [疝气手术的围手术期管理]。

IF 0.5 4区医学

Zentralblatt fur Chirurgie Pub Date : 2024-12-01 Epub Date: 2024-11-22 DOI: 10.1055/a-2447-9171

Marcus Overhaus

引用次数: 0

[Impact of Outpatient Care and Hybrid DRG - Impact on Hospitals]. [门诊护理和混合 DRG 的影响 - 对医院的影响]。

IF 0.5 4区医学

Zentralblatt fur Chirurgie Pub Date : 2024-12-01 Epub Date: 2024-09-03 DOI: 10.1055/a-2384-6511

Ralf Michael Wilke

{"title":"[Impact of Outpatient Care and Hybrid DRG - Impact on Hospitals].","authors":"Ralf Michael Wilke","doi":"10.1055/a-2384-6511","DOIUrl":"10.1055/a-2384-6511","url":null,"abstract":"Hybrid DRG is a new form of remuneration in the German healthcare system. Selected OPS codes apply to all sectors, which, in combination with a specified ICD, result in a flat fee, regardless of whether the patient is managed as an outpatient or inpatient. This new form of billing has a huge impact on hospitals. The revenue situation is significantly worse than under the previous form of billing and requires adjustments at the locations. If these changes are not made, supply would be demonstrably deficient. Therefore, increased outsourcing to an outpatient setting is necessary. The advantages are the efficient use of staff and a structured selection of patients. Ideally, outpatient surgical units have an advantage here, but outpatient paths can also be created via separate areas in the central operating theatre. Using the example of inguinal hernia, over 50% of patients can be treated on an outpatient basis if selection is optimised. The disadvantage of this form of billing is the necessary financial reserve for innovations, training and the use of expensive operational aids. With the addition of incisional hernias to the hybrid catalogue in 2025, future care will become more cost-oriented.","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"506-511"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126851","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

Ambulantisierung: Sicht der GKV. Ambulantisation: the SHI perspective.

IF 0.5 4区医学

Zentralblatt fur Chirurgie Pub Date : 2024-12-01 Epub Date: 2024-11-25 DOI: 10.1055/a-2421-1192

Hanna Tillmanns, Torsten Fürstenberg

引用次数: 0

Freiheitsentziehende Maßnahmen, § 1831 Abs. 4 BGB. 涉及剥夺自由的措施，《德国民法典》第 1831 (4) 条。

IF 0.5 4区医学

Zentralblatt fur Chirurgie Pub Date : 2024-12-01 Epub Date: 2024-11-25 DOI: 10.1055/a-2302-7263

Jörg Staatsmann

引用次数: 0

[Abdominoplasties and Suppurative Hydradenitis (Acne inversa) in Patients after Massive Weight Loss]. [腹部整形手术与大量减肥后患者的化脓性水肿（倒置性痤疮）]。

IF 0.5 4区医学

Zentralblatt fur Chirurgie Pub Date : 2024-12-01 Epub Date: 2023-07-20 DOI: 10.1055/a-2109-3015

Ulrich Eugen Ziegler, Petronela Sakova, Hans Bernd Reith

{"title":"[Abdominoplasties and Suppurative Hydradenitis (Acne inversa) in Patients after Massive Weight Loss].","authors":"Ulrich Eugen Ziegler, Petronela Sakova, Hans Bernd Reith","doi":"10.1055/a-2109-3015","DOIUrl":"10.1055/a-2109-3015","url":null,"abstract":"Post-bariatric surgical procedures in patients after massive weight loss (MWL) are often associated with elevated minor and major complications (17-55%). If there is additionally a long history of hydradenitis suppurativa (HS) in the lower abdomen and groin area, complications of infection can appear in all patients. Differentiated pre-, peri- and postoperative therapy regime is then indicated.From 2010 to 2021, a total of 12 (66.6% women, 33.3% men) consecutive patients underwent conventional (Pittsburg rating scale [PRS]: Grade 2) or fleur-de-lis abdominoplasty (PRS: Grade 3) after massive weight loss. All patients simultaneously suffered long term HS in the lower abdomen and groin area (Hurley classification Grade 2: n = 10, Grade 3: n = 2). The prevalence in our study was 1.09%.Postoperative minor and major complications (follow-up 12 months) are determined and correlated with risk factors (e.g. age, method of weight loss, nicotine abuse…).Mean age was 45.2 years (± 10.3), mean BMI pre-operative 33.24 kg/m2 (± 8.7), the mean decrease in BMI was 19.01 kg/m2 (± 5.9) and the maximum BMI before weight loss 52.25 kg/m2. The mean duration of the suppurative hydradenitis was 31.5 years and n = 2 (17.0%) had current medical therapy against this. All patients showed further locations of the HS in other parts of the body and 66.6% had had surgical procedures because of the HS. 42.0% had nicotine abuse. The mean operation time was 98 minutes and the mean resection weight was 2210 grams. The overall complication rate was n = 10 (83.0%), and the rate of major complications n = 8 (66.4%) with surgical intervention in full anaesthesia. No patient had an infected haematoma, abscess or acute bleeding in the first 24 hours postoperatively.The antibiotic regime prevented the expected soft tissue infection in all patients. Inspection of the abdomen and groin area 4 weeks before surgery is recommended, in order to start preoperative therapy for the HS.","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"537-545"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10203969","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

[Correction: Chylothorax]. [更正：乳糜胸]。

IF 0.5 4区医学

Zentralblatt fur Chirurgie Pub Date : 2024-12-01 Epub Date: 2024-10-10 DOI: 10.1055/a-2436-4353

David B Ellebrecht, Michael Hoge, Sönke von Weihe

引用次数: 0

[Status Quo of Surgical Navigation]. 【手术导航现状】。

IF 0.5 4区医学

Zentralblatt fur Chirurgie Pub Date : 2024-12-01 Epub Date: 2023-12-06 DOI: 10.1055/a-2211-4898

Philipp Anthony Wise, Alexander Studier-Fischer, Thilo Hackert, Felix Nickel

{"title":"[Status Quo of Surgical Navigation].","authors":"Philipp Anthony Wise, Alexander Studier-Fischer, Thilo Hackert, Felix Nickel","doi":"10.1055/a-2211-4898","DOIUrl":"10.1055/a-2211-4898","url":null,"abstract":"Surgical navigation, also referred to as computer-assisted or image-guided surgery, is a technique that employs a variety of methods - such as 3D imaging, tracking systems, specialised software, and robotics to support surgeons during surgical interventions. These emerging technologies aim not only to enhance the accuracy and precision of surgical procedures, but also to enable less invasive approaches, with the objective of reducing complications and improving operative outcomes for patients. By harnessing the integration of emerging digital technologies, surgical navigation holds the promise of assisting complex procedures across various medical disciplines. In recent years, the field of surgical navigation has witnessed significant advances. Abdominal surgical navigation, particularly endoscopy, laparoscopic, and robot-assisted surgery, is currently undergoing a phase of rapid evolution. Emphases include image-guided navigation, instrument tracking, and the potential integration of augmented and mixed reality (AR, MR). This article will comprehensively delve into the latest developments in surgical navigation, spanning state-of-the-art intraoperative technologies like hyperspectral and fluorescent imaging, to the integration of preoperative radiological imaging within the intraoperative setting.","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"522-528"},"PeriodicalIF":0.5,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138499577","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

Dank an die Gutachter. 感谢专家们。

IF 0.5 4区医学

Zentralblatt fur Chirurgie Pub Date : 2024-12-01 Epub Date: 2024-11-25 DOI: 10.1055/a-2439-6184

引用次数: 0