Zentralblatt fur Chirurgie最新文献

{"title":"Ethik in der Chirurgie – gemeinsam das Therapieziel im Blick.","authors":"Sonja Vonderhagen, Stefan Meier","doi":"10.1055/a-2625-9139","DOIUrl":"https://doi.org/10.1055/a-2625-9139","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"150 4","pages":"323-325"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805000","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":"[Correction: A Migrating Pulmonary Mass: a Rare Case of Thoracolithiasis].","authors":"Deborah D Wehde, Jan Reichelt, Jan Philipp Hering","doi":"10.1055/a-2625-6314","DOIUrl":"10.1055/a-2625-6314","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"e2"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327026","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":"[Possibilities and Limitations of CT-guided Intervention].","authors":"Marco Das","doi":"10.1055/a-2665-4806","DOIUrl":"https://doi.org/10.1055/a-2665-4806","url":null,"abstract":"<p><p>CT-guided transthoracic lung biopsy (CT-TTNB) is an essential method for the diagnosis of pulmonary nodules and masses. With a sensitivity of 85-97% and a specificity of 85-100%, it offers high diagnostic accuracy. By using core-needle biopsies, high-quality tissue samples can be obtained that enable molecular analyses for personalised therapy.At the same time, lung ablation has established itself as a valuable minimally invasive therapy. Procedures such as radiofrequency ablation (RFA), microwave ablation (MWA) and cryoablation enable targeted tumour destruction, particularly in inoperable patients with NSCLC or lung metastases. Studies have shown a high level of local tumour control with acceptable complication rates. The combination of imaging and interventional technique significantly improves patient safety and treatment outcomes and offers good results with low complication rates.Overall, CT-guided puncture and ablation are integral components of modern lung cancer diagnostics for primary and secondary lung tumours, while offering a new treatment option and therapy. They offer precise, low-risk alternatives to invasive procedures and can therefore make a significant contribution to effective patient care.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"150 S 01","pages":"S50-S57"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971617","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":"[Robotic Ventral Rectopexy According to D´Hoore for Rectal Prolapse - a Video Vignette].","authors":"Jan Arensmeyer, Jonas Dohmen, Gun-Soo Hong, Stephanie Knüpfer, Dominique Könsgen-Mustea, Jörg C Kalff, Philipp Feodorovici, Tim Vilz","doi":"10.1055/a-2643-9713","DOIUrl":"10.1055/a-2643-9713","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"150 4","pages":"382-384"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804997","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":"Bundesgerichtshof zur Haftung bei ärztlichen Behandlungsfehlern: Aspekt der Genugtuung kann bei schwerem Schuldvorwurf für die Bemessung des Schmerzensgeldes relevant sein.","authors":"Kathrin Thumer","doi":"10.1055/a-2577-1272","DOIUrl":"https://doi.org/10.1055/a-2577-1272","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"150 4","pages":"330-332"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804999","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":"Funktionelle Chirurgie im Wandel – Innovation trifft klinische Realität.","authors":"Michael B Ghadimi","doi":"10.1055/a-2502-3845","DOIUrl":"https://doi.org/10.1055/a-2502-3845","url":null,"abstract":"","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"150 4","pages":"335-336"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805001","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":"[CT Protocols in Thoracic Surgery: a Practical Guideline].","authors":"Fiona Mankertz, Marc-David Künnemann, Johanna Reekers, Jan Philipp Hering","doi":"10.1055/a-2587-2568","DOIUrl":"10.1055/a-2587-2568","url":null,"abstract":"<p><p>The use of radiological imaging has gained increasing importance in thoracic surgery, due to the development of new modalities. In particular, computed tomography (CT) not only offers significant diagnostic value but has also become essential for preoperative planning and postoperative follow-up in thoracic surgery. This review is intended to serve as a practical reference and guide for the indication, planning, and interpretation of thoracic CT imaging. It not only explains diagnostic aspects, such as the evaluation of specific conditions in CT imaging, but also provides practical guidance on how to formulate specific clinical questions. The appropriate indication for contrast-enhanced CT versus non-contrast imaging is evaluated. Additionally, the various contrast phases in CT imaging and their diagnostic relevance are discussed using specific thoracic surgery cases. The goal is to provide a structured guide for the application and assessment of radiological diagnostics in thoracic surgery.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":"S16-S27"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051195","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":"[Radiological Aspects of Surgery to Reduce Lung Volume].","authors":"Jan Philipp Hering, Aron Elsner, Felix Döllinger","doi":"10.1055/a-2654-6206","DOIUrl":"10.1055/a-2654-6206","url":null,"abstract":"<p><p>In cases where conservative treatment for COPD with emphysema has been unsuccessful and a lung transplant is not a viable option, reducing the lung volume may be the most appropriate therapeutic course of action. Lung volume reduction surgery (LVRS) employs a range of techniques, including apical shaving, targeted resection of a target zone and complete flap resection. In addition to these LVRS techniques, minimally invasive, bronchoscopically guided therapy with one-way valves, endobronchial coils or water vapour ablation is also a possibility. All surgical and bronchoscopic procedures have one thing in common: they all require critical patient selection and meaningful radiological diagnostics for treatment planning. This encompasses the acquisition of a data set for computed tomography of the lung, the software-supported quantification of the proportion of empyema in the lung tissue, and the assessment of fissure integrity. Nuclear medicine examinations have been shown to provide valuable additional information, particularly in cases of complex constellations of findings. The interdisciplinary emphysema conference is then convened to determine the most appropriate treatment procedure for each patient, taking into account all preliminary diagnostic findings.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":"150 S 01","pages":"S28-S38"},"PeriodicalIF":0.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971627","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":"[Effects of the Minimum Volume Requirement in Surgical Lung Cancer Therapy - an Analysis from the Patient's Perspective].","authors":"Dominik Lobinger, Andreas Hiebinger, Christian Geltner, Florian Eicher, Gudrun Groß, Iyad Shalabi, Alicia Reiche, Ekaterina Mamonova, Johannes Bodner","doi":"10.1055/a-2652-4779","DOIUrl":"https://doi.org/10.1055/a-2652-4779","url":null,"abstract":"<p><p>Due to a legislative decision, a minimum volume for the surgical treatment of lung cancer has been applied since the beginning of 2024 in Germany. This has led to a change in care structure, with the result that some patients are now being treated further away from home in an unfamiliar environment.Patient survey using standardised questionnaires, descriptive analysis of results.No more anatomical lung resections were performed at the Donau Isar Klinikum in 2024, as a consequence of the minimum volume requirement. Since then, these procedures have been performed at the Clinic for Thoracic Surgery at the Munich Bogenhausen Clinic, a certified lung cancer centre. 68% of patients (n = 25) felt sufficiently informed in advance about why their operation could not be performed near their home. 80% of respondents had not heard about the new regulation beforehand. The fact that they would be operated on in a certified centre, but would have to travel a longer distance, provided reassurance among those affected (60%; 84% among relatives), but also uncertainty (24%), incomprehension (20%) and anger (12%). The average distance to the lung cancer centre was 143.4 km (∅ 1 h 48 min). All patients were satisfied with the contact and appointment process (1: very dissatisfied/10: very satisfied, ∅ 9.3), the information about the procedure (∅ 9.4), the overall stay (∅ 9.2), the medical and nursing treatment (∅ 9.7/9.3) and the rooms and catering (∅ 8.6). The majority (76%) did not experience the longer return journey as stressful. The communication and cooperation between the primary treating physicians and the lung cancer centre was rated as good; almost all would recommend the lung cancer centre.The feedback from the patients affected by the changed guidelines was positive. The perceived safety and quality of treatment at a centre of excellence compensated for the existing uncertainty about the unfamiliar environment and the disappointment about the associated inconvenience. Although the insights gained must be confirmed by an ongoing survey and the experiences of other centres, the concept of centring complex interventions in the field of surgical lung cancer therapy appears to be supported by those affected.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761582","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":"[Reconstruction of Anorectal Defects Following Oncological Resection].","authors":"Benedikt Fuchs, Sinan Mert, Nicholas Möllhoff, Wolfram Demmer, Tim Nürnberger, Verena Alt, Riccardo Giunta, Felix Hubertus Vollbach","doi":"10.1055/a-2651-3201","DOIUrl":"https://doi.org/10.1055/a-2651-3201","url":null,"abstract":"<p><p>The management of anorectal carcinomas necessitates a multimodal therapeutic approach. Advances in modern medicine have reduced the incidence of complete rectal extirpations and permanent colostomies to below 10%. Despite these improvements, the reconstruction of anorectal defects, particularly following abdominoperineal extirpation (APE) or pelvic exenteration, remains a significant challenge. Deep tissue defects, the impact of neo- or adjuvant radiotherapy, and bacterial contamination contribute to compromised wound healing, with reported complication rates reaching up to 60%.This retrospective study analysed all patients presenting with anorectal defects following oncological surgery in 2024 at a university-based plastic surgery clinic providing maximum-care services. The study assessed various influencing factors, including radiochemotherapy, cachexia, diabetes mellitus, nicotine consumption, vascular diseases, and corticosteroid therapies. Additionally, the evaluation covered the effect of surgical defect coverage using pedicled gracilis flap reconstruction on the number of required interventions and the time to complete wound healing and patient mobilisation.Prolonged intensive care treatment and prior radiochemotherapy were identified as primary contributors to disorders in postoperative wound healing. Moreover, factors such as cachexia, diabetes mellitus, and nicotine consumption had a detrimental impact on wound healing. Plastic-surgical defect reconstruction utilising a pedicled gracilis flap significantly reduced the number of required interventions and expedited recovery time.The interdisciplinary management of patients with anorectal defects post-oncological surgery can be optimised through targeted reconstructive plastic surgery. Pedicled gracilis flap reconstruction has proven to be an effective technique for defect coverage and should be integrated into treatment protocols at an early stage. Further studies are warranted to standardise guidelines, particularly regarding the optimal timing of reconstructive interventions.</p>","PeriodicalId":23956,"journal":{"name":"Zentralblatt fur Chirurgie","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733618","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}