Innovative Surgical Sciences最新文献

{"title":"Influence of medical didactic training on the self-efficacy and motivation of clinical teachers.","authors":"Franziska Schydlo, Jasmina Sterz, Maria-Christina Stefanescu, Martina Kadmon, Sarah König, Miriam Rüsseler, Felix Walcher, Farzin Adili","doi":"10.1515/iss-2023-0073","DOIUrl":"10.1515/iss-2023-0073","url":null,"abstract":"<p><strong>Objectives: </strong>Due to increasing workload and rising expectations for both undergraduate and speciality training in medicine, teaching in a clinical environment can be challenging. The \"Train the Trainer\" course, developed by CAL (Chirurgische Arbeitsgemeinschaft Lehre, Deutsche Gesellschaft für Chirurgie (DGCH)), aims to assist clinical teachers in their task. This study investigates the effect the course has on participants' self-efficacy and teaching motivation.</p><p><strong>Methods: </strong>Prior to attending the course, participants anonymously completed a 50-question pre-course questionnaire using standardised questions to gather information on biographical data teaching experience, and validated tools measuring teaching motivation and self-efficacy (PRE). Directly after completing the course, participants evaluated it using a 25-question post-course questionnaire (POST1). At least 12 months after the course, participants received a follow-up questionnaire (POST2) by mail. This 44-question form aimed to gather biographical data, review the teaching methods participants had used since their training, and reassess their teaching motivation and self-efficacy.</p><p><strong>Results: </strong>Between June 2016 and October 2019, 20 TTT courses were held across six German medical faculties. Data were gathered from 241 participants. After the course, 182 POST2 questionnaires were mailed, 61 of which were returned (equals a 39 % return rate). The findings revealed significant increases in teacher self-efficacy (p=0.0025), identified regulation (p=0.0000), and career motivation (p=0.0044). In contrast, there was a significant decrease in introjected regulation (p=0.0048). When comparing the participants to a reference sample selected from literature, significant differences emerged in intrinsic motivation (p=0.0000) and amotivation (p=0.0025).</p><p><strong>Conclusions: </strong>Course participants already showed strong intrinsic motivation and self-efficacy before taking the course. After completing it, their confidence to meet specific teaching demands based on their abilities had increased. Notably, changes in motivational dimensions identified and introjected regulation point towards a shift in motivational sources, indicating a more self-regulated approach towards participants' teaching activities. Further research is needed to determine how much of this change was due to course participation.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lost in transition? Loss of follow-up and quality of life in adults after resection of choledochal malformation in childhood","authors":"Reem Abo-Namous, J. Kuebler, Andrej Potthoff, Omid Madadi-Sanjani, Marie Uecker, J. Dingemann, Claus Petersen, Benno M. Ure, N. Schukfeh","doi":"10.1515/iss-2023-0061","DOIUrl":"https://doi.org/10.1515/iss-2023-0061","url":null,"abstract":"Abstract Objectives Choledochal malformation (CM) is a rare disease that can lead to malignancy and potential long-term sequelae despite surgical resection. There is no long-term follow-up data on patients after CM resection in Germany. We aimed to determine the long-term outcome of our patients with a duration of follow-up >10 years and focused on long-term sequelae and health-related quality of life (HRQOL). Methods All patients who had undergone CM-resection in our department from 01/1978 to 06/2009 were contacted. Patients were interviewed about postoperative complications and their present medical attendance. HRQOL was determined using Pediatric Quality of Life Inventory 4.0 (PedsQL), version for adults. The PedsQL scales the HRQOL from 0 to 100, with higher scores indicating a better HRQOL. Scores were compared to those published for a healthy population. Results Out of 56 patients who were contacted, 23 (41 %) participated. The median age at time of surgery was 3.1 years (6 days–16.1 years) and at time of the survey 24.3 years (11.1–53.8 years). Eighteen patients (78 %) had ceased their gastroenterologic follow-up at a median time of 4.3 years after surgery. Five (22 %) were still in gastroenterologic follow-up, two of these had an uneventful clinical course, and three (13 %) had ongoing complications attributed to the CM. One of these had undergone hemihepatectomy 34 years postoperatively due to bile duct stenosis, one had undergone removal of bile duct stones 14 years postoperatively, and one suffered from portal vein thrombosis with esophageal and jejunal varices. There was no mortality in our series. Median total HRQOL score was 89. There was no significant difference in the median total health, physical health, and psychosocial health scores of our patients in comparison to the healthy population. Conclusions We confirmed that the majority of patients after CM resection are lost to follow-up. Those who answered our questionnaire showed a good HRQOL. Given the high rate of severe long-term complications and the life-long risk of malignancy, we recommend a transition program for all patients.","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141342457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depth of intact vascular plexus – visualized with optical coherence tomography – correlates to burn depth in thoracic thermic injuries in children","authors":"Valerie Dalicho, Tina Straube, Kathrin Kelly, Beke Larsen, Lutz Wünsch, Judith Lindert","doi":"10.1515/iss-2023-0066","DOIUrl":"https://doi.org/10.1515/iss-2023-0066","url":null,"abstract":"Abstract Objectives Deep thermal injuries are among the most serious injuries in childhood, often resulting in scarring and functional impairment. However, accurate assessment of burn depth by clinical judgment is challenging. Optical coherence tomography (OCT) provides structural images of the skin and can detect blood flow within the papillary plexus. In this study, we determined the depth of the capillary network in healthy and thermally injured skin and compared it with clinical assessment. Methods In 25 children between 7 months and 15 years of age (mean age 3.5 years (SD±4.14)) with thermal injuries of the ventral thoracic wall, we determined the depth of the capillary network using OCT. Measurements were performed on healthy skin and at the center of the thermal injury (16 grade IIa, 9 grade IIb). Comparisons were made between healthy skin and thermal injury. Results The capillary network of the papillary plexus in healthy skin was detected at 0.33 mm (SD±0.06) from the surface. In grade IIb injuries, the depth of the capillary network was 0.36 mm (SD±0.06) and in grade IIa injuries 0.23 mm (SD±0.04) (Mann–Whitney U test: p<0.001). The overall prediction accuracy is 84 %. Conclusions OCT can reliably detect and differentiate the depth of the capillary network in both healthy and burned skin. In clinical IIa wounds, the capillary network appears more superficial due to the loss of the epidermis, but it is still present in the upper layer, indicating a good prognosis for spontaneous healing. In clinical grade IIb wounds, the papillary plexus was visualized deeper, which is a sign of impaired blood flow.","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141353611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual tumor mapping and margin control with 3-D planning and navigation","authors":"David Steybe, P. Voss, M. Metzger, Rainer Schmelzeisen, P. Poxleitner","doi":"10.1515/iss-2021-0009","DOIUrl":"https://doi.org/10.1515/iss-2021-0009","url":null,"abstract":"\u0000 Computer technology–based treatment approaches like intraoperative navigation and intensity-modulated radiation therapy have become important components of state of the art head and neck cancer treatment. Multidirectional exchange of virtual three-dimensional patient data via an interdisciplinary platform allows all medical specialists involved in the patients treatment to take full advantage of these technologies. This review article gives an overview of current technologies and future directions regarding treatment approaches that are based on a virtual, three-dimensional patient specific dataset: storage and exchange of spatial information acquired via intraoperative navigation allow for a highly precise frozen section procedure. In the postoperative setting, virtual reconstruction of the tumor resection surface provides the basis for improved radiation therapy planning and virtual reconstruction of the tumor with integration of molecular findings creates a valuable tool for postoperative treatment and follow-up. These refinements of established treatment components and novel approaches have the potential to make a major contribution to improving the outcome in head and neck cancer patients.","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140658496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proximal humerus fracture and acromioclavicular joint dislocation","authors":"Maren Bieling, Alexander Ellwein, H. Lill, S. Sehmisch, F. M. Reeh","doi":"10.1515/iss-2023-0049","DOIUrl":"https://doi.org/10.1515/iss-2023-0049","url":null,"abstract":"\u0000 Proximal humerus fractures and injuries to the acromioclavicular joint are among the most common traumatic diseases of the upper extremity. Fractures of the proximal humerus occur most frequently in older people and are an indicator fracture of osteoporosis. While a large proportion of only slightly displaced fractures can be treated non-operatively, more complex fractures require surgical treatment. The choice of optimal treatment and the decision between joint-preserving surgery by means of osteosynthesis or endoprosthetic treatment is often a difficult decision in which both fracture morphology factors and individual factors should be taken into account. If endoprosthetic treatment is indicated, satisfactory long-term functional and clinical results have been achieved with a reverse shoulder arthroplasty. Injuries to the acromioclavicular joint occur primarily in young, athletic individuals. The common classification according to Rockwood divides the injury into 6 degrees of severity depending on the dislocation. This classification forms the basis for the decision on non-operative or surgical treatment. The indication for surgical treatment for higher-grade injuries is the subject of controversial debate in the latest literature. In chronic injuries, an autologous tendon transplant is also performed. Whereas in the past, treatment was often carried out using a hook plate, which was associated with complications, the gold standard today is minimally invasive treatment using Endobutton systems. This review provides an overview of the two injury patterns and discusses the various treatment options.","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140713836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous duodenocutaneous fistula: a rare presentation of perforated duodenal ulcer","authors":"Isabel Barreto, Arnold Kohler, René Fahrner","doi":"10.1515/iss-2023-0051","DOIUrl":"https://doi.org/10.1515/iss-2023-0051","url":null,"abstract":"\u0000 \u0000 \u0000 Fistula formation between the duodenum and the skin of the anterior abdominal wall is a rare complication and reported most often following surgery. To the best of our knowledge, the development of a spontaneous duodenocutaneous fistula in association with duodenal ulcer has only been reported once.\u0000 \u0000 \u0000 \u0000 A 52-year-old female patient presented at the emergency department with a painful ulcer and erythema on the right abdominal wall. On admission, she was in extremely poor general and nutritional condition. Laboratory analysis revealed inflammation. An empiric antibiotic therapy was initiated; parenteral nutrition, fluid, and electrolyte resuscitation were started. An enterocutaneous fistula was postulated and confirmed by endoscopy identifying a perforated duodenal ulcer. Surgery was not a valuable option and a Foley catheter was inserted through the fistula. During further endoscopic interventions, the Foley catheter was first replaced by a jejunal tube and later by a percutaneous endoscopic gastrostomy with a jejunal limb for enteral nutrition. The fistula output decreased, the local infection was controlled and the nutritional status improved.\u0000 \u0000 \u0000 \u0000 Three months later the fistula was closed and the gastrostomy tube was removed. After 2 years the patient was in good general and nutritional condition.\u0000","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140724626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts DGCH","authors":"Jan-Philipp Happe, Karen Fischhuber, Josef Stolberg-Stolberg, Dr. Janette Iking, Ursula Marschall, Michael J Raschke, Jeanette Köppe, J. C. Katthagen, Julia Sussiek, Z. Qi, Jiashu Zhang, Haitao Jin, Ch. Nimsky, Xiaolei Chen, Xinghua Xu, Qun Wang, Z. Gan, R. Xiong, Shiyu Zhang, Jingyue Wang, Minghang Liu, M. Bauer","doi":"10.1515/iss-2024-2006","DOIUrl":"https://doi.org/10.1515/iss-2024-2006","url":null,"abstract":"were classified as geriatric according to the \"Delineation Criteria of Geriatrics\" version V1.3 (4). The endpoints were defined as overall survival (OS), major adverse events (MAE), thromboembolic events (TE) and injury/surgical complications. Event rates were determined using Kaplan-Meier estimates and cumulative incidence functions using Aalen-Johansen estimates. Multivariable analyses were performed using Cox regressions and Fine-Gray models.","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140780715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts DGT","authors":"Lisann Rheinhold, Thomas Galetin, Rachel Klamer, Ahmed Alkhatam, Aris Koryllos, Romina Rösch, Laura V. Klotz, Lena Brendel, R. Griffo, P. Christopoulos, Thomas Muley, Hauke Winter, Raffella Griffo, Henrike Deissner, Peter Reimer, Martin Eichhorn","doi":"10.1515/iss-2024-2001","DOIUrl":"https://doi.org/10.1515/iss-2024-2001","url":null,"abstract":"The number of inductive immunochemotherapy (IO+CTx) in patients with lung cancer and higher-grade tumor stages is increasing. Actually the impact of IO+CTx on extended lung resections is unclear. The goal of this study was to analyze the short-term outcomes after extended lung cancer resections.","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140763276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts DGKCH","authors":"Nariman Mokhaberi, Michalis Aftzoglou, Philipp Schneider, Daniel Biermann, Rainer Gerhard Kozlik-Feldmann, Christian Tomuschat, Christine Drießler, Armin-Johannes Michel, Andrea Schmedding, Florentine Weise, Niklas Dressler, N. Peukert, Johannes Düß, S. Mayer, M. Lacher, Jan Riedel, Yuqing Lu, Julia Elrod, S. Turial, Maciej Pech, Volker Aumann, A. Nyiredi, Lena Bode, Jan-Hendrik Gosemann, Gabriel Götz, Robin Wachowiak, Peter Zimmermann, Tomasz Baranski, Matthias Nissen, Ralf-Bodo Tröbs, I. Martynov, Monika Sparber-Sauer, Amadeus T Heinz, C. Vokuhl, Martin Ebinger, J. Gesche, Marc Münter, E. Koscielniak, Jörg Fuchs, Guido Seitz, Mark Schneider, Ruben Visschers, U. Kontny, Ulf Neumann, Wilhelmus van Gemert","doi":"10.1515/iss-2024-2005","DOIUrl":"https://doi.org/10.1515/iss-2024-2005","url":null,"abstract":"Impaired intestinal endotoxin tolerance is seen in human preterms suffering from necrotizing enterocolitis (NEC), but the underlying mechanism remains unknown. Activation of the TLR4/p65 pathway deregulates β-catenin abundance in intestinal epithelial cells (IECs) from human NEC patients. The cell adhesion molecule β-catenin plays a crucial role in transcriptional activation of proliferation and cell growth in intestinal epithelial cells (IECs). It has been shown that β-catenin acts either as a pro-or anti-inflammatory mediator in a cell and tissue specific behavior. This study aims to elucidate the effects of stabilized β-catenin upon lipopolysaccharide (LPS) induced inflammatory signaling in IECs.","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140793761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts DGPRÄC","authors":"Alexander Dermietzel, Philipp Wiebringhaus, Tobias Hirsch, Maximilian Kückelhaus, Sonja Dahmann","doi":"10.1515/iss-2024-2002","DOIUrl":"https://doi.org/10.1515/iss-2024-2002","url":null,"abstract":",","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140792941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}