ChirurgPub Date : 2022-02-01Epub Date: 2022-01-18DOI: 10.1007/s00104-022-01578-y
C T Germer
{"title":"[Radical resection versus organ preservation by short-course radiotherapy followed by transanal tumor resection for early stage rectal cancer-Results of the randomized TREC study].","authors":"C T Germer","doi":"10.1007/s00104-022-01578-y","DOIUrl":"https://doi.org/10.1007/s00104-022-01578-y","url":null,"abstract":"","PeriodicalId":50700,"journal":{"name":"Chirurg","volume":"93 2","pages":"201-202"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39829097","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}
ChirurgPub Date : 2022-02-01Epub Date: 2021-09-15DOI: 10.1007/s00104-021-01502-w
Beatrice Thielmann, Frank Meyer, Irina Böckelmann
{"title":"[What (general/abdominal) surgeons should know about occupational medicine? : General vaccine recommendations and postexposure prophylaxis of hepatitis B, C and HIV].","authors":"Beatrice Thielmann, Frank Meyer, Irina Böckelmann","doi":"10.1007/s00104-021-01502-w","DOIUrl":"https://doi.org/10.1007/s00104-021-01502-w","url":null,"abstract":"<p><p>This article deals with the general recommendations on vaccination and postexposure prophylaxis, which can be utilized for cuts and needlestick injuries. Cuts and needlestick injuries among surgeons are common occupational accidents. These should be interpreted as acute or emergency situations, especially if there was contact with infectious index patients or the danger of infection cannot be excluded. This results in high economic costs but also in the individual confrontation with an infectious disease that is definitely incurable. The aim of this review is to highlight the general and occupational vaccine recommendations for surgeons. In addition, background information and legal principles are presented. There is a duty to provide and to obtain information about effective protective measures against infectious diseases from cuts and needlestick injuries even for surgeons. In addition, primary prophylaxis, vaccination recommendations, and postexposure prophylaxis after cuts and needlestick injuries as well as the TOP principle are presented. The TOP principle comprises technical, organizational and person-related protective measures.</p>","PeriodicalId":50700,"journal":{"name":"Chirurg","volume":"93 2","pages":"158-164"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8442515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39418978","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}
ChirurgPub Date : 2022-02-01Epub Date: 2022-01-13DOI: 10.1007/s00104-021-01565-9
S Axt, M Anthuber
{"title":"[Association between time to surgery and colon cancer survival in the United States].","authors":"S Axt, M Anthuber","doi":"10.1007/s00104-021-01565-9","DOIUrl":"https://doi.org/10.1007/s00104-021-01565-9","url":null,"abstract":"","PeriodicalId":50700,"journal":{"name":"Chirurg","volume":"93 2","pages":"198-199"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39678938","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}
ChirurgPub Date : 2022-02-01Epub Date: 2022-01-24DOI: 10.1007/s00104-022-01581-3
Khosro Hekmat, Christiane J Bruns
{"title":"[ASCO guidelines for the management of stage III NSCLC part 1: staging].","authors":"Khosro Hekmat, Christiane J Bruns","doi":"10.1007/s00104-022-01581-3","DOIUrl":"https://doi.org/10.1007/s00104-022-01581-3","url":null,"abstract":"","PeriodicalId":50700,"journal":{"name":"Chirurg","volume":"93 2","pages":"203-204"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39963259","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}
ChirurgPub Date : 2022-02-01Epub Date: 2021-06-16DOI: 10.1007/s00104-021-01437-2
S Oberthür, S Piatek, H Krause, H Rüther, P J Roch, A Zoch, W Lehmann, S Sehmisch, M R Klauser
{"title":"[Complication rate after femoral shaft fractures in childhood and adolescence depending on patient factors and treatment measures].","authors":"S Oberthür, S Piatek, H Krause, H Rüther, P J Roch, A Zoch, W Lehmann, S Sehmisch, M R Klauser","doi":"10.1007/s00104-021-01437-2","DOIUrl":"https://doi.org/10.1007/s00104-021-01437-2","url":null,"abstract":"<p><strong>Background: </strong>The treatment of pediatric femoral shaft fractures has undergone an increasing change in recent years. The previously predominant treatment procedures were extensively replaced by minimally invasive techniques (e.g. elastic stable intramedullary nailing, ESIN). The aim of this study was the comparison of complication rates depending on patient factors as well as various treatment procedures.</p><p><strong>Material and methods: </strong>This study involved a retrospective X‑ray morphometric evaluation of data. The patient files and X‑rays of 101 children who were treated at 2 level I trauma centers were analyzed.</p><p><strong>Results: </strong>Conservative treatment was carried out in 19% of the cases. Among the surgical procedures the ESIN technique was predominant (n = 60). Complications that needed revision occurred in 10% of the children after conservative treatment. Revision surgery had to be carried out in more than 6% of the cases in children who were surgically treated. Among the surgical procedures ESIN stabilization demonstrated the lowest revision rate with only 3%. Children under three years and adolescents had a higher risk for developing complications. If the ESIN wires used were too thin in relation to the diameter of the medullary cavity there was an increased probability of complications of around 30%.</p><p><strong>Conclusion: </strong>This study revealed a moderate risk of complications in the treatment of femoral shaft fractures in children. The risk of complications after external fixation and conservative treatment was the highest in this study. Overall, the ESIN technique showed the lowest risk of complications. The results of this study could confirm the known limitations of the ESIN technique depending on age and body weight.</p>","PeriodicalId":50700,"journal":{"name":"Chirurg","volume":"93 2","pages":"165-172"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00104-021-01437-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39237241","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}
ChirurgPub Date : 2022-02-01Epub Date: 2021-10-06DOI: 10.1007/s00104-021-01510-w
Iris Tischoff, Andrea Tannapfel
{"title":"[Complete response after neoadjuvant therapy : How certain is the pathology?]","authors":"Iris Tischoff, Andrea Tannapfel","doi":"10.1007/s00104-021-01510-w","DOIUrl":"https://doi.org/10.1007/s00104-021-01510-w","url":null,"abstract":"<p><p>Histopathologic evaluation of tumors after neoadjuvant therapy is performed by tumor regression grading (TRG) systems, which reflect the proportion of vital residual primary tumor in relation to the previous total tumor. The World Health Organization (WHO) tumor grading is replaced by TRG in tumor classification. The histopathological work-up of a tumor is based on the criteria of the TNM classification even after neoadjuvant therapy. A uniform TRG does not exist. For various tumors TRGs based on the tumor entity have been established, consisting of a 3-stage or 5‑stage grading system. Complete histopathological tumor regression is only present if no vital tumor cells are detectable in the histopathological examination of the primary surgical specimens (primary tumor and accompanying locoregional lymph nodes) and there are no distant metastases.</p>","PeriodicalId":50700,"journal":{"name":"Chirurg","volume":"93 2","pages":"115-122"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39489518","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}
ChirurgPub Date : 2022-02-01Epub Date: 2021-07-23DOI: 10.1007/s00104-021-01469-8
Alfred Simon, Frank Meyer
{"title":"[What (abdominal) surgeons must know about aspects of autonomic decisions with respect to self-determination, advance healthcare directives and suicide].","authors":"Alfred Simon, Frank Meyer","doi":"10.1007/s00104-021-01469-8","DOIUrl":"https://doi.org/10.1007/s00104-021-01469-8","url":null,"abstract":"<p><p>The right of patients to self-determination has become increasingly important in recent decades. In clinical practice, it finds concrete expression in the concept of informed consent, according to which medical interventions outside of emergency situations are only permissible with the consent of the informed patient. In the event that the patient later becomes incapable of giving consent, it is possible to document the patient's own treatment wishes in a living will or to appoint a trusted person as a proxy. The right to self-determination reaches its limits where the patient demands medical measures for which there is no medical indication, which are prohibited by law or which contradict the physician's conscience. The latter applies to physician-assisted suicide, which is legally permissible but which physicians cannot be obliged to perform.</p>","PeriodicalId":50700,"journal":{"name":"Chirurg","volume":"93 2","pages":"152-157"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00104-021-01469-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39212338","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}
ChirurgPub Date : 2022-02-01Epub Date: 2021-12-22DOI: 10.1007/s00104-021-01548-w
Hanna Kuzior, Michel Eisenblätter
{"title":"[Complete response after neoadjuvant therapy: how certain is radiology?]","authors":"Hanna Kuzior, Michel Eisenblätter","doi":"10.1007/s00104-021-01548-w","DOIUrl":"https://doi.org/10.1007/s00104-021-01548-w","url":null,"abstract":"<p><p>The concept of total neoadjuvant therapy (TNT) means a paradigm shift in the treatment of patients with rectal cancer. In cases in which the TNT induced a complete clinical response (cCR), an organ preserving watch and wait therapy concept can now be provided more often; however, this increases the demand for imaging for the determination of cCR and in the subsequent follow-up. In this article, the performance of radiology in these scenarios will be evaluated and discussed. Magnetic resonance imaging (MRI) is the current standard for local assessment of the rectum with a high sensitivity for diagnosis and staging of rectal cancer, residual tumor and tumor recurrence. However, the certain exclusion of residual malignant tissue is still difficult, in particular the differentiation of residual scar tissue from vital residual tumor is only possible with low specificity and a moderate negative predictive value (NPV). The currently discussed criteria for the assessment of imaging have not yet been validated in large cohorts and are frequently subjective. An improvement of the diagnostic accuracy for identification of cCR in patients after TNT and for monitoring patients in watch and wait treatment concepts can certainly be achieved by the integration of MRI, endoscopy and endosonography as well as clinical parameters. This should enable for identification of patients with an incomplete response or local recurrence, in time for extended treatment to be initiated without relevant impact on the patient outcome.</p>","PeriodicalId":50700,"journal":{"name":"Chirurg","volume":"93 2","pages":"123-131"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39748013","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}
ChirurgPub Date : 2022-02-01Epub Date: 2022-01-18DOI: 10.1007/s00104-022-01579-x
Oliver Rohland, Michael Ardelt, Utz Settmacher
{"title":"[Classification of intraoperative difficulty of open liver resections].","authors":"Oliver Rohland, Michael Ardelt, Utz Settmacher","doi":"10.1007/s00104-022-01579-x","DOIUrl":"https://doi.org/10.1007/s00104-022-01579-x","url":null,"abstract":"","PeriodicalId":50700,"journal":{"name":"Chirurg","volume":"93 2","pages":"200"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39829099","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}