4区医学

Chirurg Pub Date : 2022-01-01 Epub Date: 2021-12-14 DOI: 10.1007/s00104-021-01559-7

Aladdin Ali Deeb, Michael Ardelt, Utz Settmacher

引用次数: 0

S1-Leitlinie „Post-COVID/Long-COVID“ S1新冠肺炎后/长期新冠肺炎指南

4区医学

Chirurg Pub Date : 2022-01-01 DOI: 10.1007/s00104-021-01543-1

A. Koczulla, T. Ankermann, U. Behrends, P. Berlit, S. Böing, F. Brinkmann, C. Franke, R. Glöckl, C. Gogoll, T. Hummel, J. Kronsbein, T. Maibaum, E. Peters, M. Pfeifer, T. Platz, Mathias W Pletz, G. Pongratz, F. Powitz, K. F. Rabe, C. Scheibenbogen, A. Stallmach, M. Stegbauer, H. Wagner, C. Waller, H. Wirtz, A. Zeiher, R. Zwick

引用次数: 6

[Resource requirements in the surgical treatment of COVID‑19 patients at a university clinic of maximum care]. [大学最高护理诊所对COVID - 19患者手术治疗的资源需求]。

4区医学

Chirurg Pub Date : 2022-01-01 Epub Date: 2021-12-10 DOI: 10.1007/s00104-021-01547-x

H Kerndl, D Liebetrau, S Zerwes, C Römmele, A Hyhlik-Dürr

{"title":"[Resource requirements in the surgical treatment of COVID‑19 patients at a university clinic of maximum care].","authors":"H Kerndl, D Liebetrau, S Zerwes, C Römmele, A Hyhlik-Dürr","doi":"10.1007/s00104-021-01547-x","DOIUrl":"https://doi.org/10.1007/s00104-021-01547-x","url":null,"abstract":"Background: Surgical procedures in patients suffering from coronavirus disease 2019 (COVID‑19) are possible under strict hygiene and protective measures and are currently carried out regularly. This study examined how much additional work this involves.Material and methods: A structured evaluation of 71 surgical procedures performed at the Augsburg University Hospital between 1 November 2020 until 31 December 2020 was carried out. The operations on COVID‑19 patients were compared to procedures on non-COVID‑19 patients with respect to temporal, structural and staff resources, exemplified by four interventions: transbrachial embolectomy, total hip arthroplasty (H-TEP), proximal femoral nail antirotation (PFN-A) and new implantations of cardiac pacemakers.Results: The incision to suture times between the interventions in patients with COVID‑19 and non-COVID‑19 patients did not show any significant differences in any of the four interventions evaluated. The postoperative monitoring in the operating room, which is identified as time-consuming in many interventions, was often circumvented by postoperative transfer to the intensive care unit or by the use of local anesthetic procedures. For major operations, such as H‑TEP, the preparation time was shown to be significantly longer (p = 0.037). Furthermore, there was a significantly higher requirement for anesthesia nursing personnel of 1.5 vs. 1.0 (p = 0.02).Conclusion: A quantification of the additional effort of operative treatment is difficult due to the already complex care of COVID‑19 patients; however, it can be assumed that there is an increased need for additional human and structural resources due to the supply of material from outside the operating room, which is not documented in the standard recording.","PeriodicalId":50700,"journal":{"name":"Chirurg","volume":"93 1","pages":"64-71"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8661830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39712287","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}

引用次数: 0

[Preoperative diagnostics and typing of abdominal soft tissue sarcomas]. 【腹部软组织肉瘤的术前诊断与分型】。

4区医学

Chirurg Pub Date : 2022-01-01 Epub Date: 2021-11-10 DOI: 10.1007/s00104-021-01528-0

J Kirchberg, S F U Blum, J Pablik, S Herold, R T Hoffmann, G Baretton, J Weitz

{"title":"[Preoperative diagnostics and typing of abdominal soft tissue sarcomas].","authors":"J Kirchberg, S F U Blum, J Pablik, S Herold, R T Hoffmann, G Baretton, J Weitz","doi":"10.1007/s00104-021-01528-0","DOIUrl":"https://doi.org/10.1007/s00104-021-01528-0","url":null,"abstract":"Background: Abdominal sarcomas are a heterogeneous group of rare soft tissue tumors and can be localized intraperitoneally or retroperitoneally. A pretherapeutic differentiated subtyping is essential for planning an individual, multimodal treatment concept in an interdisciplinary team of experts.Objective: The central aspects of histology acquisition, imaging diagnostics and (molecular) pathological subtyping of abdominal soft tissue sarcomas are described in detail.Material and methods: Imaging and pathological diagnostics are depicted based on the German S3 guidelines on adult soft tissue sarcomas, a current literature search and personal experiences at the Sarcoma Center at the National Center for Tumor Diseases in Dresden (NCT/UCC).Results: Preoperative imaging and (molecular) pathological subtyping of abdominal soft tissue sarcomas place high demands on surgeons, radiologists and pathologists. Genome analyses of sarcomas have the potential to identify points of attack for individualized treatment options. The limitations of resectability can only be assessed by experienced sarcoma surgeons at specialized centers.Conclusion: The treatment of abdominal soft tissue sarcomas at an experienced center is associated with a better prognosis. Even at the first suspicion of an abdominal sarcoma, a referral to an experienced center should be made in order to guarantee optimal expertise in diagnostics and treatment.","PeriodicalId":50700,"journal":{"name":"Chirurg","volume":"93 1","pages":"5-15"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39607596","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: 1

[Retroperitoneal soft tissue sarcoma: surgical management]. 腹膜后软组织肉瘤:手术治疗。

4区医学

Chirurg Pub Date : 2022-01-01 Epub Date: 2021-10-01 DOI: 10.1007/s00104-021-01506-6

Franziska Willis, Martin Schneider

{"title":"[Retroperitoneal soft tissue sarcoma: surgical management].","authors":"Franziska Willis, Martin Schneider","doi":"10.1007/s00104-021-01506-6","DOIUrl":"https://doi.org/10.1007/s00104-021-01506-6","url":null,"abstract":"Background: Retroperitoneal soft tissue sarcomas are rare and heterogeneous tumors with high recurrence rates that require a multimodal treatment approach and a surgical resection strategy adapted to tumor localization and histological subtype.Objective: Based on current scientific data this article intends to provide an overview on subtype-specific features, prognostic factors and operative techniques in the surgical management of retroperitoneal soft tissue sarcomas.Material and methods: A review of the literature addressing surgical management of retroperitoneal soft tissue sarcomas was performed. Current evidence and recommendations were summarized.Results and conclusion: Macroscopically complete tumor resection represents the sole curative treatment option for both primary and recurrent retroperitoneal soft tissue sarcomas. To minimize the probability of tumor-infiltrated resection margins, compartmental resection has become a standard treatment for retroperitoneal soft tissue sarcomas. This approach includes resection of all organs and structures adjacent to the tumor. Multivisceral resection is often associated with this approach and it is acceptable in terms of morbidity and mortality if performed at a center with experience in retroperitoneal sarcoma surgery. Histologic subtype, tumor grading, and quality of initial surgical treatment are major prognostic factors for oncologic overall survival.","PeriodicalId":50700,"journal":{"name":"Chirurg","volume":"93 1","pages":"16-26"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39477299","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: 1

[Treatment recommendations for early esophageal cancer : Endoscopic and surgical options]. [早期食管癌的治疗建议:内镜和手术选择]。

4区医学

Chirurg Pub Date : 2021-12-01 Epub Date: 2021-10-07 DOI: 10.1007/s00104-021-01513-7

T Schlosser, A Hoffmeister, J Feisthammel, S Niebisch, R Thieme, I Gockel

{"title":"[Treatment recommendations for early esophageal cancer : Endoscopic and surgical options].","authors":"T Schlosser, A Hoffmeister, J Feisthammel, S Niebisch, R Thieme, I Gockel","doi":"10.1007/s00104-021-01513-7","DOIUrl":"https://doi.org/10.1007/s00104-021-01513-7","url":null,"abstract":"Background: Esophageal cancer represents a complex tumor entity with an increasing proportion of adenocarcinomas. Early esophageal cancer is staged as m1-m3 depending on the depth of infiltration into the mucosa and as sm1-sm3 depending on invasion into the submucosa. The risk of lymph node metastasis is strongly correlated with the depth of invasion and increases by leaps and bounds with submucosal infiltration.Material and methods: This review is based on publications retrieved by a selective database search (MEDLINE, PubMed, Cochrane Library, International Standard Randomised Controlled Trial Number, ISRCTN, registry) on the current management of early esophageal cancer.Results: The endoscopic diagnostics and evaluation of the dignity of superficial esophageal cancer by traditional staining techniques have been expanded by virtual chromoendoscopy. Endoscopic resection is the diagnostic and therapeutic procedure of choice for mucosal low risk adenocarcinomas (grade 1 or 2, no blood or lymph vessel invasion). Under certain prerequisites adenocarcinomas of the upper submucosa (sm1) can also be endoscopically removed. All other stages necessitate surgical treatment. In squamous cell carcinoma without risk factors a surgical oncological esophageal resection is indicated after infiltration of the third mucosal layer (m3). Endoscopic submucosal dissection (ESD) shows high rates of en bloc and R0 (curative) resections even with large lesions.Conclusion: Borderline cases between endoscopic and surgical treatment of early esophageal cancer necessitate an interdisciplinary approach and individually adapted management, which in the locally advanced stage are always embedded in a multimodal concept.","PeriodicalId":50700,"journal":{"name":"Chirurg","volume":"92 12","pages":"1077-1084"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39496528","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

[Current preoperative and perioperative concepts in tumor treatment for locally advanced esophageal carcinoma from a surgical perspective]. [从外科角度看局部晚期食管癌术前及围手术期治疗的现状]。

4区医学

Chirurg Pub Date : 2021-12-01 Epub Date: 2021-08-13 DOI: 10.1007/s00104-021-01475-w

Jens Hoeppner

{"title":"[Current preoperative and perioperative concepts in tumor treatment for locally advanced esophageal carcinoma from a surgical perspective].","authors":"Jens Hoeppner","doi":"10.1007/s00104-021-01475-w","DOIUrl":"https://doi.org/10.1007/s00104-021-01475-w","url":null,"abstract":"Locally advanced esophageal cancer is mostly treated in multimodal therapy protocols according to the current western treatment guidelines. In squamous cell cancer, neoadjuvant chemoradiotherapy is in the foreground. Unimodal surgical and chemoradiation treatment alternatives achieve poorer results for this entity. Surgical salvage resection for tumor recurrence after definitive chemoradiotherapy can be carried out with good oncological results but the frequency of postoperative complications is increased. For locally advanced adenocarcinoma of the esophagus, perioperative chemotherapy and neoadjuvant chemoradiotherapy are two competing level 1 evidence-based treatment concepts that are superior to treatment by surgery alone. The results of head-to-head comparative treatment studies are still pending. A significant number of patients show a complete locoregional remission of the tumor in the surgical specimen after treatment with the modern neoadjuvant protocols. Currently, European prospective randomized noninferiority studies with an oncological endpoint are testing the possibilities of organ-retaining concepts in clinical complete remission (surgery as needed; watch and wait). For the future, it is to be expected that the curative treatment results of locally advanced esophageal carcinoma will again significantly improve, in particular through the additional possibilities of immunotherapy and organ-preserving therapy concepts for postneoadjuvant complete remission.","PeriodicalId":50700,"journal":{"name":"Chirurg","volume":"92 12","pages":"1094-1099"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00104-021-01475-w","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39307279","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: 1

Erratum to: Robotic hernia repair III. English version : Robotic incisional hernia repair with transversus abdominis release (r-TAR). Video report and results of a cohort study. 对机器人疝气修复III的勘误。中文版本:机器人切口疝修补与腹侧释放(r-TAR)。队列研究的视频报告和结果。

4区医学

Chirurg Pub Date : 2021-12-01 DOI: 10.1007/s00104-021-01564-w

Ulrich A Dietz, O Yusef Kudsi, Miguel Garcia-Ureña, Johannes Baur, Michaela Ramser, Sladjana Maksimovic, Nicola Keller, Jörg Dörfer, Lukas Eisner, Armin Wiegering

引用次数: 0

[Reconstruction of oncological defects of the perianal region]. [肛门周围肿瘤缺损的重建]。

4区医学

Chirurg Pub Date : 2021-12-01 Epub Date: 2021-04-27 DOI: 10.1007/s00104-021-01394-w

Raymund E Horch, Ingo Ludolph, Andreas Arkudas

引用次数: 5

Robotic hernia repair II. English version : Robotic primary ventral and incisional hernia repair (rv‑TAPP and r‑Rives or r‑TARUP). Video report and results of a series of 118 patients. 机器人疝气修复II。中文版本:机器人原发性腹侧和切口疝修补术(rv - TAPP和r - Rives或r - TARUP)。118例患者的视频报告及结果。

4区医学

Chirurg Pub Date : 2021-12-01 DOI: 10.1007/s00104-021-01479-6

Johannes Baur, Michaela Ramser, Nicola Keller, Filip Muysoms, Jörg Dörfer, Armin Wiegering, Lukas Eisner, Ulrich A Dietz

{"title":"Robotic hernia repair II. English version : Robotic primary ventral and incisional hernia repair (rv‑TAPP and r‑Rives or r‑TARUP). Video report and results of a series of 118 patients.","authors":"Johannes Baur, Michaela Ramser, Nicola Keller, Filip Muysoms, Jörg Dörfer, Armin Wiegering, Lukas Eisner, Ulrich A Dietz","doi":"10.1007/s00104-021-01479-6","DOIUrl":"https://doi.org/10.1007/s00104-021-01479-6","url":null,"abstract":"Endoscopic management of umbilical and incisional hernias has adapted to the limitations of conventional laparoscopic instruments over the past 30 years. This includes the development of meshes for intraperitoneal placement (intraperitoneal onlay mesh, IPOM), with antiadhesive coatings; however, adhesions do occur in a significant proportion of these patients. Minimally invasive procedures result in fewer perioperative complications, but with a slightly higher recurrence rate. With the ergonomic resources of robotics, which offers angled instruments, it is now possible to implant meshes in a minimally invasively manner in different abdominal wall layers while achieving morphologic and functional reconstruction of the abdominal wall. This video article presents the treatment of ventral and incisional hernias with mesh implantation into the preperitoneal space (robot-assisted transabdominal preperitoneal ventral hernia repair, r‑ventral TAPP) as well as into the retrorectus space (r-Rives and robotic transabdominal retromuscular umbilical prosthetic repair, r‑TARUP, respectively). The results of a cohort study of 118 consecutive patients are presented and discussed with regard to the added value of the robotic technique in extraperitoneal mesh implantation and in the training of residents.","PeriodicalId":50700,"journal":{"name":"Chirurg","volume":"92 Suppl 1","pages":"15-26"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00104-021-01479-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10263296","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}

引用次数: 6

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