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[Postoperative chyle leakage after abdominal surgery-Diagnostic and therapeutic strategies]. 【腹腔手术后乳糜漏的诊断和治疗策略】。
Chirurgie (Heidelberg, Germany) Pub Date : 2025-08-01 Epub Date: 2025-05-08 DOI: 10.1007/s00104-025-02287-y
Alina S Ritter, Jelte Poppinga, Kira C Steinkraus, Anna Nießen, Thilo Hackert
{"title":"[Postoperative chyle leakage after abdominal surgery-Diagnostic and therapeutic strategies].","authors":"Alina S Ritter, Jelte Poppinga, Kira C Steinkraus, Anna Nießen, Thilo Hackert","doi":"10.1007/s00104-025-02287-y","DOIUrl":"10.1007/s00104-025-02287-y","url":null,"abstract":"<p><p>A postoperative chyle leakage (CL) is caused by intraoperative damage to the main lymphatic vessels or their tributaries. It is characterized by the secretion of a triglyceride-rich fluid, which classically has a characteristic milky appearance in a percutaneous drain. In visceral surgery CLs mostly occur after pancreatic and esophageal surgery but rarely occur after colorectal, liver or gastric surgery. Treatment often consists of a diet rich in medium chain triglycerides (MCT) to reduce the lymphatic flow, while ensuring a sufficient nutrient supply. If the CL does not cease, total parenteral nutrition is usually carried out. A reoperation, lymphography sometimes with percutaneous intervention or short-term irradiation for CL are rarely necessary. A CL frequently results in a prolonged hospital stay and can be accompanied by other complications but is rarely associated with a poorer prognosis.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"698-706"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059968","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}
引用次数: 0
[Deformities of the hip joint as cause of groin pain: diagnostics and therapy]. 髋关节畸形引起腹股沟疼痛：诊断和治疗。
Chirurgie (Heidelberg, Germany) Pub Date : 2025-08-01 Epub Date: 2025-05-02 DOI: 10.1007/s00104-025-02288-x
Jan Wulf, Boris M Holzapfel, Paul Reidler, Maximilian Lerchenberger
{"title":"[Deformities of the hip joint as cause of groin pain: diagnostics and therapy].","authors":"Jan Wulf, Boris M Holzapfel, Paul Reidler, Maximilian Lerchenberger","doi":"10.1007/s00104-025-02288-x","DOIUrl":"10.1007/s00104-025-02288-x","url":null,"abstract":"<p><p>Chronic groin pain in adults is often attributable to hip joint pathologies. This article analyzes important orthopedic differential diagnoses, including hip dysplasia, acetabular version abnormalities, femoral torsion anomalies, femoroacetabular impingement (FAI), femoral head necrosis, and osteoarthritis. The pathophysiology of these conditions frequently lead to disrupted joint mechanics, leading to premature degeneration and arthritis. The diagnostics include patient history, clinical examination and imaging modalities such as X‑ray, magnetic resonance imaging (MRI) or computed tomography (CT). Treatment options include conservative measures (e.g., physiotherapy, pain management) or surgical interventions, e.g., arthroscopy for FAI, periacetabular osteotomy (PAO) for dysplasia and total hip arthroplasty (THA) for advanced osteoarthritis. The choice of treatment depends on factors, such as age, disease severity and lifestyle. Preventive measures, early detection of pre-arthritic deformities and regular monitoring of patients at-risk can slow degenerative progression; however, in cases of advanced osteoarthritis THA often remains the last option for preserving mobility and quality of life.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"633-640"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056712","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}
引用次数: 0
[Active surveillance versus surgery after neoadjuvant chemoradiotherapy-Results of the SANO trial]. [主动监测与新辅助放化疗后手术- SANO试验的结果]。
Chirurgie (Heidelberg, Germany) Pub Date : 2025-08-01 Epub Date: 2025-06-20 DOI: 10.1007/s00104-025-02332-w
L M Schiffmann, C J Bruns
{"title":"[Active surveillance versus surgery after neoadjuvant chemoradiotherapy-Results of the SANO trial].","authors":"L M Schiffmann, C J Bruns","doi":"10.1007/s00104-025-02332-w","DOIUrl":"10.1007/s00104-025-02332-w","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"685-686"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334507","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}
引用次数: 0
[Reply to the letter to the editor on long-term results of a pilot study on the two-stage procedure with primary excision and Limberg flap in the interval for treatment of sacrococcygeal pilonidal sinus disease]. [回复致编辑的关于初步切除和Limberg皮瓣两阶段手术治疗骶尾椎毛窦疾病的长期初步研究结果的信]。
Chirurgie (Heidelberg, Germany) Pub Date : 2025-08-01 Epub Date: 2025-06-23 DOI: 10.1007/s00104-025-02327-7
Michael Ardelt, U Settmacher
{"title":"[Reply to the letter to the editor on long-term results of a pilot study on the two-stage procedure with primary excision and Limberg flap in the interval for treatment of sacrococcygeal pilonidal sinus disease].","authors":"Michael Ardelt, U Settmacher","doi":"10.1007/s00104-025-02327-7","DOIUrl":"10.1007/s00104-025-02327-7","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"675-676"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478046","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}
引用次数: 0
S2k-Leitlinie „Katastrophenmedizinische prähospitale Behandlungsleitlinien“. “S2K：医院前紧急护理指南”。
Chirurgie (Heidelberg, Germany) Pub Date : 2025-08-01 DOI: 10.1007/s00104-025-02326-8
Annika Rohde
{"title":"S2k-Leitlinie „Katastrophenmedizinische prähospitale Behandlungsleitlinien“.","authors":"Annika Rohde","doi":"10.1007/s00104-025-02326-8","DOIUrl":"10.1007/s00104-025-02326-8","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":"96 8","pages":"697"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735841","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}
引用次数: 0
[The stress level of surgeons influences surgical complications]. [外科医生的压力水平影响手术并发症]。
Chirurgie (Heidelberg, Germany) Pub Date : 2025-08-01 Epub Date: 2025-04-28 DOI: 10.1007/s00104-025-02302-2
Katharina Vedder, Christoph Reissfelder
{"title":"[The stress level of surgeons influences surgical complications].","authors":"Katharina Vedder, Christoph Reissfelder","doi":"10.1007/s00104-025-02302-2","DOIUrl":"10.1007/s00104-025-02302-2","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"687-689"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058400","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}
引用次数: 0
[Working conditions in surgery and their impact : Results of a national survey]. [外科工作条件及其影响 ：全国调查结果]。
Chirurgie (Heidelberg, Germany) Pub Date : 2025-08-01 Epub Date: 2024-10-10 DOI: 10.1007/s00104-024-02181-z
J Gumpp, F Fritze-Büttner, B Blank, S Axt
{"title":"[Working conditions in surgery and their impact : Results of a national survey].","authors":"J Gumpp, F Fritze-Büttner, B Blank, S Axt","doi":"10.1007/s00104-024-02181-z","DOIUrl":"10.1007/s00104-024-02181-z","url":null,"abstract":"<p><strong>Background: </strong>In surgical disciplines poor working conditions and a high level of dissatisfaction among surgeons in the various disciplines have been reported. The psychological consequences of these conditions on the surgeons themselves and the effects on their families have so far been inadequately considered.</p><p><strong>Objective: </strong>The objective of this national survey of the Professional Association of German Surgery (Berufsverband der Deutschen Chirurgie e. V.) was to determine the current status of working conditions in surgical departments of German hospitals and to demonstrate their psychological and familial effects.</p><p><strong>Material and methods: </strong>In the period January-February 2024 a questionnaire with 26 questions focusing on psychological stress, work-related partnership and family problems as well as addictive behavior was sent to all members of the Berufsverband der Deutschen Chirurgie e. V. and to all German surgical societies.</p><p><strong>Results: </strong>A total of 2221 questionnaires could be analyzed. Among the survey participants, bureaucracy (84.4%) and inadequate compensation for overtime (68.1%) were seen as the main stress factors. Alcohol (20.3%), nicotine (8.9%) and medication (8.3%) were cited as ways of managing the workload. Of the surgeons 60% reported a negative impact on their relationship with their partner and 40% on their relationship with their children.</p><p><strong>Discussion: </strong>The surgeons reported poor working conditions. These have a massive impact on the mental health of surgeons and on their family relationships. Consequently, many surgeons consider leaving the surgical profession. To improve this situation and to make the surgical profession attractive again, a drastic rethinking is needed.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"657-666"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402188","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}
引用次数: 0
[Osterix and the abdominal wall : A rare muddle]. [牡蛎和腹壁：罕见的混淆]。
Chirurgie (Heidelberg, Germany) Pub Date : 2025-08-01 Epub Date: 2025-03-27 DOI: 10.1007/s00104-025-02274-3
Sandra Groß, Martin Mucke, Marco Rudolph, Victoria Arango Galvis
{"title":"[Osterix and the abdominal wall : A rare muddle].","authors":"Sandra Groß, Martin Mucke, Marco Rudolph, Victoria Arango Galvis","doi":"10.1007/s00104-025-02274-3","DOIUrl":"10.1007/s00104-025-02274-3","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"677-680"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722770","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}
引用次数: 0
[Differential diagnosis for groin pain]. 【腹股沟疼痛的鉴别诊断】。
Chirurgie (Heidelberg, Germany) Pub Date : 2025-08-01 Epub Date: 2025-05-13 DOI: 10.1007/s00104-025-02307-x
Christoph-Thomas Germer, Michael Meir
{"title":"[Differential diagnosis for groin pain].","authors":"Christoph-Thomas Germer, Michael Meir","doi":"10.1007/s00104-025-02307-x","DOIUrl":"10.1007/s00104-025-02307-x","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"617-618"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047422","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}
引用次数: 0
[Sports injuries and overuse syndromes of the groin]. [腹股沟运动损伤和过度使用综合征]。
Chirurgie (Heidelberg, Germany) Pub Date : 2025-08-01 Epub Date: 2025-06-06 DOI: 10.1007/s00104-025-02315-x
Kai Fehske
{"title":"[Sports injuries and overuse syndromes of the groin].","authors":"Kai Fehske","doi":"10.1007/s00104-025-02315-x","DOIUrl":"10.1007/s00104-025-02315-x","url":null,"abstract":"<p><p>Injuries and overuse complaints of the groin are a common issue in competitive and professional sports. Clinically, they typically present as pulling to stabbing pains that radiate to the inner thigh and the outer side of the scrotum. Sports that involve rapid changes of direction, sudden accelerations, and strong rotational movements of the torso are at particular risk for the development of groin complaints. Diagnosis is based on clinical, sonographic, and magnetic resonance imaging (MRI) examinations, and can be quite challenging, requiring an interdisciplinary approach. An inguinal hernia should primarily be ruled out. Other causes of groin pain may include osteitis pubis, hip joint impingement, muscle injuries in the groin, thigh, or abdominal regions, and nerve compression syndromes. In most cases, conservative therapy is indicated and successful in the long term. For persistent complaints, the athlete's groin can be treated through stabilization of the posterior wall of the inguinal canal and local neurolysis.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"650-656"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251119","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}
引用次数: 0
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