Chirurgie (Heidelberg, Germany)最新文献

{"title":"[The prognostic impact of lymph node yield on survival in esophageal cancer stratified by neoadjuvant treatment regimen].","authors":"L M Schiffmann, C J Bruns","doi":"10.1007/s00104-026-02585-z","DOIUrl":"10.1007/s00104-026-02585-z","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"918-919"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957442","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":"[Management of complications of the upper gastrointestinal tract following external primary procedures : Case series on complex clinical courses and continuation of treatment at a high-volume center].","authors":"Loreen Sophie Rudek, Naita M Wirsik, Hans A Schlößer, Christiane J Bruns","doi":"10.1007/s00104-026-02553-7","DOIUrl":"10.1007/s00104-026-02553-7","url":null,"abstract":"<p><strong>Background: </strong>The centralization of hospital services and the introduction of minimum volume requirements represent key pillars of modern health policy, affecting both the quality of care and the handling of clinical complications.</p><p><strong>Objective: </strong>This case study investigates the resources required at a tertiary or high-volume care center for the further treatment of patients with externally complicated primary procedures.</p><p><strong>Material and methods: </strong>The prospective single-center study included patients who underwent externally complicated surgery, intervention, or diagnostic procedure in the upper gastrointestinal tract between 1 January 2023 and 31 December 2024, and were subsequently treated at the Department of General, Visceral, Thoracic, and Transplantation Surgery of the University Hospital Cologne.</p><p><strong>Results: </strong>A total of 39 patients (male: 38.5%, female: 61.5%; average age: 68.1 years) were treated at our center after complicated primary procedures at external hospitals. The most common complications were perforation, suture insufficiency, and incomplete resection/reconstruction. Following occurrence of a complication 15 patients were transferred directly to the high-volume center. Interventional and/or surgical revisions were performed on 24 patients at external hospitals. At the time of transfer 71.8% of patients were in need of intensive care. A cumulative total of 115 surgical and 243 endoscopic procedures with 171 endoscopic vacuum (EndoVAC) changes were performed after transfer to the high-volume center. Over time, 25.6% of patients were readmitted to a local facility and 61.5% were discharged home. The mortality rate was 12.8 %.</p><p><strong>Conclusion: </strong>The treatment of patients with externally complicated primary procedures requires considerable personnel, logistical, and medical resources, especially for extensive diagnostics, complex surgical care, and intensive medical care.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"901-910"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13687252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702382","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":"[Sarcomas of the extremities].","authors":"Jens Jakob, Christoph Reißfelder","doi":"10.1007/s00104-026-02581-3","DOIUrl":"https://doi.org/10.1007/s00104-026-02581-3","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":"97 11","pages":"857-859"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149240646","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":"[Working conditions in endocrine surgery : A study among participants of the 43rd annual conference of the Surgical Working Group Endocrinology].","authors":"Maximilian Kießler, Maximilian Berlet, Anna Mikl, Helmut Friess, Costanza Chiapponi","doi":"10.1007/s00104-026-02529-7","DOIUrl":"10.1007/s00104-026-02529-7","url":null,"abstract":"<p><strong>Introduction: </strong>Working conditions in surgical specialties are increasingly characterized by high workload and growing job dissatisfaction, negatively affecting recruitment, retention, and the long-term sustainability of healthcare services. While extensive data are available for surgery as a whole, working conditions in endocrine surgery as a subspecialty of visceral surgery have not yet been investigated separately. The aim of the present study was, for the first time, to assess job satisfaction, occupational stressors, and working conditions among endocrine surgeons in Germany and to compare these factors according to the extent of endocrine surgical practice.</p><p><strong>Materials and methods: </strong>An anonymous cross-sectional survey was conducted during the 43rd Annual Meeting of the Surgical Working Group for Endocrinology (CAEK). The standardized questionnaire comprised 28 items addressing sociodemographic characteristics, professional activity, workload, and job satisfaction.</p><p><strong>Results: </strong>A total of 84 fully completed questionnaires were included in the analysis. Overall, 85% of respondents reported high or very high job satisfaction. Predominant involvement in endocrine surgery was associated with significantly higher overall job satisfaction (OR = 2.78; p = 0.021). Differences were particularly pronounced regarding opportunities for continuing medical education (OR = 4.41; p = 0.001), working time arrangements (OR = 3.21; p = 0.006), and surgical training and professional development (OR = 2.93; p = 0.014). Furthermore, 75% of respondents stated that they would unequivocally choose endocrine surgery again as their specialty. The main sources of occupational burden were bureaucratic and organizational demands. Overall stress levels differed only marginally between groups. The only significant difference was a higher burden from night shifts among surgeons whose endocrine surgical practice constituted a secondary part of their professional activity.</p><p><strong>Conclusion: </strong>Physicians predominantly engaged in endocrine surgery demonstrate significantly higher job satisfaction despite experiencing comparable levels of occupational burden. These findings suggest that specialized clinical profiles, structured training pathways, and favorable working time models contribute substantially to the attractiveness of this field. Promoting specialized training with the goal of subspecialization may therefore represent an important strategy for improving job satisfaction, enhancing recruitment and retention, and ensuring the long-term provision of surgical care in other areas of visceral surgery as well.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"893-900"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13687142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267203","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":"[Primary and secondary microsurgical reconstruction in soft tissue sarcomas].","authors":"M Harbrücker, N Ewerbeck, B Thomas, J Vogelpohl, K Hummedah, J Jakob, U Kneser, Felix Strübing","doi":"10.1007/s00104-026-02590-2","DOIUrl":"10.1007/s00104-026-02590-2","url":null,"abstract":"<p><p>The reconstruction after soft tissue sarcoma resection is sometimes essential to enable radical R0 resection, limb salvage, satisfactory functional outcomes and timely adjuvant treatment. In a retrospective cohort of 76 soft tissue reconstructions of the lower limbs, predominantly following external resections, wound coverage was consistently performed in a staged manner with a mean interval of 18 days; in more than half of the cases this interval was ≤14 days. A comprehensive review of the scientific literature on soft tissue reconstruction after soft tissue sarcoma resection was conducted. Key prerequisites for maximum oncological safety and reconstructive reliability without delaying adjuvant therapy are plastic and reconstructive expertise within the sarcoma center, expedited pathological margin assessment and close collaboration with vascular surgery and radiotherapy.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"880-885"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119231","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":"[Rare late complication after lymphadenectomy].","authors":"J E Hollmann, S Trum, J R Egetemeyer, D Krenz","doi":"10.1007/s00104-026-02567-1","DOIUrl":"10.1007/s00104-026-02567-1","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"911-913"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802328","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":"[Use of intraoperative methylene blue spray in thyroidectomy: a prospective randomized study].","authors":"Martin Falk, Detlef K Bartsch","doi":"10.1007/s00104-026-02587-x","DOIUrl":"10.1007/s00104-026-02587-x","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"914-915"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972026","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":"[Long-term results of antibiotic treatment of uncomplicated appendicitis].","authors":"J Reibetanz, C T Germer","doi":"10.1007/s00104-026-02589-9","DOIUrl":"10.1007/s00104-026-02589-9","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"916-917"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066268","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":"[Isolated limb perfusion to avoid mutilating surgical resections].","authors":"Madelaine Hettler, Per-Ulf Tunn","doi":"10.1007/s00104-026-02580-4","DOIUrl":"10.1007/s00104-026-02580-4","url":null,"abstract":"<p><p>Isolated limb perfusion (ILP) represents a regional oncological therapeutic approach, predominantly applied in the management of locally advanced soft tissue sarcomas of the extremities and malignant melanomas. The technique involves temporary vascular isolation of the affected limb from the systemic circulation, followed by perfusion under strictly controlled hyperthermic conditions using a cytotoxic agent combination, most commonly melphalan in conjunction with human recombinant tumor necrosis factor-alpha. The primary objective of ILP is to achieve high locoregional drug concentrations while limiting systemic exposure, thereby promoting substantial tumor regression and enabling limb preservation. The most commonly reported procedure-related complications include regional and systemic perfusion reactions and postoperative compartment syndrome. When performed in high-volume specialized centers, ILP is regarded as a safe and efficacious treatment modality, with limb preservation rates of up to 93% reported in soft tissue sarcomas.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"874-879"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984329","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":"[Popliteal artery entrapment syndrome].","authors":"A Behrens, B Dorweiler","doi":"10.1007/s00104-026-02571-5","DOIUrl":"10.1007/s00104-026-02571-5","url":null,"abstract":"<p><p>Popliteal artery entrapment syndrome (PAES) is a cause of exertional calf pain, predominantly affecting young athletic patients without pre-existing vascular disease. Although the condition is generally rare, the number of undetected asymptomatic cases is thought to be substantial. In up to two thirds of cases the PAES is bilateral. Pathophysiologically, it results from external compression of the popliteal artery within the popliteal fossa. The classification distinguishes between anatomical variants (types I-V), which arise from embryological maldevelopments of muscular and tendinous insertions, most commonly involving the medial head of the gastrocnemius muscle and functional entrapment (type VI), which is caused by muscle hypertrophy. Chronic compression leads to intimal damage, fibrosis, occlusions and poststenotic aneurysms. In addition to the clinical angiological examination, the diagnostics are based on duplex ultrasonography, magnetic resonance (MR) or computed tomography (CT) angiography and invasive angiography. For anatomically driven PAES (types I-V), surgical intervention is indicated due to the risk of permanent vascular damage. If the artery is intact, myotomy alone yields excellent long-term results; however, if stenoses or occlusions are already present, arterial reconstruction is required. For symptomatic functional PAES (type VI), botulinum toxin injections offer a nonsurgical alternative to myotomy.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"928-936"},"PeriodicalIF":0.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984312","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}