Chirurgie (Heidelberg, Germany)最新文献

{"title":"[Laparoscopic vs. robotic interventions in minimally invasive surgery of chronic inflammatory bowel diseases-Results of a meta-analysis].","authors":"C T Germer, J Reibetanz","doi":"10.1007/s00104-025-02249-4","DOIUrl":"10.1007/s00104-025-02249-4","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"330-331"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400814","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":"[Large toe-Small malady? : When an outpatient operation leads to hospitalization].","authors":"A F Erdogan, A Oberhuber","doi":"10.1007/s00104-025-02250-x","DOIUrl":"10.1007/s00104-025-02250-x","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"322-325"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11933186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411812","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":"[Evidence for the extent and oncological benefit of lymphadenectomy for pancreatic cancer].","authors":"Tobias Keck","doi":"10.1007/s00104-024-02219-2","DOIUrl":"10.1007/s00104-024-02219-2","url":null,"abstract":"<p><p>Pancreatic cancer is usually diagnosed at a late stage and is characterized by early systemic metastases, which can also be present in the form of micrometastases that are not primarily visible. Lymphatic metastases in pancreatic cancer are common. The extent of lymph node removal (lymphadenectomy, LAD) in pancreatic cancer is defined in the guidelines of the Association of the Scientific Medical Societies in Germany (AWMF) and according to currently available data has more diagnostic and prognostic relevance than therapeutic relevance; however, within the framework of modern multimodal treatment algorithms, radical surgery is the most relevant of all components of multimodal treatment with LAD playing an important role. According to current data, extended LAD without technical necessity in the surgery of the primary tumor brings no advantages for the patients but numerous limitations in the quality of life and should therefore not be performed as the standard. Important aspects of LAD for pancreatic cancer are the lymph node ratio, extended vs. standard LAD and innovations in LAD in the field of interaortocaval lymph nodes and the so-called triangle operation.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"288-292"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017354","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":"[Evidence for the extent and oncological benefit of lymphadenectomy in gastric cancer].","authors":"Matthias Kelm, Sven Flemming, Christoph-Thomas Germer, Florian Seyfried","doi":"10.1007/s00104-024-02198-4","DOIUrl":"10.1007/s00104-024-02198-4","url":null,"abstract":"<p><p>The oncological standard for curative treatment of non-metastasized gastric cancer is surgical resection with systematic D2 lymphadenectomy. Early stage carcinomas (pT1a) with circumscribed prerequisites are an exception as they can be endoscopically resected; however, by infiltration of invasive gastric cancer into submucosal layers (pT1b) the risk for lymph node metastases is up to 25-28%. Due to the lack of screening programs in the western world, most gastric cancers are diagnosed in an advanced stage and the treatment is multimodal with perioperative multiple chemotherapy and increasingly more also with immunotherapy. Nevertheless, despite multidisciplinary treatment strategies, the benefits of surgical resection and an adequate systematic lymphadenectomy are still independent prognostic factors for long-term survival; however, the classification and extent of the lymphadenectomy are regularly updated, especially as a result of the spread of minimally invasive operations, and in addition are internationally evaluated differently. In the context of perioperative morbidity and oncological outcome this includes the approach with respect to individual lymph node stations, especially lymph node stations 10 and 12a and in addition the classification D1-D3. Furthermore, continuous modifications, particularly from Asia, such as sentinel lymph node resection underline the pursuit of improvements. The multitude of alterations in the context of multidisciplinary treatment concepts and the international heterogeneity make the evaluation of the value of individual surgical aspects noticeably more difficult.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"281-287"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792840","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":"[Update on follicular thyroid cancer-What is relevant for surgeons?]","authors":"Nicolas Schlegel","doi":"10.1007/s00104-025-02276-1","DOIUrl":"10.1007/s00104-025-02276-1","url":null,"abstract":"<p><p>Follicular thyroid cancer (FTC) is the second most frequent form of differentiated thyroid cancer, accounting for approximately 5-15% of all thyroid malignancies. According to the World Health Organization (WHO) classification from 2022 FTC is divided into three subtypes, which clearly differ in the overall prognosis and probability of recurrence. Furthermore, knowledge about benign follicular tumors and low-grade neoplasms is important. Prognostic factors for malignant alterations include patient age, tumor size, invasive growth, the presence of angioinvasion and the occurrence of distant metastases. The surgical management is guided by these factors and therefore varies between the different FTC subtypes. In summary, a precise understanding of the individual subtypes of thyroid tumors is essential to be able to make an appropriate and personalized decision on surgical treatment.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722806","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":"[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":"https://doi.org/10.1007/s00104-025-02274-3","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","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}

{"title":"[Neoadjuvant oxaliplatin-based chemotherapy vs. primary surgery for locally advanced colon cancer : Results of the randomized OPTICAL study].","authors":"C T Germer, J Reibetanz","doi":"10.1007/s00104-025-02281-4","DOIUrl":"https://doi.org/10.1007/s00104-025-02281-4","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712387","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":"[Update on anaplastic thyroid cancer-What is relevant for surgeons?]","authors":"Sabine Wächter, Detlef K Bartsch","doi":"10.1007/s00104-025-02277-0","DOIUrl":"https://doi.org/10.1007/s00104-025-02277-0","url":null,"abstract":"<p><p>Anaplastic thyroid cancer (ATC) is the rarest but also the most aggressive carcinoma entity of the thyroid gland. In recent years, treatment options have evolved and molecular oncological treatment approaches have gained in importance. The neoadjuvant use of these innovative therapies has the potential to convert previously unresectable tumors into a resectable state, thereby expanding surgical options and significantly improving the prognosis of patients. This article provides recommendations relevant for surgery for the diagnostics and treatment of ATC, based on a current literature review and the discussions of the S3 guideline conferences.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712388","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":"[Frozen section in oncologic endocrine surgery].","authors":"Costanza Chiapponi, Atsuko Kasajima","doi":"10.1007/s00104-025-02266-3","DOIUrl":"https://doi.org/10.1007/s00104-025-02266-3","url":null,"abstract":"<p><strong>Background: </strong>The aim of the present study is to discuss the benefits of intraoperative frozen sections (FS) for the surgical management of endocrine tumors.</p><p><strong>Methods: </strong>A systematic search of the literature of the last ten years on FS in the field of oncologic endocrine surgery was carried out and a discussion based on the available evidence and experience of the authors is provided.</p><p><strong>Results: </strong>A group of publications focused on the role of intraoperative FS in thyroid surgery in identifying the malignant potential of thyroid nodules. The detection of lymph node metastasis and extrathyroidal growth in differentiated thyroid cancer (DTC) were also two other topical groups as well as the diagnosis of lymph node involvement based on stromal desmoplasia in medullary thyroid cancer (MTC). A further group investigated the possibilities of deep learning to overcome technical problems and another investigated the cost-benefit analyses. There is no relevant literature on the role of FS in the surgical treatment of parathyroid and adrenal cancers.</p><p><strong>Discussion: </strong>The synthesis of the available evidence suggests that FS investigations of the thyroid glands should be restricted to Bethesda V nodules. The technical limitations in the exclusion of vascular and capsular invasion make the FS unsuitable for follicular neoplasms and oncocytic lesions. The Delphi lymph node seems to be suitable for investigation using FS and when positive represents an indication for lymphadenectomy in cN0 patients. Larger studies are necessary in the future to confirm if the absence of desmoplasia with an intact tumor capsule can reliably justify omitting lymph node resection in MTC, independent of the calcitonin level. The costs and benefits depend on the individual context so that generalization is difficult. Deep learning models could generally improve the performance of FS analysis in the future.</p><p><strong>Conclusion: </strong>In thyroid surgery awareness of the technical limitations of FS is crucial for correct implementation and thus to optimize its performance. A preoperative fine needle biopsy and surgical experience help in selecting the nodules that can benefit from FS. Deep image learning could help to overcome current problems in the future. In adrenal and parathyroid oncologic surgery FS do not play a relevant role.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712386","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":"[Intraoperative frozen section diagnostics for low rectal cancer-Primary surgery vs. neoadjuvant pretreatment].","authors":"Franziska Eckert, Daniela Aust, Johanna Kirchberg, Jürgen Weitz, Johannes Fritzmann","doi":"10.1007/s00104-025-02272-5","DOIUrl":"https://doi.org/10.1007/s00104-025-02272-5","url":null,"abstract":"<p><p>Depending on the extent of the tumor, the treatment strategies for rectal cancer include primary surgical resection or, in the case of locally advanced carcinoma, neoadjuvant chemo(radio)therapy (C[R]Tx) or total neoadjuvant therapy (TNT), usually followed by surgical treatment. During resection, it is important to find a balance between radicality and preservation of function. Current data show that shorter safety margins are possible for patients who received neoadjuvant treatment without compromising the oncological outcome. This enables continence-preserving surgery in many patients with low rectal cancer. In these cases in particular, intraoperative frozen section diagnostics play a central role in confirming tumor-free margins. However, frozen section diagnostics also play an important role in the transanal resection of early carcinomas or in the therapy of recurrent rectal cancer. It should not be performed routinely, but rather in a targeted maner for specific questions and the corresponding therapeutic consequences. The informative value of frozen section diagnostics in neoadjuvant treated rectal cancer may be limited, so that the final assessment of the resection status and thus the determination of further therapy must be based on paraffin-embedded sections.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673667","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}