Chirurgie (Heidelberg, Germany)最新文献

{"title":"Klinische Studien.","authors":"","doi":"10.1007/s00104-024-02230-7","DOIUrl":"https://doi.org/10.1007/s00104-024-02230-7","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":"96 1","pages":"71-76"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973508","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":"[Telemedicine and AI-supported diagnostics in the daily routine of visceral medicine].","authors":"Matthias Grade, Verena Uslar","doi":"10.1007/s00104-024-02213-8","DOIUrl":"10.1007/s00104-024-02213-8","url":null,"abstract":"<p><p>Advances in telemedicine, exemplified by augmented reality (AR) and virtual reality (VR), are rapidly progressing. For instance, AR available over long distances has already been successfully utilized in crisis intervention, such as in war zones. The potential of telemedicine also appears promising in structurally weak areas or in the involvement of experts in emergency situations. Further research and development are needed on the avatars used in such telemedicine approaches to improve the sense of presence and thereby increase acceptance. Artificial intelligence (AI) in endoscopy, particularly in colonoscopy, is already a routine practice in many gastroenterology departments. The benefits are clearly evidenced by an increased adenoma detection rate (ADR). Studies have also shown a higher detection rate for sessile serrated adenomas (SSA) compared to the control group as well as a significantly increased rate of dysplastic Barrett's areas in the upper gastrointestinal (GI) tract (potential Barrett's carcinomas).</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"23-30"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911231","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":"Endoscopic negative-pressure treatment : From management of complications to pre-emptive active reflux drainage in abdomino-thoracic esophageal resection-A new safety concept for esophageal surgery.","authors":"Gunnar Loske, Johannes Müller, Wolfgang Schulze, Burkhard Riefel, Matthias Reeh, Christian Theodor Müller","doi":"10.1007/s00104-023-01996-6","DOIUrl":"10.1007/s00104-023-01996-6","url":null,"abstract":"<p><strong>Introduction: </strong>Early postoperative reflux (PR) can compromise anastomotic healing after Ivor Lewis esophagectomy (ILE) and poses a risk for aspiration. Anastomotic insufficiency is the most threatening surgical complication. We present the protective method of pre-emptive active reflux drainage (PARD) with simultaneous enteral feeding. We report our experience with this new safety concept in esophageal surgery in a cohort of 43 patients.</p><p><strong>Materials and methods: </strong>For PARD we use a double lumen open porous film drainage (dOFD). To create the dOFD, the gastric tube of a Trelumina probe (Freka®Trelumina, Fresenius) is coated with a double-layered open-pore drainage film (Suprasorb®CNP drainage film, Lohmann & Rauscher) over a length of 25 cm. The dOFD is endoscopically inserted into the tubular stomach intraoperatively after completion of the anastomosis. Continuous negative pressure is applied with an electronic pump (-125 mm Hg). The PR is continuously aspirated completely and the stomach and anastomotic region are decompressed. At the same time, nutrition is delivered via an integrated intestinal tube. Depending on the results of the endoscopic control after 5 days, PARD is either continued or terminated.</p><p><strong>Results: </strong>During the observation period (2017-2023), PARD was used in all patients (n = 43) with ILE. The healing rate under PARD was 100% and healing was observed in all anastomoses. No additional endoscopic procedures or surgical revisions of the anastomoses were required. The median duration of PARD was 8 days (range 4-21). We observed problems in the healing of the anastomosis in 20 of 43 patients (47%) for whom we defined endoscopic criteria for at-risk anastomosis.</p><p><strong>Conclusions: </strong>Our results suggest that PARD has a strong protective effect on anastomotic healing and may reduce the risk of anastomotic insufficiency. The integrated feeding tube of the dOFD allows early postoperative enteral feeding while simultaneously applying negative pressure. PARD appears to prevent the negative consequences of impaired anastomotic healing.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"48-59"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813439","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":"[Neoadjuvant treatment with 177Lu-DOTATATE for nonfunctional neuroendocrine tumors of the pancreas (NEOLUPANET): a multicenter phase II study].","authors":"Ioannis Mintziras, Detlef K Bartsch","doi":"10.1007/s00104-024-02205-8","DOIUrl":"10.1007/s00104-024-02205-8","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"63-64"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775443","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":"[Cholangiocarcinomas].","authors":"Wenzel Schöning, Philipp K Haber, Johann Pratschke","doi":"10.1007/s00104-024-02200-z","DOIUrl":"10.1007/s00104-024-02200-z","url":null,"abstract":"<p><p>The term cholangiocarcinoma (CCA) includes a group of malignant tumors that develop in the efferent bile ducts and are characterized by a high degree of heterogeneity. These differences between intrahepatic, perihilar and distal CCAs run through all aspects of the disease including the etiology, pathogenesis, symptoms, diagnostics and treatment. This review article presents the current developments in this field of diseases. We highlight surgical innovations in the clinical routine and the application of new systemic forms of treatment to augment the oncological radicality of surgery.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"77-86"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808730","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":"[Digitally based clinically oriented anatomy: the future of teaching].","authors":"Esther C Maier, Veysel Ödemis, Anja U Bräuer","doi":"10.1007/s00104-024-02211-w","DOIUrl":"10.1007/s00104-024-02211-w","url":null,"abstract":"<p><p>University teaching is undergoing radical changes. Rising student numbers and the progressive digitalization of routine daily life are also leading to the testing of various new teaching and learning formats. This article provides an overview of the reasons for and approaches used to effectively and efficiently organize teaching of anatomy using digital learning methods and to fulfil the expectations of students.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"11-15"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959777","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":"[Prevalence and potential risk factors for nodal metastasis in early esophago-gastric adenocarcinoma-Results of the CONGRESS study].","authors":"L M Schiffmann, C J Bruns","doi":"10.1007/s00104-024-02199-3","DOIUrl":"10.1007/s00104-024-02199-3","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"69-70"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775459","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":"[Drain or no drain after gastrectomy-Results of the abdominal drain after gastrectomy (ADIGE) study].","authors":"L M Schiffmann, C J Bruns","doi":"10.1007/s00104-024-02227-2","DOIUrl":"https://doi.org/10.1007/s00104-024-02227-2","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900804","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":"[A new approach for perioperative measurement of parathyroid hormone to establish a cure in patients with primary hyperparathyroidism].","authors":"Sabine Wächter, Detlef K Bartsch","doi":"10.1007/s00104-024-02225-4","DOIUrl":"https://doi.org/10.1007/s00104-024-02225-4","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883720","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":"[Surgery of premature infants-Perspectives and limitations].","authors":"Konrad Reinshagen, Irwin Reiss","doi":"10.1007/s00104-024-02203-w","DOIUrl":"https://doi.org/10.1007/s00104-024-02203-w","url":null,"abstract":"<p><p>The continuous improvement in the quality of modern perinatology, sociodemographic changes and the increasing spread of reproductive medicine have resulted in an increasing number of premature infants to be treated. The treatment of preterm infants (< 37th week of pregnancy) and especially extremely premature infants (< 28th week of pregnancy) is challenging due to immature organ development, which differs considerably from that of other age groups. While the fate of premature infants and especially extremely premature infants was unfavorable 100 years ago, the survival of premature infants > 1000 g has now shifted to survival in over 80% of cases [30]. The main medical problem areas of immature patients are a fetal proinflammatory immune system, an immature gastrointestinal tract with reduced transport capability, an incompletely developed intestinal barrier and a developing intestinal flora (microbiome) as well as immature lungs, which was significantly limiting for the survival of premature infants before the development of synthetic pulmonary surfactants. Furthermore, the central nervous system (CNS), which is far from being fully developed in preterm infants, is particularly vulnerable to exogenous factors, such as inflammation, toxins and medications. In addition, the CNS requires an environment appropriate to the developmental stage of the neonate to ensure normal physiological psychomotor development in the future. The article presents the special aspects of surgery on premature infants, the indications, complications and outcome, taking the special general problems of prematurity into account. Finally, the ethical conflicts associated with the care of extremely premature infants are briefly discussed.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840416","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}