Chirurgie (Heidelberg, Germany)最新文献

{"title":"[Osteosynthesis of subtrochanteric femoral fractures in adults].","authors":"Carolina Vogel, Dannik Haas, Tina Histing, Benedikt J Braun","doi":"10.1007/s00104-025-02334-8","DOIUrl":"10.1007/s00104-025-02334-8","url":null,"abstract":"<p><p>Subtrochanteric femoral fractures show an increasing incidence but are different from pertrochanteric and intertrochanteric fractures mostly with respect to the injury mechanics and treatment. These fractures predominantly affect geriatric, fragile and comorbid patients suffering from osteoporosis and sarcopenia. The reduction and minimally invasive stabilization of the mostly dislocated fractures using intramedullary nail systems is the method of choice but can be technically demanding. The aim of treatment is to restore mobility as quickly as possible to avoid exacerbation of comorbidities and to restore the patient's autonomy and therefore the quality of life.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"886-898"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499628","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":"[Vascular anatomy and its variants in pancreatic surgery].","authors":"Kim C Honselmann, Stanislav Litkevych, Mykhailo Sydorenko, Tobias Keck","doi":"10.1007/s00104-025-02367-z","DOIUrl":"10.1007/s00104-025-02367-z","url":null,"abstract":"<p><p>A profound understanding of pancreatic anatomy and its vascular supply is essential for safely performing complex surgical procedures such as pancreaticoduodenectomy. Historically, anatomical exploration began with Herophilos and Ruphos of Ephesos in ancient times, evolving through major surgical innovations by Wirsung, Kausch and Whipple. The pancreas is located secondarily retroperitoneally and therefore has a close relationship of the pancreatic head to the superior mesenteric artery (SMA) and portal vein (PV) and the celiac trunc. Clinically relevant anatomical variants, such as the Rio-Branco and Bühler anastomoses and various forms of the coeliac trunk according to Hiatt's classification are crucial for surgical planning. Venous drainage primarily occurs through the superior mesenteric vein, splenic vein and the gastrocolic trunk of Henle. The \"artery first approach\" provides various access routes to safely identify and expose critical vascular structures, to optimize oncological resection and minimize perioperative complications.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"808-814"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024881","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":"[Learning from others-semitendinosus tendon autograft for inguinal hernia repair (HoTT-TAPP) : Case series with demonstration of feasibility].","authors":"Amadeus Hornemann, Fabian A Helfritz","doi":"10.1007/s00104-025-02312-0","DOIUrl":"10.1007/s00104-025-02312-0","url":null,"abstract":"<p><strong>Background: </strong>Plastic meshes are widely used in medicine. Since they are controversial for various reasons, alternatives are being sought.</p><p><strong>Objectives: </strong>Presentation of a case series of inguinal hernia operations (transabdominal preperitoneal [TAPP] technique) with a biological mesh made of autologous tendon tissue.</p><p><strong>Materials and methods: </strong>Laparoscopic transperitoneal inguinal hernia operation in 5 patients with tissue from the tendon of the semitendinosus muscle for unilateral inguinal hernia repair.</p><p><strong>Results: </strong>All 5 patients successfully underwent surgery.</p><p><strong>Conclusion: </strong>Tendon tissue from the thigh is used successfully in knee surgery and also by gynecologists in prolapse surgery. Since the morbidity at the donor site is low and the tissue is stable, it might also be used routinely in hernia surgery.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"862-866"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683719","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":"[Anatomical variants].","authors":"Christoph-T Germer, Sven Flemming","doi":"10.1007/s00104-025-02368-y","DOIUrl":"https://doi.org/10.1007/s00104-025-02368-y","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":"96 10","pages":"797-798"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126565","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 rare cause of acute upper abdominal pain].","authors":"C Barz, A Franke, H Steffen, K Ludwig","doi":"10.1007/s00104-025-02318-8","DOIUrl":"10.1007/s00104-025-02318-8","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"867-869"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192546","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":"[Thoracic outlet syndrome : Interdisciplinary diagnostics and treatment].","authors":"Marc Ahrens, Jan-H Egberts, Julia Umstadt, Thomas Bürger, Rouven Berndt, E S Debus, Mark Preuß","doi":"10.1007/s00104-025-02371-3","DOIUrl":"https://doi.org/10.1007/s00104-025-02371-3","url":null,"abstract":"<p><p>The thoracic outlet syndrome (TOS) refers to a group of clinical conditions caused by compression of nerves and blood vessels in congenital or acquired anatomical narrowing of the upper thoracic aperture. This includes the anatomical structures, such as the scalene muscles, the first rib, a possibly present cervical rib, the costoclavicular joint or the pectoralis minor muscle. Isolated venous compression is also known as thoracic inlet syndrome (TIS). The symptoms are diverse and the path to a correct diagnosis is often prolonged. In the absence of anatomical anomalies, conservative treatment is indicated, such as physical therapy and adequate pain management. Especially in young patients, TOS should be considered when embolic events in the upper extremities occur without other risk factors. Appropriate multimodal diagnostics and targeted therapy are challenging and require treatment in specialized departments. Surgical treatment is complex and over the years various procedures with a favorable outcome for the affected patients have been established.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132545","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":"[Planned iliohypogastric neurectomy for prevention of chronic pain after inguinal hernia repair].","authors":"Mario Kaufmann, Christoph Reissfelder","doi":"10.1007/s00104-025-02386-w","DOIUrl":"https://doi.org/10.1007/s00104-025-02386-w","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126563","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":"[Mycotic aortic aneurysm-Representative cases : Case series of clinical case examples and the current literature on the treatment options of open surgical resection with prosthesis implantation (OR) and endovascular aortic repair (EVAR)].","authors":"E Schwarz, P Arndt, F Meyer, M Pech, U Barth","doi":"10.1007/s00104-025-02375-z","DOIUrl":"https://doi.org/10.1007/s00104-025-02375-z","url":null,"abstract":"<p><strong>Background: </strong>The mycotic aortic aneurysm (MAA) is a rare life-threatening condition. Treatment options include open surgical resection (OR) with prosthesis implantation and endovascular aortic repair (EVAR).</p><p><strong>Aim: </strong>Presentation of the therapeutic decisions illustrated by clinical case examples and discussion of current references from the medical scientific literature.</p><p><strong>Case reports: </strong>1. An emergency resection of a covered ruptured abdominal aortic aneurysm (AAA) in a 74-year-old female patient revealed a MAA. A xenograft was implanted. Ultimately, the comorbidities led to death. 2. A 79-year-old male patient with a MAA as the focus of a Salmonella sepsis underwent EVAR using implantation of a stent graft. Correct graft placement and adequate perfusion were confirmed. On postoperative day 7, the patient was discharged with long-term antibiotic therapy. 3. A 63-year-old male patient with a covered ruptured AAA and psoas muscle abscess underwent emergency surgery with OR and implantation of a xenograft prosthesis. On postoperative day 12 the patient was discharged with long-term antibiotic therapy.</p><p><strong>Discussion: </strong>An analysis of 21 studies (2433 patients) showed a better short-term survival using EVAR (3-month survival, 96% vs. 74% for OR) but a higher reinfection rate (42 % vs. 18 %). The 5‑year survival rates are similar (EVAR: 57-79.7%, OR: 60%). The most common pathogens were Salmonella (26.3%) and Staphylococcus aureus (13.9%). Blood cultures remained negative in 37.4%. Risk factors are advanced age, male gender and comorbidities. A long-term antibiotic therapy of > 6 months improves the outcome.</p><p><strong>Conclusion: </strong>The treatment of MAA requires an individualized approach as both OR and EVAR exhibit similar long-term outcomes but different early complication rates. Long-term antibiotic therapy is essential for an optimal outcome.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071351","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":"[Suboptimal treatment success after metabolic bariatric surgery-Additive pharmacotherapy or surgical conversion?]","authors":"Jakob Lauerer, Lars Kollmann, Ann-Cathrin Koschker, Mirko Otto, Florian Seyfried","doi":"10.1007/s00104-025-02384-y","DOIUrl":"https://doi.org/10.1007/s00104-025-02384-y","url":null,"abstract":"<p><p>Morbid obesity is a recognized chronic disease. Metabolic bariatric surgery (MBS) currently represents the most effective treatment, with efficacy in achieving significant weight reduction and improving obesity-related comorbidities, quality of life and overall survival; however, unsatisfactory treatment outcomes manifesting as suboptimal weight loss, recurrent weight gain, or poor control of comorbid conditions, represent a clinically relevant challenge requiring further treatment. Conversion surgery can positively influence weight trajectories and associated comorbidities but are associated with higher risk profiles compared to primary procedures. Additive pharmacological treatment, particularly glucagon-like peptide 1 (GLP-1) analogues, also demonstrate efficacy with an acceptable side effect profile. This article examines the definitions of suboptimal treatment success following MBS and provides an overview of available treatment options as well as the decision-making process for individualized treatment. Special attention must be paid to the comorbidities and the preferences of patients within an interdisciplinary framework supported by appropriate clinical expertise.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076643","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":"[Multimodal data processing through AI: envisioning the operating room of the future].","authors":"Jennifer A Eckhoff, Dolores T Krauss, Stefanie Brunner, Christiane J Bruns, Hans F Fuchs","doi":"10.1007/s00104-025-02377-x","DOIUrl":"https://doi.org/10.1007/s00104-025-02377-x","url":null,"abstract":"<p><strong>Background: </strong>Despite intensive research the clinical implementation of artificial intelligence (AI) in surgery remains limited. In addition to infrastructural and regulatory barriers, this is due to the isolated processing of individual data sources (e.g. video), although the true potential of surgical AI lies in the integration of multimodal data.</p><p><strong>Objective: </strong>What added value does AI-driven analysis of multimodal data offer in surgery, and how can it realistically be integrated into clinical practice?</p><p><strong>Method: </strong>This review is based on first results on multimodal data acquisition and processing at University Hospital Cologne as well as a targeted literature search.</p><p><strong>Results: </strong>The integration of different data sources shows great potential; however, lack of infrastructure and regulation hinders the implementation.</p><p><strong>Discussion: </strong>In addition to technological development, clear legal frameworks are required to enable the clinical integration of innovative AI systems.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042290","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}