Chirurgie (Heidelberg, Germany)最新文献

{"title":"[Evidence of intraoperative frozen section examinations].","authors":"Christiane J Bruns","doi":"10.1007/s00104-025-02283-2","DOIUrl":"https://doi.org/10.1007/s00104-025-02283-2","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":"96 5","pages":"363-364"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054295","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":"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":"385-393"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","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":"[Plastic surgical treatment of neurofibromatosis type 1].","authors":"Gregor Längle, Andreas Gohritz, Clemens Gstöttner, Leopold Harnoncourt, Hannes Platzgummer, Amedeo A Azizi, Oskar Aszmann","doi":"10.1007/s00104-024-02232-5","DOIUrl":"10.1007/s00104-024-02232-5","url":null,"abstract":"<p><p>Neurofibromatosis type 1 (NF1, formerly Recklinghausen's disease) is a genetic tumor predisposition syndrome in which the mutation of a tumor suppressor gene (neurofibromin) leads to the development of mostly benign neurofibromas of the skin and the central and peripheral nervous systems and malformations or tumors of other organ systems. Patients with NF1 should receive lifelong interdisciplinary care in specialized centers and important treatment decisions should be made by a regularly meeting interdisciplinary panel of experts. Plastic surgery plays an important role in the multidisciplinary management of all clinical forms of NF1-associated peripheral nerve sheath tumors, from cutaneous and subcutaneous to deep nodular and diffuse plexiform neurofibromas. Each patient requires individualized surgical planning, whereby the timing and extent of surgery are determined by the accompanying symptoms, functional and esthetic limitations, disease progression and potential malignant transformation. As any region of the body can be affected, the esthetic and reconstructive procedures required include a wide range of interventions, such as eyelid surgery and facial restoration to breast shaping and nerve reconstruction or motor replacement surgery. A timely surgical intervention can have a profoundly positive effect on the course of the disease and the quality of life of those affected and, in the case of transformation into a malignant peripheral nerve sheath tumor (MPNST), can even be lifesaving.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"394-404"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12014788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061263","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":"[Cure probabilities after resection of ductal adenocarcinoma of the pancreas: a multi-institutional analysis of 2554 patients].","authors":"Laura Schwenk, Michael Ardelt, Utz Settmacher","doi":"10.1007/s00104-025-02280-5","DOIUrl":"10.1007/s00104-025-02280-5","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"421-422"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659867","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":"[The stress level of surgeons influences surgical complications].","authors":"Katharina Vedder, Christoph Reissfelder","doi":"10.1007/s00104-025-02302-2","DOIUrl":"https://doi.org/10.1007/s00104-025-02302-2","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","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}

{"title":"[Osteitis pubis and spinal diseases : Differential diagnosis of groin pain].","authors":"Martin C Jordan, Stefan Zwingenberger, Martin Burchardt, Willi L Wagner, Mark O Wielpütz, Georgi Wassilew","doi":"10.1007/s00104-025-02284-1","DOIUrl":"https://doi.org/10.1007/s00104-025-02284-1","url":null,"abstract":"<p><p>Aseptic osteitis pubis can be a possible cause of groin pain in young physically active patients. As a correlation with femoroacetabular impingement has been demonstrated, this pathological condition should also be considered as a possible cause. In older patients aseptic osteitis pubis is usually a degenerative alteration of the symphysis, which can also lead to groin pain. It is important to distinguish this from septic osteitis pubis, which is often associated with infections in the region of the true pelvis or previous surgery in this area. Vertebrogenic causes of groin pain are attributable to irritation of the nerve roots L1-L3, which can result from inflammatory, traumatic or degenerative alterations of the spine. This article provides an overview of these differential diagnoses based on case examples.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043869","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":"S2k-Leitlinie „Rehabilitation nach Majoramputation an der oberen Extremität (proximal der Hand)“.","authors":"Diana Schoppe","doi":"10.1007/s00104-025-02303-1","DOIUrl":"https://doi.org/10.1007/s00104-025-02303-1","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060608","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":"[In memoriam Univ.-Prof. em. Dr. med. Hans-Ulrich Steinau : *27 April 1946 †26 February 2025].","authors":"Peter M Vogt","doi":"10.1007/s00104-025-02282-3","DOIUrl":"https://doi.org/10.1007/s00104-025-02282-3","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999383","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 papillary thyroid cancer-What is relevant for surgeons?]","authors":"Ann-Kathrin Lederer, Thomas J Musholt","doi":"10.1007/s00104-025-02275-2","DOIUrl":"https://doi.org/10.1007/s00104-025-02275-2","url":null,"abstract":"<p><p>Papillary thyroid cancer (PTC) is the most frequent malignant thyroid tumor in Germany. The diagnosis can only be confirmed by histological examination of the suspicious tissue. The clinical signs, sonographic findings, and the results of fine-needle aspiration, possibly supplemented by subsequent molecular genetic analysis, can confirm the suspected diagnosis before surgery. The prognosis is very good if the diagnosis is made early and, depending on the size of the tumor, complete surgical removal is achieved, with a 10-year survival rate of more than 90%; however, histologically PTC has several variants that are associated with either a high or low risk of metastases and recurrence in patients. Therefore, the extent of necessary treatment, in particular surgical interventions for PTC has been discussed for years. This article provides an overview of the current knowledge on the diagnosis, treatment and prognosis of PTC.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765941","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":"[Robotic vs. laparoscopic adrenalectomy in pheochromocytoma].","authors":"Ioannis Mintziras, Detlef K Bartsch","doi":"10.1007/s00104-025-02257-4","DOIUrl":"10.1007/s00104-025-02257-4","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"326-327"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525221","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}