Chirurgie (Heidelberg, Germany)最新文献_第7页

[Multimorbidity in liver surgery]. [肝脏手术中的多病]。

Chirurgie (Heidelberg, Germany) Pub Date : 2025-02-01 Epub Date: 2025-01-08 DOI: 10.1007/s00104-024-02222-7

Emrullah Birgin, Jan Heil, Elisabeth Miller, Marko Kornmann, Nuh N Rahbari

引用次数: 0

[Colorectal surgery in multimorbid patients].

Chirurgie (Heidelberg, Germany) Pub Date : 2025-02-01 Epub Date: 2025-01-29 DOI: 10.1007/s00104-024-02236-1

Romualdas Dasevicius, Sabine Jeanette Presser

{"title":"[Colorectal surgery in multimorbid patients].","authors":"Romualdas Dasevicius, Sabine Jeanette Presser","doi":"10.1007/s00104-024-02236-1","DOIUrl":"10.1007/s00104-024-02236-1","url":null,"abstract":"Colorectal surgery in multimorbid patients requires a comprehensive interdisciplinary planning of the treatment approach, from preoperative to posthospital care, in order to minimize complications and improve the patient's outcome. Therefore, the integration of the outpatient and inpatient sectors is essential as is a perioperative interdisciplinary coordinated approach. Preoperatively, all possible risks of concomitant diseases must be considered and optimized if necessary. As part of the prehabilitation, physical exercise, optimization of eating habits and psychological care contribute to a reduction in the complication rate and a shortening of the duration of hospitalization. In older patients a comprehensive geriatric assessment improves the success of the treatment. Perioperatively, interdisciplinary care of the patient is required, whereby enhanced recovery after surgery (ERAS) programs, in particular an individually adapted volume therapy and risk-based planning of the surgical procedure, have a significant influence on the outcome. Posthospital care is also initiated through postoperative management in order to ensure continued outpatient care and surgical success.","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"95-101"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061260","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}

引用次数: 0

[The multimorbid patient in visceral surgery].

Chirurgie (Heidelberg, Germany) Pub Date : 2025-02-01 Epub Date: 2025-01-31 DOI: 10.1007/s00104-024-02239-y

Christiane J Bruns, Utz Settmacher

引用次数: 0

[Abdominal organ transplantation in multimorbid patients]. [腹部器官移植在多病患者中的应用]。

Chirurgie (Heidelberg, Germany) Pub Date : 2025-02-01 Epub Date: 2024-12-06 DOI: 10.1007/s00104-024-02201-y

Astrid Bauschke, Aladdin Ali-Deeb, Felix Dondorf, Falk Rauchfuss, Oliver Rohland, Utz Settmacher

引用次数: 0

[The multimorbid patient-Risk stratification and indications in pancreatic surgery]. 胰腺手术的多病患者风险分层和适应症。

Chirurgie (Heidelberg, Germany) Pub Date : 2025-02-01 Epub Date: 2025-01-06 DOI: 10.1007/s00104-024-02223-6

Islam Labib, Jürgen Weitz, Sebastian Hempel

{"title":"[The multimorbid patient-Risk stratification and indications in pancreatic surgery].","authors":"Islam Labib, Jürgen Weitz, Sebastian Hempel","doi":"10.1007/s00104-024-02223-6","DOIUrl":"10.1007/s00104-024-02223-6","url":null,"abstract":"Background: Pancreatic surgery is still associated with significant morbidity. In a simultaneously increasingly ageing population with elevated morbidity, the risk stratification and indications for surgery are of particular importance.Objective: Assessment of the impact of multimorbidity of patients on the postoperative outcome after pancreatic surgery.Material and methods: Evaluation and summary of the available literature.Results: The postoperative morbidity after pancreatic surgery remains high. Relevant comorbidities, such as liver cirrhosis, cardiac and pulmonary diseases and advanced renal insufficiency enormously increase the risk of perioperative morbidity and mortality; however, in high-volume centers with appropriate expertise in pancreatic surgery the mortality is below 5%.Conclusion: Pancreatic surgery with severe comorbidity can be safely performed in centers with proven expertise. Nevertheless, a careful interpretation of the indications and good patient selection are essential for the postoperative outcome.","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"108-112"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933829","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}

引用次数: 0

[Multimorbid patients in endocrine surgery].

Chirurgie (Heidelberg, Germany) Pub Date : 2025-02-01 Epub Date: 2025-01-27 DOI: 10.1007/s00104-024-02224-5

Kerstin Lorenz, Ariane Braun, Stephan Eisenmann, Malik Elwerr, Rick Schneider

引用次数: 0

[Plastic surgical treatment of neurofibromatosis type 1].

Chirurgie (Heidelberg, Germany) Pub Date : 2025-01-28 DOI: 10.1007/s00104-024-02232-5

Gregor Längle, Andreas Gohritz, Clemens Gstöttner, Leopold Harnoncourt, Hannes Platzgummer, Amedeo A Azizi, Oskar Aszmann

{"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":"https://doi.org/10.1007/s00104-024-02232-5","url":null,"abstract":"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.","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061263","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}

引用次数: 0

[Conversion therapies for initially unresectable hepatocellular carcinoma]. [最初不可切除的肝细胞癌的转化治疗]。

Chirurgie (Heidelberg, Germany) Pub Date : 2025-01-01 Epub Date: 2024-12-02 DOI: 10.1007/s00104-024-02207-6

J Fritsch, M Ardelt, U Settmacher

引用次数: 0

[Cost comparison of conservative vs. surgical treatment of chronic lymphedema]. [慢性淋巴水肿保守治疗与手术治疗的成本比较]。

Chirurgie (Heidelberg, Germany) Pub Date : 2025-01-01 Epub Date: 2024-06-28 DOI: 10.1007/s00104-024-02123-9

Rima Nuwayhid, Stefan Langer, Nikolaus von Dercks

{"title":"[Cost comparison of conservative vs. surgical treatment of chronic lymphedema].","authors":"Rima Nuwayhid, Stefan Langer, Nikolaus von Dercks","doi":"10.1007/s00104-024-02123-9","DOIUrl":"10.1007/s00104-024-02123-9","url":null,"abstract":"Background: Lymphedema is primarily treated conservatively using complex physical decongestion treatment (CDT). Lymphovenous anastomosis (LVA), vascularized lymph node transplantation (VLNT) and liposuction are available as surgical treatment methods; however, reimbursement in the diagnosis-related groups (DRG) system is sometimes inadequate or only possible following an individual application. The costs of these relatively new surgical procedures have not yet been set in relation to those of CDT.Method: The costs of conservative treatment were determined in accordance with the guidelines. The costs for LVA, VLNT and liposuction of the upper and lower extremities were estimated on the basis of the DRG reimbursement per case and the expected reduction in conservative measures according to current knowledge. The annual treatment costs were then compared.Results: The annual treatment costs of LVA and VLNT are already lower than conservative treatment alone in the second postoperative year. Liposuction reaches this point in the 6th (upper extremity) or 47th postoperative year (lower extremity).Conclusion: The evidence for the positive effects of lymphatic surgery is still limited; however, it is recognizable that the curative surgical approach can significantly reduce the treatment costs and improve the quality of life of lymphedema patients; however, there is a lack of adequate reflection of the surgical effort in the reimbursement.","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"41-47"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473197","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}

引用次数: 0

[New digital assistive systems: potential in visceral medicine]. [新的数字辅助系统：内脏医学的潜力]。

Chirurgie (Heidelberg, Germany) Pub Date : 2025-01-01 Epub Date: 2025-01-13 DOI: 10.1007/s00104-024-02220-9

Dirk Weyhe

引用次数: 0