Alina S Ritter, Jelte Poppinga, Kira C Steinkraus, Anna Nießen, Thilo Hackert
{"title":"[Postoperative chyle leakage after abdominal surgery-Diagnostic and therapeutic strategies].","authors":"Alina S Ritter, Jelte Poppinga, Kira C Steinkraus, Anna Nießen, Thilo Hackert","doi":"10.1007/s00104-025-02287-y","DOIUrl":"10.1007/s00104-025-02287-y","url":null,"abstract":"<p><p>A postoperative chyle leakage (CL) is caused by intraoperative damage to the main lymphatic vessels or their tributaries. It is characterized by the secretion of a triglyceride-rich fluid, which classically has a characteristic milky appearance in a percutaneous drain. In visceral surgery CLs mostly occur after pancreatic and esophageal surgery but rarely occur after colorectal, liver or gastric surgery. Treatment often consists of a diet rich in medium chain triglycerides (MCT) to reduce the lymphatic flow, while ensuring a sufficient nutrient supply. If the CL does not cease, total parenteral nutrition is usually carried out. A reoperation, lymphography sometimes with percutaneous intervention or short-term irradiation for CL are rarely necessary. A CL frequently results in a prolonged hospital stay and can be accompanied by other complications but is rarely associated with a poorer prognosis.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"698-706"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059968","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":"[Reply to the letter to the editor on long-term results of a pilot study on the two-stage procedure with primary excision and Limberg flap in the interval for treatment of sacrococcygeal pilonidal sinus disease].","authors":"Michael Ardelt, U Settmacher","doi":"10.1007/s00104-025-02327-7","DOIUrl":"10.1007/s00104-025-02327-7","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"675-676"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478046","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}
Sandra Groß, Martin Mucke, Marco Rudolph, Victoria Arango Galvis
{"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":"10.1007/s00104-025-02274-3","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"677-680"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","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":"[Working conditions in surgery and their impact : Results of a national survey].","authors":"J Gumpp, F Fritze-Büttner, B Blank, S Axt","doi":"10.1007/s00104-024-02181-z","DOIUrl":"10.1007/s00104-024-02181-z","url":null,"abstract":"<p><strong>Background: </strong>In surgical disciplines poor working conditions and a high level of dissatisfaction among surgeons in the various disciplines have been reported. The psychological consequences of these conditions on the surgeons themselves and the effects on their families have so far been inadequately considered.</p><p><strong>Objective: </strong>The objective of this national survey of the Professional Association of German Surgery (Berufsverband der Deutschen Chirurgie e. V.) was to determine the current status of working conditions in surgical departments of German hospitals and to demonstrate their psychological and familial effects.</p><p><strong>Material and methods: </strong>In the period January-February 2024 a questionnaire with 26 questions focusing on psychological stress, work-related partnership and family problems as well as addictive behavior was sent to all members of the Berufsverband der Deutschen Chirurgie e. V. and to all German surgical societies.</p><p><strong>Results: </strong>A total of 2221 questionnaires could be analyzed. Among the survey participants, bureaucracy (84.4%) and inadequate compensation for overtime (68.1%) were seen as the main stress factors. Alcohol (20.3%), nicotine (8.9%) and medication (8.3%) were cited as ways of managing the workload. Of the surgeons 60% reported a negative impact on their relationship with their partner and 40% on their relationship with their children.</p><p><strong>Discussion: </strong>The surgeons reported poor working conditions. These have a massive impact on the mental health of surgeons and on their family relationships. Consequently, many surgeons consider leaving the surgical profession. To improve this situation and to make the surgical profession attractive again, a drastic rethinking is needed.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"657-666"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12307500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402188","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":"[Sports injuries and overuse syndromes of the groin].","authors":"Kai Fehske","doi":"10.1007/s00104-025-02315-x","DOIUrl":"10.1007/s00104-025-02315-x","url":null,"abstract":"<p><p>Injuries and overuse complaints of the groin are a common issue in competitive and professional sports. Clinically, they typically present as pulling to stabbing pains that radiate to the inner thigh and the outer side of the scrotum. Sports that involve rapid changes of direction, sudden accelerations, and strong rotational movements of the torso are at particular risk for the development of groin complaints. Diagnosis is based on clinical, sonographic, and magnetic resonance imaging (MRI) examinations, and can be quite challenging, requiring an interdisciplinary approach. An inguinal hernia should primarily be ruled out. Other causes of groin pain may include osteitis pubis, hip joint impingement, muscle injuries in the groin, thigh, or abdominal regions, and nerve compression syndromes. In most cases, conservative therapy is indicated and successful in the long term. For persistent complaints, the athlete's groin can be treated through stabilization of the posterior wall of the inguinal canal and local neurolysis.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"650-656"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251119","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}
U A Dietz, M Heimke, R Frey, D Pohl, A Widder, M Meir
{"title":"[Occult hernias, classification of inguinal lipomas and chronic postoperative groin pain].","authors":"U A Dietz, M Heimke, R Frey, D Pohl, A Widder, M Meir","doi":"10.1007/s00104-025-02301-3","DOIUrl":"10.1007/s00104-025-02301-3","url":null,"abstract":"<p><p>Inguinal hernias that are asymptomatic and cannot be easily detected clinically are called occult hernias. The question arises whether these hernias, when incidentally detected intraoperatively during the repair of a symptomatic contralateral inguinal hernia, should be repaired simultaneously. Some of these hernias become symptomatic over time and require surgery (metachronous inguinal hernia). Metachronous hernias must be distinguished from overlooked lipomas of the inguinal canal (cord lipomas) missed at the index operation. Until now, no classification of cord lipomas has been available. This article is the first to present such a classification. Lastly, chronic postoperative inguinal pain (CPIP) is a key reason for reluctance in the occasional treatment of occult hernias. The following text provides an overview and decision-making aid for the management of occult inguinal hernias.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"619-625"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303818","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}