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European Surgery: ACA: Acta Chirurgica Austriaca

Sonja Kappel-Latif, Johannes Zacherl, Michael Hejna, Maria Westerhoff, Dietmar Tamandl, Ahmed Ba-Ssalamah, Martina Mittlböck, Brigitte Wolf, Friedrich Wrba, Irene Kührer, Ursula Pluschnig, Sebastian F Schoppmann, Reinhold Függer, Ronald Zwrtek, Karl Glaser, Josef Karner, Friedrich Längle, Etienne Wenzl, Rudolf Roka, Dietmar Öfner, Jörg Tschmelitsch, Michael Hold, Felix Keil, Michael Gnant, Daniela Kandioler
Background: In operable esophageal cancer patients, neoadjuvant therapy benefits only those who respond to the treatment. The • Pancho trial represents the first prospective randomized trial evaluating the relevance of the mark53 status for predicting the effect of two different neoadjuvant chemotherapies. Method: Biomarker analysis was conducted using the mark53 analysis. Calculation of patient number needed was based on a 60% rate of marker positivity, deduced from the results of a phase II pilot study...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
Margot Fodor, Florian Primavesi, Dagmar Morell-Hofert, Matthias Haselbacher, Eva Braunwarth, Benno Cardini, Eva Gassner, Dietmar Öfner, Stefan Stättner
Background: Non-operative management (NOM) of blunt hepatic and splenic injuries has become popular in haemodynamically stable adult patients, despite uncertainty about efficacy, patient selection, and details of management. Up-to-date strategies and practical recommendations are presented. Methods: A selective literature search was conducted in PubMed and the Cochrane Library (1989-2016). Results: No randomized clinical trial was found. Non-randomized controlled trials and large retrospective and prospective series dominate...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
M Bolliger, J-A Kroehnert, F Molineus, D Kandioler, M Schindl, P Riss
Background: The standardized Clavien-Dindo classification of surgical complications is applied as a simple and widely used tool to assess and report postoperative complications in general surgery. However, most documentation uses this classification to report surgery-related morbidity and mortality in a single field of surgery or even particular intervention. The aim of the present study was to present experiences with the Clavien-Dindo classification when applied to all patients on the general surgery ward of a tertiary referral care center...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
Matthias Paireder, Reza Asari, Ivan Kristo, Erwin Rieder, Johannes Zacherl, Barbara Kabon, Edith Fleischmann, Sebastian F Schoppmann
Background: The minimally invasive esophagectomy (MIE) for esophageal cancer was introduced assuming a reduction of morbidity and operation time. After implementation of MIE at our institution, a randomized controlled trial was designed. Methods: This is a prospective randomized controlled study comparing open (OE) and laparoscopic gastric tube (MIE) formation in Ivor Lewis esophagectomy. Primary endpoints were morbidity and 30-day mortality. Secondary endpoints included the duration of intensive care unit stay, length of hospital stay, operative time as well as relapse-free and overall survival...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
Sven Jonas, Felix Krenzien, Georgi Atanasov, Hans-Michael Hau, Matthias Gawlitza, Michael Moche, Georg Wiltberger, Johann Pratschke, Moritz Schmelzle
Background: A right trisectionectomy with portal vein resection represents the conventional approach for hilar cholangiocarcinoma. Here, we present a technical modification of hilar en bloc resection in order to increase the remnant volume by partially preserving liver segment 4. Methods: The caudal parenchymal dissection line starts centrally between the left lateral and left medial segments. Cranially, the resection line switches to the right towards Cantlie's line and turns again upwards perpendicularly...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
Philipp Riss, Angelika Geroldinger, Andreas Selberherr, Lindsay Brammen, Julian Heidtmann, Christian Scheuba
Background: In primary hyperparathyroidism (pHPT), quick intraoperative parathyroid hormone monitoring (IOPTH) is performed to predict complete excision of hyperfunctioning tissue and therefore cure. In recent years, efforts have been made to make this prediction more accurate and to shorten the duration of the test, respectively, and therefore reduce waiting and total operating time. The aim of this study was to evaluate the practicability and safety of a time-reduced criterion (decline ≥ 35% after 5 min) in a large cohort of patients...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
D Pereyra, P Starlinger
Background: While liver surgery has become a safe and feasible operation technique, the incidence of postoperative liver dysfunction still remains a central problem. Approximately 10% of patients undergoing liver resection were shown to develop liver dysfunction, which is associated with an increased risk of morbidity and mortality. Yet, to date there is no effective treatment option for postoperative liver dysfunction available. The development of postoperative liver dysfunction was linked to a disruption in the liver's potential to regenerate...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
Margot Fodor, Florian Primavesi, Eva Braunwarth, Benno Cardini, Thomas Resch, Reto Bale, Daniel Putzer, Benjamin Henninger, Rupert Oberhuber, Manuel Maglione, Christian Margreiter, Stefan Schneeberger, Dietmar Öfner, Stefan Stättner
Background: Management of benign liver tumours (BLT) is still object of discussion. Uncertainty still exists about patient selection, details of management, indications for surgical intervention and potential surgery-related complications. The up-to-date strategies for management of the most common benign solid tumours are recapitulated in this article. In addition, recommendations concerning practical issues are presented. Methods: Available data from peer-reviewed publications associated with the major controversies concerning treatment strategies of solid BLT were selected through a PubMed literature search...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
D Putzer, P Schullian, E Braunwarth, M Fodor, F Primavesi, B Cardini, T Resch, R Oberhuber, M Maglione, C Margreiter, S Schneeberger, S Stättner, D Öfner-Velano, W Jaschke, R J Bale
Background: Percutaneous ablation techniques offer a vast armamentarium for local, minimally invasive treatment of liver tumors, nowadays representing an established therapeutic option, which is integrated in treatment algorithms, especially for non-resectable liver tumors. The results of ablative treatment compare very well to surgical treatment in liver lesions, and confirm that these techniques are a valuable option for bridging for transplantation. Different techniques have been established to perform tumor ablation, and the feasibility varies according to the procedure and technical skills of the operator, depending on the size and location of the liver lesion...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
Christoph Schwarz, Klaus Kaczirek, Martin Bodingbauer
Whereas liver resection for colorectal metastasis has become standard of care, hepatectomy in patients with non-colorectal metastases remains controversial, mainly due to a heterogeneous tumor biology and missing data from prospective trials. This review aims at giving an overview about the indications and limits of liver surgery in patients with an advanced disease of a non-colorectal malignancy. Even though prospective trials are largely missing, results from retrospective studies indicate a survival benefit for liver resection in selected patients...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
Eva Braunwarth, Stefan Stättner, Margot Fodor, Benno Cardini, Thomas Resch, Rupert Oberhuber, Daniel Putzer, Reto Bale, Manuel Maglione, Christian Margreiter, Stefan Schneeberger, Dietmar Öfner, Florian Primavesi
Background: Owing to remarkable improvements of surgical techniques and associated specialities, liver surgery has become the standard of care for hepatocellular carcinoma and cholangiocarcinoma. Although applied with much greater safety, hepatic resections for primary liver tumours remain challenging and need to be integrated in a complex multidisciplinary treatment approach. Methods: This literature review gives an update on the recent developments regarding basics of open and laparoscopic liver surgery and surgical strategies for primary liver tumours...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
Leonard M Quinn, Declan F J Dunne, Robert P Jones, Graeme J Poston, Hassan Z Malik, Stephen W Fenwick
Surgical resection remains the only proven curative treatment for peri-hilar cholangiocarcinoma. Despite recent advances in liver surgery techniques and perioperative care, resection for peri-hilar cholangiocarcinoma remains associated with significant morbidity and mortality. Considerable variation in the perioperative management of these patients exists. Optimal perioperative management has the potential to deliver improved outcomes. This article seeks to summarize the evidence underpinning best practice in the perioperative care of patients undergoing resection of peri-hilar cholangiocarcinoma...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
Lukas Gasteiger, Stephan Eschertzhuber, Werner Tiefenthaler
An increasing number of patients present for liver surgery. Given the complex pathophysiological changes in chronic liver disease (CLD), it is pivotal to understand the fundamentals of chronic and acute liver failure. This review will give an overview on related organ dysfunction as well as recommendations for perioperative management and treatment of liver failure-related symptoms.
2018: European Surgery: ACA: Acta Chirurgica Austriaca
Elisabeth Gschwandtner, Rudolf Seemann, Claudia Bures, Lejla Preldzic, Eduard Szucsik, Michael Hermann
Background: The purpose of this study is to provide guidance for medical experts regarding malpractice claims on permanent hypoparathyroidism by analyzing the number of parathyroid glands (PGs) identified during thyroidectomy and the clinical outcome. Methods: Parathyroid findings were documented in a standardized protocol for 357 patients undergoing thyroidectomy and treated by a single specialized surgeon. The resected thyroid was routinely dissected for accidentally removed PGs with consecutive autotransplantation and the pathological report also described unintentionally resected PGs...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
M Riegler, I Kristo, M Nikolic, E Rieder, S F Schoppmann
Background: Barrett's esophagus (BE) is the premalignant manifestation of gastroesophageal reflux disease (GERD). Radiofrequency ablation (RFA) with and without endoscopic resection (ER) is a novel treatment for BE. Methods: Here we present a single-center update of the recommendations of a recent (June 2015) interdisciplinary expert panel meeting on the management of BE with dysplasia as well as cancer-positive and cancer-negative BE. We conducted a PubMed search of studies published in 2016 and 2017 on the topic of BE and RFA...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
M Riegler, I Kristo, R Asari, E Rieder, S F Schoppmann
Introduction: Barrett's esophagus (BE) represents the premalignant morphology of gastroesophageal reflux disease (GERD). Evidence indicates a positive correlation between GERD vs. obesity and increased sugar consumption. Methods: Here we analyzed recently published data (2006-2017) on the role of dietary sugar intake for BE development (main focus year 2017). Results: Recent investigations found a positive association between obesity, hip waist ratio and dietary sugar intake and Barrett's esophagus...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
Georg P Györi, D Moritz Felsenreich, Gerd R Silberhumer, Thomas Soliman, Gabriela A Berlakovich
Background: It is current practice that patients with hepatocellular carcinoma (HCC) listed for liver transplantation should receive locoregional treatment if the suspected waiting time for transplantation is longer than 6 months, even in the absence of prospective randomized data. Aim of this study was the comparison of single versus multimodality locoregional treatment strategies on outcomes after liver transplantation. Methods: This is a retrospective analysis of 150 HCC patients listed for liver transplantation at our center between 2004 and 2011...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
Michael Weitzendorfer, Gernot Köhler, Stavros A Antoniou, Leo Pallwein-Prettner, Lisa Manzenreiter, Philipp Schredl, Klaus Emmanuel, Oliver Owen Koch
Background: The assessment of hiatal hernias (HH) is typically done with barium swallow X‑ray, upper endoscopy, and by high-resolution esophageal manometry (HRM). The aim of this study was to assess the clinical utility of these methods in terms of HH detection and their correlation to gastroesophageal reflux disease (GERD). Methods: A retrospective comparative analysis of patients with symptoms of GERD was carried out. The performance of endoscopy and HRM in diagnosing HH was assessed, taking barium swallow X‑ray as a reference...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
Marlena Brzozowa-Zasada, Adam Piecuch, Marek Michalski, Oliwia Segiet, Józef Kurek, Marzena Harabin-Słowińska, Romuald Wojnicz
Background: Increasing evidence has demonstrated that Notch signaling is deregulated in human hematological malignancies and solid tumors. This signaling has a protumorigenic effect but may also act as a tumor suppressor. How induction of a single pathway gives rise to the opposite effects in different cell types is still unknown. Methods: This review article includes available data from peer-reviewed publications associated with the role of Notch signaling during cancer pathogenesis...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
Christoph Schwarz, Jakob Mühlbacher, Georg A Böhmig, Marin Purtic, Eleonore Pablik, Lukas Unger, Ivan Kristo, Thomas Soliman, Gabriela A Berlakovich
BACKGROUND: Ultrasound is routinely performed at our transplant unit within the first 48 h of kidney transplantation (KTX). The objective of this study was to evaluate the association of ultrasound results and, in particular, elevated resistance indices (RIs) with the occurrence of surgical complications and allograft outcomes. METHODS: The study included all kidney allograft recipients undergoing transplantation at our center between January 2010 and December 2011 (N = 329)...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
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