Assessing the practice of total neoadjuvant therapy for rectal cancer: an online survey among radiation oncology departments in Germany and German-speaking regions of Austria and Switzerland.

Total neoadjuvant therapy (TNT) of rectal cancer improves rates of pathological complete remission and progression-free survival. With improved clinical response rates, interest grew in a non-operative approach/watch and wait (WaW) for this disease. In 2020, the working groups of ACO/AIO/ARO published a consensus statement on the use of TNT, including a non-operative approach.

[Conversion to outpatient treatment beyond the hybrid DRG-A view abroad].

Outpatient visceral surgery is still in its infancy in Germany. While hernia repair that can be performed on an outpatient basis is still being discussed in this country, larger visceral surgery procedures such as thyroidectomy, fundoplication, bariatric procedures and colorectal resection are increasingly being performed abroad on an outpatient basis or in a short inpatient setting (< 24 h). The USA is the pioneer of outpatient care.

Parameters predicting postoperative pain and quality of life after hemorrhoidectomy: follow-up results from a prospective multicenter randomized trial.

Purpose: Pain and reduced quality of life (QoL) are major subjects of interest after surgery for hemorrhoids. The aim of this study was to find predictive parameters for postoperative pain and QoL after hemorrhoidectomy.

Methods: This is a follow-up analysis of data derived from a multicenter randomized controlled trial including 770 patients, which examines the usefulness of tamponade after hemorrhoidectomy.

The Postoperative Utilization of Intensive Care Beds After Visceral Surgery Procedures.

Background: The necessary number of intensive care beds has been under debate in recent years. This study aims to provide a descriptive analysis of postoperative intensive care for visceral surgery patients based on three indicator procedures, with particular attention to the frequency and duration of intensive care among these patients, trends in the occupancy of intensive care units, and the course during the COVID-19 pandemic.

Methods: Routine data from inpatient cases of the Helios group (24 888 cases from 71 acute care hospitals) from 01.

Adherence to fast track measures in colorectal surgery-a survey among German and Austrian surgeons.

Purpose: The effectiveness of modern perioperative treatment concepts has been demonstrated in several studies and meta-analyses. Despite good evidence, limited implementation of the fast track (FT) concept is still a widespread concern. To assess the status quo in Austrian and German hospitals, a survey on the implementation of FT measures was conducted among members of the German Society of General and Visceralsurgery (DGAV), the German Society of Coloproctology (DGK) and the Austrian Society of Surgery (OEGCH) to analyze where there is potential for improvement.

German guideline diverticular disease/diverticulitis: Part II: Conservative, interventional and surgical management.

Diverticulosis and diverticular disease are ranked among the most common gastroenterological diseases and conditions. While for many years diverticulitis was found to be mainly an event occurring in the elder population, more recent work in epidemiology demonstrates increasing frequency in younger subjects. In addition, there is a noticeable trend towards more complicated disease.

Risk Factor Identification for Delayed Gastric Emptying after Distal Pancreatectomy-An Evaluation of 1688 Patients Based on the German StuDoQ|Pancreas Registry.

Delayed gastric emptying (DGE) ranks as one of the most frequent complications in pancreatic surgery. It leads to increased costs for healthcare systems, lengthened hospital stays and reduced quality of life. Data about DGE after distal pancreatectomy (DP) are scarce.

[Dissemination of fast-track concepts in Germany].

Background: Fast-track concepts have fundamentally changed the perioperative care of patients in the last 30 years. Sufficient evidence is available for these concepts.

Objective: The aim of this article is to evaluate the dissemination of fast-track concepts in Germany based on routine data.

[The Usefulness of ERAS Concepts for Colorectal Resections - an Economic Analysis under DRG Conditions].

Background: ERAS (Enhanced Recovery After Surgery) describes a multimodal, interdisciplinary and interprofessional treatment concept that optimizes the postoperative convalescence of the patient through the use of evidence-based measures.

Goal Of The Work: The aim of this article is to examine the economic feasibility of the concept in the German DRG system.

Material And Methods: Since August 2019, patients have been treated in our clinic according to the later certified ERAS concept.

The usefulness of Enhanced Recovery After Surgery concepts for colorectal resections: an economic analysis under DRG conditions.

Purpose: ERAS® (Enhanced Recovery After Surgery) describes a multimodal, interdisciplinary, and interprofessional treatment concept that optimizes the postoperative convalescence of the patient through the use of evidence-based measures. Goal of the work. The aim of this article is to examine the economic feasibility of the ERAS® concept in the German DRG (diagnosis-related groups) system.

Tamponade dressing versus no dressing after haemorrhoidectomy: multicentre, randomized clinical trial.

Background: Symptomatic haemorrhoids are a common anorectal disorder. The aim of the study was to investigate whether the omission of tamponade dressings after haemorrhoidectomy reduces postoperative pain without increasing the risk of severe bleeding.

Method: This was an open-label, randomized clinical trial conducted at 14 German hospitals.

Impact of pylorus preservation on delayed gastric emptying after pancreaticoduodenectomy-analysis of 5,000 patients based on the German StuDoQ|Pancreas-Registry.

Background: Delayed gastric emptying (DGE) is one of the most common complications after pancreatic head resection. It leads to increased length of hospital stay, high costs for healthcare systems and reduced quality of life. The primary aim of the study was to assess the impact of pylorus preservation, respectively resection on the occurrence of DGE in patients undergoing pancreaticoduodenectomy (PD).

Cholecystectomies in the COVID-19 Pandemic During and After the First Lockdown in Germany: an Analysis of 8561 Patients.

Purpose: The COVID-19 pandemic has led to global changes in healthcare systems. The purpose of this study was to investigate the effects on surgical care of patients.

Methods: We performed a retrospective analysis of routine data from the largest hospital group in Germany (68 acute hospitals).

[The "Big Five" of Invasiveness - the Usefulness of Drains, Probes and Catheters in Colorectal Surgery].

The perioperative management of colorectal resections is often dominated by traditional procedures and a strong focus on safety. Evidence-based measures such as those established in Fast Track or ERAS programs, are rarely applied in a standardised manner. As part of elective colorectal surgery, many patients therefore continue to routinely receive central venous access, peridural catheters, urinary catheters, drains and/or gastric tubes ("Big Five" of invasiveness).

[Has the COVID19 Pandemic Changed the Emergency Situation in German Clinics? A Nationwide Analysis of Routine Data from 73 Acute Hospitals].

COVID-19 has led to profound changes in the world as we have known it. Due to the sharp increase in intensive care, COVID patients, elective admissions and interventions have been postponed. But emergencies such as myocardial infarction have also decreased.

[Perioperative Management - Tasks and Significance of Specially Trained Nursing Staff].

Modern concepts of perioperative treatment place great value on the active role of the patient. In order to make this possible, intensive patient support is necessary. The position of the ERAS nurse has developed from this necessity.

Utilization of in- and outpatient hospital care in Germany during the Covid-19 pandemic insights from the German-wide Helios hospital network.

Background: During the early phase of the Covid-19 pandemic, reductions of hospital admissions with a focus on emergencies have been observed for several medical and surgical conditions, while trend data during later stages of the pandemic are scarce. Consequently, this study aims to provide up-to-date hospitalization trends for several conditions including cardiovascular, psychiatry, oncology and surgery cases in both the in- and outpatient setting.

Methods And Findings: Using claims data of 86 Helios hospitals in Germany, consecutive cases with an in- or outpatient hospital admission between March 13, 2020 (the begin of the "protection" stage of the German pandemic plan) and December 10, 2020 (end of study period) were analyzed and compared to a corresponding period covering the same weeks in 2019.

Training strategies for a sustainable medical care: a survey among assistant and chief physicians in a tertiary care hospital in Germany.

Purpose: As an essential part of the health care system, the requirements for specialist training are subject to a continuous process of change. The aim of the present study was to evaluate the current specialist training situation of all departments in a tertiary care hospital in Germany. Differences between assistant and chief physicians should be pointed out.

The Indications for and Timing of Surgery for Diverticular Disease.

Background: Diverticular disease is one of the more common abdominal disorders. In 2016, approximately 130 000 patients received inpatient treatment for diverticular disease in Germany. The disease has a number of subtypes, each of which has an appropriate treatment.

Impact of staged surgery on quality of life in refractory ulcerative colitis.

Introduction: Coloproctomucosectomy (CPM) with ileopouchanal anastomosis (IPAA), as the procedure of choice for surgical management of ulcerative colitis (UC), is commonly performed either as a 2- or 3-staged procedure. For patients with considerable immunosuppression, reduced nutritional or general health status, and as part of emergency treatment, a 3-staged (3S) procedure is recommended by guidelines to minimize perioperative complication rates compared to 2-staged (2S) procedure. However, the necessity of additional hospitalization and surgery is suspect to affect quality of life (QoL).