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[Colorectal surgery in multimorbid patients].

Chirurgie (Heidelb)

January 2025

Klinik für Allgemein- und Viszeralchirurgie, SRH Zentralklinikum Suhl, Albert-Schweitzer-Straße 2, 98527, Suhl, Deutschland.

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.

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Objectives: Many individuals with dementia with Lewy bodies (DLB) die of disease-related complications, but predicting the end of life can be challenging. We identified a phenotype associated with approaching end of life.

Methods: We present 4 exemplar cases where individuals with DLB experienced refractory psychosis before death.

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Background: Despite guideline recommendations, few institutions have implemented clinical pathways that incorporate frailty into routine decision-making for patients undergoing radical cystectomy (RC). This paper presents an integrated clinical pathway designed to address the needs of frail patients undergoing RC. The purpose of the study is to determine whether a multifaceted prevention programme that tailors interventions to the syndromic components of frailty can improve postoperative morbidity and recovery time for patients.

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Concealed penis (CP), also known as hidden or buried penis, is an external genital deformity in which a normal-sized penis is covered by skin, subcutaneous tissue or fat tissue in the prepubic area, leading to abnormal exposure. This condition has significant morbidity and a negative effect on certain aspects of the patient's quality of life, including but not limited to hygiene, micturition, self-image and sexual function. Current classification systems for CP are heterogeneous, but most of these further classify CP based on their division into congenital concealed penis (CCP) and adult-acquired buried penis (AABP).

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Background: Heart Failure (HF) quality of care (QoC) is associated with clinical outcomes. Therefore, we investigated differences in HF QoC across worldwide regions (with differing national income) and the association of quality indicators with outcomes.

Methods: We examined the quality of care (QoC) in acute heart failure (HF) patients across different regions using quality indicators (QIs) from the European Society of Cardiology (ESC) and the American Heart Association (AHA) to evaluate QoC.

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