PubMed | University of Liverpool, Sint Lucas Andreas Ziekenhuis, Harvard University, University of Chicago and 7 more.
Type: Journal Article | Journal: Obesity surgery | Year: 2015
The refurbished International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) website ( www.ifso.com ) showcases a wealth of high-quality information for bariatric surgery professionals and patients. The website provides free online access to the organisational structure of IFSO and useful information on IFSO-endorsed congresses, symposia and courses. Online access to the journal, Obesity Surgery, and the IFSO Newsletter can also be obtained via the IFSO website. There is also easy-to-understand information on the topics of obesity and the various bariatric/metabolic surgeries for our patients.
Jackisch C.,Sana Klinikum Offenbach GmbH |
Kim S.-B.,University of Ulsan |
Semiglazov V.,NN Petrov Research Institute of Oncology |
Melichar B.,Palacky` University Medical School and Teaching Hospital |
And 7 more authors.
Annals of Oncology | Year: 2015
HannaH revealed consistent overall safety profiles between fixed-dose subcutaneous (s.c.) and weight-based intravenous (i.v.) trastuzumab (median follow-up 20 months). Event-free survival rates were balanced between i.v. and s.c. There was no association between toxicity and exposure or body weight. Similar pathologic complete response rates were observed in higher weight patients in i.v. and s.c. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
May A.,Sana Klinikum Offenbach GmbH
Internist | Year: 2016
The esophagus is one of the areas of the gastrointestinal tract, for which therapeutic concepts have changed the most over the last two decades. The most decisive advance is the development of endoscopic resection techniques for early esophageal carcinomas. These methods provide excellent short- and long-term results combined with very low morbidity and negligible mortality rates in comparison with surgical esophagectomy, especially in case of mucosal Barrett’s adenocarcinoma. In addition, the endoscopic myotomy techniques in Zenker’s diverticulum and spastic achalasia are new, attractive endoscopic treatment modalities. © 2016, Springer-Verlag Berlin Heidelberg.
de Groot K.,Sana Klinikum Offenbach GmbH
Nephrologe | Year: 2016
Scleroderma renal crisis (SRC) remains the most feared renal complication in patients with systemic sclerosis, presenting clinically as thrombotic microangiopathy with reduced kidney and patient survival. Rapidly progressive dermal fibrosis, joint contractures, positive detection of anti-RNA polymerase III autoantibodies, antecedent high-dose glucocorticoid medication as well as reduced renal blood flow were identified as risk factors for SRC. Prompt recognition and initiation of treatment with angiotensin-converting enzyme (ACE) inhibitors and supportive renal replacement therapy provides the best chance for a favorable outcome. Nevertheless, survival after SRC is worse than in patients with systemic sclerosis without SRC and also poorer with all forms of renal replacement compared to patients with other causes of end-stage renal disease. A variety of novel therapeutic targets were recently discovered and remain to be evaluated concerning their benefits for treatment of SRC. © 2016, Springer-Verlag Berlin Heidelberg.
Pauthner M.,Sana Klinikum Offenbach GmbH |
Lorenz D.,Sana Klinikum Offenbach GmbH |
Wedemeyer J.,Klinikum Region Hanover GmbH
Gastroenterologe | Year: 2014
Background. Leaks can occur at any type of gastrointestinal anastomosis. Treatment strategies have changed over the last years. Endoscopic therapy has increasingly gained acceptance and has replaced surgical revision in various indications. However, there are still many indications for a surgical approach. The type and location of the anastomosis are important in this context. Objectives. In this review article we report on the various types of anastomotic leaks from the esophagus to the rectum. We report the diagnostics and therapeutic approach depending on the location. The capabilities of the relevant endoscopic methods as well as their limitations will be discussed. Results and conclusions. This article clearly shows that only an interdisciplinary approach can achieve an optimal medical treatment of this dangerous complication. Therefore, it is important to know the various treatment options with their specific advantages and disadvantages. This article supports the interdisciplinary approach to anastomotic leaks. © 2014 Springer-Verlag.
PubMed | University of Leipzig and Sana Klinikum Offenbach GmbH
Type: | Journal: Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen | Year: 2017
Minimally invasive resections are increasingly employed in oncologic surgery for esophageal carcinoma. The new German S3 guideline states that esophagectomy, as well as reconstruction of the esophagus, can be performed minimally invasively or in combination with open techniques (hybrid). However, the current value of different techniques - ranging from complete minimally invasive esophagectomy over hybrid to robotic surgery - remains unregarded.This review provides acritical comparison of these techniques based on current evidence. Minimally invasive procedures of oncologic esophageal resection are safe in experienced hands and show numerous advantages with regard to postoperative reconvalescence. Laparoscopic gastrolysis with intra-abdominal lymphadenectomy and muscle sparing as well as anterolateral mini-thoracotomy (also via VATS as single-port technique) as a hybrid method also result in arelevant reduction of postoperative mortality and offer the possibility of extended mediastinal lymphadenectomy, which requires a high level of expertise when performed thoracoscopically. At present, robotic esophagectomy is applied in only afew clinics in Germany. Alack of evidence based on studies for esophageal surgery, as well as high acquisition and operating costs of the robotic system, have to be taken into account.
PubMed | Sana Klinikum Offenbach GmbH
Type: Review | Journal: Gastrointestinal endoscopy clinics of North America | Year: 2016
Since the introduction of double-balloon enteroscopy 15 years ago, flexible enteroscopy has become an established method in the diagnostic and therapeutic work-up of small bowel disorders. With appropriate patient selection, diagnostic and therapeutic yields of 70% to 85% can be expected. The complication rates with diagnostic and therapeutic DBE are estimated at approximately 1% and 3% to 4%, respectively. Appropriate patient selection and device selection, as well as skill, are the key issues for successful enteroscopy. However, technical developments and improvements mean that carrying out enteroscopy is likely to become easier.
PubMed | Sana Klinikum Offenbach GmbH
Type: Journal Article | Journal: Der Internist | Year: 2016
The esophagus is one of the areas of the gastrointestinal tract, for which therapeutic concepts have changed the most over the last two decades. The most decisive advance is the development of endoscopic resection techniques for early esophageal carcinomas. These methods provide excellent short- and long-term results combined with very low morbidity and negligible mortality rates in comparison with surgical esophagectomy, especially in case of mucosal Barretts adenocarcinoma. In addition, the endoscopic myotomy techniques in Zenkers diverticulum and spastic achalasia are new, attractive endoscopic treatment modalities.
PubMed | University of Leipzig and Sana Klinikum Offenbach GmbH
Type: | Journal: Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen | Year: 2016
The incidence of esophageal carcinoma has increased in recent years in Germany. The aim of this article is a discussion of the economic aspects of oncological esophageal surgery within the German diagnosis-related groups (DRG) system focusing on the association between minimum caseload requirements and outcome quality as well as costs. The margins for the DRG classification G03A are low and quickly exhausted if complications determine the postoperative course. Acurrent study using nationwide German hospital discharge data proved asignificant difference in hospital mortality between clinics with and without achieving the minimum caseload requirements for esophagectomy. Data from the USA clearly showed that besides patient-relevant parameters, the caseload of a surgeon is relevant for the cost of treatment. Such cost-related analyses do not exist in Germany at present. Scientific validation of reliable minimum caseload numbers for oncological esophagectomy is desirable in the future.
PubMed | Sana Klinikum Offenbach GmbH and Asklepios Childrens Hospital
Type: Journal Article | Journal: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery | Year: 2016
After the introduction of folate supplementation, the number of open spinal dysraphism was successfully reduced over time. In 2007, the department for pediatric neurosurgery was established in the childrens hospital. Since then, newborns with myelomeningocele (MMC), the most common form of open neural tube defects (NTD), are treated here. The aim of this study is to present the concepts applied to and experiences resulting from treatment of MMC.Records of all newborns with MMC treated surgically during the period January 2007 to August 2015 in our institution were analyzed. Children, who were previously operated in utero were excluded. The type of neural tube defect, its location, associated comorbidities, and ambulation were recorded.Forty-eight children (25 males, 23 females) with spinal dysraphism were included in the analysis. In nearly 90% of the cases, the repair of the MMC was done on the day of delivery. The follow-up period ranges from 9weeks to 8 9/12years (loss of follow-up in 2 cases). In 19%, the defect remained undetected during gestation and in one case, carbamazepine was taken despite pregnancy. In 36 children (75%), we found a Chiari malformation type II (CMII) associated with myelomeningocele. 85.4% suffered from hydrocephalus and implantation of a shunt was necessary. In cases of bladder impairment, an intermittent catheterization was the most common management (83.3%); no bladder augmentation was required. Twelve children required orthopedic surgery. Twenty-three of 33 patients (70%) are ambulatory w/wo orthoses and devices. The 13 children who are younger than 2years were considered separately to assess the motor activity safely.Our data show that neural tube defects to this day can remain undetected despite medical care during pregnancy. The most common associated diseases with MMC are Chiari II malformations and hydrocephalus. In the seven cases of simultaneous repair of MMC with shunt implantation, no additional complications were encountered. An interdisciplinary approach was allowed in a high percentage independence and social continence.