Abstract:
BACKGROUND:The outcome volume relationship has been analysed for more than 30 years and debated ever since. For German hospitals minimum volume standards (MVS) have been introduced for some procedures in 2004. Hospitals have to report procedure volumes in their quality reports. This study analyses for the first time how constant hospitals comply with minimum volume standards over time. MATERIALS AND METHODS:Data used are the reported volumes, which hospitals published in their quality reports in 2006, 2008, and 2010. The case volumes of complex oesophageal and pancreatic interventions, total knee replacements, and liver, kidney and stem cell transplantations (KTX, LTX, STX) are analysed in a retrospective, longitudinal study design. RESULTS:More than 80 % of hospitals conducting LTX, KTX, and total knee replacements are complying with MVS constantly, in STX 57 % of hospitals comply, and with complex pancreatic and oesophageal interventions compliance is 44 and 28 %, respectively. Twenty-seven to 36 % of hospitals conducting the three last mentioned procedures vary in complying with the MVS over time. 3.5 % (total knee replacements) up to 26 % (pancreatic interventions) and 37 % (oesophageal interventions) of all hospitals constantly fail to comply with MVS. Hospitals constantly over the MVS treat more than 80 % of all patients, except in complex oesophageal interventions. Hospitals with varying compliance in oesophageal and pancreatic interventions are mainly hospitals with 100 to 599 beds. Only very few hospitals of these two procedure types stop conducting the interventions after failing to comply with MVS earlier, the other some 120 hospitals for each intervention type treat 2 cases on average per year. CONCLUSION:The MVS on KTX, LTX, STX, and total knee replacement are almost constantly complied with. A considerable number of hospitals conducting oesophageal and pancreatic interventions never or rarely meet the MVS without discontinuing this type of intervention. At least for hospitals that never comply with MVS on oesophageal and pancreatic interventions, requirements and possibilities for a regional patient transfer should be studied in depth.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
de Cruppé W,Geraedts Mdoi
10.1055/s-0034-1383371subject
Has Abstractpub_date
2016-08-01 00:00:00pages
425-32issue
4eissn
0044-409Xissn
1438-9592journal_volume
141pub_type
杂志文章abstract::The normalisation of head circumference and ventricular dilatation are aims of the therapy of hydrocephalus. Sonographic follow-up after ventriculo-peritoneal shunt demonstrates a changed ventricular morphology and inform about clinical relevant questions in regard of effectivity and complications of the shunt. The di...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::Medical responsibility and hospital management, competency for resident's training and decision making in therapy are better performed in a system of hierarchy than other kinds of organisation of a surgical department. If all the duties and responsibilities are concentrated to a head of the department, it is also nece...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::The importance of surgery in the aged is based on the increased life expectancy of the population. Besides the multimorbidity of geriatric people psychological and social aspects must be taken into consideration. In old age the danger of shock is increased therefore the indication for urgent surgery permits no delay. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::Nailing has become the major method of treating lower leg fractures: though there are still different opinions how to treat lower leg fractures localized between the proximal-middle and middle-distal third as well as in the second and fifth/sixth. Following our own experiences with 192 lower leg nailings in that spher...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::The growing clinical impact of radiofrequency ablation of liver lesions is reflected by a rapidly increasing number of published papers. Experimental work focuses on factors that reduce the variability of the ablation zone. The Pringle-maneuver plays a key role in this question from a surgeon's perspective. Large sing...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-2007-981198
更新日期:2007-08-01 00:00:00
abstract::In an effort to demonstrate and explain the peristalsis and intact pylorus-function of an oesophagus substituted by a transformed stomach-tube and despite total vagotomy, acute tests were undertaken on 14 dogs of mixed breed in the form of electromyographic examinations on the normal stomach, the stomach after vagotom...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::Diagnosing posttraumatic haemobilia is difficult since the symptoms are neither specific nor early or easy to detect. At present the mortality rate comes up to 20%. Clinical signs and diagnostic procedures are described in detail. Selective ligation of the liver arteries or partial resection of the involved lobes of t...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::Diabetic foot syndrome represents a challenge for every practicing physician. The multifactorial genesis requires a broad therapeutic approach. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::Background The relevance of ultrasound (US) in diagnosing acute appendicitis is controversial. The validity of US in comparison with other imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), is unclear, as is the difference between surgeon-performed ultrasound (SPUS) and radiolog...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0043-114414
更新日期:2017-08-01 00:00:00
abstract::Neuroendocrine tumors are rare and can be observed in different gastrointestinal organs. The diagnosis often is made by incidence like in carcinoids of the appendix vermiformis, or special clinical symptoms may develop due to tumor growth. 29 consecutive patients were evaluated prospectively during 30 months. In 21 of...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-2001-11721
更新日期:2001-01-01 00:00:00
abstract::With 44.9 % trauma is the main cause of death in men under 40 years. From September 3(rd) 1997 to June 30(th) 1998 174 patients with severe injuries or polytrauma were treated in our hospital. The mean ISS was 29 (18-75). 15 (8.75 %) patients died within the first 24 hours. The mean age was 34.5 (2-85) years. The mean...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2001-19658
更新日期:2001-12-01 00:00:00
abstract::This disease has not been fully clarified yet. In our opinion, surgery should only be performed in cases of stage IV because of ulcers, irreversible scar formation, metaplasia of the epithelium, endobrachyoesophagus, stenoses or malignant degeneration. 11 patients suffering from severe reflux oesophagitis (stage IV) u...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::The German Stomach Cancer TNM Study Group registered 1444 patients from 1982 to 1984 in a multicenter observational study to validate the tumor node metastasis stage groupings. The follow-up-rate in 1989 was 99.4%. Among others the pattern of lymph node metastases and the benefit of systematic lymphadenectomy (SLA) wa...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract:INTRODUCTION:The aim of the study was to evaluate the efficiency of the endovenous use of laser for treatment of varicose veins. In particular the influence of laser energy on the perivenous temperature, the postoperative clinical and duplex ultrasound course was taken into account. METHOD:The patients were divided in...
journal_title:Zentralblatt fur Chirurgie
pub_type: 临床试验,杂志文章
doi:10.1055/s-2006-921389
更新日期:2006-02-01 00:00:00
abstract::Case report. A 59 year old woman was thought to suffer from a neoplasm of the hypophysis. This "tumour" was simulated by a giant aneurysm of the infraorbital segment of the left carotid artery. For technical reasons the left carotid artery had not been demonstrated in the angiogram. For final clarification CT as well ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::In the present paper a technique is demonstrated wherein the closure of the pancreatic remnant following left pancreatectomy with absorbable staples was performed. The good results with minimal complications recommend this method. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::This case demonstrates the importance for surgeons to use the endoscope. A multimorbid patient in nearly dying condition, with a megacolon due to a functional sigmastenosis could be successfully treated by endoscopic intervention. After the patients recompensation, an early elective sigmaresection could be performed. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::Hydroactive wound dressings retain exsudate in the wound region or incorporate wound exsudate by gel formation. They create the local environment for moist wound healing which is experimentally and clinically characterized by accelerated reepithelialization, inflammatory reaction and angiogenesis as well as reduced wo...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1999-01-01 00:00:00
abstract::Background Physician shortage is particularly striking in surgical specialities. Umbrella organisations are making an effort to recruit medical students. Students' symposia during congresses seem to provide a promising approach to developing motivation and promoting interest. An exemplary students' symposium took plac...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-120450
更新日期:2017-12-01 00:00:00
abstract::The surgical approach to malignant hepatoma in cirrhotic liver has continued to be an unresolved problem. Early diagnosis, differentiated indication, and surgical techniques need further improvement, before adjuvant therapy can be discussed. All surgeons are called upon to verify experience of the past and to integrat...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1989-01-01 00:00:00
abstract::Arthroscopic treatment of glenohumeral instability has become more common over the last years. Compared with open reconstruction which still is the gold standard in the treatment of glenohumeral instability the arthroscopic techniques show several advantages but also disadvantages that must be proved for every single ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-2002-24251
更新日期:2002-03-01 00:00:00
abstract::54 patients suffering from esophageal cancer have been treated in a period from 1990 to 1994. In 29 cases curative resection was possible, corresponding to a resection rate of 54%. Average age of resected patients was 62 years. According to pTNM-classification the stages T1 and T2 amounted to 45%, T3 and T4 to 55%. Ly...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract::Autologous blood procurement remains in evolution. Interest in preoperative autologous blood donation (PAD) increased substantially in the 1980's due to the recognition that HIV was transmissible by blood. Concomitant with increased blood safety, however, PAD activity has declined approximately 40% since 1992. Reasons...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2003-40618
更新日期:2003-06-01 00:00:00
abstract::Early postoperative intestinal motility after conventional and laparoscopic cholecystectomy was registered in dogs (n = 10) by implanted serosal electrodes to compare the abdominal trauma. In addition postoperative adhesions after laparoscopic and conventional resection of the cecum were measured in dogs (n = 14). A s...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
abstract::Ureterosigmoidostomy was the method of choice for continent urinary diversion in cases of bladder exstrophy. The development of colonic cancer at the ureterocolic junction is one of the major complications in the late course of this procedure. The risk of large bowel carcinoma is increased 150-500-fold compared to the...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1998-01-01 00:00:00
abstract::Regional chemotherapy offers a means to enhance the local efficacy of an otherwise ineffective systemic chemotherapy. The regional concentration advantage of a drug is proportional to its total body clearance and inversely proportional to the blood flow through the organ. Regional infusion of adriamycin, cisplatin, me...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract::From 1966 to 1978, 122 infants and children suffering from injuries of the distal radial epiphysis were treated by reposition and repeated reposition. 68 of them were followed-up from 2 to 13 years later. In most cases spontaneous correction of remaining deformities by growth could be demonstrated. This remodelling of...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::In our study, we retrospectively evaluated 203 patients with medial or lateral femoral neck fractures who received 210 bipolar prosthesis (7 bilateral implantations) at our institution. 204 patients underwent cemented bipolar hemiarthroplasty. These included 149 females and 54 males with a median age of 82 (46-97) yea...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0028-1098711
更新日期:2008-12-01 00:00:00
abstract::From 1956 to 1982, 4126 patients suffering from rectal cancer underwent surgery, 3229 of them had radical operations. The total postoperative mortality rate came up to 7.1% (n = 295) in the radical operated group it was 6.6% (n = 214). Between 1956 to 1982 continence preserving surgical procedures were constantly on t...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::A highly evacuated wound drainage system according to Redon (980 mbar) was applied to 100 women who had undergone laparotomy. No change of bottles was necessary up to removal of the system in 96 cases. Bacteriological tests were applied to various points of the Redon system and revealed only minimum colonisation with ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00