Abstract：
:Laparoscopic colorectal surgery has become increasingly more common since first being described in a publication in 1990. Despite a multitude of studies about the learning curve in laparoscopic colon surgery, there are almost no such studies with regard to laparoscopic rectum surgery. This paper aims to describe a surgeon's learning curve with regard to laparoscopic rectum surgery. Based on data collected in a prospective observational study of 180 patients, it can be established that a surgeon experienced in open colorectal surgery, with basic experience in laparoscopic surgery, after suitable preparation and having a personal interest in minimally invasive surgery, needs to perform about 35 laparoscopic rectum resections within 200 laparoscopic colon resections until selection rate, operating time and rates of general and surgical complications reach a plateau. A selection of cases suited to a surgeon's personal level of operating experience, is a prerequisite for a low rate of conversions and complications and for oncological long-term results comparable to those achieved through open surgery. However, the learning curve is dependent on a multitude of factors that are partly unknown at this point. Its duration most certainly varies between individual surgeons. Every surgeon is required to critically evaluate his or her own laparoscopic experience and select cases accordingly. Supervision by surgeons more experienced in laparoscopic colorectal surgery prevents disadvantages for patients in the early phases of the surgeon's learning curve. Training in laparoscopic colorectal surgery should take place only in institutions with a sufficient number of cases treated and a continuity in experienced teachers. CAMIC's efforts in establishing centres of competence and reference are therefore to be commended and supported.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Böttger TC,Mohseni D,Beardi J,Rodehorst Adoi
10.1055/s-0030-1262684subject
Has Abstractpub_date
2011-06-01 00:00:00pages
273-81issue
3eissn
0044-409Xissn
1438-9592journal_volume
136pub_type
杂志文章abstract：INTRODUCTION:In a prospective trial we analysed the results and the management of complications following a combined endovascular and vascular surgical therapy of peripheral occlusive arterial disease (POAD). PATIENTS AND METHODS:From November 1998 until January 2001 a total number of 61 patients with 64 extremities w...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2002-22030
更新日期：2002-02-01 00:00:00
abstract：:This review gives a summary of historical developments of the technique of epidural anaesthesia as well as a synopsis of current knowledges in this method of regional anaesthesia. Besides of anatomical basics, the technique of epidural anaesthesia and its use in postoperative pain relief including indications, contrai...
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 January 1990 to December 1995 79 patients with mediastinal lesions were seen for parasternal mediastinoscopy at the Ruhrlandklinik Essen. Diagnosis was achieved in 91.1%. In 7 cases (8.9%) the diagnosis was not established. Six intraoperative complications occurred following mediastinoscopy: minor bleeding in fiv...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1997-01-01 00:00:00
abstract：:Experience obtained from operations on 2,458 patients for benign stenosis of Vater's papilla provided a background against which a classification was made of this pathological pattern. Preoperative and intraoperative diagnostic methods and surgical techniques are discussed and are critically appraised. Endoscopic papi...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1989-01-01 00:00:00
abstract：:The planning of locoregional tumor therapy (radical surgical resection, curative radiotherapy) is based on the knowledge of locoregional tumor spread, in particular lymph node metastasis. In general, lymphatic spread follows anatomic rules, skipping of nodes is observed maximally in 3%. According to tumor site, uni- o...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：10.1055/s-2000-10046
更新日期：2000-01-01 00:00:00
abstract：:Continuous arteriovenous hemofiltration is the treatment of choice for postoperative acute renal failure (ARF). The clinical value of two different treatment modalities (spontaneous vs. pump-driven hemofiltration PDHF) were compared in two groups of patients with postoperative ARF. There were no differences in both gr...
journal_title：Zentralblatt fur Chirurgie
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1991-01-01 00:00:00
abstract：:In the knee joints of 195 animals autologous, stored and fresh homologous osteochondral grafts were implanted. Even after 2 years the ultrastructural examination indicates that autologous and fresh homologous grafts survive. The stored grafts are absorbed. The clinical results after transplantation of 38 patients as w...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1979-01-01 00:00:00
abstract：:Laparoscopic total gastrectomy for early and advanced gastric cancer is an exacting procedure which is increasingly performed in specialised institutions. Not only gastric resection and extended lymphadenectomy but especially the reconstruction by oesophagojejunostomy is a technically demanding and vulnerable operativ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-0033-1360122
更新日期：2014-02-01 00:00:00
abstract：:In contrast to prehospital emergency medicine, there are no comparable established structures or statutory requirements for structural and procedural organisation, or qualification of personnel and equipment for in-hospital emergency care in Germany. However, in perioperative patients, unexpected complications are fai...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/a-0631-4867
更新日期：2020-10-01 00:00:00
abstract：:There are several reasons for the possible development of a short bowel syndrome, which, however, occurs only rarely. The main causes consist of extended intestinal resections in cases of congenital anomalies (e.g., gastroschisis, intestinal atresia or dysplasia) or ischaemic lesions due to a volvulus. In addition, an...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-0032-1315200
更新日期：2013-08-01 00:00:00
abstract：:Minor amputations are frequently performed in neuroischemic or neuropathic lesions of the diabetic foot. In German-speaking countries, the term "Grenzzonenamputation" was created to describe the combination of minor amputation exactly in the border zone to vital tissues, necrosectomy and débridement. For early and opt...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：10.1055/s-2003-42748
更新日期：2003-09-01 00:00:00
abstract：:In a period of 10 years we carried out two prospective multicentric trials to evaluate the state of the art in treatment of appendicitis. One study was performed before introduction of laparoscopy. Important criteria like new diagnostic methods (sonography, laparoscopy), frequency of operation, perforation rate, frequ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1998-01-01 00:00:00
abstract：:We report a retrospective analysis of 61 patients admitted during the years 1974 to 1992 after having recently swallowed a corrosive agent. Within 24 hours, the localisation, severity and extent of the injury had been determined by endoscopy. In 13 patients the injury was restricted to the oropharynx, and in 48 it inv...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1995-01-01 00:00:00
abstract：:In this paper it is tried to give an answer whether Bassini-plastic as compared to the excellent results of Shouldice operation should be further performed. In a consecutive series of 197 Bassini operations from 1982-1986 we found after a mean follow up time of 6.8 years a 3.2% recurrency rate. We suggest therefore th...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1993-01-01 00:00:00
abstract：:In newborns, acute appendicitis is a very rare condition associated with significant lethality. Due to mostly non-specific symptoms, it is difficult to find the correct diagnosis preoperatively. Interestingly, rectal bleeding as a clinical sign in neonatal appendicitis is very uncommon. Here, we report on a 4-day-old ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-0028-1098922
更新日期：2009-12-01 00:00:00
abstract：:The development of anaesthesiology has brought about a great variety of problems e.g. unforeseen capacities, money, vacancies and equipment. The patients welfare, of course necessitates the establishment of anaesthesiological departments wherever operations are being performed. We believe that in hospitals without ana...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1978-01-01 00:00:00
abstract：:Early and late infections are severe complications after osteosynthesis in closed fractures. Using gentamicin chains is an effective form of local treatment in these cases. The indications for the application and different surgical procedures are described and the authors experiences are given. ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1991-01-01 00:00:00
abstract：:After edovascular repair of infrarenal aortic aneurysms (EVAR) endoleaks may occur necessitating further therapy. Therefore a reliable method for follow-up imaging after EVAR for detection and control of endoleaks is of high importance. Contrast-enhanced sonography (CEUS) does not require the application of nephrotoxi...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：10.1055/s-0035-1546147
更新日期：2015-10-01 00:00:00
abstract：:During the period from January 1990 to December 1998 65 patients were operated upon for a Baker's cyst. 41 patients (43 operations) were subjected to a clinical and sonographical follow-up examination and interrogation. In 11 cases, the cysts were merely removed, while an open synovectomy was carried out four times (r...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2002-35140
更新日期：2002-10-01 00:00:00
abstract：:Nearly 200 clinical studies concerning perioperative antibiotic prophylaxis are compiled and evaluated by biometric methods, however without fulfilling the criteria of meta-analysis. Derived from its results it can be concluded, that this prophylaxis is indicated for the wound categories "clean" and "clean-contaminate...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：
更新日期：1991-01-01 00:00:00
abstract：:Indication for thoracotomy is undisputed in cases of gaping wounds with massive haemorrhage. However, discrete stab and gunshot wounds may quite often conceal imminent pericardial tamponade. Three quarters of all penetrating thorax injuries are located in or close to the cardiac silhouette. When it comes to patients w...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1987-01-01 00:00:00
abstract：:The aim of this study was to determine whether arterial reconstructions in old age carry an acceptable risk and are reasonable as far as long term results are concerned. The operative mortality was 3,4% for reconstructions distal to the inguinal ligament and 20.5% for reconstructions in the aorto-iliac region. Limb am...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1980-01-01 00:00:00
abstract：:When in 1910 F. Sauerbruch became head of the Surgical Dept. of Zurich-University (Switzerland) he took over a young promising surgeon from his predecessor: E. D. Schumacher. Soon Schumacher became a close and well accepted coworker of the head of the Dept, thus beginning an extraordinary career as an outstanding thor...
journal_title：Zentralblatt fur Chirurgie
pub_type： 传,历史文章,杂志文章
doi：
更新日期：1984-01-01 00:00:00
abstract：:The aim of this study was to determine the pressure conditions in the tissue beneath and on the surface of wounds. This was done in vitro both on a plain surface and on a bovine muscle. In comparison we measured the pressure of the anterior tibial muscle of a patient with compartment syndrome. Besides, we applied nega...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2004-822650
更新日期：2004-05-01 00:00:00
abstract：:Laparoscopic common bile duct exploration offers the possibility of complete minimal invasive therapy of biliary stone disease with respect to the anatomical structures of the papilla Vateri. In spite of generously indicated preoperative ERC, we found in 23 of 376 laparoscopic cholecystectomies unsuspected common bile...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1993-01-01 00:00:00
abstract：:On the basis of 341 liver biopsies routinely taken during cholecystectomies using Menghini's technique the pathological changes of the liver in comparison to the degree of cholecystitis were studied. Because of the frequency of morphological changes detected in the liver tissue, the low risk of the procedure and the p...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：:In this retrospective study with a group of 55 patients aged 47.7 +/- 8.3 years, surveyed for a period of 16 months, the results of different face lift techniques--subcutaneous face lift combined with imbrication of the SMAS-Platysma complex versus sub-SMAS-dissection with transposition of the SMAS-Platysma complex--w...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：2000-01-01 00:00:00
abstract：:Pneumothorax is defined as the accumulation of air in the pleural space. A distinction is made between a primary (idiopathic) spontaneous pneumothorax (PSP), secondary spontaneous pneumothorax (SSP) as well as between iatrogenic pneumothorax and traumatic pneumothorax. Primary spontaneous pneumothorax (PSP) occurs mai...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：10.1055/s-0031-1284013
更新日期：2012-06-01 00:00:00
abstract：:Following a brief overview on parathyroid surgery, ontogenesis, anatomy and physiology of the parathyroids are described. Clinical symptoms and signs of hyperparathyroidism are as variable as the topography of parathyroid bodies may be. While parathyroid hyperfunction can easily be demonstrated by determination of ser...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1989-01-01 00:00:00
abstract：:Recurrent duodenal ulceration after highly selective vagotomy is best managed by antral gastric resection and gastroduodenostomy (BI). In cases of gastral localisation of the recurrent ulcer and in cases with high postoperative acidity a 2/3 partial gastrectomy (BI) should be performed. Revagotomy after highly selecti...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1985-01-01 00:00:00
