Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
-
The SARS-CoV-2/COVID-19 pandemic necessitates a rapid reorganization of the hospital procedures. The establishment of centers dedicated to COVID-19 treatment and care also necessitates preparation of the surgical departments for the forthcoming emergency interventions for infected patients and patients with an unclear infection status. This article summarizes the evidence on standards for personal protective equipment for personnel in the central emergency admission department and in the operations area as well as restructuring measures for the procedures in the operations area in a COVID-plus area. ⋯ The correct personal protective equipment considering the occupational safety helps to sustainably protect personnel from infections. Reorganizational measures in the operating room are urgently indicated for potential aerosol-forming procedures in infected patients or patients with an unclear infection status. The current dynamic situation necessitates a high level of flexibility as well as reassessment and adaptation of the measures at short intervals.
-
Artificial intelligence, automatization and digital transformation increasingly dominate the business models of almost all enterprises. Even in medicine and medical technology, companies also no longer close their minds to this development as the advantages provided by the new ideas and processes in medicine and particularly in compact disciplines, such as pediatric surgery have occasionally been recognized. ⋯ Disciplines such as pediatric surgery cannot disregard the trend towards the application of artificial intelligence in daily practice. In addition to the establishment of current developments, the requirements of pediatric surgery should also be taken into account. These were some of the impulses that led to the founding of the working group on digitalization of the German Association for Pediatric Surgery in September 2019.
-
Every third surgical patient already suffers from anemia before surgery. The main cause is iron deficiency. ⋯ Preoperative iron deficiency with/without anemia is an underestimated risk factor for perioperative complications. The implementation of preoperative diagnostics and treatment as part of a comprehensive patient blood management reduces complications and increases patient safety.
-
The incidence of esophageal cancer continues to increase. Despite increasing experience in esophageal surgery and perioperative management, anastomotic leakage remains a frequent and severe complication. ⋯ The use of FA with ICG is suitable for evaluation of perfusion of the gastric tube. The implementation is simple and can be standardized. Prospective, randomized trials and objective quantification are needed in the future in order to clarify the potential of the technique.
-
Fluorescence angiography with indocyanine green (ICG-FA) is frequently used in colorectal surgery to assess the blood perfusion in the region of an anastomosis. Previous studies with ICG-FA in both open and laparoscopic surgery could show a low rate of anastomotic leakage, e.g. the PILLAR II study with a leakage rate of 1.4%. This article presents own results, the current status of ICG-FA and the fields of application. ⋯ The results show a very low rate of anastomotic leakage when using ICG-FA. These results are promising in colorectal surgery but controlled randomized studies are lacking and should be carried out before final recommendations can be given.