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Schröder W, Bruns C. [Current trends in oncological esophageal surgery : A worldwide survey]. Chirurg 2019; 90:30. [PMID: 30758624 DOI: 10.1007/s00104-019-0823-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Moghadam SMA, Meinke M, Schröder W. Numerical Analysis of the Acoustic Field of a Ducted Axial Fan at Varying Tip Clearances. ACTA ACUST UNITED AC 2019. [DOI: 10.3813/aaa.919286] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Winterhoff B, Kommoss S, Heitz F, Konecny GE, Dowdy SC, Mullany SA, Park-Simon TW, Baumann K, Hilpert F, Brucker S, du Bois A, Schröder W, Burges A, Shen S, Wang J, Tourani R, Ma S, Pfisterer J, Aliferis CF. Developing a Clinico-Molecular Test for Individualized Treatment of Ovarian Cancer: The interplay of Precision Medicine Informatics with Clinical and Health Economics Dimensions. AMIA ... ANNUAL SYMPOSIUM PROCEEDINGS. AMIA SYMPOSIUM 2018; 2018:1093-1102. [PMID: 30815151 PMCID: PMC6371365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We report recent progress in the development of a precision test for individualized use of the VEGF-A targeting drug bevacizumab for treating ovarian cancer. We discuss the discovery model stage (i.e., past feasibility modeling and before conversion to the production test). Main results: (a) Informatics modeling plays a critical role in supporting driving clinical and health economic requirements. (b) The novel computational models support the creation of a precision test with sufficient predictivity to reduce healthcare system costs up to $30 billion over 10 years, and make the use of bevacizumab affordable without loss of length or quality of life.
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Schröder W, Bruns CJ. [Robot-assisted minimally invasive esophagectomy]. Chirurg 2018; 90:66. [PMID: 30406808 DOI: 10.1007/s00104-018-0767-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Schmalfeldt B, Brambs C, Burges A, El-Balat A, Emons G, Fink D, Fotopoulou C, Gropp-Meier M, Hanker LC, Harter P, Hasenburg A, Hauptmann S, Hilpert F, Kimmig R, Kommoss S, Kurzeder C, Mahner S, Marmé F, Mayr D, Meier W, Meinhold-Heerlein I, Mustea A, Ortmann O, Oskay-Özcelik G, Pfisterer J, Pölcher M, Runnebaum IB, Schröder W, Tanner B, Wagner U, Wimberger P, Sehouli J. What is the evidence for lymphadenectomy in presumed early ovarian cancer? Arch Gynecol Obstet 2018; 299:1-5. [PMID: 30374648 DOI: 10.1007/s00404-018-4945-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Heitz F, Kommoss S, Baumann K, Hilpert F, Brucker SY, Schröder W, Burges A, Canzler U, Belau A, Hanker L, Sehouli J, du Bois A, Pfisterer J. Vorhersage des Tumorrestes beim fortgeschrittenen Ovarialkarzinom durch Nutzung einer Gesamt-Transkription-Expressionsanalyse. Eine Analyse der AGO-OVAR 11 (ICON7) Studie. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Fuchs HF, Müller DT, Berlth F, Maus MK, Fuchs C, Dübbers M, Schröder W, Bruns CJ, Leers JM. Simultaneous laryngopharyngeal pH monitoring (Restech) and conventional esophageal pH monitoring-correlation using a large patient cohort of more than 100 patients with suspected gastroesophageal reflux disease. Dis Esophagus 2018. [PMID: 29534167 DOI: 10.1093/dote/doy018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
24-hour esophageal pH-metry is not designed to detect laryngopharyngeal reflux (LPR). The new laryngopharyngeal pH-monitoring system (Restech) may detect LPR better. There is no established correlation between these two techniques as only small case series exist. The aim of this study is to examine the correlation between the two techniques with a large patient cohort. All patients received a complete diagnostic workup for gastroesophageal reflux including symptom evaluation, endoscopy, 24-hour pH-metry, high resolution manometry, and Restech. Consecutive patients with suspected gastroesophageal reflux and disease-related extra-esophageal symptoms were evaluated using 24-hour laryngopharyngeal and concomitant esophageal pH-monitoring. Subsequently, the relationship between the two techniques was evaluated subdividing the different reflux scenarios into four groups. A total of 101 patients from December 2013 to February 2017 were included. All patients presented extra-esophageal symptoms such as cough, hoarseness, asthma symptoms, and globus sensation. Classical reflux symptoms such as heartburn (71%), regurgitation (60%), retrosternal pain (54%), and dysphagia (32%) were also present. Esophageal 24-hour pH-metry was positive in 66 patients (65%) with a mean DeMeester Score of 66.7 [15-292]. Four different reflux scenarios were detected (group A-D): in 39% of patients with abnormal esophageal pH-metry, Restech evaluation was normal (group A, n = 26, mean DeMeester-score = 57.9 [15-255], mean Ryan score = 2.6 [2-8]). In 23% of patients with normal pH-metry (n = 8, group B), Restech evaluation was abnormal (mean DeMeester-score 10.5 [5-13], mean Ryan score 63.5 [27-84]). The remaining groups C and D showed corresponding results. Restech evaluation was positive in 48% of cases in this highly selective patient cohort. As demonstrated by four reflux scenarios, esophageal pH-metry and Restech do not necessarily need to correspond. Especially in patients with borderline abnormal 24-hour pH-metry, Restech may help to support the decision for or against laparoscopic anti-reflux surgery.
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Schröder W, Bruns CJ. [Treatment of achalasia : Laparoscopic Heller myotomy or peroral endoscopic myotomy?]. Chirurg 2018. [PMID: 29520414 DOI: 10.1007/s00104-018-0621-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Visser E, van Rossum PSN, van Veer H, Al-Naimi K, Chaudry MA, Cuesta MA, Gisbertz SS, Gutschow CA, Hölscher AH, Luyer MDP, Mariette C, Moorthy K, Nieuwenhuijzen GAP, Nilsson M, Räsänen JV, Schneider PM, Schröder W, Cheong E, van Hillegersberg R. A structured training program for minimally invasive esophagectomy for esophageal cancer- a Delphi consensus study in Europe. Dis Esophagus 2018; 31:4601761. [PMID: 29121243 DOI: 10.1093/dote/dox124] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 09/18/2017] [Indexed: 12/11/2022]
Abstract
Evidence suggests that structured training programs for laparoscopic procedures can ensure a safe standard of skill acquisition prior to independent practice. Although minimally invasive esophagectomy (MIO) is technically demanding, no consensus on requirements for training for the MIO procedure exists. The aim of this study is to determine essential steps required for a structured training program in MIO using the Delphi consensus methodology. Eighteen MIO experts from 13 European hospitals were asked to participate in this study. The consensus process consisted of two structured meetings with the expert panel, and two Delphi questionnaire rounds. A list of items required for training MIO were constructed for three key domains of MIO, including (1) requisite criteria for units wishing to be trained and (2) to proctor MIO, and (3) a framework of a MIO training program. Items were rated by the experts on a scale 1-5, where 1 signified 'not important' and 5 represented 'very important.' Consensus for each domain was defined as achieving Cronbach alpha ≥0.70. Items were considered as fundamental when ≥75% of experts rated it important (4) or very important (5). Both Delphi rounds were completed by 16 (89%) of the 18 invited experts, with a median experience of 18 years with minimally invasive surgery. Consensus was achieved for all three key domains. Following two rounds of a 107-item questionnaire, 50 items were rated as essential for training MIO. A consensus among European MIO experts on essential items required for training MIO is presented. The identified items can serve as directive principles and core standards for creating a comprehensive training program for MIO.
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Schröder W, Wolters S, Cremerius U, Rath W, Büll U, Zimny M. 18F-Fluordeoxyglukose PET beim Ovarialkarzinom: Methodik und erste Ergebnisse. Nuklearmedizin 2018. [DOI: 10.1055/s-0038-1629838] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Zusammenfassung
Ziel der vorliegenden Studie war die Evaluierung der PET mit 18F-Fluor-deoxyglukose in der Primär- und Rezidivdiagnostik von Ovarialkarzino-men. Methoden: Untersucht wurden 26 Patientinnen mit Verdacht auf primäres Ovarialkarzinom (n = 17) bzw. Rezidiwerdacht (n = 9). Die PET-Untersuchung von Abdomen und Becken erfolgte mit einem ECAT 953/15-Scanner beginnend 45 min nach i.v. Applikation von im Mittel 245 MBq 18FDG. Die PET-Ergebnisse wurden anhand von intraoperativem Befund, Histologie und Zytologie validiert. Ergebnisse: Der richtige Nachweis eines primären, malignen Ovarialtumors bzw. eines Rezidivs gelang in 16 von 19 Fällen, der Malignomausschluß in sechs von sieben Fällen. Falsch negative PET-Befunde wurden bei zwei Borderline-Karzinomen und einem gut differenzierten, serös-muzinösen Ovarialkarzinom erhoben. Ein falsch positiver PET-Befund ergab sich bei einer abszedierenden Salpingoophoritis. Die quantitative Analyse erbrachte einen SUV von 6,8 ± 2,3 für primäre, epitheliale Ovarialkarzinome gegenüber 2,6 ± 1,2 bei benignen, nicht entzündlichen Raumforderungen (p <0,05). Schlußfolgerung: Diese vorläufigen Ergebnisse zeigen, daß PET mit 18FDG zwar geeignet ist zur Rezidivdiagnostik von Ovarialkarzinomen, jedoch limitiert ist in der Differenzierung von Borderline-Karzinomen gegenüber benignen Veränderungen sowie malignen Tumoren des Ovars gegenüber entzündlichen Prozessen. Die quantitative Bildanalyse führt hierbei nicht zu einer Verbesserung der diagnostischen Genauigkeit.
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Schröder W, Bruns CJ. [Influence of centralization on the outcome of esophageal perforation]. Chirurg 2018; 89:158. [PMID: 29368081 DOI: 10.1007/s00104-018-0600-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Thoma N, Dietlein M, Moka D, Eschner W, Faust M, Schröder W, von Hülst-Schlabrendorff M, Ehses W, Schicha H, Schmidt M. 99mTc-MIBI SPECT in primary hyperparathyroidism. Nuklearmedizin 2018. [DOI: 10.3413/nukmed-0057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
SummaryAim of the study was to analyse the influence of a concomitant vitamin D deficiency on the results of 99mTc-MIBI studies in patients (pts) with primary hyperparathyroidism (pHPT). Patients, methods: Between January 1998 and May 2004, 71 pts with pHPT had undergone operation after a 99mTc-MIBI study of whom 54 pts (76%) had normal values of 25-OH-vitamin D3 and 17 pts (24%) had vitamin D deficiency. Results of a dual-phase 99mTc-MIBI protocol with SPECT were compared with histopathology. Results: In 54 pts with normal vitamin D values late SPECT images identified more lesions (n = 51, sensitivity 91%) than early planar (n = 45, sensitivity 82%) or late planar images (n = 50, sensitivity 88%). In 17 pts with vitamin D deficiency late SPECT images identified more lesions (n = 13, sensitivity 72%) than early planar (n = 10, sensitivity 56%) or late planar images (n = 10, sensitivity 56%) too. In pts with vitamin D deficiency the sensitivity of a 99mTc-MIBI SPECT study was lower than in those with normal vitamin D status (72% vs. 91%) and dependent on the value for PTH. However, the results did not reach statistical significance: early planar: p = 0.1625; late planar: p = 0.0039; 99mTc-MIBI SPECT: p = 0.1180. Conclusion: The likelihood of a pathological 99mTc-MIBI study being obtained in pts with pHPT is dependent on the parathyroid hormone level. However, a negative influence of a low vitamin D level on the scintigraphic detection rate of a parathyroid adenoma could not be proven which may be due to the low number of pts with vitamin D deficiency.
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Fuchs HF, Schmidt HM, Meissner M, Brinkmann S, Maus M, Bludau M, Schröder W, Hölscher AH, Leers JM. Endoscopic and histopathologic reflux-associated mucosal damage in the remnant esophagus following transthoracic esophagectomy for cancer-5-year long-term follow-up. Dis Esophagus 2018; 31:1-6. [PMID: 29036607 DOI: 10.1093/dote/dox115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Gastroesophageal reflux is a common problem following esophagectomy and reconstruction with gastric interposition. Despite a routine prescription of proton pump inhibitors, reflux-associated mucosal damage in the remnant esophagus is frequently observed. Purpose of this study is to evaluate mucosal damage in the esophageal remnant during long-term follow-up and to compare the prevalence of this damage between the subgroups of esophageal squamous cell and adenocarcinoma. All patients undergoing transthoracic Ivor-Lewis esophagectomy were prospectively entered in our IRB approved database. All patients underwent a routine check-up program with yearly surveillance endoscopies following esophagectomy. Only patients with a complete follow-up were included into this study. Endoscopic and histopathologic mucosal changes of the remnant esophagus were analyzed in close intervals. A total of 50 patients met the inclusion criteria, consisting of 31 adenocarcinomas (AC) and 19 squamous cell carcinomas (SCC). Mucosal damage was already seen 1 year after surgery in 20 patients macroscopically (43%) and in 21 patients microscopically (45%). At 5-year follow-up the prevalence for macroscopic and microscopic damage was 55% and 60%, respectively. The prevalence of mucosal damage was higher in AC patients than in SCC patients (1y-FU: 51% [AC] vs. 28% [SCC]; 5y-FU: 68% [AC] vs. 35% [SCC], P < 0.05). Newly acquired Barrett's esophagus was seen in 10 patients (20%) with two of those patients (20%) showing histopathologic proof of neoplasia. This study shows a high prevalence of reflux-associated mucosal damage in the remnant esophagus one year out of surgery and only a moderate increase in prevalence in the following years. Mucosal damage was more frequently seen in AC patients and the occurrence of de-novo Barrett's esophagus and de-novo neoplasia was high. Endoscopic surveillance with targeted biopsies seems to be an indispensable tool to follow patients after esophagectomy appropriately.
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Rehrl S, Schröder W, Müller C, Staszyk C, Lischer C. Radiological prevalence of equine odontoclastic tooth resorption and hypercementosis. Equine Vet J 2017; 50:481-487. [DOI: 10.1111/evj.12776] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/11/2017] [Indexed: 11/29/2022]
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Schröder W, Lambertz R, van Hillegesberger R, Bruns C. [Differentiated surgical approach for adenocarcinoma of the gastroesophageal junction]. Chirurg 2017; 88:1010-1016. [PMID: 29098306 DOI: 10.1007/s00104-017-0544-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
For adenocarcinoma of the gastroesophageal junction (GEJ) the classification of Siewert with its three subtypes is well established as a practical approach to surgical treatment. Transthoracic esophagectomy with gastric tube formation is generally accepted as the surgical standard for adenocarcinoma of the distal esophagus (GEJ type I). Intrathoracic esophagogastrostomy has become the most frequently used anastomotic technique (Ivor Lewis esophagectomy). Both the abdominal and thoracic part can be safely performed with a minimally invasive access. For subcardiac gastric cancer (GEJ type III) transhiatal extended gastrectomy is the resection of choice. For true cardiac carcinomas (GEJ type II) it has not yet been decided which of the abovementioned surgical procedures offers the best long-term survival. If technically possible in terms of a complete resection, transhiatal extended gastrectomy should be preferred because of a better postoperative quality of life. For GEJ type II tumors a minimally invasive approach is not recommended if the extent of resection cannot be safely determined preoperatively.
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Najm J, Rath M, Schröder W, Felbor U. Diagnostic single gene analyses beyond Sanger. Hamostaseologie 2017; 38:158-165. [DOI: 10.5482/hamo-17-01-0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Schröder W, Bruns CJ. Multimodale Therapie des Magenkarzinoms und Karzinoms des gastroösophagealen Übergangs – ECF vs. FLOT. Chirurg 2017; 88:540. [DOI: 10.1007/s00104-017-0440-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schröder W, Bruns C. [Bariatric surgery versus medical therapy in the treatment of obesity]. Chirurg 2017; 88:449-450. [PMID: 28421259 DOI: 10.1007/s00104-017-0426-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Siedek F, Giese D, Weiss K, Brinkmann S, Schröder W, Maintz D, Haneder S. Beschleunigte 4D-MR-Phasenkontrastflussmessung zur Analyse flussdynamischer Prozesse im Truncus coeliacus und der Arteria mesenterica superior. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lambertz R, Drinhaus H, Schedler D, Bludau M, Schröder W, Annecke T. [Perioperative management of transthoracic oesophagectomies : Fundamentals of interdisciplinary care and new approaches to accelerated recovery after surgery]. Anaesthesist 2017; 65:458-66. [PMID: 27245922 DOI: 10.1007/s00101-016-0179-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Locally advanced carcinomas of the oesophagus require multimodal treatment. The core element of curative therapy is transthoracic en bloc oesophagectomy, which is the standard procedure carried out in most specialized centres. Reconstruction of intestinal continuity is usually achieved with a gastric sleeve, which is anastomosed either intrathoracically or cervically to the remaining oesophagus. This thoraco-abdominal operation is associated with significant postoperative morbidity, not least because of a vast array of pre-existing illnesses in the surgical patient. For an optimal outcome, the careful interdisciplinary selection of patients, preoperative risk evaluation and conditioning are essential. The caseload of the centres correlates inversely with the complication rate. The leading surgical complication is anastomotic leakage, which is diagnosed endoscopically and usually treated with the aid of endoscopic procedures. Pulmonary infections are the most frequent non-surgical complication. Thoracic epidural anaesthesia and perfusion-orientated fluid management can reduce the rate of pulmonary complications. Patients are ventilated protecting the lungs and are extubated as early as possible. Oesophagectomies should only be performed in high-volume centres with the close cooperation of surgeons and anaesthesia/intensive care specialists. Programmes of enhanced recovery after surgery (ERAS) hold further potential for the patient's quicker postoperative recovery. In this review article the fundamental aspects of the interdisciplinary perioperative management of transthoracic oesophagectomy are described.
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Kleber W, Peibst H, Schröder W. Über die elektrische Leitfähigkeit von synthetischen Rutileinkristallen. Z PHYS CHEM 2017. [DOI: 10.1515/zpch-1960-21506] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Schröder W, Bruns CJ. [Impact of hiatal hernia on the postoperative outcome after esophagectomy]. Chirurg 2017; 88:165. [PMID: 28105516 DOI: 10.1007/s00104-017-0370-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Fricke R, Schoon T, Schröder W. Eine gleichzeitige röntgenographische und elektronenmikroskopische Verfolgung der thermischen Umwandlungsreihe γ-FeOOH–γ-Fe2O3—a-Fe2O3. ACTA ACUST UNITED AC 2017. [DOI: 10.1515/zpch-1941-5003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Lorenz R, Stechemesser B, Reinpold W, Fortelny R, Mayer F, Schröder W, Köckerling F. Development of a standardized curriculum concept for continuing training in hernia surgery: German Hernia School. Hernia 2016; 21:153-162. [PMID: 28032227 DOI: 10.1007/s10029-016-1566-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 12/17/2016] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The increasingly more complex nature of hernia surgery means that training programs for young surgeons must now meet ever more stringent requirements. There is a growing demand for improved structuring and standardization of education and training in hernia surgery. MATERIALS AND METHODS In 2011, the concept of a Hernia School was developed in Germany and has been gradually implemented ever since. That concept comprises the following series of interrelated, tiered course elements: Hernie kompakt (Hernia compact), Hernie konkret (Hernia concrete), and Hernie complex (Hernia complex). All three course elements make provision for structured clinical training based on guest visits to approved hernia centers. The Hernia compact basic course imparts knowledge of anatomy working with fresh cadavers. Hernia surgery procedures can also be conducted using unfixed specimens. Knowledge of abdominal wall ultrasound diagnostics is also imparted and hernia surgery procedures simulated on pelvic trainers. In all three course elements, lectures are delivered by experts across the entire field of hernia surgery using evidence-based practices from the literature. RESULTS To date, eight Hernie kompakt (Hernia compact) courses have been conducted, in each case with up to 55 participants, and with a total of 390 participants. On evaluating the course, over 95% of participants expressed the view that the Hernia compact course content improved hernia surgery training. Following that positive feedback, the more advanced Hernie konkret (Hernia concrete) and Hernie complex (Hernia complex) course elements were introduced in 2016. CONCLUSION The experiences gained to date since the introduction of a Hernia School-a standardized curriculum concept for continuing training in hernia surgery-has been evaluated by participants as an improvement on hitherto hernia surgery training.
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