Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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In the past decades various techniques of esophagectomy for the curative treatment of esophageal cancer have been described. Especially minimally invasive techniques of esophagectomy have been used increasingly in the last decade. Technical issues and results of hybrid laparoscopic-thoracotomic en bloc esophagectomy with intrathoracic esophagogastric anastomosis (HMIE) are presented and discussed in the article. ⋯ The HMIE procedure combines the advantages of minimally invasive operative approaches on especially postoperative pulmonary morbidity after esophagectomy with the high safety of anastomosis and reconstruction achieved in OE. Further advantages are shorter duration of operation and shorter length of hospital stay in HMIE.
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The aim of the perioperative management of anticoagulation in patients with long-term oral anticoagulation is to minimize bleeding complications of surgical interventions. ⋯ The perioperative management of coagulation is still a challenge. While there are consolidated decision aids for phenprocoumon, the approach under DOAC treatment is still controversial due to limited data.
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Diagnostic imaging with positron emission tomography (PET) is becoming increasingly more involved in oncological therapy management. ⋯ Hybrid imaging with PET computed tomography (CT) and PET magnetic resonance imaging (MRI) further improves diagnostic imaging and increases the acceptance of PET further.
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Review Case Reports
[Acute appendicitis mimicking cholecystitis. Case reports and review with focus on medicolegal aspects].
Since 1955 simultaneous presentation of acute appendicitis und acute cholecystitis have been described. These cases are understood as concomitance on the one hand and as imitation or induction of acute cholecystitis due to acute appendicitis. In laparoscopic surgery for inflammatory diseases, in particular acute cholecystitis, exploration of the entire abdomen should be more than cursory. In remarkable postoperative courses after cholecystectomy in acute cholecystitis, acute appendicitis should be taken into account if it could not be excluded intraoperatively.