Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Cardiology and cardiothoracic surgery are closely related so that collaboration and communication are required to offer optimal therapy for patients. During the last decades many innovations have reduced the borders between cardiology and cardiothoracic surgery. ⋯ New developments in cardiothoracic surgery have led to less invasive procedures and many surgical procedures can now be performed with minimally invasive techniques and without a cardiopulmonary bypass. To enable optimal therapy for patients, closer collaboration between cardiologists and cardiothoracic surgeons is required setting the stage for individualized therapy in the future.
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Vascular surgeons increasingly claim that percutaneous interventional treatment of peripheral arterial disease belongs to their discipline. In further medical training interventional radiology is exclusively bound to the discipline of radiology and necessitates a minimum of 250 procedures for valid qualification. ⋯ The desired expansion of vascular surgery to include the complete field of vascular medicine is not based on adequate specific training, is functionally unnecessary and not achievable for practical reasons. However, this desired expansion endangers the consensus of an interdisciplinary concept of treatment as represented by interdisciplinary vascular centers which offer a high level of competence.
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The need for red blood cell units in cancer surgery is increasing. The role of the better immunological options, such as preoperative blood donation or intraoperative autologous blood salvage is not known. The aim of this survey was to clarify the transfusion setting and options for cancer patients in Germany. ⋯ Perioperative blood loss is compensated by allogenic blood transfusion. The better immunological procedures, such as preoperative blood donation or intraoperative blood salvage, are not used because of the higher costs and the possible retransfusion of tumor cells.
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The present day and future requirement profiles for leading surgeons have become manifold and are defined as such. Many requirements are teachable and learnable, such as economy and management. ⋯ Only such personalities will be able to remain authentic as leader of a clinic. Success is based as always on a symbiosis of the learnable basics and the personality structure with the willingness to lead and to serve and not to become tired of it.