Langenbeck's archives of surgery
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Langenbecks Arch Surg · Jun 2011
Comparative StudyWhich surgical procedure offers the best treatment for pilonidal disease?
Our aim was to determine the most effective surgical procedure for treatment of pilonidal disease, by comparing different surgical techniques. ⋯ Despite the increasing volume of data on the treatment of pilonidal disease, the optimal treatment has yet to be established.
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Langenbecks Arch Surg · Jun 2011
Practice GuidelineGerman Association of Endocrine Surgeons practice guidelines for the surgical treatment of benign thyroid disease.
Benign thyroid disorders are among the most common diseases in Germany, affecting around 15 million people and leading to more than 100,000 thyroid surgeries per year. Since the first German guidelines for the surgical treatment of benign goiter were published in 1998, abundant new information has become available, significantly shifting surgical strategy towards more radical interventions. Additionally, minimally invasive techniques have been developed and gained wide usage. These circumstances demanded a revision of the guidelines. ⋯ Evidence-based recommendations for the surgical treatment of benign thyroid diseases have been created to aid the surgeon and to support optimal patient care, based on current knowledge. These recommendations comply with the Association of the Scientific Medical Societies in Germany requirements for S2k guidelines.
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Langenbecks Arch Surg · Jun 2011
ReviewFast-track surgery-an update on physiological care principles to enhance recovery.
The concept of fast-track surgery (enhanced recovery programs) has been evolved and been documented to be successful by decreasing length of stay, morbidity and convalescence across procedures. ⋯ However, there are several possibilities for further improvement of most of the components of fast-track surgery, where surgical stress, fluid and pain management are key factors. There is an urgent need for better design of studies, especially in minimal invasive surgery to achieve maximal outcome effects when integrated into the fast-track methodology.
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Langenbecks Arch Surg · Jun 2011
Comparative StudyTransvaginal-hybrid vs. single-port-access vs. 'conventional' laparoscopic cholecystectomy: a prospective observational study.
In the recent past, access to the peritoneal cavity has involved primarily 'natural orifice transluminal' and 'single-port access' techniques, which are based on laparoscopy. The most frequently performed procedure using these new developments is cholecystectomy. Few studies compare more than one 'new' method with the 'golden standard' of laparoscopic cholecystectomy. Here we present the results of the first prospective observational study comparing standard laparoscopic cholecystectomy with single-port cholecystectomy as well as transvaginal-hybrid cholecystectomy. ⋯ Concerning the length of hospital stay, transvaginal-hybrid cholecystectomy and single-port cholecystectomy appear to be superior to 'conventional' laparoscopic cholecystectomy. Additionally, transvaginal-hybrid access is associated with significantly less pain in the early postoperative course.
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Langenbecks Arch Surg · Jun 2011
Workload and quality of life of surgeons. Results and implications of a large-scale survey by the German Society of Surgery.
Quality of life is of vital importance for patients undergoing surgery. However, little is known about the quality of life of surgeons who are facing a stressful and dramatically changing working environment. For this reason, this large-scale study investigated the quality of life (QL) of surgeons in Germany in the context of occupational, private, and system-related risk factors. ⋯ Improving the working conditions for surgeons requires a concerted action of all relevant parties, including hospital administrators, insurance companies, and the German Society of Surgery. The present study clearly identified measures that should be taken.