@article{FlemmingHankirKusanetal.2021,
  author    = {Flemming, Sven and Hankir, Mohammed K. and Kusan, Simon and Krone, Manuel and Anger, Friedrich and Germer, Christoph-Thomas and Wiegering, Armin},
  title     = {Safety of elective abdominal and vascular surgery during the COVID-19 pandemic: a retrospective single-center study},
  series = {European Journal of Medical Research},
  volume    = {26},
  journal   = {European Journal of Medical Research},
  doi       = {10.1186/s40001-021-00583-x},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-264975},
  year      = {2021},
  abstract  = {Background Patients with coronavirus disease 2019 (COVID-19) who undergo surgery have impaired postoperative outcomes and increased mortality. Consequently, elective and semi-urgent operations on the increasing number of patients severely affected by COVID-19 have been indefinitely postponed.in many countries with unclear implications on disease progression and overall survival. The purpose of this study was to evaluate whether the establishment of a standardized screening program for acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is sufficient to ensure high-quality medical and surgical treatment of COVID-19 and non-COVID-19 patients while minimizing in-hospital SARS-CoV-2 transmission. Methods The screening program comprised polymerase chain reaction (PCR) testing of nasopharyngeal swabs and a standardized questionnaire about potential symptoms for SARS-CoV-2 infection. All elective and emergency patients admitted to the surgical department of a tertiary-care hospital center in Lower Franconia, Germany, between March and May 2020 were included and their characteristics were recorded. Results Out of the study population (n = 657), 509 patients (77.5\%) had at least one risk factor for a potentially severe course of COVID-19 and 164 patients (25\%) were active smokers. The average 7-day incidence in Lower Franconia was 24.0/100,000 during the observation period. Preoperative PCR testing revealed four asymptomatic positive patients out of the 657 tested patients. No postoperative SARS-CoV-2 infection or transmission could be detected. Conclusion The implementation of a standardized preoperative screening program to both COVID-19 and non-COVID-19 patients can ensure high-quality surgical care while minimizing infection risk for healthcare workers and potential in-hospital transmission.},
  language  = {en}
}
@article{KelmAngerEichlingeretal.2021,
  author    = {Kelm, Matthias and Anger, Friedrich and Eichlinger, Robin and Brand, Markus and Kim, Mia and Reibetanz, Joachim and Krajinovic, Katica and Germer, Christoph-Thomas and Schlegel, Nicolas and Flemming, Sven},
  title     = {Early Ileocecal Resection Is an Effective Therapy in Isolated Crohn's Disease},
  series = {Journal of Clinical Medicine},
  volume    = {10},
  journal   = {Journal of Clinical Medicine},
  number    = {4},
  issn      = {2077-0383},
  doi       = {10.3390/jcm10040731},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-228822},
  year      = {2021},
  abstract  = {Despite the increasing incidence and prevalence of Crohn's Disease (CD), no curative options exist and treatment remains complex. While therapy has mainly focused on medical approaches in the past, growing evidence reveals that in cases of limited inflammation, surgery can suffice as an alternative primary treatment. We retrospectively assessed the disease course and outcomes of 103 patients with terminal Ileitis who underwent primary surgery (n = 29) or received primary medical treatment followed by surgery (n = 74). Primary endpoint was the need for immunosuppressive medication after surgical treatment (ileocecal resection, ICR) during a two-years follow-up. Rates for laparoscopic ICR were enhanced in case of early surgery, but no differences were seen for postoperative complications. In case of immunosuppressive medication, patients with ICR at an early state of disease needed significantly less anti-inflammatory medication during the two-year postoperative follow-up compared to patients who were primarily treated medically. Furthermore, in a subgroup analysis for patients with localized ileocecal disease manifestation, early surgery consistently resulted in a decreased amount of medical therapy postoperatively. In conclusion primary ICR is safe and effective in patients with limited CD, and the need for immunosuppressive medication during the postoperative follow-up is low compared to patients receiving surgery at a later stage of disease.},
  language  = {en}
}
@article{AngerDoeringvanDametal.2021,
  author    = {Anger, Friedrich and D{\"o}ring, Anna and van Dam, Jacob and Lock, Johann Frisco and Klein, Ingo and Bittrich, Max and Germer, Christoph-Thomas and Wiegering, Armin and Kunzmann, Volker and van Eijck, Casper and L{\"o}b, Stefan},
  title     = {Impact of Borderline Resectability in Pancreatic Head Cancer on Patient Survival: Biology Matters According to the New International Consensus Criteria},
  series = {Annals of Surgical Oncology},
  volume    = {28},
  journal   = {Annals of Surgical Oncology},
  number    = {4},
  issn      = {1068-9265},
  doi       = {10.1245/s10434-020-09100-6},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235251},
  pages     = {2325-2336},
  year      = {2021},
  abstract  = {Background International consensus criteria (ICC) have redefined borderline resectability for pancreatic ductal adenocarcinoma (PDAC) according to three dimensions: anatomical (BR-A), biological (BR-B), and conditional (BR-C). The present definition acknowledges that resectability is not just about the anatomic relationship between the tumour and vessels but that biological and conditional dimensions also are important. Methods Patients' tumours were retrospectively defined borderline resectable according to ICC. The study cohort was grouped into either BR-A or BR-B and compared with patients considered primarily resectable (R). Differences in postoperative complications, pathological reports, overall (OS), and disease-free survival were assessed. Results A total of 345 patients underwent resection for PDAC. By applying ICC in routine preoperative assessment, 30 patients were classified as stage BR-A and 62 patients as stage BR-B. In total, 253 patients were considered R. The cohort did not contain BR-C patients. No differences in postoperative complications were detected. Median OS was significantly shorter in BR-A (15 months) and BR-B (12 months) compared with R (20 months) patients (BR-A vs. R: p = 0.09 and BR-B vs. R: p < 0.001). CA19-9, as the determining factor of BR-B patients, turned out to be an independent prognostic risk factor for OS. Conclusions Preoperative staging defining surgical resectability in PDAC according to ICC is crucial for patient survival. Patients with PDAC BR-B should be considered for multimodal neoadjuvant therapy even if considered anatomically resectable.},
  language  = {en}
}