@article{UlrichsEcksteinHeiseretal.1992,
  author    = {Ulrichs, Karin and Eckstein, V. and Heiser, A. and M{\"u}ller-Ruchholtz, W.},
  title     = {Die zellvermittelte Immunantwort des menschlichen Transplantat Empf{\"a}ngers gegen xenogenes Antigen (Schwein) ist abh{\"a}ngig vom Spenderkompartiment.},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-86978},
  year      = {1992},
  abstract  = {No abstract available.},
  subject      = {Transplantation},
  language  = {de}
}
@article{BreitkreuzUlrichsEcksteinetal.1992,
  author    = {Breitkreuz, A. and Ulrichs, Karin and Eckstein, V. and M{\"u}ller-Ruchholtz, W.},
  title     = {Induktion von Transplantat-Toleranz gegen Xenoantigen durch eine Pharmakon-Antigen-Kombinationsbehandlung},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-86969},
  year      = {1992},
  abstract  = {No abstract available.},
  subject      = {Transplantat},
  language  = {de}
}
@article{HeiserUlrichsWinotoMorbachetal.1992,
  author    = {Heiser, A. and Ulrichs, Karin and Winoto-Morbach, S. and Vanucchi, A. and J{\"a}ger, H. and M{\"u}ller-Ruchholtz, W.},
  title     = {Erste Kieler Erfahrungen mit 45 Isolierungen von Langerhansinseln aus Schweinepankreas},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-73205},
  year      = {1992},
  abstract  = {No abstract available.},
  subject      = {Langerhans-Inseln},
  language  = {de}
}
@article{UlrichsMuellerRuchholtz1993,
  author    = {Ulrichs, Karin and M{\"u}ller-Ruchholtz, W.},
  title     = {Pharmakologische Beeinflussung nat{\"u}rlicher Antik{\"o}rper als Vorbedingung f{\"u}r die erfolgreiche Xenotransplantation},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-73216},
  year      = {1993},
  abstract  = {No abstract available.},
  subject      = {Heterotransplantation},
  language  = {de}
}
@article{HeiserUlrichsGieretal.1993,
  author    = {Heiser, A. and Ulrichs, Karin and Gier, C. and M{\"u}ller-Ruchholtz, W.},
  title     = {Isolierung Langerhans'scher Inseln aus dem Pankreas von Schweinen: Einfluss biologischer und technischer Parameter auf die Inselausbeite und -integrit{\"a}t},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-73223},
  year      = {1993},
  abstract  = {No abstract available.},
  subject      = {Langerhans-Inseln},
  language  = {de}
}
@article{UlrichsHeiserBosseetal.1993,
  author    = {Ulrichs, Karin and Heiser, A. and Bosse, M. and Wacker, H. H. and M{\"u}ller-Ruchholtz, W.},
  title     = {Histologische Untersuchungen des Schweinepankreas zur Verbesserung der Inselausbeute und -integrit{\"a}t nach Kollagenase-Verdauung},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-73237},
  year      = {1993},
  abstract  = {No abstract available.},
  subject      = {Schwein},
  language  = {de}
}
@article{DickneiteSchorlemmerSedlaceketal.1987,
  author    = {Dickneite, G. and Schorlemmer, H. U. and Sedlacek, H. H. and Falk, W. and Ulrichs, Karin and M{\"u}ller-Ruchholtz, W.},
  title     = {Suppression of macrophage function and prolongation of graft survival by the new guanidinic-like structure, 15-deoxyspergualin},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-86991},
  year      = {1987},
  abstract  = {No abstract available.},
  subject      = {Makrophage},
  language  = {en}
}
@article{BuschLorenzTiurbeetal.2013,
  author    = {Busch, Albert and Lorenz, Udo and Tiurbe, George Christian and B{\"u}hler, Christoph and Kellersmann, Richard},
  title     = {Femoral vein obturator bypass revascularization in groin infectious bleeding: two case reports and review of the literature},
  series = {Journal of Medical Case Reports},
  journal   = {Journal of Medical Case Reports},
  doi       = {10.1186/1752-1947-7-75},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-95901},
  year      = {2013},
  abstract  = {Introduction Groin infections resulting in arterial bleeding due to bacterial vessel destruction are a severe challenge in vascular surgery. Patients with them most often present as emergencies and therefore need individualized reconstruction solutions. Case presentation Case 1 is a 67-year-old man with infectious bleeding after an autologous reconstruction of the femoral bifurcation with greater saphenous vein due to infection of a bovine pericard patch after thrombendarterectomy. Case 2 is a 35-year-old male drug addict and had severe femoral bleeding and infection after repeated intravenous and intra-arterial substance abuse. Both patients were treated with an autologous obturator bypass of the superficial femoral vein. We review the current literature and highlight our therapeutic concept of this clinical entity. Conclusions Treatment should include systemic antibiotic medication, surgical control of the infectious site, revascularization and soft tissue repair. An extra-anatomical obturator bypass with autologous superficial femoral vein should be considered as the safest revascularization procedure in infections caused by highly pathogenic bacteria.},
  language  = {en}
}
@article{UlrichsEcksteinTibelletal.1994,
  author    = {Ulrichs, Karin and Eckstein, V. and Tibell, A. and Groth, C. G. and Korsgren, O. and M{\"u}ller-Ruchholtz, W. and Thiede, A.},
  title     = {Nat{\"u}rliche und induzierte xenoreaktive Antik{\"o}rper vor und nach klinischer Transplantation f{\"o}taler porziner Pankreasinselzellen},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-72967},
  year      = {1994},
  abstract  = {No abstract available.},
  subject      = {Antik{\"o}rper},
  language  = {de}
}
@article{UlrichsEcksteinKorsgrenetal.1994,
  author    = {Ulrichs, Karin and Eckstein, V. and Korsgren, O. and Tibell, A. and Groth, C. G. and M{\"u}ller-Ruchholtz, W.},
  title     = {Characterization of natural and induced human xenophile antibodies before and after transplantation of the fetal porcine endocrine pancreas},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-86985},
  year      = {1994},
  abstract  = {No abstract available.},
  subject      = {Bauspeicheldr{\"u}se},
  language  = {de}
}
@article{JohanssenHahnerSaegeretal.2010,
  author    = {Johanssen, Sarah and Hahner, Stefanie and Saeger, Wolfgang and Quinkler, Marcus and Beuschlein, Felix and Dralle, Henning and Haaf, Michaela and Kroiss, Matthias and Jurowich, Christian and Langer, Peter and Oelkers, Wolfgang and Spahn, Martin and Willenberg, Holger S. and Maeder, Uwe and Allolio, Bruno and Fassnacht, Martin},
  title     = {Deficits in the Management of Patients With Adrenocortical Carcinoma in Germany},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-85897},
  year      = {2010},
  abstract  = {Background: Adrenocortical carcinoma (ACC) is a rare tumor with a poor prognosis. Often, the physicians who first treat patients with ACC have no prior experience with the disease. The aim of our study was to evaluate the quality of medical care for patients with ACC in Germany. Methods: Data from the German ACC registry were analyzed with regard to the patients' preoperative diagnostic evaluation, histopathological reporting, and clinical followup. The findings were compared with the recommendations of the European Network for the Study of Adrenal Tumors (ENSAT). Results: Data were analyzed from 387 patients who had been given an initial diagnosis of ACC in the years 1998 to 2009. 21\% of them underwent no hormonal evaluation before surgery, and 59\% underwent an inadequate hormonal evaluation. This exposed the patients to unnecessary perioperative risks and impaired their follow-up. 48\% did not undergo CT scanning of the chest, even though the lungs are the most frequent site of metastases of ACC. For 13\% of the patients, the diagnosis of ACC was later revised by a reference pathologist. For 11\% of the patients, the histopathology report contained no information about resection status, even though this is an important determinant of further treatment and prognosis. Optimal management requires re-staging at three-month intervals, yet some patients underwent re-staging only after a longer delay, or not at all. Conclusion: We have identified significant deficits in the care of patients with ACC in Germany. We suspect that the situation is similar for other rare diseases. The prerequisite to better care is close and early cooperation of the treating physicians with specialized centers.},
  language  = {en}
}
@article{SuratMeyerSautterRueschetal.2022,
  author    = {Surat, G{\"u}zin and Meyer-Sautter, Pascal and R{\"u}sch, Jan and Braun-Feldweg, Johannes and Markus, Christian Karl and Germer, Christoph-Thomas and Lock, Johan Friso},
  title     = {Cefazolin might be adequate for perioperative antibiotic prophylaxis in intra-abdominal infections without sepsis: a quality improvement study},
  series = {Antibiotics},
  volume    = {11},
  journal   = {Antibiotics},
  number    = {4},
  issn      = {2079-6382},
  doi       = {10.3390/antibiotics11040501},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-270816},
  year      = {2022},
  abstract  = {Background: The adequate choice of perioperative antibiotic prophylaxis (PAP) could influence the risk of surgical site infections (SSIs) in general surgery. A new local PAP guideline was implemented in May 2017 and set the first-generation cefazolin (CFZ) instead the second-generation cefuroxime (CXM) as the new standard prophylactic antibiotic. The aim of this study was to compare the risk of SSIs after this implementation in intra-abdominal infections (IAIs) without sepsis. Methods: We performed a single center-quality improvement study at a 1500 bed sized university hospital in Germany analyzing patients after emergency surgery during 2016 to 2019 (n = 985), of which patients receiving CXM or CFZ were selected (n = 587). Propensity score matching was performed to ensure a comparable risk of SSIs in both groups. None-inferiority margin for SSIs was defined as 8\% vs. 4\%. Results: Two matched cohorts with respectively 196 patients were compared. The rate of SSIs was higher in the CFZ group (7.1\% vs. 3.6\%, p = 0.117) below the non-inferiority margin. The rate of other postoperative infections was significantly higher in the CFZ group (2.0\% vs. 8.7\%, p = 0.004). No other differences including postoperative morbidity, mortality or length-of-stay were observed. Conclusion: Perioperative antibiotic prophylaxis might be safely maintained by CFZ even in the treatment of intra-abdominal infections.},
  language  = {en}
}
@phdthesis{Jaeger2009,
  author    = {J{\"a}ger, Simon Ulrich},
  title     = {Surveillance des Barrett-{\"O}sophagus - Vergleich konservative Therapie versus Anti-Reflux-Operation},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-39391},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2009},
  abstract  = {Der Zusammenhang von Zylinder-Epithel ausgekleideten Abschnitten des {\"O}sophagus mit der Entwicklung eines {\"o}sophagealen Adenokarzinoms ist nun schon seit fast 50 Jahren bekannt. Im Jahre 2008 geht man davon aus, dass j{\"a}hrlich etwa 0.5\% der Patienten mit Barrett-{\"O}sophagus ein Adenokarzinom entwickeln. Trotz verbesserter Operationstechnik und der zus{\"a}tzlich angewandten neoadjuvanten Therapie bleibt die Prognose des Adenokarzinom infaust, nicht zuletzt weil sich die Patienten mangels eindr{\"u}cklicher Fr{\"u}hsymptome oft erst in weit fortgeschrittenen Stadien pr{\"a}sentieren. Bei insgesamt kleinen Fallzahlen f{\"u}r das Adenokarzinom, der hohen Pr{\"a}valenz der GERD-Symptomatik und des hohen Anteils der Patienten mit Barrett-{\"O}sophagus die offensichtlich nie zu einem Adenokarzinom progredieren, erscheint ein weit angelegtes Screening durch Gastroskopien mit Biopsie-Entnahmen ineffektiv und un{\"o}konomisch. Aus dem Ende der Neunziger Jahre prospektiv angelegten Barrett-Register der chirurgischen Universit{\"a}tsklinik W{\"u}rzburg wurden 125 Patienten mit Barrett-Diagnose {\"u}ber 819 Patientenjahre verfolgt. Hier wurde lediglich ein Adenokarzinom mit begleitender high-grade Dysplasie beobachtet, das sich nach einem Intervall von 8 Jahren aus einem nicht-dysplastischen Barrett-Segment entwickelte. Weiterhin wurde in einer Patientin mit einem long-segment Barrett-{\"O}sophagus die R{\"u}ckbildung einer low-grade Dysplasie in ein nicht-dysplastisches Zylinderepithel beobachtet. Die um in etwa ein Drittel erniedrigte Inzidenz des Adenokarzinoms in dieser Studie (1,22 pro 1000 Patientenjahre) k{\"o}nnte sich durch ein l{\"a}ngeres Follow-Up an die in der Literatur beschriebene Inzidenz durch das Auftreten weniger F{\"a}lle angleichen. Eine regelm{\"a}ßige endoskopische {\"U}berwachung der Barrett-Schleimhaut bleibt, solange noch keine anderen Modalit{\"a}ten zur sicheren Risikostratifizierung erh{\"a}ltlich sind, eine zwar belastende, im Einzelfall aber lebenswichtige Maßnahme.},
  subject      = {Endobrachy{\"o}sophagus},
  language  = {de}
}
@phdthesis{Mueller2009,
  author    = {Mueller, Nicolas},
  title     = {Langzeitergebnisse der intraoperativen iliakalen Angioplastie bei der Therapie der peripheren arteriellen Verschlusskrankheit vom Mehretagen-Typ durch Hybrideingriffe},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-48514},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2009},
  abstract  = {In den letzten Jahren hat sich die intraoperative Angioplastie (ITA) der Beckengef{\"a}ße bei simultaner konventioneller peripherer Rekonstruktion als Behandlungsoption der Mehretagen-AVK entwickelt, ohne dass eine umfangreiche Datenlage bez{\"u}glich ihrer langfristigen Offenheitsraten vorliegt. Die Ergebnisse der weitaus h{\"a}ufiger durchgef{\"u}hrten perkutanen Angioplastie (PTA) im Iliakalbereich lassen sich nicht ohne weiteres auf die ITA {\"u}bertragen. Daher soll es Ziel dieser Arbeit sein, die Langzeitergebnisse der intraoperativen iliakalen Angioplastie und Stentapplikation bei der kombinierten endovaskul{\"a}ren/ konventionellen gef{\"a}ßchirurgischen Therapie der peripheren arteriellen Verschlusskrankheit vom Mehretagentyp darzustellen. Im Zeitraum von 11/98 bis 10/03 wurden bei insgesamt 63 Patienten (mittleres Alter: 65,5 Jahre) 66 Beckenetagen durch ITA behandelt. Es kamen insgesamt 76 Stents (12 x ballon-expandierend, 64 x selbst-expandierend) zum Einsatz. Simultan erfolgte bei allen Patienten eine periphere Gef{\"a}ßrekonstruktion (Femoralis-TEA, poplitealer/cruraler Bypass, cross-over Bypass). Die Daten wurden anhand der Krankenakte, Hausarztanfragen sowie gezielter klinischer und sonographischer Nachuntersuchungen erhoben. Anhand der pr{\"a}operativen Angiographien wurden s{\"a}mtliche Beckenetagenl{\"a}sionen nachtr{\"a}glich nach TASC-Kriterien klassifiziert. Von den 63 Patienten konnten von 55 (58 Beckenetagen) relevante Nachuntersuchungsdaten gewonnen werden (87\%). Nach einem mittleren Beoachtungszeitraum von 5,5 Jahren ergab sich eine prim{\"a}re Offenheitsrate der iliakalen Stents bezogen auf die behandelten Beckenetagen von 86\%. Die kumulative Stentoffenheitsrate lag bei 73,9 \% nach 9 Jahren. Es bestand kein signifikanter Unterschied der Stentoffenheitsrate zwischen TASC-A- (n=32) und Non-A- (n=26) L{\"a}sionen (p=0,82, log-Rang-Test). Ebenfalls fand sich kein signifikanter Unterschied in Abh{\"a}ngigkeit von der Art der peripheren Gef{\"a}ßrekonstruktion. Im Verlauf des Untersuchungszeitraumes sind 16 Patienten verstorben (29\%). Neunmal (15,5\%) musste eine Major-Amputation der behandelten Extremit{\"a}t nach einer mittleren Zeitdauer von 2,7 Jahren erfolgen. Zusammenfassend l{\"a}sst sich formulieren, dass ITA/Stent aufgrund ihrer guten Offenheitsrate auch im Langzeitverlauf eine sinnvolle Erg{\"a}nzung des Behandlungsspektrums bei der pAVK vom Beckentyp darstellt. Unter Ber{\"u}cksichtigung der Morphologie der Gef{\"a}ßl{\"a}sionen eignet sich ihr gering-invasiver Charakter besonders f{\"u}r Patienten mit einem h{\"o}heren perioperativen Risiko. Gerade bei komplexer Mehretagen-AVK bietet sie eine effiziente M{\"o}glichkeit der Einstromverbesserung f{\"u}r periphere Rekonstruktionen.},
  subject      = {Arterielle Verschlusskrankheit},
  language  = {de}
}
@phdthesis{Stratmann2021,
  author    = {Stratmann, Robert Henrik},
  title     = {Ursachen und Therapie duodenaler Obstruktion im Kindesalter am Universit{\"a}tsklinikum W{\"u}rzburg - Analyse von Genese, assoziierten Fehlbildungen, Therapie und Outcome},
  doi       = {10.25972/OPUS-25055},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-250552},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Eine retrospektive Analyse von kindlichen Patienten mit duodenaler Obstruktion, welche zwischen dem 01.01.2005 und dem 30.06.2020 im Universit{\"a}tsklinikum W{\"u}rzburg in der Abteilung f{\"u}r Kinderchirurgie operativ behandelt wurden. Analyse von Ursachen, Gestationsalter, Geburtsgewicht, Geburtsmodus, Begleitfehlbildungen, Diagnosestellung, operativer Versorgung und aufgetretener Komplikationen. Duodenale Obstruktion wird meist von duodenalen Atresien und Stenosen verursacht. Es besteht eine H{\"a}ufung von begleitenden Fehlbildungen wie z.B. einer Trisomie 21, urogenitalen- oder Herzfehlbildungen. Eine Mehrheit der Patienten ist fr{\"u}hgeboren, extreme Unreife ist jedoch selten. Es besteht eine leichte Linksverschiebung des Geburtsgewichtes zur Hypotrophie. Bei korrekter chirurgischer Therapie haben Duodenalatresien und -stenosen eine gute Prognose, welche zumeist von den Begleiterkrankungen limitiert wird.},
  subject      = {Atresie},
  language  = {de}
}
@phdthesis{ChristagebLudwig2022,
  author    = {Christa [geb. Ludwig], Natalie Yvonne},
  title     = {Persistierender Urachus - h{\"a}ufiger als gedacht? Eine retrospektive Datenanalyse},
  doi       = {10.25972/OPUS-28743},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-287438},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Eine retrospektive Datenanalyse der Urachusoperationen von 2009- 2019 an der Kinderchirurgischen Klinik des Universit{\"a}tsklinikums in W{\"u}rzburg. Es zeigte sich, dass der Urachus h{\"a}ufiger als gedacht vorkommt und dies oft als intraoperativer Zufallsbefund.},
  subject      = {Urachus},
  language  = {de}
}
@phdthesis{Langseder2023,
  author    = {Langseder, Theresa Christina},
  title     = {Charakterisierung intestinaler Barrierever{\"a}nderungen bei Ratten nach Roux-en-Y Magenbypass},
  doi       = {10.25972/OPUS-30575},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-305756},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2023},
  abstract  = {Die bariatrische Chirurgie ist momentan die einzige Therapieoption der morbiden Adipositas mit der eine langfristige Gewichtsreduktion erreicht werden kann. Unter den Operationsmethoden gilt der RYGB als eine der wirksamsten Behandlungen bezogen auf den Gewichtsverlust und die Verbesserung von Begleiterkrankungen wie dem Diabetes mellitus Typ 2. Dar{\"u}ber hinaus belegt eine wachsende Zahl an Ver{\"o}ffentlichungen, dass der RYGB den Zustand chronischer Entz{\"u}ndung, wie er typischerweise mit Adipositas einhergeht, verringern kann. Diese sogenannte Endotox{\"a}mie geht unter anderem mit einer gest{\"o}rten Integrit{\"a}t der intestinalen Epithelbarriere einher. Ziel der vorliegenden Arbeit war es eine Analyse der Ver{\"a}nderungen von f{\"u}r die Darmbarriere wichtigen Junktionsproteinen vorzunehmen, um eine Grundlage f{\"u}r k{\"u}nftige mechanistische Untersuchungen zu schaffen. Daf{\"u}r wurden die Ver{\"a}nderungen von Barriereproteinen in Vollwandresektaten des Duodenums, des Jejunums, des Ileums sowie des Kolons von Ratten, die einen RYGB erhalten hatten, mittels Western Blot Untersuchungen quantifiziert. Als Kontrollgruppe dienten schein-operierte Ratten. Es kam zu tiefgreifenden Ver{\"a}nderungen der analysierten Barriereproteine in den Vollwandresektaten. Interessanterweise unterschieden sich die Verteilungsmuster der Ver{\"a}nderungen der Barriereproteinte deutlich zwischen den einzelnen Darmregionen. Um herauszufinden, ob diese Ver{\"a}nderungen durch regionale Ver{\"a}nderungen der Mikroumgebung nach RYGB- Operation induziert wurden, wurden im reduktionistischen Zellkultursystem Stuhl- Transferexperimente durchgef{\"u}hrt. Caco2-Zellkulturen dienten hierbei als Modell f{\"u}r die intestinale epitheliale Barriere. Es wurden funktionelle Messungen und quantitative Analysen der Ver{\"a}nderungen der Barriereproteine der Zellkultur durchgef{\"u}hrt. Die Funktionsmessungen zeigten, dass der Inhalt des Duodenums, des Jejunums sowie des Kolons deutliche barrierestabilisierende Effekte auf die Caco2-Zellmonolayer hatte. Zudem zeigten sich tiefgreifende Ver{\"a}nderungen der untersuchten Barriereproteine. Zusammenfassend wurde in der vorliegenden Arbeit erstmals eine regionenspezfische Regulation der intestinalen Barriereproteine in Korrelation mit funktionellen Messungen nach RYGB nachgewiesen.},
  subject      = {Operation},
  language  = {de}
}
@phdthesis{Fink2023,
  author    = {Fink, Nicolas Robin},
  title     = {H{\"a}lt doppelt besser? Retrospektiver Vergleich zweier operativer Therapiestrategien kindlicher Unterarmfrakturen},
  doi       = {10.25972/OPUS-30260},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-302604},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2023},
  abstract  = {Die hier vorliegende Untersuchung besch{\"a}ftigt sich mit dem Vergleich zweier minimalinvasiver operativer Therapiestrategien der distalen Unterarmfraktur als h{\"a}ufigster Fraktur im Kindesalter. F{\"u}r die vorliegende Studie erfolgte eine umfassende retrospektive Auswertung von 122 F{\"a}llen distaler kindlicher Unterarmfrakturen aus einem Zeitraum von elf Jahren, die in der kinderchirurgischen Abteilung des Universit{\"a}tsklinikums W{\"u}rzburg osteosynthetisch versorgt wurden. Ziel der Untersuchung war die Betrachtung der Epidemiologie des Verletzungsbildes und des Therapieerfolges in Abh{\"a}ngigkeit von der gew{\"a}hlten Osteosynthesetechnik. Die Kinder wurden dabei entweder allein durch eine Kirschner-Draht-Osteosynthese des Radius oder durch eine zus{\"a}tzliche Fixierung der Ulna mittels elastisch stabiler intramedull{\"a}rer Nagelung versorgt. Durch beide Operationsstrategien konnte f{\"u}r die meisten Patientinnen und Patienten ein gutes Therapieergebnis erreicht werden. Hinsichtlich der Operations- und Hospitalisierungsdauer zeigte sich ein Vorteil f{\"u}r Kinder, die osteosynthetisch lediglich durch Kirschner-Dr{\"a}hte versorgt wurden. In anderen Studien beobachtete Komplikationen in Form sekund{\"a}rer Dislokationen der Fraktur auch nach Osteosynthese oder Infektionen im Bereich der Drahtenden konnten im hier untersuchten Kollektiv seltener festgestellt werden. Die vorliegende Untersuchung zeigt, dass, sofern die Indikation zur operativen Versorgung besteht, die Fixierung des Radius allein mittels Kirschner-Dr{\"a}hten eine ad{\"a}quate Therapie distaler Frakturen von Ulna und Radius im Kindesalter darstellt. Von einer kombinierten Osteosynthese mittels Kirschner-Dr{\"a}hten und ESIN k{\"o}nnten besonders Patientinnen und Patienten profitieren, bei denen initial große Dislokationen der Fraktur, Begleitverletzungen des Arms oder eine Lokalisation im Bereich des diametaphys{\"a}ren {\"U}bergangs bestehen. Um diese Beobachtungen auch in gr{\"o}ßeren Kollektiven und prospektiv sowie randomisiert zu untersuchen, sind weitere Studien w{\"u}nschenswert.},
  subject      = {Unterarmbruch},
  language  = {de}
}
@article{LenschowFussKircheretal.2021,
  author    = {Lenschow, Christina and Fuss, Carmina Teresa and Kircher, Stefan and Buck, Andreas and Kickuth, Ralph and Reibetanz, Joachim and Wiegering, Armin and Stenzinger, Albrecht and H{\"u}bschmann, Daniel and Germer, Christoph Thomas and Fassnacht, Martin and Fr{\"o}hling, Stefan and Schlegel, Nicolas and Kroiss, Matthias},
  title     = {Case Report: Abdominal Lymph Node Metastases of Parathyroid Carcinoma: Diagnostic Workup, Molecular Diagnosis, and Clinical Management},
  series = {Frontiers in Endocrinology},
  volume    = {12},
  journal   = {Frontiers in Endocrinology},
  issn      = {1664-2392},
  doi       = {10.3389/fendo.2021.643328},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-233362},
  year      = {2021},
  abstract  = {Parathyroid carcinoma (PC) is an orphan malignancy accounting for only ~1\% of all cases with primary hyperparathyroidism. The localization of recurrent PC is of critical importance and can be exceedingly difficult to diagnose and sometimes futile when common sites of recurrence in the neck and chest cannot be confirmed. Here, we present the diagnostic workup, molecular analysis and multimodal therapy of a 46-year old woman with the extraordinary manifestation of abdominal lymph node metastases 12 years after primary diagnosis of PC. The patient was referred to our endocrine tumor center in 2016 with the aim to localize the tumor causative of symptomatic biochemical recurrence. In view of the extensive previous workup we decided to perform [18F]FDG-PET-CT. A pathological lymph node in the liver hilus showed slightly increased FDG-uptake and hence was suspected as site of recurrence. Selective venous sampling confirmed increased parathyroid hormone concentration in liver veins. Abdominal lymph node metastasis was resected and histopathological examination confirmed PC. Within four months, the patient experienced biochemical recurrence and based on high tumor mutational burden detected in the surgical specimen by whole exome sequencing the patient received immunotherapy with pembrolizumab that led to a biochemical response. Subsequent to disease progression repeated abdominal lymph node resection was performed in 10/2018, 01/2019 and in 01/2020. Up to now (12/2020) the patient is biochemically free of disease. In conclusion, a multimodal diagnostic approach and therapy in an interdisciplinary setting is needed for patients with rare endocrine tumors. Molecular analyses may inform additional treatment options including checkpoint inhibitors such as pembrolizumab.},
  language  = {en}
}
@article{HendricksLenschowKroissetal.2021,
  author    = {Hendricks, Anne and Lenschow, Christina and Kroiss, Matthias and Buck, Andreas and Kickuth, Ralph and Germer, Christoph-Thomas and Schlegel, Nicolas},
  title     = {Evaluation of diagnostic efficacy for localization of parathyroid adenoma in patients with primary hyperparathyroidism undergoing repeat surgery},
  series = {Langenbeck's Archives of Surgery},
  volume    = {406},
  journal   = {Langenbeck's Archives of Surgery},
  number    = {5},
  issn      = {1435-2451},
  doi       = {10.1007/s00423-021-02191-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-267520},
  pages     = {1615-1624},
  year      = {2021},
  abstract  = {Purpose Repeat surgery in patients with primary hyperparathyroidism (pHPT) is associated with an increased risk of complications and failure. This stresses the need for optimized strategies to accurately localize a parathyroid adenoma before repeat surgery is performed. However, evidence on the extent of required diagnostics for a structured approach is sparse. Methods A retrospective single-center evaluation of 28 patients with an indication for surgery due to pHPT and previous thyroid or parathyroid surgery was performed. Diagnostic workup, surgical approach, and outcome in terms of complications and successful removement of parathyroid adenoma with biochemical cure were evaluated. Results Neck ultrasound, sestamibi scintigraphy, C11-methionine PET-CT, and selective parathyroid hormone venous sampling, but not MRI imaging, effectively detected the presence of a parathyroid adenoma with high positive predictive values. Biochemical cure was revealed by normalization of calcium and parathormone levels 24-48h after surgery and was achieved in 26/28 patients (92.9\%) with an overall low rate of complications. Concordant localization by at least two diagnostic modalities enabled focused surgery with success rates of 100\%, whereas inconclusive localization significantly increased the rate of bilateral explorations and significantly reduced the rate of biochemical cure to 80\%. Conclusion These findings suggest that two concordant diagnostic modalities are sufficient to accurately localize parathyroid adenoma before repeat surgery for pHPT. In cases of poor localization, extended diagnostic procedures are warranted to enhance surgical success rates. We suggest an algorithm for better orientation when repeat surgery is intended in patients with pHPT.},
  language  = {en}
}
@article{SuratVogelWiegeringetal.2021,
  author    = {Surat, G{\"u}zin and Vogel, Ulrich and Wiegering, Armin and Germer, Christoph-Thomas and Lock, Johan Friso},
  title     = {Defining the scope of antimicrobial stewardship interventions on the prescription quality of antibiotics for surgical intra-abdominal infections},
  series = {Antibiotics},
  volume    = {10},
  journal   = {Antibiotics},
  number    = {1},
  issn      = {2079-6382},
  doi       = {10.3390/antibiotics10010073},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-223034},
  year      = {2021},
  abstract  = {Background: The aim of this study was to assess the impact of antimicrobial stewardship interventions on surgical antibiotic prescription behavior in the management of non-elective surgical intra-abdominal infections, focusing on postoperative antibiotic use, including the appropriateness of indications. Methods: A single-center quality improvement study with retrospective evaluation of the impact of antimicrobial stewardship measures on optimizing antibacterial use in intra-abdominal infections requiring emergency surgery was performed. The study was conducted in a tertiary hospital in Germany from January 1, 2016, to January 30, 2020, three years after putting a set of antimicrobial stewardship standards into effect. Results: 767 patients were analyzed (n = 495 in 2016 and 2017, the baseline period; n = 272 in 2018, the antimicrobial stewardship period). The total days of therapy per 100 patient days declined from 47.0 to 42.2 days (p = 0.035). The rate of patients receiving postoperative therapy decreased from 56.8\% to 45.2\% (p = 0.002), comparing both periods. There was a significant decline in the rate of inappropriate indications (17.4\% to 8.1 \%, p = 0.015) as well as a significant change from broad-spectrum to narrow-spectrum antibiotic use (28.8\% to 6.5\%, p ≤ 0.001) for postoperative therapy. The significant decline in antibiotic use did not affect either clinical outcomes or the rate of postoperative wound complications. Conclusions: Postoperative antibiotic use for intra-abdominal infections could be significantly reduced by antimicrobial stewardship interventions. The identification of inappropriate indications remains a key target for antimicrobial stewardship programs.},
  language  = {en}
}
@article{DietzKudsiGarciaUrenaetal.2021,
  author    = {Dietz, Ulrich A. and Kudsi, O. Yusef and Garcia-Ure{\~n}a, Miguel and Baur, Johannes and Ramser, Michaela and Maksimovic, Sladjana and Keller, Nicola and D{\"o}rfer, J{\"o}rg and Eisner, Lukas and Wiegering, Armin},
  title     = {Robotische Hernienchirurgie III: Robotische Inzisionalhernienversorgung mit „transversus abdominis release" (r-TAR). Videobeitrag und Ergebnisse einer Kohortenstudie},
  series = {Der Chirurg},
  volume    = {92},
  journal   = {Der Chirurg},
  number    = {10},
  doi       = {10.1007/s00104-021-01480-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265172},
  pages     = {936-947},
  year      = {2021},
  abstract  = {Das Prinzip der gezielten Trennung bzw. Schw{\"a}chung einzelner Komponenten der Bauchdecke zur Spannungsentlastung der Medianlinie bei großen abdominellen Rekonstruktionen ist seit {\"u}ber 30 Jahren als anteriore Komponentenseparation (aKS) bekannt und ein etabliertes Verfahren. Auf der Suche nach Alternativen mit geringerer Komplikationsrate wurde die posteriore Komponentenseparation (pKS) entwickelt; der „transversus abdominis release" (TAR) ist eine nervenschonende Modifikation der pKS. Mit den ergonomischen Ressourcen der Robotik (z. B. abgewinkelte Instrumente) kann der TAR minimal-invasiv durchgef{\"u}hrt werden (r-TAR): Bruchl{\"u}cken von bis zu 14 cm lassen sich verschließen und ein großes extraperitoneales Netz implantieren. In diesem Videobeitrag wird die Versorgung großer Inzisionalhernien in der r‑TAR-Technik pr{\"a}sentiert. Exemplarisch werden die Ergebnisse einer Kohortenstudie an 13 konsekutiven Patienten vorgestellt. Der Eingriff ist anspruchsvoll, die eigenen Ergebnisse sind - wie auch die Berichte aus der Literatur - ermutigend. Der r‑TAR entwickelt sich zur K{\"o}nigsdisziplin der Bauchdeckenrekonstruktion.},
  language  = {de}
}
@article{LauruschkatPageWhiteetal.2021,
  author    = {Lauruschkat, Chris D. and Page, Lukas and White, P. Lewis and Etter, Sonja and Davies, Helen E. and Duckers, Jamie and Ebel, Frank and Schnack, Elisabeth and Backx, Matthijs and Dragan, Mariola and Schlegel, Nicolas and Kniemeyer, Olaf and Brakhage, Axel A. and Einsele, Hermann and Loeffler, Juergen and Wurster, Sebastian},
  title     = {Development of a simple and robust whole blood assay with dual co-stimulation to quantify the release of T-cellular signature cytokines in response to Aspergillus fumigatus antigens},
  series = {Journal of Fungi},
  volume    = {7},
  journal   = {Journal of Fungi},
  number    = {6},
  issn      = {2309-608X},
  doi       = {10.3390/jof7060462},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-241025},
  year      = {2021},
  abstract  = {Deeper understanding of mold-induced cytokine signatures could promote advances in the diagnosis and treatment of invasive mycoses and mold-associated hypersensitivity syndromes. Currently, most T-cellular immunoassays in medical mycology require the isolation of mononuclear cells and have limited robustness and practicability, hampering their broader applicability in clinical practice. Therefore, we developed a simple, cost-efficient whole blood (WB) assay with dual α-CD28 and α-CD49d co-stimulation to quantify cytokine secretion in response to Aspergillus fumigatus antigens. Dual co-stimulation strongly enhanced A. fumigatus-induced release of T-cellular signature cytokines detectable by enzyme-linked immunosorbent assay (ELISA) or a multiplex cytokine assay. Furthermore, T-cell-dependent activation and cytokine response of innate immune cells was captured by the assay. The protocol consistently showed little technical variation and high robustness to pre-analytic delays of up to 8 h. Stimulation with an A. fumigatus lysate elicited at least 7-fold greater median concentrations of key T-helper cell signature cytokines, including IL-17 and the type 2 T-helper cell cytokines IL-4 and IL-5 in WB samples from patients with Aspergillus-associated lung pathologies versus patients with non-mold-related lung diseases, suggesting high discriminatory power of the assay. These results position WB-ELISA with dual co-stimulation as a simple, accurate, and robust immunoassay for translational applications, encouraging further evaluation as a platform to monitor host immunity to opportunistic pathogens.},
  language  = {en}
}
@article{GerhardHartmannWiegeringBenoitetal.2021,
  author    = {Gerhard-Hartmann, Elena and Wiegering, Verena and Benoit, Clemens and Meyer, Thomas and Rosenwald, Andreas and Maurus, Katja and Ernestus, Karen},
  title     = {A large retroperitoneal lipoblastoma as an incidental finding: a case report},
  series = {BMC Pediatrics},
  volume    = {21},
  journal   = {BMC Pediatrics},
  doi       = {10.1186/s12887-021-02628-w},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-260173},
  year      = {2021},
  abstract  = {Background Lipoblastoma is a rare benign mesenchymal neoplasm of infancy that most commonly occurs on the extremities and trunk but can arise at variable sites of the body. Retroperitoneal lipoblastomas are particularly rare but can grow to enormous size, and preoperative diagnosis is difficult with diverse, mostly malignant differential diagnoses that would lead to aggressive therapy. Since lipoblastoma is a benign tumor that has an excellent prognosis after resection, correct diagnosis is crucial. Case presentation A case of a large retroperitoneal tumor of a 24-month old infant that was clinically suspicious of a malignant tumor is presented. Due to proximity to the right kidney, clinically most probably a nephroblastoma or clear cell sarcoma of the kidney was suspected. Radiological findings were ambiguous. Therefore, the mass was biopsied, and histology revealed an adipocytic lesion. Although mostly composed of mature adipocytes, in view of the age of the patient, the differential diagnosis of a (maturing) lipoblastoma was raised, which was supported by molecular analysis demonstrating a HAS2-PLAG1 fusion. The tumor was completely resected, and further histopathological workup led to the final diagnosis of a 13 cm large retroperitoneal maturing lipoblastoma. The child recovered promptly from surgery and showed no evidence of recurrence so far. Conclusion Although rare, lipoblastoma should be included in the differential diagnoses of retroperitoneal tumors in infants and children, and molecular diagnostic approaches could be a helpful diagnostic adjunct in challenging cases.},
  language  = {en}
}
@article{KayisogluSchlegelBartfeld2021,
  author    = {Kayisoglu, {\"O}zge and Schlegel, Nicolas and Bartfeld, Sina},
  title     = {Gastrointestinal epithelial innate immunity-regionalization and organoids as new model},
  series = {Journal of Molecular Medicine},
  volume    = {99},
  journal   = {Journal of Molecular Medicine},
  number    = {4},
  doi       = {10.1007/s00109-021-02043-9},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265220},
  pages     = {517-530},
  year      = {2021},
  abstract  = {The human gastrointestinal tract is in constant contact with microbial stimuli. Its barriers have to ensure co-existence with the commensal bacteria, while enabling surveillance of intruding pathogens. At the centre of the interaction lies the epithelial layer, which marks the boundaries of the body. It is equipped with a multitude of different innate immune sensors, such as Toll-like receptors, to mount inflammatory responses to microbes. Dysfunction of this intricate system results in inflammation-associated pathologies, such as inflammatory bowel disease. However, the complexity of the cellular interactions, their molecular basis and their development remains poorly understood. In recent years, stem cell-derived organoids have gained increasing attention as promising models for both development and a broad range of pathologies, including infectious diseases. In addition, organoids enable the study of epithelial innate immunity in vitro. In this review, we focus on the gastrointestinal epithelial barrier and its regional organization to discuss innate immune sensing and development.},
  language  = {en}
}
@phdthesis{Kettler2019,
  author    = {Kettler, Julia},
  title     = {Der antiproliferative Effekt des epigenetischen BRD4- Inhibitors JQ1 auf den proliferativen Ph{\"a}notyp humaner kolorektaler Karzinomzellen},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-176418},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2019},
  abstract  = {Der niedermolekulare Inhibitor JQ1 bindet an der Bromodom{\"a}ne von BRD4, ein auf epigenetischer Ebene agierendes Protein. Der antiproliferative Effekt von JQ1 wurde bisher bei verschiedenen Tumorentit{\"a}ten vor allem des lymphatischen und blutbildenden Systems gezeigt. In dieser Arbeit wurde der antiproliferative Effekt von JQ1 an f{\"u}nf humanen kolorektalen Karzinomzelllinien im Vergleich zu nicht transformierten Kontrollzellen (Fibroblasten) in Normoxie, Hypoxie und in der Langzeitkultur nachgewiesen. Außerdem verringerte JQ1 die Expression von MYC auf Protein- und mRNA-Ebene und steigerte die Transkription des durch MYC negativ regulierten Zielegens p21. Diese Steigerung korrelierte mit einem Zellzyklusarrest in der G0/G1-Phase in vier von f{\"u}nf kolorektalen Karzinomzelllinien.},
  subject      = {MYC},
  language  = {de}
}
@phdthesis{Fuhr2022,
  author    = {Fuhr, Sebastian},
  title     = {Behandlungsoptionen Offene Abdomen Therapie - Entwicklung und Validierung eines multizentrischen Registers},
  doi       = {10.25972/OPUS-25708},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-257080},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Die Offene Abdomen Therapie (OAT) stellt eine der gr{\"o}ßten Herausforderungen im Bereich der Chirurgie dar. Ziel war es ein offenes, kostenloses und internationales Register zu entwickeln, um eine Basis f{\"u}r zuk{\"u}nftige Therapien und den Weg zu einer evidenzbasierten Leitlinie zu legen. Es wurden 630 F{\"a}lle identifiziert welche mittels OAT behandelt wurden und im Rahmen einer gemischt retrospektiven als auch prospektiven Datenauswertung in das von uns entwickelte Register eingetragen. Schwerpunkte waren dabei einerseits die Praktikabilit{\"a}t des Registers zu testen als auch Einflussfaktoren f{\"u}r eine erfolgreiche OAT zu finden. Es konnte gezeigt werden, dass das Register in seiner Konzeption funktioniert und in der ersten Auswertungen Einflussfaktoren f{\"u}r eine erh{\"o}hte Faszienverschlussrate gefunden werden konnten. Der verbesserte Faszienverschluss am Ende der Therapie mit zeitgleich reduzierter Komplikationsrate ist m{\"o}glich. Aus diesem Grund besitzt die konsequente Nutzung des Registers von behandelnden Einrichtungen, die wo immer m{\"o}gliche l{\"u}ckenlose Dokumentation, sowie die multizentrische Auswertung der Daten einen hohen Stellenwert in Hinsicht auf Pr{\"a}vention, Therapie und Nachsorge der OAT.},
  subject      = {Chirurgie},
  language  = {de}
}
@phdthesis{Doerries2022,
  author    = {D{\"o}rries, Luise},
  title     = {Einfluss der pr{\"a}operativen Konditionierung mittels Magenballon vor bariatrischer Operation auf den Therapieerfolg bei extremer Adipositas - Eine retrospektive Vergleichsstudie},
  doi       = {10.25972/OPUS-27294},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-272945},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Die Adipositaschirurgie ist die effektivste Methode in der Behandlung der Adipositas. Bei extrem adip{\"o}sen Patientin ist eine prim{\"a}re Operation oftmals riskant. Die Anlage eines Magenballons als erster Schritt von Mehrstufenkonzepten kann die Operabilit{\"a}t gew{\"a}hrleisten und die perioperative Sicherheit erh{\"o}hen. Durch den Magenballon wird ein signifikanter Gewichtsverlust erreicht. Der postoperative Gewichtsverlust f{\"a}llt allerdings schw{\"a}cher aus. Es ist wichtig, den Patienten realistische Therapieergebnisse zu vermitteln, um {\"u}berh{\"o}hte Erwartungen und Unzufriedenheit zu vermeiden. Die Sleevegastrektomie eignet sich besonders f{\"u}r extrem adip{\"o}se Patienten, da diese eine geringere Komplikationsrate aufweist und einfach in einen Roux-en-Y Bypass umzuwandeln ist.},
  subject      = {Sleeve-Resektion},
  language  = {de}
}
@article{ReimerLockFlemmingetal.2022,
  author    = {Reimer, Stanislaus and Lock, Johan F. and Flemming, Sven and Weich, Alexander and Widder, Anna and Plaßmeier, Lars and D{\"o}ring, Anna and Hering, Ilona and Hankir, Mohammed K. and Meining, Alexander and Germer, Christoph-Thomas and Groneberg, Kaja and Seyfried, Florian},
  title     = {Endoscopic management of large leakages after upper gastrointestinal surgery},
  series = {Frontiers in Surgery},
  volume    = {9},
  journal   = {Frontiers in Surgery},
  issn      = {2296-875X},
  doi       = {10.3389/fsurg.2022.885244},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-274044},
  year      = {2022},
  abstract  = {Background Endoscopic vacuum therapy (EVT) is an evidence-based option to treat anastomotic leakages of the upper gastrointestinal (GI) tract, but the technical challenges and clinical outcomes of patients with large defects remain poorly described. Methods All patients with leakages of the upper GI tract that were treated with endoscopic negative pressure therapy at our institution from 2012-2021 were analyzed. Patients with large defects (>30 mm) as an indicator of complex treatment were compared to patients with smaller defects (control group). Results Ninety-two patients with postoperative anastomotic or staplerline leakages were identified, of whom 20 (21.7\%) had large defects. Compared to the control group, these patients required prolonged therapy (42 vs. 14 days, p < 0.001) and hospital stay (63 vs. 26 days, p < 0.001) and developed significantly more septic complications (40 vs. 17.6\%, p = 0.027.) which often necessitated additional endoscopic and/or surgical/interventional treatments (45 vs. 17.4\%, p = 0.007.) Nevertheless, a resolution of leakages was achieved in 80\% of patients with large defects, which was similar compared to the control group (p = 0.42). Multiple leakages, especially on the opposite side, along with other local unfavorable conditions, such as foreign material mass, limited access to the defect or extensive necrosis occurred significantly more often in cases with large defects (p < 0.001). Conclusions Overall, our study confirms that EVT for leakages even from large defects of the upper GI tract is feasible in most cases but comes with significant technical challenges.},
  language  = {en}
}
@article{WidderKelmReibetanzetal.2022,
  author    = {Widder, Anna and Kelm, Matthias and Reibetanz, Joachim and Wiegering, Armin and Matthes, Niels and Germer, Christoph-Thomas and Seyfried, Florian and Flemming, Sven},
  title     = {Robotic-assisted versus laparoscopic left hemicolectomy — postoperative inflammation status, short-term outcome and cost effectiveness},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {19},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {17},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph191710606},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-286203},
  year      = {2022},
  abstract  = {Robotic-assisted colon surgery may contain advantages over the laparoscopic approach, but clear evidence is sparse. This study aimed to analyze postoperative inflammation status, short-term outcome and cost-effectiveness of robotic-assisted versus laparoscopic left hemicolectomy. All consecutive patients who received minimal-invasive left hemicolectomy at the Department of Surgery I at the University Hospital of Wuerzburg in 2021 were prospectively included. Importantly, no patient selection for either procedure was carried out. The robotic-assisted versus laparoscopic approaches were compared head to head for postoperative short-term outcomes as well as cost-effectiveness. A total of 61 patients were included, with 26 patients having received a robotic-assisted approach. Baseline characteristics did not differ among the groups. Patients receiving a robotic-assisted approach had a significantly decreased length of hospital stay as well as lower rates of complications in comparison to patients who received laparoscopic surgery (n = 35). In addition, C-reactive protein as a marker of systemic stress response was significantly reduced postoperatively in patients who were operated on in a robotic-assisted manner. Consequently, robotic-assisted surgery could be performed in a cost-effective manner. Thus, robotic-assisted left hemicolectomy represents a safe and cost-effective procedure and might improve patient outcomes in comparison to laparoscopic surgery.},
  language  = {en}
}
@phdthesis{OsterholtgebCallies2022,
  author    = {Osterholt [geb. Callies], Simone Caroline},
  title     = {Die Bedeutung von tumorzellassoziierter CD137L-Aktivierung f{\"u}r das Proliferationsverhalten und das Proteinexpressions- und -sekretionsprofil von humanen Kolonkarzinomzellen},
  doi       = {10.25972/OPUS-29338},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-293382},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {CD137 und CD137L stellen ein Rezeptor-Liganden-Paar dar, welches auf vielen Immunzellen exprimiert wird und eine wichtige Rolle im Rahmen der Immunstimulation spielt. CD137L fungiert jedoch nicht nur als Ligand sondern auch als Rezeptor und vermittelt als ein solcher Signale in die ihn exprimierende Zelle. Neben seinem Vorkommen auf Immunzellen wird CD137L auch von einigen Tumorzellen exprimiert, unter anderem auch auf denen des Kolonkarzinoms. In dieser Tumorentit{\"a}t korreliert eine hohe CD137L-Expression mit dem Auftreten von Fernmetastasen und einer insgesamt schlechteren Prognose. Die genaue Rolle von CD137L im Kolonkarzinom ist bislang kaum erforscht. Im Rahmen dieser Arbeit wurden daher die Auswirkungen einer CD137L-Aktivierung auf die Proliferation sowie die Proteinexpression und -sekretion von Kolonkarzinomzellen untersucht. Die Ergebnisse deuten erstmals darauf hin, dass die CD137L-Stimulation in vitro die Proliferation der entarteten Zellen reduziert und die Expression bzw. Sekretion der Proteine Vimentin, TLR7, VEGF und PDGF steigert. Hieraus wird geschlossen, dass eine Stimulation des von den Kolonkarzinomzellen exprimierten CD137L dazu f{\"u}hrt, dass sich der Ph{\"a}notyp der Tumorzellen von einem epithelialen in Richtung eines mesenchymalen Zelltyps ver{\"a}ndert. Dar{\"u}ber hinaus werden vermehrt Proteine exprimiert und sezerniert, welche {\"u}ber unterschiedliche Signalwege an der Invasion und Migration der entarteten Zellen beteiligt sind. Folglich l{\"a}sst sich annehmen, dass CD137L eine entscheidende Rolle im Metastasierungsprozess von humanen Kolonkarzinomzellen spielt. Sollte sich dies in weiterf{\"u}hrenden Untersuchungen best{\"a}tigen, k{\"o}nnte eine pharmazeutische Beeinflussung der beteiligten Signalwege m{\"o}glicherweise die Prognose von an Kolonkarzinomen erkrankten Patient:innen deutlich verbessern.},
  subject      = {Colonkrebs},
  language  = {de}
}
@phdthesis{Nagel2023,
  author    = {Nagel, Kathrin},
  title     = {Definition und Diagnostik des postoperativen Hypoparathyreoidismus nach Thyreoidektomie - ein systematischer Review und Metaanalyse},
  doi       = {10.25972/OPUS-30008},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300083},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2023},
  abstract  = {Der postoperative Hypoparathyreoidismus (PH) stellt eine der h{\"a}ufigsten Komplikationen nach Schilddr{\"u}senoperationen dar. Ziel dieses systematischen Reviews und Metaanalyse ist die Erarbeitung einer einheitlichen Definition sowie die Ermittlung des bestm{\"o}glichen Ansatzes f{\"u}r eine fr{\"u}hzeitige Detektion des PH. Nach Durchf{\"u}hrung einer systematischen Literaturrecherche gem{\"a}ß der PICo-Systematik unter Verwendung der Datenbanken Embase, Pubmed und der Cochrane Library, erfolgte die themenbezogene Aufarbeitung der eingeschlossenen Studien, sowie eine Bias-Bewertung und Metaanalyse geeigneter Arbeiten. Von 13.704 Artikeln konnten 188 in die weitere Analyse eingeschlossen werden. In diesen fanden sich sehr heterogene Definitionen des PH. Sowohl in der systematischen Analyse als auch in der Metaanalyse zeigte sich eine genauere Vorhersagekraft des PH durch eine postoperative im Vergleich zu einer intraoperativen PTH-Messung. Keiner der analysierten Zeitr{\"a}ume innerhalb des ersten postoperativen Tages (POD1) zeigte eine signifikante {\"U}berlegenheit in der Vorhersage eines PH. Die PTH- Schwellenwerte 10 bzw. 15 pg/ml k{\"o}nnen einen PH zuverl{\"a}ssig detektieren. Als Entscheidungsgrundlage zwischen den beiden Werten kann die untere Normwertgrenze des angewendeten Testverfahrens herangezogen werden. Bei pr{\"a}operativer PTH-Abnahme nach An{\"a}sthesieeinleitung ist ein relativer PTH-Abfall von pr{\"a}- nach postoperativ von 73 ± 11\% pr{\"a}diktiv f{\"u}r die Entwicklung eines PH. Die Bestimmung des Calciumspiegels an POD1 ist obligat und optimiert insbesondere die Erkennung einer biochemischen Hypokalz{\"a}mie. Ein nicht nachweisbarer oder inad{\"a}quat niedriger postoperativer PTH-Spiegel im Zusammenhang mit einer biochemischen oder symptomatischen Hypokalz{\"a}mie kann als einheitliche Definition des postoperativen Hypoparathyreoidismus vorgeschlagen werden. Die Messung des Parathormons sollte zwischen einer und sechs Stunden postoperativ, sp{\"a}testens aber innerhalb von 24 Stunden erfolgen. Sowohl der Schwellenwert ≤ 15 pg/ml als auch ein relativer PTH-Abfall von pr{\"a}- nach postoperativ sind zuverl{\"a}ssig in der Detektion gef{\"a}hrdeter Patienten.},
  subject      = {Hypoparathyreoidismus},
  language  = {de}
}
@article{DiersBaumLehmannetal.2022,
  author    = {Diers, Johannes and Baum, Philip and Lehmann, Kai and Uttinger, Konstatin and Baumann, Nikolas and Pietryga, Sebastian and Hankir, Mohammed and Matthes, Niels and Lock, Johann F. and Germer, Christoph-Thomas and Wiegering, Armin},
  title     = {Disproportionately high failure to rescue rates after resection for colorectal cancer in the geriatric patient population - A nationwide study},
  series = {Cancer Medicine},
  volume    = {11},
  journal   = {Cancer Medicine},
  number    = {22},
  doi       = {10.1002/cam4.4784},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-312858},
  pages     = {4256-4264},
  year      = {2022},
  abstract  = {Background Colorectal cancer incidence increases with patient age. The aim of this study was to assess, at the nationwide level, in-hospital mortality, and failure to rescue in geriatric patients (≥ 80 years old) with colorectal cancer arising from postoperative complications. Methods All patients receiving surgery for colorectal cancer in Germany between 2012 and 2018 were identified in a nationwide database. Association between age and in-hospital mortality following surgery and failure to rescue, defined as death after complication, were determined in univariate and multivariate analyses. Results Three lakh twenty-eight thousands two hundred and ninety patients with colorectal cancer were included of whom 77,287 were 80 years or older. With increasing age, a significant relative increase in right hemicolectomy was observed. In general, these patients had more comorbid conditions and higher frailty. In-hospital mortality following colorectal cancer surgery was 4.9\% but geriatric patients displayed a significantly higher postoperative in-hospital mortality of 10.6\%. The overall postoperative complication rate as well as failure to rescue increased with age. In contrast, surgical site infection (SSI) and anastomotic leakage (AL) did not increase in geriatric patients, whereas the associated mortality increased disproportionately (13.3\% for SSI and 29.9\% mortality for patients with AI, both p < 0.001). Logistic regression analysis adjusting for confounders showed that geriatric patients had almost five-times higher odds for death after surgery than the baseline age group below 60 (OR 4.86; 95\%CI [4.45-5.53], p < 0.001). Conclusion Geriatric patients have higher mortality after colorectal cancer surgery. This may be partly due to higher frailty and disproportionately higher rates of failure to rescue arising from postoperative complications.},
  language  = {en}
}
@article{UttingerRiedmeierReibetanzetal.2022,
  author    = {Uttinger, Konstantin L. and Riedmeier, Maria and Reibetanz, Joachim and Meyer, Thomas and Germer, Christoph Thomas and Fassnacht, Martin and Wiegering, Armin and Wiegering, Verena},
  title     = {Adrenalectomies in children and adolescents in Germany - a diagnose related groups based analysis from 2009-2017},
  series = {Frontiers in Endocrinology},
  volume    = {13},
  journal   = {Frontiers in Endocrinology},
  issn      = {1664-2392},
  doi       = {10.3389/fendo.2022.914449},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-282280},
  year      = {2022},
  abstract  = {Background Adrenalectomies are rare procedures especially in childhood. So far, no large cohort study on this topic has been published with data on to age distribution, operative procedures, hospital volume and operative outcome. Methods This is a retrospective analysis of anonymized nationwide hospital billing data (DRG data, 2009-2017). All adrenal surgeries (defined by OPS codes) of patients between the age 0 and 21 years in Germany were included. Results A total of 523 patient records were identified. The mean age was 8.6 ± 7.7 years and 262 patients were female (50.1\%). The majority of patients were between 0 and 5 years old (52\% overall), while 11.1\% were between 6 and 11 and 38.8\% older than 12 years. The most common diagnoses were malignant neoplasms of the adrenal gland (56\%, mostly neuroblastoma) with the majority being younger than 5 years. Benign neoplasms in the adrenal gland (D350) account for 29\% of all cases with the majority of affected patients being 12 years or older. 15\% were not defined regarding tumor behavior. Overall complication rate was 27\% with a clear higher complication rate in resection for malignant neoplasia of the adrenal gland. Bleeding occurrence and transfusions are the main complications, followed by the necessary of relaparotomy. There was an uneven patient distribution between hospital tertiles (low volume, medium and high volume tertile). While 164 patients received surgery in 85 different "low volume" hospitals (0.2 cases per hospital per year), 205 patients received surgery in 8 different "high volume" hospitals (2.8 cases per hospital per year; p<0.001). Patients in high volume centers were significant younger, had more extended resections and more often malignant neoplasia. In multivariable analysis younger age, extended resections and open procedures were independent predictors for occurrence of postoperative complications. Conclusion Overall complication rate of adrenalectomies in the pediatric population in Germany is low, demonstrating good therapeutic quality. Our analysis revealed a very uneven distribution of patient volume among hospitals.},
  language  = {en}
}
@article{LeikamHufnagelOttoetal.2015,
  author    = {Leikam, C and Hufnagel, AL and Otto, C and Murphy, DJ and M{\"u}hling, B and Kneitz, S and Nanda, I and Schmid, M and Wagner, TU and Haferkamp, S and Br{\"o}cker, E-B and Schartl, M and Meierjohann, S},
  title     = {In vitro evidence for senescent multinucleated melanocytes as a source for tumor-initiating cells},
  series = {Cell Death and Disease},
  volume    = {6},
  journal   = {Cell Death and Disease},
  number    = {e1711},
  doi       = {10.1038/cddis.2015.71},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-148718},
  year      = {2015},
  abstract  = {Oncogenic signaling in melanocytes results in oncogene-induced senescence (OIS), a stable cell-cycle arrest frequently characterized by a bi-or multinuclear phenotype that is considered as a barrier to cancer progression. However, the long-sustained conviction that senescence is a truly irreversible process has recently been challenged. Still, it is not known whether cells driven into OIS can progress to cancer and thereby pose a potential threat. Here, we show that prolonged expression of the melanoma oncogene N-RAS\(^{61K}\) in pigment cells overcomes OIS by triggering the emergence of tumor-initiating mononucleated stem-like cells from senescent cells. This progeny is dedifferentiated, highly proliferative, anoikis-resistant and induces fast growing, metastatic tumors. Our data describe that differentiated cells, which are driven into senescence by an oncogene, use this senescence state as trigger for tumor transformation, giving rise to highly aggressive tumor-initiating cells. These observations provide the first experimental in vitro evidence for the evasion of OIS on the cellular level and ensuing transformation.},
  language  = {en}
}
@article{DiersAcarWagneretal.2022,
  author    = {Diers, Johannes and Acar, Laura and Wagner, Johanna C. and Baum, Philip and Hankir, Mohammed and Flemming, Sven and Kastner, Carolin and Germer, Christoph-Thomas and L'hoest, Helmut and Marschall, Ursula and Lock, Johan Friso and Wiegering, Armin},
  title     = {Cancer diagnosis is one quarter lower than the expected cancer incidence in the first year of COVID-19 pandemic in Germany: A retrospective register-based cohort study},
  series = {Cancer Communications},
  volume    = {42},
  journal   = {Cancer Communications},
  number    = {7},
  doi       = {10.1002/cac2.12314},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-312862},
  pages     = {673-676},
  year      = {2022},
  abstract  = {No abstract available.},
  language  = {en}
}
@article{KoehlerReeseHendricksetal.2022,
  author    = {K{\"o}hler, Franziska and Reese, Lena and Hendricks, Anne and Kastner, Carolin and M{\"u}ller, Sophie and Lock, Johan F. and Germer, Christoph-Thomas and Wiegering, Armin},
  title     = {Low-grade mucinous neoplasms (LAMN) of the appendix in Germany between 2011 and 2018: a nationwide analysis based on data provided by the German Center for Cancer Registry Data (ZfKD) at the Robert Koch Institute (RKI)},
  series = {Langenbeck's Archives of Surgery},
  volume    = {407},
  journal   = {Langenbeck's Archives of Surgery},
  number    = {8},
  doi       = {10.1007/s00423-022-02639-w},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323919},
  pages     = {3615-3622},
  year      = {2022},
  abstract  = {Introduction Low-grade appendiceal mucinous neoplasms (LAMN) are semi-malignant tumors of the appendix which are incidentally found in up to 1\% of appendectomy specimen. To this day, no valid descriptive analysis on LAMN is available for the German population. Methods Data of LAMN (ICD-10: D37.3) were collected from the population-based cancer registries in Germany, provided by the German Center for Cancer Registry Data (Zentrum f{\"u}r Krebsregisterdaten—ZfKD). Data was anonymized and included gender, age at diagnosis, tumor staging according to the TNM-classification, state of residence, information on the performed therapy, and survival data. Results A total of 612 cases were reported to the ZfKD between 2011 and 2018. A total of 63.07\% were female and 36.93\% were male. Great inhomogeneity in reporting cases was seen in the federal states of Germany including the fact that some federal states did not report any cases at all. Age distribution showed a mean age of 62.03 years (SD 16.15) at diagnosis. However, data on tumor stage was only available in 24.86\% of cases (n = 152). A total of 49.34\% of these patients presented with a T4-stage. Likewise, information regarding performed therapy was available in the minority of patients: 269 patients received surgery, 22 did not and for 312 cases no information was available. Twenty-four patients received chemotherapy, 188 did not, and for 400 cases, no information was available. Overall 5-year survival was estimated at 79.52\%. Patients below the age of 55 years at time of diagnosis had a significantly higher 5-year survival rate compared to patients above the age of 55 years (85.77\% vs. 73.27\%). Discussion In this study, we observed an incidence of LAMN in 0.13\% of all appendectomy specimen in 2018. It seems likely that not all cases were reported to the ZfKD; therefore, case numbers may be considered underestimated. Age and gender distribution goes in line with international studies with females being predominantly affected. Especially regarding tumor stage and therapy in depth information cannot be provided through the ZfKD-database. This data analysis emphasizes the need for further studies and the need for setting up a specialized registry for this unique tumor entity to develop guidelines for the appropriate treatment and follow-up.},
  language  = {en}
}
@article{ReibetanzKelmUttingeretal.2022,
  author    = {Reibetanz, Joachim and Kelm, Matthias and Uttinger, Konstantin L. and Reuter, Miriam and Schlegel, Nicolas and Hankir, Mohamed and Wiegering, Verena and Germer, Christoph-Thomas and Fassnacht, Martin and Lock, Johan Friso and Wiegering, Armin},
  title     = {Differences in morbidity and mortality between unilateral adrenalectomy for adrenal Cushing's syndrome and bilateral adrenalectomy for therapy refractory extra-adrenal Cushing's syndrome},
  series = {Langenbeck's Archives of Surgery},
  volume    = {407},
  journal   = {Langenbeck's Archives of Surgery},
  number    = {6},
  doi       = {10.1007/s00423-022-02568-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323947},
  pages     = {2481-2488},
  year      = {2022},
  abstract  = {Purpose In selected cases of severe Cushing's syndrome due to uncontrolled ACTH secretion, bilateral adrenalectomy appears unavoidable. Compared with unilateral adrenalectomy (for adrenal Cushing's syndrome), bilateral adrenalectomy has a perceived higher perioperative morbidity. The aim of the current study was to compare both interventions in endogenous Cushing's syndrome regarding postoperative outcomes. Methods We report a single-center, retrospective cohort study comparing patients with hypercortisolism undergoing bilateral vs. unilateral adrenalectomy during 2008-2021. Patients with adrenal Cushing's syndrome due to adenoma were compared with patients with ACTH-dependent Cushing's syndrome (Cushing's disease and ectopic ACTH production) focusing on postoperative morbidity and mortality as well as long-term survival. Results Of 83 patients with adrenalectomy for hypercortisolism (65.1\% female, median age 53 years), the indication for adrenalectomy was due to adrenal Cushing's syndrome in 60 patients (72.2\%; 59 unilateral and one bilateral), and due to hypercortisolism caused by Cushing's disease (n = 16) or non-pituitary uncontrolled ACTH secretion of unknown origin (n = 7) (27.7\% of all adrenalectomies). Compared with unilateral adrenalectomy (n = 59), patients with bilateral adrenalectomy (n = 24) had a higher rate of severe complications (0\% vs. 33\%; p < 0.001) and delayed recovery (median: 10.2\% vs. 79.2\%; p < 0.001). Using the MTL30 marker, patients with bilateral adrenalectomy fared worse than patients after unilateral surgery (MTL30 positive: 7.2\% vs. 25.0\% p < 0.001). Postoperative mortality was increased in patients with bilateral adrenalectomy (0\% vs. 8.3\%; p = 0.081). Conclusion While unilateral adrenalectomy for adrenal Cushing's syndrome represents a safe and definitive therapeutic option, bilateral adrenalectomy to control ACTH-dependent extra-adrenal Cushing's syndrome or Cushing's disease is a more complicated intervention with a mortality of nearly 10\%.},
  language  = {en}
}
@article{DewulfDietzMontgomeryetal.2022,
  author    = {Dewulf, Maxime and Dietz, Ulrich A. and Montgomery, Agneta and Pauli, Eric M. and Marturano, Matthew N. and Ayuso, Sullivan A. and Augenstein, Vedra A. and Lambrecht, Jan R. and K{\"o}hler, Gernot and Keller, Nicola and Wiegering, Armin and Muysoms, Filip},
  title     = {Robotische Hernienchirurgie Teil IV : Roboterassistierte endoskopische parastomale Hernienversorgung. Videobericht und Ergebnisse},
  series = {Chirurgie},
  volume    = {93},
  journal   = {Chirurgie},
  number    = {11},
  doi       = {10.1007/s00104-022-01715-7},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323882},
  pages     = {1051-1062},
  year      = {2022},
  abstract  = {Die chirurgische Behandlung parastomaler Hernien gilt als komplex und ist bekanntermaßen komplikationstr{\"a}chtig. In der Vergangenheit wurden diese Hernien durch die Relokation des Stomas oder Nahtverfahren der Austrittstelle versorgt. In den letzten Jahren wurden verschiedene netzbasierte Techniken vorgeschlagen, die heute in der minimal-invasiven Chirurgie eingesetzt werden. Mit der Verbreitung der roboterassistierten Hernienchirurgie wurden die Netzverfahren weiterentwickelt und die Ergebnisse f{\"u}r die Patienten erheblich verbessert. In diesem Beitrag wird ein {\"U}berblick {\"u}ber die verf{\"u}gbaren Techniken der roboterassistierten Versorgung parastomaler Hernien pr{\"a}sentiert. Es werden technische {\"U}berlegungen und erste Ergebnisse des roboterassistierten modifizierten Sugarbaker-Verfahrens, der roboterassistierten Pauli-Technik und der Verwendung des trichterf{\"o}rmigen Netzes IPST vorgestellt. Dar{\"u}ber hinaus werden die Herausforderungen bei der roboterassistierten Versorgung parastomaler Hernien am Ileum-Conduit diskutiert. Die Operationstechniken werden durch Foto- und Videomaterial veranschaulicht.},
  language  = {de}
}
@article{WidderBackhausWierlemannetal.,
  author    = {Widder, A. and Backhaus, J. and Wierlemann, A. and Hering, I. and Flemming, S. and Hankir, M. and Germer, C.-T. and Wiegering, A. and Lock, J. F. and K{\"o}nig, S. and Seyfried, F.},
  title     = {Optimizing laparoscopic training efficacy by 'deconstruction into key steps': a randomized controlled trial with novice medical students},
  series = {Surgical Endoscopy},
  volume    = {36},
  journal   = {Surgical Endoscopy},
  number    = {12},
  doi       = {10.1007/s00464-022-09408-2},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323969},
  pages     = {8726-8736},
  abstract  = {Background Simulator training is an effective way of acquiring laparoscopic skills but there remains a need to optimize teaching methods to accelerate learning. We evaluated the effect of the mental exercise 'deconstruction into key steps' (DIKS) on the time required to acquire laparoscopic skills. Methods A randomized controlled trial with undergraduate medical students was implemented into a structured curricular laparoscopic training course. The intervention group (IG) was trained using the DIKS approach, while the control group (CG) underwent the standard course. Laparoscopic performance of all participants was video-recorded at baseline (t0), after the first session (t1) and after the second session (t2) nine days later. Two double-blinded raters assessed the videos. The Impact of potential covariates on performance (gender, age, prior laparoscopic experience, self-assessed motivation and self-assessed dexterity) was evaluated with a self-report questionnaire. Results Both the IG (n = 58) and the CG (n = 68) improved their performance after each training session (p < 0.001) but with notable differences between sessions. Whereas the CG significantly improved their performance from t0 -t1 (p < 0.05), DIKS shortened practical exercise time by 58\% so that the IG outperformed the CG from t1 -t2, (p < 0.05). High self-assessed motivation and dexterity associated with significantly better performance (p < 0.05). Male participants demonstrated significantly higher overall performance (p < 0.05). Conclusion Mental exercises like DIKS can improve laparoscopic performance and shorten practice times. Given the limited exposure of surgical residents to simulator training, implementation of mental exercises like DIKS is highly recommended. Gender, self-assessed dexterity, and motivation all appreciably influence performance in laparoscopic training.},
  language  = {en}
}
@article{LenschowWennmannHendricksetal.2022,
  author    = {Lenschow, Christina and Wennmann, Andreas and Hendricks, Anne and Germer, Christoph-Thomas and Fassnacht, Martin and Buck, Andreas and Werner, Rudolf A. and Plassmeier, Lars and Schlegel, Nicolas},
  title     = {Questionable value of [\(^{99m}\)Tc]-sestamibi scintigraphy in patients with pHPT and negative ultrasound},
  series = {Langenbeck's Archives of Surgery},
  volume    = {407},
  journal   = {Langenbeck's Archives of Surgery},
  number    = {8},
  doi       = {10.1007/s00423-022-02648-9},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323926},
  pages     = {3661-3669},
  year      = {2022},
  abstract  = {Purpose A successful focused surgical approach in primary hyperparathyroidism (pHPT) relies on accurate preoperative localization of the parathyroid adenoma (PA). Most often, ultrasound is followed by [\(^{99m}\)Tc]-sestamibi scintigraphy, but the value of this approach is disputed. Here, we evaluated the diagnostic approach in patients with surgically treated pHPT in our center with the aim to further refine preoperative diagnostic procedures. Methods A single-center retrospective analysis of patients with pHPT from 01/2005 to 08/2021 was carried out followed by evaluation of the preoperative imaging modalities to localize PA. The localization of the PA had to be confirmed intraoperatively by the fresh frozen section and significant dropping of the intraoperative parathyroid hormone (PTH) levels. Results From 658 patients diagnosed with pHPT, 30 patients were excluded from the analysis because of surgery for recurrent or persistent disease. Median age of patients was 58.0 (13-93) years and 71\% were female. Neck ultrasound was carried out in 91.7\% and localized a PA in 76.6\%. In 23.4\% (135/576) of the patients, preoperative neck ultrasound did not detect a PA. In this group, [\(^{99m}\)Tc]-sestamibi correctly identified PA in only 25.4\% of patients. In contrast, in the same cohort, the use of [\(^{11}\)C]-methionine or [\(^{11}\)C]-choline PET resulted in the correct identification of PA in 79.4\% of patients (OR 13.23; 95\% CI 5.24-33.56). Conclusion [\(^{11}\)C]-Methionine or [\(^{11}\)C]-choline PET/CT are superior second-line imaging methods to select patients for a focused surgical approach when previous ultrasound failed to identify PA.},
  language  = {en}
}
@article{HeringDoerriesFlemmingetal.2022,
  author    = {Hering, Ilona and D{\"o}rries, Luise and Flemming, Sven and Krietenstein, Laura and Koschker, Ann-Kathrin and Fassnacht, Martin and Germer, Christoph-Thomas and Hankir, Mohammed K. and Seyfried, Florian},
  title     = {Impact of preoperative weight loss achieved by gastric balloon on peri- and postoperative outcomes of bariatric surgery in super-obese patients: a retrospective matched-pair analysis},
  series = {Langenbeck's Archives of Surgery},
  volume    = {407},
  journal   = {Langenbeck's Archives of Surgery},
  number    = {5},
  doi       = {10.1007/s00423-022-02472-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323909},
  pages     = {1873-1879},
  year      = {2022},
  abstract  = {Background An intragastric balloon is used to cause weight loss in super-obese patients (BMI > 60 kg/m\(^2\)) prior to bariatric surgery. Whether weight loss from intragastric balloon influences that from bariatric surgery is poorly studied. Methods In this retrospective, single-center study, the effects of intragastric balloon in 26 patients (BMI 69.26 ± 6.81) on weight loss after bariatric surgery (primary endpoint), postoperative complications within 30 days, hospital readmission, operation time, and MTL30 (secondary endpoints) were evaluated. Fifty-two matched-pair patients without intragastric balloon prior to bariatric surgery were used as controls. Results Intragastric balloon resulted in a weight loss of 17.3 ± 14.1 kg (BMI 5.75 ± 4.66 kg/m\(^2\)) with a nadir after 5 months. Surgical and postoperative outcomes including complications were comparable between both groups. Total weight loss was similar in both groups (29.0\% vs. 32.2\%, p = 0.362). Direct postoperative weight loss was more pronounced in the control group compared to the gastric balloon group (29.16 ± 7.53\% vs 23.78 ± 9.89\% after 1 year, p < 0.05 and 32.13 ± 10.5\% vs 22.21 ± 10.9\% after 2 years, p < 0.05), who experienced an earlier nadir and started to regain weight during the follow-up. Conclusion A multi-stage therapeutic approach with gastric balloon prior to bariatric surgery in super-obese patients may be effective to facilitate safe surgery. However, with the gastric balloon, pre-treated patients experienced an attenuated postoperative weight loss with an earlier nadir and earlier body weight regain. This should be considered when choosing the appropriate therapeutic regime and managing patients' expectations.},
  language  = {en}
}
@article{BaurRamserKelleretal.2021,
  author    = {Baur, Johannes and Ramser, Michaela and Keller, Nicola and Muysoms, Filip and D{\"o}rfer, J{\"o}rg and Wiegering, Armin and Eisner, Lukas and Dietz, Ulrich A.},
  title     = {Robotic hernia repair II. English version},
  series = {Der Chirurg},
  volume    = {92},
  journal   = {Der Chirurg},
  number    = {Suppl 1},
  doi       = {10.1007/s00104-021-01479-6},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323866},
  pages     = {S15-S26},
  year      = {2021},
  abstract  = {Endoscopic management of umbilical and incisional hernias has adapted to the limitations of conventional laparoscopic instruments over the past 30 years. This includes the development of meshes for intraperitoneal placement (intraperitoneal onlay mesh, IPOM), with antiadhesive coatings; however, adhesions do occur in a significant proportion of these patients. Minimally invasive procedures result in fewer perioperative complications, but with a slightly higher recurrence rate. With the ergonomic resources of robotics, which offers angled instruments, it is now possible to implant meshes in a minimally invasively manner in different abdominal wall layers while achieving morphologic and functional reconstruction of the abdominal wall. This video article presents the treatment of ventral and incisional hernias with mesh implantation into the preperitoneal space (robot-assisted transabdominal preperitoneal ventral hernia repair, r‑ventral TAPP) as well as into the retrorectus space (r-Rives and robotic transabdominal retromuscular umbilical prosthetic repair, r‑TARUP, respectively). The results of a cohort study of 118 consecutive patients are presented and discussed with regard to the added value of the robotic technique in extraperitoneal mesh implantation and in the training of residents.},
  language  = {en}
}
@article{RamserBaurKelleretal.2021,
  author    = {Ramser, Michaela and Baur, Johannes and Keller, Nicola and Kukleta, Jan F. and D{\"o}rfer, J{\"o}rg and Wiegering, Armin and Eisner, Lukas and Dietz, Ulrich A.},
  title     = {Robotic hernia surgery I. English version},
  series = {Der Chirurg},
  volume    = {92},
  journal   = {Der Chirurg},
  number    = {Suppl 1},
  doi       = {10.1007/s00104-021-01446-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323934},
  pages     = {S1-S13},
  year      = {2021},
  abstract  = {The treatment of inguinal hernias with open and minimally invasive procedures has reached a high standard in terms of outcome over the past 30 years. However, there is still need for further improvement, mainly in terms of reduction of postoperative seroma, chronic pain, and recurrence. This video article presents the endoscopic anatomy of the groin with regard to robotic transabdominal preperitoneal patch plasty (r‑TAPP) and illustrates the surgical steps of r‑TAPP with respective video sequences. The results of a cohort study of 302 consecutive hernias operated by r‑TAPP are presented and discussed in light of the added value of the robotic technique, including advantages for surgical training. r‑TAPP is the natural evolution of conventional TAPP and has the potential to become a new standard as equipment availability increases and material costs decrease. Future studies will also have to refine the multifaceted added value of r‑TAPP with new parameters.},
  language  = {en}
}
@article{DewulfDietzMontgomeryetal.2022,
  author    = {Dewulf, Maxime and Dietz, Ulrich A. and Montgomery, Agneta and Pauli, Eric M. and Marturano, Matthew N. and Ayuso, Sullivan A. and Augenstein, Vedra A. and Lambrecht, Jan R. and K{\"o}hler, Gernot and Keller, Nicola and Wiegering, Armin and Muysoms, Filip},
  title     = {Robotic hernia surgery IV. English version},
  series = {Chirurgie},
  volume    = {93},
  journal   = {Chirurgie},
  number    = {Suppl 2},
  doi       = {10.1007/s00104-022-01779-5},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323875},
  pages     = {S129-S140},
  year      = {2022},
  abstract  = {The surgical treatment of parastomal hernias is considered complex and is known to be prone to complications. Traditionally, this condition was treated using relocation techniques or local suture repairs. Since then, several mesh-based techniques have been proposed and are nowadays used in minimally invasive surgery. Since the introduction of robot-assisted surgery to the field of abdominal wall surgery, several adaptations to these techniques have been made, which may significantly improve patient outcomes. In this contribution, we provide an overview of available techniques in robot-assisted parastomal hernia repair. Technical considerations and preliminary results of robot-assisted modified Sugarbaker repair, robot-assisted Pauli technique, and minimally invasive use of a funnel-shaped mesh in the treatment of parastomal hernias are presented. Furthermore, challenges in robot-assisted ileal conduit parastomal hernia repair are discussed. These techniques are illustrated by photographic and video material. Besides providing a comprehensive overview of robot-assisted parastomal hernia repair, this article focuses on the specific advantages of robot-assisted techniques in the treatment of this condition.},
  language  = {en}
}
@article{DietzKudsiGarciaUrenaetal.2021,
  author    = {Dietz, Ulrich A. and Kudsi, O. Yusef and Garcia-Ure{\~n}a, Miguel and Baur, Johannes and Ramser, Michaela and Maksimovic, Sladjana and Keller, Nicola and D{\"o}rfer, J{\"o}rg and Eisner, Lukas and Wiegering, Armin},
  title     = {Robotic hernia repair III. English version},
  series = {Der Chirurg},
  volume    = {92},
  journal   = {Der Chirurg},
  number    = {Suppl 1},
  doi       = {10.1007/s00104-021-01500-y},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323896},
  pages     = {S28-S39},
  year      = {2021},
  abstract  = {The principle of targeted separation or weakening of individual components of the abdominal wall to relieve tension in the median line during major abdominal reconstruction has been known for over 30 years as anterior component separation (aCS) and is an established procedure. In search of alternatives with lower complication rates, posterior component separation (pCS) was developed; transversus abdominis release (TAR) is a nerve-sparing modification of pCS. With the ergonomic resources of robotics (e.g., angled instruments), TAR can be performed in a minimally invasive manner (r-TAR): hernia gaps of up to 14 cm can be closed and a large extraperitoneal mesh implanted. In this video article, the treatment of large incisional hernias using the r‑TAR technique is presented. Exemplary results of a cohort study in 13 consecutive patients are presented. The procedure is challenging, but our own results—as well as reports from the literature—are encouraging. The r‑TAR is becoming the pinnacle procedure for abdominal wall reconstruction.},
  language  = {en}
}
@article{AngerLockKleinetal.2022,
  author    = {Anger, Friedrich and Lock, Johan Friso and Klein, Ingo and Hartlapp, Ingo and Wiegering, Armin and Germer, Christoph-Thomas and Kunzmann, Volker and L{\"o}b, Stefan},
  title     = {Does concurrent cholestasis alter the prognostic value of preoperatively elevated CA19-9 serum levels in patients with pancreatic head adenocarcinoma?},
  series = {Annals of Surgical Oncology},
  volume    = {29},
  journal   = {Annals of Surgical Oncology},
  number    = {13},
  doi       = {10.1245/s10434-022-12460-w},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323854},
  pages     = {8523-8533},
  year      = {2022},
  abstract  = {Background Pancreatic adenocarcinoma (PDAC) patients with preoperative carbohydrate antigen 19-9 (CA19-9) serum levels higher than 500 U/ml are classified as biologically borderline resectable (BR-B). To date, the impact of cholestasis on preoperative CA19-9 serum levels in these patients has remained unquantified. Methods Data on 3079 oncologic pancreatic resections due to PDAC that were prospectively acquired by the German Study, Documentation and Quality (StuDoQ) registry were analyzed in relation to preoperative CA19-9 and bilirubin serum values. Preoperative CA19-9 values were adjusted according to the results of a multivariable linear regression analysis of pathologic parameters, bilirubin, and CA19-9 values. Results Of 1703 PDAC patients with tumor located in the pancreatic head, 420 (24.5 \%) presented with a preoperative CA19-9 level higher than 500 U/ml. Although receiver operating characteristics (ROC) analysis failed to determine exact CA19-9 cut-off values for prognostic indicators (R and N status), the T, N, and G status; the UICC stage; and the number of simultaneous vein resections increased with the level of preoperative CA19-9, independently of concurrent cholestasis. After adjustment of preoperative CA19-9 values, 18.5 \% of patients initially staged as BR-B showed CA19-9 values below 500 U/ml. However, the postoperative pathologic results for these patients did not change compared with the patients who had CA19-9 levels higher than 500 U/ml after bilirubin adjustment. Conclusions In this multicenter dataset of PDAC patients, elevation of preoperative CA19-9 correlated with well-defined prognostic pathologic parameters. Bilirubin adjustment of CA19-9 is feasible but does not affect the prognostic value of CA19-9 in jaundiced patients.},
  language  = {en}
}
@article{ReimerSeyfriedFlemmingetal.2022,
  author    = {Reimer, Stanislaus and Seyfried, Florian and Flemming, Sven and Brand, Markus and Weich, Alexander and Widder, Anna and Plaßmeier, Lars and Kraus, Peter and D{\"o}ring, Anna and Hering, Ilona and Hankir, Mohammed K. and Meining, Alexander and Germer, Christoph-Thomas and Lock, Johan F. and Groneberg, Kaja},
  title     = {Evolution of endoscopic vacuum therapy for upper gastrointestinal leakage over a 10-year period: a quality improvement study},
  series = {Surgical Endoscopy},
  volume    = {36},
  journal   = {Surgical Endoscopy},
  number    = {12},
  doi       = {10.1007/s00464-022-09400-w},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-323953},
  pages     = {9169-9178},
  year      = {2022},
  abstract  = {Background Endoscopic vacuum therapy (EVT) is an effective treatment option for leakage of the upper gastrointestinal (UGI) tract. The aim of this study was to evaluate the clinical impact of quality improvements in EVT management on patients' outcome. Methods All patients treated by EVT at our center during 2012-2021 were divided into two consecutive and equal-sized cohorts (period 1 vs. period 2). Over time several quality improvement strategies were implemented including the earlier diagnosis and EVT treatment and technical optimization of endoscopy. The primary endpoint was defined as the composite score MTL30 (mortality, transfer, length-of-stay > 30 days). Secondary endpoints included EVT efficacy, complications, in-hospital mortality, length-of-stay (LOS) and nutrition status at discharge. Results A total of 156 patients were analyzed. During the latter period the primary endpoint MTL30 decreased from 60.8 to 39.0\% (P = .006). EVT efficacy increased from 80 to 91\% (P = .049). Further, the need for additional procedures for leakage management decreased from 49.9 to 29.9\% (P = .013) and reoperations became less frequent (38.0\% vs.15.6\%; P = .001). The duration of leakage therapy and LOS were shortened from 25 to 14 days (P = .003) and 38 days to 25 days (P = .006), respectively. Morbidity (as determined by the comprehensive complication index) decreased from 54.6 to 46.5 (P = .034). More patients could be discharged on oral nutrition (70.9\% vs. 84.4\%, P = .043). Conclusions Our experience confirms the efficacy of EVT for the successful management of UGI leakage. Our quality improvement analysis demonstrates significant changes in EVT management resulting in accelerated recovery, fewer complications and improved functional outcome.},
  language  = {en}
}
@phdthesis{Kannapin2023,
  author    = {Kannapin, Felix},
  title     = {Untersuchungen zur Bedeutung des neurotrophen Faktors GDNF f{\"u}r die Interaktion zwischen enterischen Gliazellen und Enterozyten f{\"u}r die Regulation der Darmbarriere},
  doi       = {10.25972/OPUS-34471},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-344719},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2023},
  abstract  = {In der vorliegenden Dissertation wurde das Zusammenspiel von enterischen Gliazellen (EGC) und Darmepithelzellen (Caco-2) thematisiert, wobei der Fokus auf der Bedeu-tung des neurotrophen Faktors GDNF f{\"u}r die Interaktion zwischen den beiden genann-ten Zelltypen lag. Weiterhin wurde evaluiert, ob die Tyrosinkinase RET auch in Darme-pithelzellen f{\"u}r die GDNF-Signaltransduktion unter Ruhebedingungen und bei Entz{\"u}n-dungen verantwortlich ist. Als Grundlage diente ein Ko-Kultur-Modell mit Caco-2 und EGC. Durch Permeabili-t{\"a}ts- und Widerstandsmessungen wurden die Auswirkungen von GDNF auf Zell-Monolayer ermittelt. Effekte auf die Barrieredifferenzierung wurden anhand subkon-fluenter Zell-Monolayer charakterisiert, wohingegen die Auswirkungen auf Entz{\"u}n-dungsstimuli an konfluenten Zellen untersucht wurden. Ver{\"a}nderungen von Junktions-proteinen wurden mit Immunfluoreszenzf{\"a}rbungen und Western-Blot-Analysen aufge-zeigt. Abschließend erfolgte eine Analyse humaner Gewebeproben von Patienten mit und ohne chronisch-entz{\"u}ndlichen Darmerkrankungen (CED) in Bezug auf deren GDNF-Expression. Die verwendeten intestinalen Epithelzellen exprimieren die GDNF-Rezeptoren GFRα1, GFRα2, GFRα3 und RET. Nach Etablierung des Kultursystems zeigten Permeabilit{\"a}ts-messungen, Messungen des Epithelwiderstandes sowie Immunfluoreszenz-F{\"a}rbungen, dass die Differenzierung der Darmepithelzellen in der Ko-Kultur mit EGC durch GDNF vermittelt wird. Zudem war eine GDNF-abh{\"a}ngige, barrierestabilisierende Wirkung in einem Inflammationsmodell zu beobachten. Weiterhin wurde nachgewiesen, dass GDNF-Effekte auf Enterozyten auch im Darmepithel {\"u}ber die RET-Tyrosinkinase mit nachfolgender Hemmung des p38-MAPK-Signalwegs bedingt werden. Eine Stimulation der EGC mit Zytokinen best{\"a}tigte eine Hochregulation der GDNF-Expression und Sek-retion. In humanen Proben war intestinales GDNF bei schwerer Entz{\"u}ndung reduziert. Zusammenfassend wurde erstmalig der Nachweis erbracht, dass von EGC sezerniertes GDNF die Differenzierung der Barriere in Darmepithelzellen induziert und diese gegen einen Zytokin-vermittelten Zusammenbruch sch{\"u}tzt. Dies wird {\"u}ber eine RET-abh{\"a}ngige Regulation der p38-MAPK vermittelt. Die Reduktion der GDNF-Konzentration in transmuralen Gewebeproben von Patienten mit CED tr{\"a}gt m{\"o}glicher-weise zur Pathogenese der CED bei.},
  subject      = {Crohn-Krankheit},
  language  = {de}
}
@article{SilwedelHuettenSpeeretal.2023,
  author    = {Silwedel, Christine and H{\"u}tten, Matthias C. and Speer, Christian P. and H{\"a}rtel, Christoph and Haarmann, Axel and Henrich, Birgit and Tijssen, Maud P. M. and Alnakhli, Abdullah Ahmed and Spiller, Owen B. and Schlegel, Nicolas and Seidenspinner, Silvia and Kramer, Boris W. and Glaser, Kirsten},
  title     = {Ureaplasma-driven neonatal neuroinflammation: novel insights from an ovine model},
  series = {Cellular and Molecular Neurobiology},
  volume    = {43},
  journal   = {Cellular and Molecular Neurobiology},
  number    = {2},
  doi       = {10.1007/s10571-022-01213-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324285},
  pages     = {785-795},
  year      = {2023},
  abstract  = {Ureaplasma species (spp.) are considered commensals of the adult genitourinary tract, but have been associated with chorioamnionitis, preterm birth, and invasive infections in neonates, including meningitis. Data on mechanisms involved in Ureaplasma-driven neuroinflammation are scarce. The present study addressed brain inflammatory responses in preterm lambs exposed to Ureaplasma parvum (UP) in utero. 7 days after intra-amniotic injection of UP (n = 10) or saline (n = 11), lambs were surgically delivered at gestational day 128-129. Expression of inflammatory markers was assessed in different brain regions using qRT-PCR and in cerebrospinal fluid (CSF) by multiplex immunoassay. CSF was analyzed for UP presence using ureB-based real-time PCR, and MRI scans documented cerebral white matter area and cortical folding. Cerebral tissue levels of atypical chemokine receptor (ACKR) 3, caspases 1-like, 2, 7, and C-X-C chemokine receptor (CXCR) 4 mRNA, as well as CSF interleukin-8 protein concentrations were significantly increased in UP-exposed lambs. UP presence in CSF was confirmed in one animal. Cortical folding and white matter area did not differ among groups. The present study confirms a role of caspases and the transmembrane receptors ACKR3 and CXCR4 in Ureaplasma-driven neuroinflammation. Enhanced caspase 1-like, 2, and 7 expression may reflect cell death. Increased ACKR3 and CXCR4 expression has been associated with inflammatory central nervous system (CNS) diseases and impaired blood-brain barrier function. According to these data and previous in vitro findings from our group, we speculate that Ureaplasma-induced caspase and receptor responses affect CNS barrier properties and thus facilitate neuroinflammation.},
  language  = {en}
}