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v Frankenberg M, Schmitz-Winnenthal H, Bornemann T, Köninger J, Büchler MW. Projekt Partnerschaft – Universitätsklinik und Krankenhaus der Grund- und Regelversorgung. Chirurg 2007; 78:368-73. [PMID: 17187258 DOI: 10.1007/s00104-006-1266-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Over the last 20 years, urgently needed changes in the German health care system have forced hospitals to make a flexible adjustment to rising costs and the single handed, almost unmanageable dynamics of technical innovation in medicine. The partnership between the Salem Hospital and the Heidelberg University Hospital represents a pioneering management concept for the future. The alliance between a university surgical department with a basic peripheral hospital provides large advantages to patients, staff, hospitals and cost carriers.
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Ulrich A, Z'graggen K, Schmitz-Winnenthal H, Weitz J, Büchler MW. The transverse coloplasty pouch. Langenbecks Arch Surg 2005; 390:355-60. [PMID: 15947942 DOI: 10.1007/s00423-005-0563-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2004] [Accepted: 03/11/2005] [Indexed: 01/08/2023]
Abstract
BACKGROUND The introduction of the total mesorectal excision (TME) and the use of modern staplers have improved outcome and increased the rate of sphincter-preserving low anterior resections in rectal cancer. Consequently, the interest in functional results after rectal reservoir reconstruction increased significantly. METHODS A review of the current literature was conducted on the development of colon pouch procedures with a particular focus on the transverse coloplasty pouch compared with the colon J-pouch and other current techniques of reconstruction after TME such as the side-to-end anastomosis. RESULTS The colon J-pouch (CJP) became the "gold standard" for rectal reservoir reconstruction owing to better early functional results compared with the straight coloanal anastomosis (CAA). However, 30% of the patients with CJP faced late evacuation problems requiring the chronic use of enemas or laxatives. This rate could be decreased by shortening the limb of the CJP from 8-10 to 5-6 cm, but the late evacuation problems remained in approximately 10% of the patients. An overview of the current knowledge on technical and functional aspects as well as indications and results of the transverse coloplasty pouch (TCP) is presented. CONCLUSION The TCP was developed to provide early functional results comparable to the CJP while avoiding the late evacuation problems. Functional results after TCP, small colon J-pouch and side-to-end anastomosis are similar. Evacuation problems after TCP have not been reported.
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Affiliation(s)
- A Ulrich
- Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany
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Knaebel HP, Märten A, Schmidt J, Hoffmann K, Seiler C, Lindel K, Schmitz-Winnenthal H, Fritz S, Herrmann T, Goldschmidt H, Mansmann U, Debus J, Diehl V, Büchler MW. Phase III trial of postoperative cisplatin, interferon alpha-2b, and 5-FU combined with external radiation treatment versus 5-FU alone for patients with resected pancreatic adenocarcinoma -- CapRI: study protocol [ISRCTN62866759]. BMC Cancer 2005; 5:37. [PMID: 15826316 PMCID: PMC1087479 DOI: 10.1186/1471-2407-5-37] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2005] [Accepted: 04/12/2005] [Indexed: 11/12/2022] Open
Abstract
After surgical intervention with curative intention in specialised centres the five-year survival of patients with carcinoma of the exocrine pancreas is only 15%. The ESPAC-1 trial showed an increased five-year survival of 21% achieved with adjuvant chemotherapy. Investigators from the Virginia Mason Clinic have reported a 5-year survival rate of 55% in a phase II trial evaluating adjuvant chemotherapy, immunotherapy and external-beam radiation.
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Affiliation(s)
- HP Knaebel
- University of Heidelberg, Department of Surgery, Im Neuenheimer Feld 110,69120 Heidelberg, Germany
| | - A Märten
- University of Heidelberg, Department of Surgery, Im Neuenheimer Feld 110,69120 Heidelberg, Germany
- National Centre for Tumor Diseases, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany
| | - J Schmidt
- University of Heidelberg, Department of Surgery, Im Neuenheimer Feld 110,69120 Heidelberg, Germany
| | - K Hoffmann
- University of Heidelberg, Department of Surgery, Im Neuenheimer Feld 110,69120 Heidelberg, Germany
- National Centre for Tumor Diseases, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany
| | - C Seiler
- University of Heidelberg, Department of Surgery, Im Neuenheimer Feld 110,69120 Heidelberg, Germany
| | - K Lindel
- University of Heidelberg, Department of Radiology, Im Neuenheimer Feld 400,69120 Heidelberg, Germany
- National Centre for Tumor Diseases, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany
| | - H Schmitz-Winnenthal
- University of Heidelberg, Department of Surgery, Im Neuenheimer Feld 110,69120 Heidelberg, Germany
- National Centre for Tumor Diseases, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany
| | - S Fritz
- University of Heidelberg, Department of Surgery, Im Neuenheimer Feld 110,69120 Heidelberg, Germany
- National Centre for Tumor Diseases, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany
| | - T Herrmann
- University of Heidelberg, Department of Medicine, Im Neuenheimer Feld 410,69120 Heidelberg, Germany
| | - H Goldschmidt
- University of Heidelberg, Department of Medicine, Im Neuenheimer Feld 410,69120 Heidelberg, Germany
- National Centre for Tumor Diseases, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany
| | - U Mansmann
- LMU München, IBE Medical School, Marchioninistr. 15, 81377 München, Germany
| | - J Debus
- University of Heidelberg, Department of Radiology, Im Neuenheimer Feld 400,69120 Heidelberg, Germany
- National Centre for Tumor Diseases, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany
| | - V Diehl
- National Centre for Tumor Diseases, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany
| | - MW Büchler
- University of Heidelberg, Department of Surgery, Im Neuenheimer Feld 110,69120 Heidelberg, Germany
- National Centre for Tumor Diseases, Im Neuenheimer Feld 350, 69120 Heidelberg, Germany
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