Determination of Minimum Surgical Caseloads for Major Oncologic Resections Using a Population-Attributable Fraction Model of Observational Data in Germany.

Purpose: There is a volume-outcome association in cancer surgery; fulfillment of minimum surgical caseloads (MSCs) is known to be associated with reduced in-hospital mortality. To our knowledge, to date, there is no evidence-based approach to determine MSC with regard to in-hospital mortality.

Methods: Hospital billing data of pulmonary, esophageal, gastric, pancreatic, colon, and rectal cancer resections were analyzed.

Weekday effect of surgery on in-hospital outcome in pancreatic surgery: a population-based study.

Importance: There is conflicting evidence regarding weekday dependent outcome in complex abdominal surgery, including pancreatic resections.

Objective: To clarify weekday-dependency of outcome after pancreatic resections in a comprehensive nationwide context.

Design: Retrospective cross-sectional study of anonymized nationwide hospital billing data (DRG data).

Editor's Choice - Ten Year Time Trends of Amputation Surgery in Peripheral Arterial Disease in Germany: Before and During the COVID-19 Pandemic.

Objective: Peripheral arterial disease (PAD) has been associated with suboptimal treatment, high mortality, and high amputation rates. It is unclear how the COVID-19 (coronavirus disease 2019) pandemic affected this development in a long term context.

Methods: This is a registry based, retrospective, nationwide cohort study including patients hospitalised with PAD as a main or secondary diagnosis and amputation surgery between 2012 - 2021 in Germany.

The impact of surgical timing on outcome in acute appendicitis in adults: a retrospective observational population-based cohort study.

Background: Acute appendicitis is a global disease with high incidence. The main objective was to assess the association between time from admission to surgery (TAS) and surgery during emergency hours with operative outcome in light of conflicting evidence.

Methods: This is a retrospective population-wide analysis of hospital billing data (2010-2021) of all adult patient records of surgically treated cases of acute appendicitis in Germany by TAS.

Lipoprotein(a) serum concentrations in children in relation to body mass index, age and sex.

Background: Lipoprotein(a) (Lp(a)) is an inherited risk factor for atherosclerotic cardiovascular disease (ASCVD). Limited data exist on Lp(a) values in children. We aimed to evaluate whether Lp(a) concentrations in youth are influenced by BMI.

Nationwide volume-outcome relationship concerning in-hospital mortality and failure-to-rescue in surgery of sigmoid diverticulitis.

Purpose: A correlation between the hospital volume and outcome is described for multiple entities of oncological surgery. To date, this has not been analyzed for the surgical treatment of sigmoid diverticulitis. The aim of this study was to explore the impact of the annual caseload per hospital of colon resection on the postoperative incidence of complications, failure to rescue, and mortality in patients with diverticulitis.

Impact of Surgical Postponements due to Covid-19 on Weight and Metabolic Parameters in Bariatric Surgery in Germany: Monocentric Experiences and Considerations in a National Context.

Background: Due to Covid-19, elective medical procedures were partly postponed to reduce the burden on the medical system. The impact of these effects in bariatric surgery and their individual consequences remain unknown.

Materials/methods: In a retrospective monocentric analysis, all bariatric patients at our centre between 01/2020 and 12/2021 were investigated.

Impact of the COVID pandemic on major abdominal cancer resections in Germany: a retrospective population-based cohort study.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is estimated to have claimed more than 6 million lives globally since it started in 2019. Germany was exposed to two waves of coronavirus disease 2019 in 2020, one starting in April and the other in October. To ensure sufficient capacity for coronavirus disease 2019 patients in intensive care units, elective medical procedures were postponed.

The role of intraoperative hyperspectral imaging (HSI) in colon interposition after esophagectomy.

Background: Colon conduit is an alternative approach to reconstructing the alimentary tract after esophagectomy. Hyperspectral imaging (HSI) has been demonstrated to be effective for evaluating the perfusion of gastric conduits, but not colon conduits. This is the first study to describe this new tool addressing image-guided surgery and supporting esophageal surgeons to select the optimal colon segment for the conduit and anastomotic site intraoperatively.

Volume-outcome relationship in adrenal surgery from 2009-2017 in Germany-a retrospective study.

Objective: Adrenal resections are rare procedures of a heterogeneous nature. While recent European guidelines advocate a minimum annual caseload for adrenalectomies (6 per surgeon), evidence for a volume-outcome relationship for this surgery remains limited.

Design: A retrospective analysis of all adrenal resections in Germany between 2009 and 2017 using hospital billing data was performed.

Adrenalectomies in children and adolescents in Germany - a diagnose related groups based analysis from 2009-2017.

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).

Differences in morbidity and mortality between unilateral adrenalectomy for adrenal Cushing's syndrome and bilateral adrenalectomy for therapy refractory extra-adrenal Cushing's syndrome.

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.

Mortality, complications and failure to rescue after surgery for esophageal, gastric, pancreatic and liver cancer patients based on minimum caseloads set by the German Cancer Society.

Background: The German Cancer Society (DKG) board certifies hospitals in treating esophageal, gastric, liver and pancreatic cancer among others. There has been no systematic verification of the number of major surgical resections set by DKG certification with regards to in-house mortality and failure to rescue (FtR).

Methods: This is a retrospective analysis of anonymized nationwide hospital billing data (DRG data, 2009-2017).

Adrenocortical Carcinoma in Childhood: A Systematic Review.

Adrenocortical tumors are rare in children. This systematic review summarizes the published evidence on pediatric adrenocortical carcinoma (ACC) to provide a basis for a better understanding of the disease, investigate new molecular biomarkers and therapeutic targets, and define which patients may benefit from a more aggressive therapeutic approach. We included 137 studies with 3680 ACC patients (~65% female) in our analysis.

Giant intracranial aneurysms: natural history and 1-year case fatality after endovascular or surgical treatment.

Objective: Clinical evidence on giant intracranial aneurysms (GIAs), intracranial aneurysms with a diameter of at least 25 mm, is limited. The authors aimed to investigate the natural history, case fatality, and treatment outcomes of ruptured and unruptured GIAs.

Methods: In this international observational registry study, patients with a ruptured or unruptured GIA received conservative management (CM), surgical management (SM), or endovascular management (EM).