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  1. Article: Postoperative Management in Visceral Medicine.

    Kühn, Florian / Schulz, Christian

    Visceral medicine

    2022  Volume 38, Issue 5, Page(s) 309–310

    Language English
    Publishing date 2022-10-21
    Publishing country Switzerland
    Document type Editorial
    ZDB-ID 2850733-2
    ISSN 2297-475X ; 2297-4725
    ISSN (online) 2297-475X
    ISSN 2297-4725
    DOI 10.1159/000526587
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2103: Show issues Location:
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  2. Article ; Online: Clinical outcomes and perioperative morbidity and mortality following segmental resections of the colon for Crohn's colitis.

    Kappenberger, Alina-Sophie / Schardey, Josefine / Wirth, Ulrich / Kühn, Florian / Werner, Jens / Zimmermann, Petra

    International journal of colorectal disease

    2024  Volume 39, Issue 1, Page(s) 36

    Abstract: Introduction: Crohn's disease (CD) is a chronic inflammatory bowel disease of a multifactorial pathogenesis. Recently numerous genetic variants linked to an aggressive phenotype were identified, leading to a progress in therapeutic options, resulting in ...

    Abstract Introduction: Crohn's disease (CD) is a chronic inflammatory bowel disease of a multifactorial pathogenesis. Recently numerous genetic variants linked to an aggressive phenotype were identified, leading to a progress in therapeutic options, resulting in a decreased necessity for surgery. Nevertheless, surgery is often inevitable. The aim of the study was to evaluate possible risk factors for postoperative complications and disease recurrence specifically after colonic resections for CD.
    Patients and methods: A total of 241 patients who underwent colonic and ileocaecal resections for CD at our instiution between 2008 and 2018 were included. All data was extracted from clinical charts.
    Results: Major complications occurred in 23.8% of all patients. Patients after colonic resections showed a significantly higher rate of major postoperative complications compared to patients after ICR (p =  < 0.0001). The most common complications after colonic resections were postoperative bleeding (22.2%), the need for revision surgery (27.4%) and ICU (17.2%) or hospital readmission (15%). As risk factors for the latter, we identified time interval between admission and surgery (p = 0.015) and the duration of the surgery (p = 0.001). Isolated distal resections had a higher risk for revision surgery and a secondary stoma (p = 0.019). Within the total study population, previous bowel resections (p = 0.037) were identified as independent risk factors for major perioperative complications.
    Conclusion: The results indicate that both a complex surgical site and a complex surgical procedure lead to a higher perioperative morbidity in colonic resections for Crohn's colitis.
    MeSH term(s) Humans ; Crohn Disease/complications ; Crohn Disease/surgery ; Crohn Disease/pathology ; Colectomy/adverse effects ; Colectomy/methods ; Neoplasm Recurrence, Local/surgery ; Postoperative Complications/epidemiology ; Colitis/surgery ; Colitis/complications ; Morbidity
    Language English
    Publishing date 2024-03-08
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 84975-3
    ISSN 1432-1262 ; 0179-1958
    ISSN (online) 1432-1262
    ISSN 0179-1958
    DOI 10.1007/s00384-024-04596-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Book ; Online ; Thesis: Morbus Crohn

    Kühn, Florian [Verfasser]

    translationale und klinisch-chirurgische Aspekte

    2019  

    Author's details Florian Kühn
    Keywords Medizin, Gesundheit ; Medicine, Health
    Subject code sg610
    Language German
    Publisher Universitätsbibliothek der Ludwig-Maximilians-Universität
    Publishing place München
    Document type Book ; Online ; Thesis
    Database Digital theses on the web

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  4. Book: Risikopolitik

    Kühn, Florian P

    eine Einführung

    (Elemente der Politik ; Lehrbuch)

    2017  

    Institution Springer Fachmedien Wiesbaden GmbH
    Author's details Florian Kühn
    Series title Elemente der Politik
    Lehrbuch
    Keywords Risiko ; Politisches Handeln
    Language German
    Size VIII, 215 Seiten, Illustrationen, 19 cm x 12.5 cm, 0 g
    Publisher Springer VS
    Publishing place Wiesbaden
    Document type Book
    Note Literaturverzeichnis: Seite 207-215
    ISBN 3658155205 ; 9783658155209 ; 9783658155216 ; 3658155213
    Database Federal Institute for Risk Assessment

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  5. Article ; Online: Internationale Gesundheitsrisiken

    Kühn, Florian P.

    Risikopolitik

    Abstract: Machtverhältnisse drücken sich in der Zuschreibung von Risiken aus. Spezifisches Wissen um Risiken dient dabei als Katalysator, Machtressourcen aufzubringen und steuernd in gesellschaftliche Prozesse einzugreifen. Dabei zeigt sich, dass die Steuerung ... ...

    Abstract Machtverhältnisse drücken sich in der Zuschreibung von Risiken aus. Spezifisches Wissen um Risiken dient dabei als Katalysator, Machtressourcen aufzubringen und steuernd in gesellschaftliche Prozesse einzugreifen. Dabei zeigt sich, dass die Steuerung trotz operativer Kooperation in internationalen Institutionen wie Europol oder geheimdienstlicher Zusammenarbeit noch weitgehend national organisiert ist, was die rechtlichen Rahmenbedingungen ebenso wie die diskursive Einbettung terroristischer Risiken betrifft. Weniger kontrovers sind ‚weiche‘ Themen wie Gesundheitsvorsorge und Management von Pandemien. Hier setzen internationale Institutionen Standards durch, die als Risikomanagement deutliche Eingriffe in staatliche Steuerungsautonomie bedeuten.
    Keywords covid19
    Publisher PMC
    Document type Article ; Online
    DOI 10.1007/978-3-658-15521-6_8
    Database COVID19

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  6. Article: Impact of Modern Drug Therapy on Surgery: Ulcerative Colitis.

    Kuehn, Florian / Hodin, Richard A

    Visceral medicine

    2018  Volume 34, Issue 6, Page(s) 426–431

    Abstract: Background: The primary treatment of ulcerative colitis (UC) is conservative, and substantial therapeutic progress has been made in the past few decades. Meanwhile, biologicals have become a mainstay in the treatment for steroid-refractory UC. Despite ... ...

    Abstract Background: The primary treatment of ulcerative colitis (UC) is conservative, and substantial therapeutic progress has been made in the past few decades. Meanwhile, biologicals have become a mainstay in the treatment for steroid-refractory UC. Despite further development of drug therapy and an increased time span to operation, a significant proportion of patients with UC require surgical intervention. Surgical intervention needs to be carried out in medically refractory cases, imminent or malignant transformation, or complications. This article discusses the impact of modern drug therapy on surgery for UC.
    Methods: A selective literature search of PubMed was conducted, taking into account current studies, reviews, meta-analyses, and guidelines. Selected articles were then reviewed in detail and recommendations were drafted based on data and conclusions of the articles.
    Results: In recent years, modern drug therapy has changed the timing, approach, and outcomes of surgery for UC. Most of the studies showed a decrease in surgery rates over time while the rate of emergency colectomies remains unchanged. So far, no convincing surgery-sparing effect of newer medications has been established, and it remains debatable if surgery rates have decreased because of improved management for UC in general or due to the introduction of biologicals. The intensified conservative therapy with increasing use of biologics has been accompanied by a trend towards performing a three-step procedure in the last decade. There is a subset of patients with complex refractory disease who most likely benefit from elective surgery as an alternative to prolonged conservative therapies after failure of first-line treatment. The majority of patients after ileal pouch-anal anastomosis can avoid hospitalizations and colitis-related medications with their associated potential adverse effects. In addition, the procedure substantially reduces UC-related symptoms and the risk for dysplasia or cancer. There is a long-term pouch success rate of >90% after 10 and 20 years of follow-up.
    Conclusion: Conservative medical therapy in the treatment of UC will continue to develop and the number of approved therapeutics will grow. Surgery should not be considered as the negative endpoint of treatment modalities but as a good alternative to a prolonged conservative therapy for some patients. In conclusion, a close cooperation between the various disciplines in the pre- and postoperative management is essential in order to optimize the timing and outcome of patients with UC.
    Language English
    Publishing date 2018-10-31
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2850733-2
    ISSN 2297-475X ; 2297-4725
    ISSN (online) 2297-475X
    ISSN 2297-4725
    DOI 10.1159/000493492
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2103: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    ab Jg. 2022: Lesesaal (EG)

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  7. Book ; Online ; Thesis: Characterization of peripheral immune events in primary colorectal cancer patients

    Lu, Can [Verfasser] / Kühn, Florian [Akademischer Betreuer]

    2022  

    Author's details Can Lu ; Betreuer: Florian Kühn
    Keywords Medizin, Gesundheit ; Medicine, Health
    Subject code sg610
    Language English
    Publisher Universitätsbibliothek der Ludwig-Maximilians-Universität
    Publishing place München
    Document type Book ; Online ; Thesis
    Database Digital theses on the web

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  8. Book ; Online ; Thesis: The role of intestinal alkaline phosphatase and bacterial lipopolysaccharides in patients undergoing pancreaticoduodenectomy

    Duan, Ruifeng [Verfasser] / Kühn, Florian [Akademischer Betreuer]

    2022  

    Author's details Ruifeng Duan ; Betreuer: Florian Kühn
    Keywords Medizin, Gesundheit ; Medicine, Health
    Subject code sg610
    Language English
    Publisher Universitätsbibliothek der Ludwig-Maximilians-Universität
    Publishing place München
    Document type Book ; Online ; Thesis
    Database Digital theses on the web

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  9. Article: Acute Mesenteric Ischemia.

    Kühn, Florian / Schiergens, Tobias S / Klar, Ernst

    Visceral medicine

    2020  Volume 36, Issue 4, Page(s) 256–262

    Abstract: Background: Despite constant improvements in diagnostic as well as interventional and surgical techniques, acute mesenteric ischemia (AMI) remains a life-threatening emergency with high mortality rates. The time to diagnosis of AMI is the most important ...

    Abstract Background: Despite constant improvements in diagnostic as well as interventional and surgical techniques, acute mesenteric ischemia (AMI) remains a life-threatening emergency with high mortality rates. The time to diagnosis of AMI is the most important predictor of patients' outcome; therefore, prompt diagnosis and intervention are essential to reduce mortality in patients with AMI. The present review was performed to analyze potential risk factors and to help find ways to improve the outcome of patients with AMI.
    Summary: Whereas AMI only applies to approximately 1% of all patients with an "acute abdomen," its incidence is rising up to 10% in patients >70 years of age. The initial clinical stage of AMI is characterized by a sudden onset of strong abdominal pain followed by a painless interval. Depending on the extent of disease, the symptoms of nonocclusive mesenteric ischemia (NOMI) and patients with a venous thrombosis can be very different from those of acute occlusive ischemia. Biphasic contrast-enhanced CT represents the gold standard for the diagnosis of arterial and venous occlusion. In case of a central occlusion of the superior mesenteric artery or signs of peritonitis, immediate surgery should be performed. If major bowel resection becomes necessary, critical residual intestinal length limits must be kept in mind. Endovascular techniques for arterial occlusion have taken on a much greater importance today. For stable patients with NOMI, interventional catheter angiography is recommended because it enables diagnosis and treatment with selective application of vasodilators. Depending on its degree, interventional treatment with a transhepatic catheter lysis should be considered for acute and chronic portal vein thrombosis.
    Key message: The prompt and targeted use of the appropriate diagnostics and interventions appears to be the only way to reduce the persistently high mortality rates for AMI.
    Language English
    Publishing date 2020-08-04
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2850733-2
    ISSN 2297-475X ; 2297-4725
    ISSN (online) 2297-475X
    ISSN 2297-4725
    DOI 10.1159/000508739
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2103: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  10. Article: Diagnostic and Therapeutic Management of Early Colorectal Cancer.

    Knoblauch, Mathilda / Kühn, Florian / von Ehrlich-Treuenstätt, Viktor / Werner, Jens / Renz, Bernhard Willibald

    Visceral medicine

    2022  Volume 39, Issue 1, Page(s) 10–16

    Abstract: Background: Early colorectal cancer (eCRC) is defined as cancer that does not cross the submucosal layer of the colon or rectum, including carcinoma in situ (pTis), pT1a, and pT1b. Early carcinomas differ in their prognosis depending on the risk profile. ...

    Abstract Background: Early colorectal cancer (eCRC) is defined as cancer that does not cross the submucosal layer of the colon or rectum, including carcinoma in situ (pTis), pT1a, and pT1b. Early carcinomas differ in their prognosis depending on the risk profile. The differentiation between low and high risk is essential. The low-risk group includes R0-resected, well (G1) or moderately (G2) differentiated tumors without lymphatic vessel invasion (L0), without blood vessel invasion (V0) and a tumor size ≤3 cm. In this constellation, the estimated risk of lymph node metastasis is around 1% or below. The high-risk group includes tumors with incomplete resection (Rx), poor (G3) or undifferentiated (G4) carcinomas, and/or lymphatic and blood vessel invasion (L1) and size ≥3 cm. In a "high-risk" situation, there is a risk for lymph node metastasis of up to 23%.
    Summary: The incidence of eCRC is rising with a rate of 10% in all endoscopically removed lesions during colonoscopy. For a correct histological evaluation, all suspected lesions should be completely resected. In case of a pT1 lesion in the rectum, pelvic magnetic resonance imaging should be performed to evaluate for suspicious lymph nodes. The therapeutic approach for eCRC is based on histological assessment and ranges from endoscopic resection to radical oncological surgery. The advantages, disadvantages, and associated risks of the individual treatment strategy need to be carefully discussed on a tumor board and with the patient.
    Key messages: Treatment options for early colorectal cancer depend on the histological assessment. Poorly differentiated carcinomas, a Kudo ≥ SM2 classified lesion, and a Haggitt level 4 always represent a "high-risk" situation. It should also be mentioned that in rectal cancer, local surgical tumor excision (full-wall excision) is also sufficient for pT1 carcinomas with a "low-risk" constellation (G1/G2; L0, size <3 cm) and an R0 resection.
    Language English
    Publishing date 2022-11-30
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2850733-2
    ISSN 2297-475X ; 2297-4725
    ISSN (online) 2297-475X
    ISSN 2297-4725
    DOI 10.1159/000526633
    Database MEDical Literature Analysis and Retrieval System OnLINE

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