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Article: Intrathoracic migration of a breast implant seven years after thoracotomy. A case report.

Damirov, Fuad / Zimmermann, Julia / Ketscher, Christian / Hatz, Rudolf / Manapov, Farkhad / Lindner, Michael

International journal of surgery case reports

2022 Volume 98, Page(s) 107506

Abstract: A 52-year-old woman, who had previous bilateral subpectoral breast augmentation, underwent thoracotomy for a right upper lobe pulmonary adenocarcinoma. Seven years after her thoracic surgery, the patient noticed a reduction in her right breast volume, ... ...

Abstract	A 52-year-old woman, who had previous bilateral subpectoral breast augmentation, underwent thoracotomy for a right upper lobe pulmonary adenocarcinoma. Seven years after her thoracic surgery, the patient noticed a reduction in her right breast volume, with shortness of breath and cough. A computed tomography study of the chest revealed intrathoracic migration of her right breast implant with no sing of capsule rupture. Subsequent video-assisted thoracoscopy confirmed this diagnosis.
Language	English
Publishing date	2022-08-13
Publishing country	Netherlands
Document type	Journal Article
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2022.107506
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Article ; Online: Preoperative risk factors predict perioperative allogenic blood transfusion in patients undergoing primary lung cancer resections: a retrospective cohort study from a high-volume thoracic surgery center.

Stoleriu, Mircea Gabriel / Gerckens, Michael / Zimmermann, Julia / Schön, Johannes / Damirov, Fuad / Samm, Nicole / Kovács, Julia / Stacher-Priehse, Elvira / Kellerer, Christina / Jörres, Rudolf A / Kauke, Teresa / Ketscher, Christian / Grützner, Uwe / Hatz, Rudolf

BMC surgery

2023 Volume 23, Issue 1, Page(s) 44

Abstract: Background: Our study aimed to identify preoperative predictors for perioperative allogenic blood transfusion (ABT) in patients undergoing major lung cancer resections in order to improve the perioperative management of patients at risk for ABT.: ... ...

Abstract	Background: Our study aimed to identify preoperative predictors for perioperative allogenic blood transfusion (ABT) in patients undergoing major lung cancer resections in order to improve the perioperative management of patients at risk for ABT. Methods: Patients admitted between 2014 and 2016 in a high-volume thoracic surgery clinic were retrospectively evaluated in a cohort study based on a control group without ABT and the ABT group requiring packed red blood cell units within 15 days postoperatively until discharge. The association of ABT with clinically established parameters (sex, preoperative anemia, liver and coagulation function, blood groups, multilobar resections) was analyzed by contingency tables, receiver operating characteristics (ROC) and logistic regression analysis, taking into account potential covariates. Results: 60 out of 529 patients (11.3%) required ABT. N1 and non-T1 tumors, thoracotomy approach, multilobar resections, thoracic wall resections and Rhesus negativity were more frequent in the ABT group. In multivariable analyses, female sex, preoperative anemia, multilobar resections, as well as serum alanine-aminotransferase levels, thrombocyte counts and Rhesus negativity were identified as independent predictors of ABT, being associated with OR (95% Confidence interval, p-value) of 2.44 (1.23-4.88, p = 0.0112), 18.16 (8.73-37.78, p < 0.0001), 5.79 (2.50-13.38, p < 0.0001), 3.98 (1.73-9.16, p = 0.0012), 2.04 (1.04-4.02, p = 0.0390) and 2.84 (1.23-6.59, p = 0.0150), respectively. Conclusions: In patients undergoing major lung cancer resections, multiple independent risk factors for perioperative ABT apart from preoperative anemia and multilobar resections were identified. Assessment of these predictors might help to identify high risk patients preoperatively and to improve the strategies that reduce perioperative ABT.
MeSH term(s)	Female ; Humans ; Thoracic Surgery ; Retrospective Studies ; Cohort Studies ; Blood Transfusion ; Lung Neoplasms/surgery
Language	English
Publishing date	2023-02-27
Publishing country	England
Document type	Journal Article
ZDB-ID	2050442-1
ISSN	1471-2482 ; 1471-2482
ISSN (online)	1471-2482
ISSN	1471-2482
DOI	10.1186/s12893-023-01924-9
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Article ; Online: Predicting Long-term Survival After Lung Metastasectomy in Patients With Malignant Germ-cell Tumors.

Stoleriu, Mircea Gabriel / Stathopoulos, Georgios / Stacher-Priehse, Elvira / Ketscher, Christian / Grützner, Uwe / Fertmann, Jan / Schneider, Christian / Hatz, Rudolf / Strobl, Nicole / Preissler, Gerhard

Anticancer research

2022 Volume 42, Issue 9, Page(s) 4517–4527

Abstract: Background/aim: The aim of the study was to identify predictors of long-term survival and propose an improved risk stratification in patients with pulmonary germ-cell metastases admitted for pulmonary metastasectomy.: Patients and methods: Thirty- ... ...

Abstract	Background/aim: The aim of the study was to identify predictors of long-term survival and propose an improved risk stratification in patients with pulmonary germ-cell metastases admitted for pulmonary metastasectomy. Patients and methods: Thirty-four patients admitted to the Division of Thoracic Surgery Munich, Germany, from 04/1994 until 09/2017 were retrospectively analyzed. The impact of clinical parameters on survival was calculated using Kaplan-Meier, multivariate Cox regression analysis and receiver-operator curves. Results: Ten-year overall survival was 75.3%. Elevated American Society of Anesthesiologists score, metachronous metastasis, embryonal histology, intrathoracic lymph node involvement, brain metastases and thoracic wall infiltration were significant predictors of reduced survival. With the independent predictors (embryonal histology, metachronous metastasis and thoracic wall infiltration), a germinal non-seminomatous lung metastasis risk of death score (GLUMER) was calculated, accurately predicting survival (area under curve=0.8839, p=0.0023). Conclusion: In patients with pulmonary germ-cell metastases, intrathoracic lymph node involvement, embryonal carcinoma, metachronous metastasis and thoracic wall infiltration represent negative predictors of long-term survival. The GLUMER score might represent a promising tool for use in adapted follow-up care in high-risk patients.
MeSH term(s)	Humans ; Lung/pathology ; Lung Neoplasms/pathology ; Lymph Nodes/pathology ; Metastasectomy ; Neoplasms, Germ Cell and Embryonal/surgery ; Pneumonectomy ; Prognosis ; Retrospective Studies
Language	English
Publishing date	2022-08-29
Publishing country	Greece
Document type	Journal Article
ZDB-ID	604549-2
ISSN	1791-7530 ; 0250-7005
ISSN (online)	1791-7530
ISSN	0250-7005
DOI	10.21873/anticanres.15954
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Zs.A 1642: Show issues

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Article ; Online: Prevention of COVID-19 in Thoracic Surgery Patients: Lessons Learned during the First Pandemic Wave.

Stoleriu, Mircea Gabriel / Gerckens, Michael / Ströh, Katja / Kovács, Julia / Samm, Nicole / Obereisenbuchner, Florian / Hetrodt, Justin / Schmidt, Felicitas Maria / Reinmuth, Niels / Heiß-Neumann, Marion / Stacher-Priehse, Elvira / Koch, Ina / Behr, Jürgen / Ketscher, Christian / Grützner, Uwe / Hatz, Rudolf

Pneumologie (Stuttgart, Germany)

2021 Volume 75, Issue 12, Page(s) 960–970

Abstract: Background: The aim of this retrospective study was to investigate the implementation of measures to prevent perioperative COVID-19 in thoracic surgery during the first wave of the COVID-19 pandemic 2020 allowing a continued surgical treatment of ... ...

Title translation	Prävention postoperativer COVID-19-Erkrankungen in der Thoraxchirurgie: Lehren aus der ersten COVID-19-Welle.
Abstract	Background: The aim of this retrospective study was to investigate the implementation of measures to prevent perioperative COVID-19 in thoracic surgery during the first wave of the COVID-19 pandemic 2020 allowing a continued surgical treatment of patients. Methods: The implemented preventive measures in patient management of the thoracic surgery department of the Asklepios Lung Clinic Munich-Gauting, Germany were retrospectively analyzed. Postoperative COVID-19 incidence before and after implementation of preventive measures was investigated. Patients admitted for thoracic surgical procedures between March and May 2020 were included in the study. Patient characteristics were analyzed. For the early detection of putative postoperative COVID-19 symptoms, typical post-discharge symptomatology of thoracic surgery patients was compared to non-surgical patients hospitalized for COVID-19. Results: Thirty-five surgical procedures and fifty-seven surgical procedures were performed before and after implementation of the preventive measures, respectively. Three patients undergoing thoracic surgery before implementation of preventive measures developed a COVID-19 pneumonia post-discharge. After implementation of preventive measures, no postoperative COVID-19 cases were identified. Fever, dyspnea, dry cough and diarrhea were significantly more prevalent in COVID-19 patients compared to normally recovering thoracic surgery patients, while anosmia, phlegm, low energy levels, body ache and nausea were similarly frequent in both groups. Conclusions: Based on the lessons learned during the first pandemic wave, we here provide a blueprint for successful easily implementable preventive measures minimizing SARS-CoV-2 transmission to thoracic surgery patients perioperatively. While symptoms of COVID-19 and the normal postoperative course of thoracic surgery patients substantially overlap, we found dyspnea, fever, cough, and diarrhea significantly more prevalent in COVID-19 patients than in normally recovering thoracic surgery patients. These symptoms should trigger further diagnostic testing for postoperative COVID-19 in thoracic surgery patients.
MeSH term(s)	Aftercare ; COVID-19 ; Humans ; Pandemics ; Patient Discharge ; Retrospective Studies ; SARS-CoV-2 ; Thoracic Surgery ; Thoracic Surgical Procedures/adverse effects
Language	English
Publishing date	2021-07-14
Publishing country	Germany
Document type	Journal Article
ZDB-ID	607630-0
ISSN	1438-8790 ; 0934-8387
ISSN (online)	1438-8790
ISSN	0934-8387
DOI	10.1055/a-1526-9979
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Uh II Zs.142: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Risk factors for impaired lung function after pulmonary metastasectomy: a prospective observational study of 117 cases.

Welter, Stefan / Cheufou, Danjouma / Ketscher, Christian / Darwiche, Kaid / Maletzki, Frank / Stamatis, Georgios

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

2012 Volume 42, Issue 2, Page(s) e22–7

Abstract: Objectives: The prediction of postoperative preserved pulmonary function is essential for ascertaining the functional operability of pulmonary metastasectomy candidates. Formulae to predict pulmonary function after metastasectomy have not yet been ... ...

Abstract	Objectives: The prediction of postoperative preserved pulmonary function is essential for ascertaining the functional operability of pulmonary metastasectomy candidates. Formulae to predict pulmonary function after metastasectomy have not yet been described. This study was undertaken to provide data about the functional loss after a pulmonary metastasectomy, which often includes non-anatomical resections or combinations with anatomical resections. Methods: Pulmonary function tests were performed preoperatively, postoperatively and 3 months after a pulmonary metastasectomy, and the factors potentially influencing the functional outcome were prospectively collected in a database. The functional loss was calculated as the difference in the values between the follow-up visit and the preoperative values, and the influencing factors were tested using the Mann-Whitney test. Results: A total of 162 patients were prospectively included in the study and 117 completed the study protocol with a follow-up evaluation after a mean of 3.4 months. Of these, 33 patients had bilateral resections, 30 interventions were repeated resections and adhesions were removed in 46. The greatest lung resection performed was a lobectomy in 13, with segmentectomy in 27 and wedge resection in 77 patients. The mean overall functional loss was: forced vital capacity -9.2%, total lung capacity -8.8%, forced expiratory volume in 1 s -10.8% and diffusion capacity for carbon monoxide (DLCO) -9.7%, whereas the diffusion coefficient (KCO) and pO(2) remained unchanged after 3 months. This functional loss was significant (P < 0.001) for all the parameters mentioned. The two factors were inversely found to influence the functional outcome: bilateral resection reduced spirometry values (P < 0.01), postoperative chemotherapy reduced DLCO (P = 0.011) and KCO (P = 0.029). Conclusions: A pulmonary metastasectomy leads to a significant loss of pulmonary function after 3 months in an average patient collective. The most important factors for deteriorating lung function are a bilateral operation and postoperative chemotherapy.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lung Neoplasms/physiopathology ; Lung Neoplasms/secondary ; Lung Neoplasms/surgery ; Male ; Metastasectomy/adverse effects ; Middle Aged ; Postoperative Care/methods ; Preoperative Care/methods ; Prospective Studies ; Respiratory Function Tests/methods ; Risk Factors ; Young Adult
Language	English
Publishing date	2012-08
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639293-3
ISSN	1873-734X ; 1010-7940 ; 1567-4258
ISSN (online)	1873-734X
ISSN	1010-7940 ; 1567-4258
DOI	10.1093/ejcts/ezs293
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Zs.A 2303: Show issues

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Article: Prevention of COVID-19 in Thoracic Surgery Patients: Lessons Learned during the First Pandemic Wave

Pneumologie

2021 Volume 75, Issue 12, Page(s) 960–970

Abstract	Background: The aim of this retrospective study was to investigate the implementation of measures to prevent perioperative COVID-19 in thoracic surgery during the first wave of the COVID-19 pandemic 2020 allowing a continued surgical treatment of patients. Methods: The implemented preventive measures in patient management of the thoracic surgery department of the Asklepios Lung Clinic Munich-Gauting, Germany were retrospectively analyzed. Postoperative COVID-19 incidence before and after implementation of preventive measures was investigated. Patients admitted for thoracic surgical procedures between March and May 2020 were included in the study. Patient characteristics were analyzed. For the early detection of putative postoperative COVID-19 symptoms, typical post-discharge symptomatology of thoracic surgery patients was compared to non-surgical patients hospitalized for COVID-19. Results: Thirty-five surgical procedures and fifty-seven surgical procedures were performed before and after implementation of the preventive measures, respectively. Three patients undergoing thoracic surgery before implementation of preventive measures developed a COVID-19 pneumonia post-discharge. After implementation of preventive measures, no postoperative COVID-19 cases were identified. Fever, dyspnea, dry cough and diarrhea were significantly more prevalent in COVID-19 patients compared to normally recovering thoracic surgery patients, while anosmia, phlegm, low energy levels, body ache and nausea were similarly frequent in both groups. Conclusions: Based on the lessons learned during the first pandemic wave, we here provide a blueprint for successful easily implementable preventive measures minimizing SARS-CoV-2 transmission to thoracic surgery patients perioperatively. While symptoms of COVID-19 and the normal postoperative course of thoracic surgery patients substantially overlap, we found dyspnea, fever, cough, and diarrhea significantly more prevalent in COVID-19 patients than in normally recovering thoracic surgery patients. These symptoms should trigger further diagnostic testing for postoperative COVID-19 in thoracic surgery patients.
Language	English
Publishing date	2021-07-14
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	607630-0
ISSN	1438-8790 ; 0934-8387
ISSN (online)	1438-8790
ISSN	0934-8387
DOI	10.1055/a-1526-9979
Database	Thieme publisher's database

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Conference proceedings: Clinical instruction in a surgical endoscopic unit

Happich, Susanne / Ketscher, Christian / Jauch, Karl-Walter

optimization by implementation of standardised online-tutorials

2006 , Page(s) 06gma022

Event/congress	Jahrestagung der Gesellschaft für Medizinische Ausbildung - GMA; Köln; 2006
Keywords	Medizin, Gesundheit ; Humanmedizin
Publishing date	2006-10-23
Publisher	German Medical Science; Düsseldorf, Köln
Document type	Conference proceedings
Database	German Medical Science

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Article: Use of the molecular adsorbent recycling system in the treatment of postoperative hepatic failure and septic multiple organ dysfunction--preliminary results.

Rittler, Peter / Ketscher, Christian / Inthorn, Dietrich / Jauch, Karl-Walter / Hartl, Wolfgang H

Liver international : official journal of the International Association for the Study of the Liver

2004 Volume 24, Issue 2, Page(s) 136–141

Abstract: Purpose of the study: Molecular adsorbent recycling system (MARS) has been applied successfully in patients with a variety of liver diseases. However, preliminary results in patients with multiple organ failure (MOF) and sepsis were disappointing, ... ...

Abstract	Purpose of the study: Molecular adsorbent recycling system (MARS) has been applied successfully in patients with a variety of liver diseases. However, preliminary results in patients with multiple organ failure (MOF) and sepsis were disappointing, possibly because the number of applied MARS cycles was too low. To determine potential effects of prolonged MARS treatment in patients with postsurgical MOF we evaluated five postoperative patients with acute liver failure and septic multiple organ dysfunction in a retrospective observational study. Methods: MARS cycles (13.4+/-1.9) were applied during an average time period of 17.2+/-5.2 days. Fresh frozen plasma, thrombocyte units and blood units were transfused to maintain pre-MARS Quick values and thrombocyte counts, and to keep the hemoglobin concentration above 8 g/dl. Main findings: Plasma bilirubin concentrations declined significantly during treatment. In contrast, ammonia concentration remained constant, and parameters of the clotting system (Quick value) did not get better or even worsened (partial thromboplastin time) despite significantly increasing the substitution frequency of coagulatory factors. Due to poor clotting, we observed significant bleeding complications during MARS therapy causing a simultaneous rise in the number of transfused blood units. All patients demonstrated persistent, severe abdominal infection during MARS therapy. After discontinuing MARS treatment because of insufficient efficiency, all patients died of progressive septic organ malfunction. Conclusion: Our preliminary findings do not support use of MARS in patients with postoperative hepatic failure and progressive septic multiple organ dysfunction, particularly if the septic focus cannot be eliminated. If MARS is still applied, special attention should be paid to simultaneous clotting disorders and bleeding complications.
MeSH term(s)	APACHE ; Adult ; Humans ; Inactivation, Metabolic ; Liver Failure, Acute/etiology ; Liver Failure, Acute/physiopathology ; Liver Failure, Acute/therapy ; Liver, Artificial ; Middle Aged ; Multiple Organ Failure/complications ; Multiple Organ Failure/physiopathology ; Multiple Organ Failure/therapy ; Postoperative Period ; Retrospective Studies ; Sepsis/complications ; Sepsis/physiopathology ; Sepsis/therapy ; Severity of Illness Index ; Treatment Outcome
Language	English
Publishing date	2004-04
Publishing country	United States
Document type	Clinical Trial ; Journal Article
ZDB-ID	2102783-3
ISSN	1478-3231 ; 1478-3223
ISSN (online)	1478-3231
ISSN	1478-3223
DOI	10.1111/j.1478-3231.2004.0898.x
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