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Book ; Thesis: Möglichkeiten der Prädiktion eines tumorindividuellen Ansprechens auf eine neoadjuvante Radiochemotherapie beim lokal fortgeschrittenen Rektumkarzinom anhand molekularer Expressionsmuster

Müssle, Benjamin

2012

Author's details	vorgelegt von Benjamin Moritz Müßle
Language	German
Size	54 Bl. : graph. Darst.
Publishing country	Germany
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Heidelberg, Univ., Diss., 2012
HBZ-ID	HT017418156
Database	Catalogue ZB MED Medicine, Health

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Article ; Conference proceedings: The use of discharge criteria to optimize patient discharge after gastrointestinal operations

Müssle, B. / Wille, L. / Weitz, J. / Welsch, T.

Zeitschrift für Gastroenterologie

2023 Volume 61, Issue 08

Event/congress	Viszeralmedizin 2023 77. Jahrestagung der DGVS mit Sektion Endoskopie Herbsttagung der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie mit den Arbeitsgemeinschaften der DGAV und Jahrestagung der CACP, Erst online. Dann Hamburg., 2023-09-11
Language	German
Publishing date	2023-08-01
Publisher	Georg Thieme Verlag
Publishing place	Stuttgart ; New York
Document type	Article ; Conference proceedings
ZDB-ID	201387-3
ISSN	1439-7803 ; 0044-2771 ; 0172-8504
ISSN (online)	1439-7803
ISSN	0044-2771 ; 0172-8504
DOI	10.1055/s-0043-1772112
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Article ; Conference proceedings: Impact of targeted antibiotic therapy and extended intraoperative peritoneal lavage during pancreatoduodenectomy

Müssle, B. / Groß, T. / Merboth, F. / Klimova, A. / Weitz, J. / Welsch, T.

Zeitschrift für Gastroenterologie

2023 Volume 61, Issue 08

Event/congress	Viszeralmedizin 2023 77. Jahrestagung der DGVS mit Sektion Endoskopie Herbsttagung der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie mit den Arbeitsgemeinschaften der DGAV und Jahrestagung der CACP, Erst online. Dann Hamburg., 2023-09-11
Language	German
Publishing date	2023-08-01
Publisher	Georg Thieme Verlag
Publishing place	Stuttgart ; New York
Document type	Article ; Conference proceedings
ZDB-ID	201387-3
ISSN	1439-7803 ; 0044-2771 ; 0172-8504
ISSN (online)	1439-7803
ISSN	0044-2771 ; 0172-8504
DOI	10.1055/s-0043-1772068
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Article ; Online: Drainless robot-assisted minimally invasive oesophagectomy-randomized controlled trial (RESPECT).

Müssle, B / Kirchberg, J / Buck, N / Radulova-Mauersberger, O / Stange, D / Richter, T / Müller-Stich, B / Klotz, R / Larmann, J / Korn, S / Klimova, A / Grählert, X / Trips, E / Weitz, J / Welsch, T

Trials

2023 Volume 24, Issue 1, Page(s) 303

Abstract: Background: The purpose of this randomized trial is to evaluate the early removal of postoperative drains after robot-assisted minimally invasive oesophagectomy (RAMIE). Evidence is lacking about feasibility, associated pain, recovery, and morbidity.: ...

Abstract	Background: The purpose of this randomized trial is to evaluate the early removal of postoperative drains after robot-assisted minimally invasive oesophagectomy (RAMIE). Evidence is lacking about feasibility, associated pain, recovery, and morbidity. Methods/design: This is a randomized controlled multicentric trial involving 72 patients undergoing RAMIE. Patients will be allocated into two groups. The "intervention" group consists of 36 patients. In this group, abdominal and chest drains are removed 3 h after the end of surgery in the absence of contraindications. The control group consists of 36 patients with conventional chest drain management. These drains are removed during the further postoperative course according to a standard algorithm. The primary objective is to investigate whether postoperative pain measured by NRS on the second postoperative day can be significantly reduced in the intervention group. Secondary endpoints are the intensity of pain during the first week, analgesic use, number of postoperative chest X-ray and CT scans, interventions, postoperative mobilization (steps per day as measured with an activity tracker), postoperative morbidity and mortality. Discussion: Until now, there have been no trials investigating different intraoperative chest drain strategies in patients undergoing RAMIE for oesophageal cancer with regard to perioperative complications until discharge. Minimally invasive approaches combined with enhanced recovery after surgery (ERAS) protocols lower morbidity but still include the insertion of chest drains. Reduction and early removal have been proposed after pulmonary surgery but not after RAMIE. The study concept is based on our own experience and the promising current results of the RAMIE procedure. Therefore, the presented randomized controlled trial will provide statistical evidence of the effectiveness and feasibility of the "drainless" RAMIE. Trial registration: ClinicalTrials.gov NCT05553795. Registered on 23 September 2022.
MeSH term(s)	Humans ; Esophagectomy/methods ; Robotics ; Postoperative Complications/etiology ; Abdomen ; Esophageal Neoplasms/surgery ; Pain, Postoperative/surgery ; Treatment Outcome ; Minimally Invasive Surgical Procedures/methods
Language	English
Publishing date	2023-05-02
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2040523-6
ISSN	1745-6215 ; 1468-6694 ; 1745-6215
ISSN (online)	1745-6215
ISSN	1468-6694 ; 1745-6215
DOI	10.1186/s13063-023-07233-z
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Article: Single chest drain is not inferior to double chest drain after robotic esophagectomy: a propensity score-matched analysis.

Eckert, F / Merboth, F / Giehl-Brown, E / Hasanovic, J / Müssle, B / Plodeck, V / Richter, T / Welsch, T / Kahlert, C / Fritzmann, J / Distler, M / Weitz, J / Kirchberg, J

Frontiers in surgery

2023 Volume 10, Page(s) 1213404

Abstract: Background: Chest drain management has a significant influence on postoperative recovery after robot-assisted minimally invasive esophagectomy (RAMIE). The use of chest drains increases postoperative pain by irritating intercostal nerves and hinders ... ...

Abstract	Background: Chest drain management has a significant influence on postoperative recovery after robot-assisted minimally invasive esophagectomy (RAMIE). The use of chest drains increases postoperative pain by irritating intercostal nerves and hinders patients from early postoperative mobilization and recovery. To our knowledge, no study has investigated the use of two vs. one intercostal chest drains after RAMIE. Methods: This retrospective cohort study evaluated patients undergoing elective RAMIE with gastric conduit pull-up and intrathoracic anastomosis. Patients were divided into two groups according to placement of one (11/2020-08/2022) or two (08/2018-11/2020) chest drains. Propensity score matching was performed in a 1:1 ratio, and the incidences of overall and pulmonary complications, drainage-associated re-interventions, radiological diagnostics, analgesic use, and length of hospital stay were compared between single drain and double drain groups. Results: During the study period, 194 patients underwent RAMIE. Twenty-two patients were included after propensity score matching in the single and double chest drain group, respectively. Time until removal of the last chest drain [postoperative day (POD) 6.7 ± 4.4 vs. POD 9.4 ± 2.7, Conclusion: This study is the first to demonstrate the safety of single intercostal chest drain use and, at least, non-inferiority to double chest drains in terms of perioperative complications after RAMIE.
Language	English
Publishing date	2023-07-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2023.1213404
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Article ; Online: Roboterassistierte Pankreasresektion.

Müssle, B / Distler, M / Weitz, J / Welsch, T

Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen

2017 Volume 88, Issue 6, Page(s) 490–495

Abstract: Although robot-assisted pancreatic surgery has been considered critically in the past, it is nowadays an established standard technique in some centers, for distal pancreatectomy and pancreatic head resection. Compared with the laparoscopic approach, the ...

Title translation	Robot-assisted pancreatic resection.
Abstract	Although robot-assisted pancreatic surgery has been considered critically in the past, it is nowadays an established standard technique in some centers, for distal pancreatectomy and pancreatic head resection. Compared with the laparoscopic approach, the use of robot-assisted surgery seems to be advantageous for acquiring the skills for pancreatic, bile duct and vascular anastomoses during pancreatic head resection and total pancreatectomy. On the other hand, the use of the robot is associated with increased costs and only highly effective and professional robotic programs in centers for pancreatic surgery will achieve top surgical and oncological quality, acceptable operation times and a reduction in duration of hospital stay. Moreover, new technologies, such as intraoperative fluorescence guidance and augmented reality will define additional indications for robot-assisted pancreatic surgery.
Language	German
Publishing date	2017-06
Publishing country	Germany
Document type	English Abstract ; Journal Article
ZDB-ID	1521-0
ISSN	1433-0385 ; 0009-4722
ISSN (online)	1433-0385
ISSN	0009-4722
DOI	10.1007/s00104-017-0400-9
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Article ; Online: Perioperative Blood Management of Preoperative Anemia Determines Long-Term Outcome in Patients with Pancreatic Surgery.

Oehme, F / Hempel, S / Knote, R / Addai, D / Distler, M / Muessle, B / Bork, U / Weitz, J / Welsch, T / Kahlert, C

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2021 Volume 25, Issue 10, Page(s) 2572–2581

Abstract: Background/purpose: Anemia affects the postoperative course of patients undergoing a major surgical procedure. However, it remains unclear whether anemia has a different impact on the long-term outcome of patients with malignant or benign pancreatic ... ...

Abstract	Background/purpose: Anemia affects the postoperative course of patients undergoing a major surgical procedure. However, it remains unclear whether anemia has a different impact on the long-term outcome of patients with malignant or benign pancreatic disease. Methods: A retrospective analysis of patients undergoing pancreatic surgery for pancreatic malignancies or chronic pancreatitis was conducted between January 2012 and June 2018 at the University Hospital Dresden, Germany. The occurrence of preoperative anemia and the administration of pre-, intra-, and postoperative blood transfusions were correlated with postoperative complications and survival data by uni- and multivariate analysis. Results: A total of 682 patients were included with 482 (70.7%) undergoing surgical procedures for pancreatic malignancies. Univariate regression analysis confirmed preoperative anemia as a risk factor for postoperative complications > grade 2 according to the Clavien-Dindo classification. Multivariate regression analyses indicated postoperative blood transfusion as an independent risk factor for postoperative complications in patients with a benign (OR 20.5; p value < 0.001) and a malignant pancreatic lesion (OR 4.7; p value < 0.01). Univariate and multivariate analysis revealed preoperative anemia and pre-, intra-, and postoperative blood transfusions as independent prognostic factors for shorter overall survival in benign and malignant patients (p value < 0.001-0.01). Conclusion: Preoperative anemia is a prevalent, independent, and adjustable factor in pancreatic surgery, which poses a significant risk for postoperative complications irrespective of the entity of the underlying disease. It should therefore be understood as an adjustable factor rather than an indicator of underlying disease severity.
MeSH term(s)	Anemia/complications ; Blood Transfusion ; Digestive System Surgical Procedures ; Humans ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Retrospective Studies ; Risk Factors
Language	English
Publishing date	2021-02-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1007/s11605-021-04917-2
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Article ; Online: Serum C-reactive protein level after ventral hernia repair with mesh reinforcement can predict infectious complications: a retrospective cohort study.

Pochhammer, J / Scholtes, B / Keuler, J / Müssle, B / Welsch, T / Schäffer, M

Hernia : the journal of hernias and abdominal wall surgery

2018 Volume 24, Issue 1, Page(s) 41–48

Abstract: Purpose: Infectious complications (ICs) after mesh-reinforced ventral hernioplasty often lead to prolonged and complicated hospitalizations. As early diagnosis and management can mitigate complications, early prediction is important. Our aim was to ... ...

Abstract	Purpose: Infectious complications (ICs) after mesh-reinforced ventral hernioplasty often lead to prolonged and complicated hospitalizations. As early diagnosis and management can mitigate complications, early prediction is important. Our aim was to determine whether postoperative blood tests are valuable predictors of IC. Methods: We retrospectively analyzed 373 patients who underwent conventional ventral hernioplasty with mesh augmentation between 2008 and 2011. The clinical outcome was correlated with postoperative serum C-reactive protein (CRP) and white blood cell counts (WBC) and assessed by area under the curve (AUC) analysis of the receiver operating characteristics curve. Results: ICs occurred in 51 (13.7%) patients, who required further management. Among these, 48 patients developed a procedure-related complication, the most frequent being surgical site infection (n = 44). The infections appeared after a median postoperative delay of 12 days. Serum CRP was superior to WBC in the prediction of a complicated course. A maximum CRP < 105 mg/L on postoperative day (POD) 2 or 3 had the highest negative predictive value (NPV; 100%) in ruling out ICs [positive predictive value (PPV) 29%; sensitivity 100%; specificity 55%]. The PPV for occurrence of IC improved each day after surgery, reaching up to 46% on POD 5 or 6 for a CRP cut-off of 63.2 mg/L (NPV 93%; sensitivity 69%; specificity 83%). The AUC was 0.80 at both time points. Conclusions: Our results indicate that postoperative serum CRP allows for early prediction of the postoperative course. Low CRP during the initial PODs is associated with lower risk of ICs. Higher levels on POD 5 or 6 behoove close surveillance.
MeSH term(s)	Biomarkers ; C-Reactive Protein/metabolism ; Cohort Studies ; Female ; Hernia, Ventral/surgery ; Herniorrhaphy/adverse effects ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Predictive Value of Tests ; ROC Curve ; Retrospective Studies ; Sensitivity and Specificity ; Surgical Mesh/adverse effects ; Surgical Wound Infection/blood ; Surgical Wound Infection/diagnosis
Chemical Substances	Biomarkers ; C-Reactive Protein (9007-41-4)
Keywords	covid19
Language	English
Publishing date	2018-11-07
Publishing country	France
Document type	Evaluation Study ; Journal Article
ZDB-ID	1388125-5
ISSN	1248-9204 ; 1265-4906
ISSN (online)	1248-9204
ISSN	1265-4906
DOI	10.1007/s10029-018-1844-7
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Article ; Conference proceedings: Bedeutung von paraaortalen Lymphknotenmetastasen für Outcome und Behandlung periampullärer Karzinome

Hempel, S / Müssle, B / Distler, M / Weitz, J / Welsch, T

Zeitschrift für Gastroenterologie

2018 Volume 56, Issue 08

Event/congress	Viszeralmedizin 2018 - 73. Jahrestagung der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten mit Sektion Endoskopie - 12. Herbsttagung der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie gemeinsam mit den Arbeitsgemeinschaften der DGAV, München, 2018-09-12
Language	German
Publishing date	2018-08-01
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article ; Conference proceedings
ZDB-ID	201387-3
ISSN	1439-7803 ; 0044-2771 ; 0172-8504
ISSN (online)	1439-7803
ISSN	0044-2771 ; 0172-8504
DOI	10.1055/s-0038-1668999
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Article ; Online: Short-term preoperative drainage is associated with improved postoperative outcomes compared to that of long-term biliary drainage in pancreatic surgery.

Oehme, F / Hempel, S / Pecqueux, M / Müssle, B / Hau, H M / Teske, C / von Bechtolsheim, F / Seifert, L / Distler, M / Welsch, T / Weitz, J / Kahlert, Cristoph

Langenbeck's archives of surgery

2021 Volume 407, Issue 3, Page(s) 1055–1063

Abstract: Purpose: The treatment of choice for patients presenting with obstructive cholestasis due to periampullary carcinoma is oncologic resection without preoperative biliary drainage (PBD). However, resection without PBD becomes virtually impossible in ... ...

Abstract	Purpose: The treatment of choice for patients presenting with obstructive cholestasis due to periampullary carcinoma is oncologic resection without preoperative biliary drainage (PBD). However, resection without PBD becomes virtually impossible in patients with obstructive cholangitis or severely impaired liver cell function. The appropriate duration of drainage by PBD has not yet been defined for these patients. Methods: A retrospective analysis was conducted on 170 patients scheduled for pancreatic resection following biliary drainage between January 2012 and June 2018 at the University Hospital Dresden in Germany. All patients were deemed eligible for inclusion, regardless of the underlying disease entity. The primary endpoint analysis was defined as the overall morbidity (according to the Clavien-Dindo classification). Secondary endpoints were the in-hospital mortality and malignancy adjusted overall and recurrence-free survival rates. Results: A total of 170 patients were included, of which 45 (26.5%) and 125 (73.5%) were assigned to the short-term (< 4 weeks) and long-term (≥ 4 weeks) preoperative drainage groups, respectively. Surgical complications (Clavien-Dindo classification > 2) occurred in 80 (47.1%) patients, with significantly fewer complications observed in the short-term drainage group (31.1% vs. 52%; p = 0.02). We found that long-term preoperative drainage (unadjusted OR, 3.386; 95% CI, 1.507-7.606; p < 0.01) and periampullary carcinoma (unadjusted OR, 5.519; 95% CI, 1.722-17.685; p-value < 0.01) were independent risk factors for postoperative morbidity, based on the results of a multivariate regression model. The adjusted overall and recurrence-free survival did not differ between the groups (p = 0.12). Conclusion: PBD in patients scheduled for pancreatic surgery is associated with substantial perioperative morbidity. Our results indicate that patients who have undergone PBD should be operated on within 4 weeks after drainage.
MeSH term(s)	Carcinoma/surgery ; Drainage/methods ; Duodenal Neoplasms/surgery ; Humans ; Jaundice, Obstructive/surgery ; Pancreatic Neoplasms/pathology ; Pancreaticoduodenectomy/adverse effects ; Pancreaticoduodenectomy/methods ; Postoperative Complications ; Preoperative Care/methods ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-12-15
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-021-02402-7
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