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  1. Book: Die Kapsel

    Reichert, Martin

    Aids in der Bundesrepublik

    (Schriftenreihe / Bundeszentrale für politische Bildung ; Band 10322)

    2018  

    Author's details Martin Reichert
    Series title Schriftenreihe / Bundeszentrale für politische Bildung ; Band 10322
    Schriftenreihe der Bundeszentrale für Politische Bildung
    Collection Schriftenreihe der Bundeszentrale für Politische Bildung
    Keywords Deutschland ; Aids ; Sozialgeschichte 1982-2015
    Subject Acquired immune deficiency syndrome ; Erworbenes Immundefektsyndrom
    Language German
    Size 271 Seiten, Illustrationen
    Edition Sonderausgabe für die Bundeszentrale für politische Bildung
    Publisher Bundeszentrale für politische Bildung
    Publishing place Bonn
    Publishing country Germany
    Document type Book
    Note © Suhrkamp Verlag Berlin 2018
    HBZ-ID HT020053675
    ISBN 978-3-7425-0322-0 ; 3-7425-0322-7
    Database Catalogue ZB MED Medicine, Health

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  2. Article ; Online: Pharmacologic prevention and therapy of postoperative paralytic ileus after gastrointestinal cancer surgery - systematic review and meta-analysis.

    Reichert, Martin / Willis, Franziska / Post, Stefan / Schneider, Martin / Vilz, Tim / Willis, Maria / Hecker, Andreas

    International journal of surgery (London, England)

    2024  

    Abstract: Background: Postoperative paralytic ileus (POI) is a significant concern following gastrointestinal tumor surgery. Effective preventive and therapeutic strategies are crucial but remain elusive. Current evidence from randomized-controlled trials on ... ...

    Abstract Background: Postoperative paralytic ileus (POI) is a significant concern following gastrointestinal tumor surgery. Effective preventive and therapeutic strategies are crucial but remain elusive. Current evidence from randomized-controlled trials on pharmacological interventions for prevention or treatment of POI are systematically reviewed to guide clinical practice and future research.
    Materials and methods: Literature was systematically searched for prospective randomized-controlled trials testing pharmacological interventions for prevention or treatment of POI after gastrointestinal tumor surgery. Meta-analysis was performed using a random effects model to determine risk ratios and mean differences with 95% confidence intervals. Risk of bias and evidence quality were assessed.
    Results: Results from 55 studies, involving 5078 patients who received experimental interventions, indicate that approaches of opioid-sparing analgesia, peripheral opioid antagonism, reduction of sympathetic hyperreactivity, and early use of laxatives effectively prevent POI. Perioperative oral Alvimopan or intravenous administration of Lidocaine or Dexmedetomidine, while safe regarding cardio-pulmonary complications, demonstrated effectiveness concerning various aspects of postoperative bowel recovery (Lidocaine: -5.97 [-7.20 - -4.74]h, P<0.0001; Dexmedetomidine: -13.00 [-24.87 - -1.14]h, P=0.03 for time to first defecation; Alvimopan: -15.33 [-21.22 - -9.44]h, P<0.0001 for time to GI-2) and length of hospitalization (Lidocaine: -0.67 [-1.24 - -0.09]d, P=0.02; Dexmedetomidine: -1.28 [-1.96 - -0.60]d, P=0.0002; Alvimopan: -0.58 [-0.84 - -0.32]d, P<0.0001) across wide ranges of evidence quality. Perioperative non-opioid analgesic use showed efficacy concerning bowel recovery as well as length of hospitalization (-1.29 [-1.95 - -0.62]d, P=0.0001). Laxatives showed efficacy regarding bowel movements, but not food tolerance and hospitalization. Evidence supporting pharmacological treatment for clinically evident POI is limited. Results from one single study suggest that Neostigmine reduces time to flatus and accelerates bowel movements (-37.06 [-40.26 - -33.87]h, P<0.0001 and -42.97 [-47.60 - -38.35]h, P<0.0001, respectively) with low evidence quality.
    Conclusion: Current evidence concerning pharmacological prevention and treatment of POI following gastrointestinal tumor surgery is limited. Opioid-sparing concepts, reduction of sympathetic hyperreactivity, and laxatives should be implemented into multimodal perioperative approaches.
    Language English
    Publishing date 2024-03-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2212038-5
    ISSN 1743-9159 ; 1743-9191
    ISSN (online) 1743-9159
    ISSN 1743-9191
    DOI 10.1097/JS9.0000000000001393
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Editorial on: current state of empyema management.

    Reichert, Martin / Bodner, Johannes

    Journal of thoracic disease

    2018  Volume 10, Issue Suppl 33, Page(s) S4043–S4046

    Language English
    Publishing date 2018-10-22
    Publishing country China
    Document type Editorial ; Comment
    ZDB-ID 2573571-8
    ISSN 2077-6624 ; 2072-1439
    ISSN (online) 2077-6624
    ISSN 2072-1439
    DOI 10.21037/jtd.2018.10.46
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Perioperative statin medication impairs pulmonary outcome after abdomino-thoracic esophagectomy.

    Reichert, Martin / Lang, Maike / Pons-Kühnemann, Joern / Sander, Michael / Padberg, Winfried / Hecker, Andreas

    Perioperative medicine (London, England)

    2022  Volume 11, Issue 1, Page(s) 47

    Abstract: Background: Although surgery is the curative option of choice for patients with locally advanced esophageal cancer, morbidity, especially the rate of pulmonary complications, and consequently mortality of patients undergoing abdomino-thoracic ... ...

    Abstract Background: Although surgery is the curative option of choice for patients with locally advanced esophageal cancer, morbidity, especially the rate of pulmonary complications, and consequently mortality of patients undergoing abdomino-thoracic esophagectomy remain unacceptably high. Causes for developing post-esophagectomy pulmonary complications are trauma to the lung and thoracic cavity as well as systemic inflammatory response. Statins are known to influence inflammatory pathways, but whether perioperative statin medication impacts on inflammatory response and pulmonary complication development after esophagectomy had not been investigated, yet.
    Methods: Retrospective analysis and propensity score matching of patients, who either received perioperative statin medication [statin( +)] or not [statin( -)], with regard to respiratory impairment (PaO
    Results: Seventy-eight patients who underwent abdomino-thoracic esophagectomy for cancer were included into propensity score pair-matched analysis [statin( +): n = 26 and statin( -): n = 52]. Although no differences were seen in postoperative inflammatory serum markers, C-reactive protein values correlated significantly with the development of pneumonia beyond postoperative day 3 in statin( -) patients. This effect was attenuated under statin medication. No difference was seen in cumulative incidences of respiratory impairment; however, significantly higher rate (65.4% versus 38.5%, p = 0.0317, OR 3.022, 95% CI 1.165-7.892) and higher cumulative incidence (p = 0.0468) of postoperative pneumonia were seen in statin( +) patients, resulting in slightly longer postoperative stay on intensive care unit (p = 0.0612) as well as significantly prolonged postoperative in-hospital stay (p = 0.0185).
    Conclusions: Development of pulmonary complications after abdomino-thoracic esophagectomy is multifactorial but frequent. The establishment of preventive measures into the perioperative clinical routine is mandatory for an improved patient outcome. Perioperative medication with statins might influence pneumonia development in the highly vulnerable lung after abdomino-thoracic esophagectomy. Perioperative interruption of statin medication might be beneficial in appropriate patients; however, further clinical trials and translational studies are needed to prove this hypothesis.
    Language English
    Publishing date 2022-09-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 2683800-X
    ISSN 2047-0525
    ISSN 2047-0525
    DOI 10.1186/s13741-022-00280-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Frailty in elderly patients with acute appendicitis.

    Reinisch, Alexander / Reichert, Martin / Ondo Meva, Christian Charles / Padberg, Winfried / Ulrich, Frank / Liese, Juliane

    European journal of trauma and emergency surgery : official publication of the European Trauma Society

    2022  Volume 48, Issue 4, Page(s) 3033–3042

    Abstract: Purpose: Acute appendicitis in the elderly is becoming increasingly recognized for its often severe course. For various elective and urgent operations in older patients, frailty is a risk factor for poor outcomes. However, there is a lack of data on ... ...

    Abstract Purpose: Acute appendicitis in the elderly is becoming increasingly recognized for its often severe course. For various elective and urgent operations in older patients, frailty is a risk factor for poor outcomes. However, there is a lack of data on frailty in elderly patients with acute appendicitis.
    Methods: Patients over 65 years old who underwent surgery for acute appendicitis in three hospitals between January 2015 and September 2020 were assessed with the Hospital Frailty Risk Score (HFRS) and the modified Frailty Index (mFI). Outcomes of interest, including morbidity, mortality, and length of stay, were recorded.
    Results: While frailty can be measured with both tests, the mFI has better applicability and takes significantly less time to implement compared to the HFRS (21.6 s vs. 80.3 s, p < 0.0001) while providing the same information value. Patients who exhibited frailty according to either assessment had a significantly higher rate of milder (OR 5.85/2.87, p < 0.0001/0.009) and serious (OR 4.92/3.61, p < 0.011/0.029) complications, more admissions to the intensive care unit (OR 5.16/7.36, p < 0.0001), and an almost doubled length of stay (12.7 days vs. 6.6 days, p < 0.005). Up to 31% of these patients required institutional care after discharge, which is significantly more than those without frailty (p < 0.0001). Furthermore, the mortality rate in frail patients was significantly elevated to 17%, compared to less than 1% in non-frail patients (p = 0.018).
    Conclusion: In elderly patients, frailty is a significant risk factor for negative outcomes. Frailty can be assessed more quickly and reliably with the mFI compared to the HFRS.
    MeSH term(s) Acute Disease ; Aged ; Appendicitis/complications ; Appendicitis/surgery ; Frail Elderly ; Frailty/complications ; Geriatric Assessment ; Hemorrhagic Fever with Renal Syndrome/complications ; Humans ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Risk Assessment ; Risk Factors
    Language English
    Publishing date 2022-02-02
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2275480-5
    ISSN 1863-9941 ; 1863-9933
    ISSN (online) 1863-9941
    ISSN 1863-9933
    DOI 10.1007/s00068-022-01878-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Right colectomy from open to robotic - a single-center experience with functional outcomes in a learning-curve setting.

    Hirschburger, Markus / Schneider, Rolf / Kraenzlein, Sophie / Padberg, Winfried / Hecker, Andreas / Reichert, Martin

    Langenbeck's archives of surgery

    2022  Volume 407, Issue 7, Page(s) 2915–2927

    Abstract: Purpose: Right colectomy (RC) is a frequently performed procedure. Beneath standard conventional open surgery (COS), various minimally invasive techniques had been introduced. Several advantages had recently been described for robotic approaches over ... ...

    Abstract Purpose: Right colectomy (RC) is a frequently performed procedure. Beneath standard conventional open surgery (COS), various minimally invasive techniques had been introduced. Several advantages had recently been described for robotic approaches over COS or conventional laparoscopy. Nevertheless, novel minimally invasive techniques require continuous benchmarking against standard COS to gain maximum patient safety. Bowel dysfunction is a frequent problem after RC. Together with general complication rates postoperative bowel recovery are used as surrogate parameters for postoperative patient outcome in this study.
    Methods: Retrospective, 10-year single-center analysis of consecutive patients who underwent sequentially either COS (n = 22), robotic-assisted (ECA: n = 39), or total robotic surgery (ICA: n = 56) for oncologic RC was performed.
    Results: The conversion from robotic to open surgery rate was low (overall: 3.2%). Slightly longer duration of surgery had been observed during the early phase after introduction of the robotic program to RC (ECA versus COS, p = 0.044), but not anymore thereafter (versus ICA). No differences were observed in oncologic parameters including rates of tumor-negative margins, lymph node-positive patients, and lymph node yield during mesocolic excision. Both robotic approaches are beneficial regarding postoperative complication rates, especially wound infections, and shorter length of in-hospital stay compared with COS. The duration until first postoperative stool is the shortest after ICA (COS: 4 [2-8] days, ECA: 3 [1-6] days, ICA: 3 [1-5] days, p = 0.0004). Regression analyses reveal neither a longer duration of surgery nor the extent of mesocolic excision, but the degree of minimally invasiveness and postoperative systemic inflammation contribute to postoperative bowel dysfunction, which prolongs postoperative in-hospital stay significantly.
    Conclusion: The current study reflects the institutional learning curve of oncologic RC during implementation of robotic surgery from robotic-assisted to total robotic approach without compromises in oncologic results and patient safety. However, the total robotic approach is beneficial regarding postoperative bowel recovery and general patient outcome.
    MeSH term(s) Humans ; Robotic Surgical Procedures/adverse effects ; Robotic Surgical Procedures/methods ; Learning Curve ; Retrospective Studies ; Colonic Neoplasms/surgery ; Colonic Neoplasms/pathology ; Colectomy/adverse effects ; Colectomy/methods ; Laparoscopy/adverse effects ; Laparoscopy/methods ; Treatment Outcome
    Language English
    Publishing date 2022-06-09
    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/s00423-022-02576-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Establishing robotic bariatric surgery at an academic tertiary hospital: a learning curve analysis for totally robotic Roux-en-Y gastric bypass.

    Kauffels, Anne / Reichert, Martin / Askevold, Ingolf / Bender, Anna / Hecker, Andreas / Padberg, Winfried / Sprenger, Thilo

    Journal of robotic surgery

    2022  Volume 17, Issue 2, Page(s) 577–585

    Abstract: The use of robotic systems in bariatric surgery has constantly increased over the last years. However, beside its technical advantages in morbidly obese patients the conclusive role of robotics in bariatric and metabolic surgery is still under ... ...

    Abstract The use of robotic systems in bariatric surgery has constantly increased over the last years. However, beside its technical advantages in morbidly obese patients the conclusive role of robotics in bariatric and metabolic surgery is still under controversial debate. This is an analysis of prospectively collected data of consecutive patients undergoing fully robotic Roux-en-Y gastric bypasses (TR-RYGB) during the first year after implementation of a robotic bariatric program at a tertiary university hospital. All patients were operated by a previously untrained robotic but experienced laparoscopic bariatric surgeon using the daVinci Xi system (Intuitive Surgical, Sarl). Data recording included patient characteristics, operative and functional outcomes, complications and learning curves for surgeon and assistants. In total, 80 patients underwent primary or revisional robotic bariatric surgery. Seventy-two patients (90%) received a TR-RYGB. There were no major complications, re-interventions or readmissions. The overall complication rate was 2.5% (Clavien-Dindo grade I and II). The overall operation time was 140.7 ± 24.6 min and decreased significantly from the first to the last decade of procedures (procedure 1-10: 171.2 ± 26.3 min versus procedure 63-72: 116.0 ± 10.9 min, p < 0.0001). A stabilization of the learning curve was observed after 30 procedures for the surgeon and after five procedures for the bedside assistant. With immediate effect, TR-RYGB is a safe procedure with low complication rates for an experienced laparoscopic bariatric surgeon without prior robotic skills. Learning curves are steep and operation times can be effectively decreased by increasing the experience of the surgeon.
    MeSH term(s) Humans ; Gastric Bypass/methods ; Obesity, Morbid ; Learning Curve ; Tertiary Care Centers ; Robotic Surgical Procedures/methods ; Retrospective Studies ; Bariatric Surgery/methods ; Laparoscopy/methods ; Treatment Outcome
    Language English
    Publishing date 2022-08-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2268283-1
    ISSN 1863-2491 ; 1863-2483
    ISSN (online) 1863-2491
    ISSN 1863-2483
    DOI 10.1007/s11701-022-01454-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Outcomes of totally robotic Roux-en-Y gastric bypass in patients with BMI ≥ 50 kg/m

    Kauffels, Anne / Reichert, Martin / Sauerbier, Lisa / Hauenschild, Annette / Hecker, Andreas / Strowitzki, Moritz J / Sprenger, Thilo

    Journal of robotic surgery

    2023  Volume 17, Issue 6, Page(s) 2881–2888

    Abstract: Roux-en-Y gastric bypass (RYGB) in patients with body mass index (BMI) ≥ 50 kg/ ... ...

    Abstract Roux-en-Y gastric bypass (RYGB) in patients with body mass index (BMI) ≥ 50 kg/m
    MeSH term(s) Humans ; Female ; Gastric Bypass/adverse effects ; Gastric Bypass/methods ; Robotics ; Obesity, Morbid/surgery ; Body Mass Index ; Robotic Surgical Procedures/methods ; Prospective Studies ; Treatment Outcome ; Retrospective Studies ; Weight Loss ; Risk Factors ; Laparoscopy/methods
    Language English
    Publishing date 2023-10-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 2268283-1
    ISSN 1863-2491 ; 1863-2483
    ISSN (online) 1863-2491
    ISSN 1863-2483
    DOI 10.1007/s11701-023-01729-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Drug resistant bacteria in perianal abscesses are frequent and relevant.

    Bender, Fabienne / Eckerth, Lukas / Fritzenwanker, Moritz / Liese, Juliane / Askevold, Ingolf / Imirzalioglu, Can / Padberg, Winfried / Hecker, Andreas / Reichert, Martin

    Scientific reports

    2022  Volume 12, Issue 1, Page(s) 14866

    Abstract: Perianal abscesses are frequent diseases in general surgery. Principles of standard patient care are surgical drainage with exploration and concomitant treatment of fistula. Antiinfective therapy is frequently applied in cases of severe local disease and ...

    Abstract Perianal abscesses are frequent diseases in general surgery. Principles of standard patient care are surgical drainage with exploration and concomitant treatment of fistula. Antiinfective therapy is frequently applied in cases of severe local disease and perianal sepsis. However, the role of microbiologic testing of purulence from perianal abscesses is disputed and the knowledge concerning bacteriology and bacterial resistances is very limited. A retrospective cohort study was performed of consecutive patients (≥ 12 years of age) from a tertiary care hospital, who underwent surgical treatment for perianal abscess from 01/2008 to 12/2019. Subdividing the cohort into three groups regarding microbiological testing results: no microbiological testing of purulence (No_Swab, n = 456), no detection of drug resistant bacteria [DR(-), n = 141] or detection of bacteria with acquired drug resistances from purulence [DR(+), n = 220]. Group comparisons were performed using Kruskall-Wallis test and, if applicable, followed by Dunn´s multiple comparisons test for continuous variables or Fishers exact or Pearson's X
    MeSH term(s) Abscess/drug therapy ; Abscess/microbiology ; Anti-Bacterial Agents/therapeutic use ; Anus Diseases/diagnosis ; Anus Diseases/drug therapy ; Anus Diseases/surgery ; Bacteria ; Humans ; Retrospective Studies ; Sepsis/drug therapy ; Skin Diseases/drug therapy ; Treatment Outcome
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 2022-09-01
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-022-19123-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Activation of Humoral Immunity during the Pathogenesis of Experimental Chronic Lung Allograft Dysfunction.

    Reichert, Martin / Atanasova, Srebrena / Petri, Kathrin / Kampschulte, Marian / Kojonazarov, Baktybek / Fuchs-Moll, Gabriele / Krombach, Gabriele A / Padberg, Winfried / Grau, Veronika

    International journal of molecular sciences

    2022  Volume 23, Issue 15

    Abstract: Alloreactive and autoreactive antibodies have been associated with the development of chronic lung allograft dysfunction (CLAD), but their pathogenic role is disputed. Orthotopic left lung transplantation was performed in the Fischer-344 to Lewis rat ... ...

    Abstract Alloreactive and autoreactive antibodies have been associated with the development of chronic lung allograft dysfunction (CLAD), but their pathogenic role is disputed. Orthotopic left lung transplantation was performed in the Fischer-344 to Lewis rat strain combination followed by the application of ciclosporine for 10 days. Four weeks after transplantation, lipopolysaccharide (LPS) was instilled into the trachea. Lungs were harvested before (postoperative day 28) and after LPS application (postoperative days 29, 33, 40, and 90) for histopathological, immunohistochemical, and Western blot analyses. Recipient serum was collected to investigate circulating antibodies. Lung allografts were more strongly infiltrated by B cells and deposits of immunoglobulin G and M were more prominent in allografts compared to right native lungs or isografts and increased in response to LPS instillation. LPS induced the secretion of autoreactive antibodies into the circulation of allograft and isograft recipients, while alloreactive antibodies were only rarely detected. Infiltration of B cells and accumulation of immunoglobulin, which is observed in allografts treated with LPS but not isografts or native lungs, might contribute to the pathogenesis of experimental CLAD. However, the LPS-induced appearance of circulating autoreactive antibodies does not seem to be related to CLAD, because it is observed in both, isograft and allograft recipients.
    MeSH term(s) Allografts/pathology ; Animals ; Bronchiolitis Obliterans ; Graft Rejection ; Graft vs Host Disease/pathology ; Immunity, Humoral ; Lipopolysaccharides ; Lung/pathology ; Lung Transplantation/adverse effects ; Rats ; Rats, Inbred Lew
    Chemical Substances Lipopolysaccharides
    Language English
    Publishing date 2022-07-23
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms23158111
    Database MEDical Literature Analysis and Retrieval System OnLINE

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