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6. APRI+ALBI Score Outperforms Indocyanine Green (ICG) Clearance and LiMAx in Predicting Posthepatectomy Liver Failure – An International Multicenter Study of 14776 Patients

Author

Santol, J., primary, Kim, S., additional, Gregory, L., additional, Kern, A.E., additional, Hackl, H., additional, Baumgartner, R., additional, Starlinger, J., additional, Murtha-Lemekhova, A., additional, Birgin, E., additional, Gloor, S., additional, Braunwarth, E., additional, Ammann, M., additional, Pereyra, D., additional, Ammon, D., additional, Ninkovic, M., additional, Huber, F.X., additional, Dong, Y., additional, Weninger, J., additional, Thiels, C., additional, Warner, S., additional, Smoot, R., additional, Truty, M., additional, Kendrick, M., additional, Nagorney, D., additional, Cleary, S., additional, Beldi, G., additional, Rahbari, N., additional, Hoffmann, K., additional, Gilg, S., additional, Assinger, A., additional, Gruenberger, T., additional, and Starlinger, P., additional

Published
2023
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7. Surgical site infections after simultaneous pancreas kidney and pancreas transplantation in the Swiss Transplant Cohort Study

Author

Schreiber, P W, Laager, M, Boggian, K, Neofytos, Dionysios, van Delden, Christian, Egli, Adrian, Dickenmann, M, Hirzel, Cédric, Manuel, O, Koller, M, Rossi, S, Schmied, Brigitte, Gürke, L, Matter, M, Berney, Thierry, de Rougemont, Olivier, Kuster, S P, Stampf, S, Mueller, N J, Amico, Patrizia, Aubert, J D, Banz, Vanessa, Beckmann, S, Beldi, G, Berger, Christoph, Berishvili, E, Berzigotti, Annalisa, Binet, I, Bochud, Pierre-Yves, Branca, S, et al, University of Zurich, and Schreiber, P W

Subjects
10234 Clinic for Infectious Diseases, 10036 Medical Clinic, 10209 Clinic for Cardiology, 610 Medicine & health, 2725 Infectious Diseases, General Medicine, 2726 Microbiology (medical)
Published
2022

8. Surgical site infections after simultaneous pancreas kidney and pancreas transplantation in the Swiss Transplant Cohort Study

Author

Schreiber, P.W., primary, Laager, M., additional, Boggian, K., additional, Neofytos, D., additional, van Delden, C., additional, Egli, A., additional, Dickenmann, M., additional, Hirzel, C., additional, Manuel, O., additional, Koller, M., additional, Rossi, S., additional, Schmied, B., additional, Gürke, L., additional, Matter, M., additional, Berney, T., additional, de Rougemont, O., additional, Kuster, S.P., additional, Stampf, S., additional, Mueller, N.J., additional, Amico, P., additional, Aubert, J-D., additional, Banz, V., additional, Beckmann, S., additional, Beldi, G., additional, Berger, C., additional, Berishvili, E., additional, Berzigotti, A., additional, Binet, I., additional, Bochud, P-Y., additional, Branca, S., additional, Bucher, H., additional, Catana, E., additional, Cairoli, A., additional, Chalandon, Y., additional, De Geest, S., additional, De Rougemont, O., additional, De Seigneux, S., additional, Dreifuss, J.L., additional, Duchosal, M., additional, Fehr, T., additional, Ferrari-Lacraz, S., additional, Garzoni, C., additional, Golshayan, D., additional, Goossens, N., additional, Halter, F.H.J., additional, Heim, D., additional, Hess, C., additional, Hillinger, S., additional, Hirsch, H.H., additional, Hirt, P., additional, Hofbauer, G., additional, Huynh-Do, U., additional, Immer, F., additional, Laesser, B., additional, Lamoth, F., additional, Lehmann, R., additional, Leichtle, A., additional, Marti, H.P., additional, Martinelli, M., additional, McLin, V., additional, Mellac, K., additional, Merçay, A., additional, Mettler, K., additional, Müller, A., additional, Müller-Arndt, U., additional, Müllhaupt, B., additional, Nägeli, M., additional, Oldani, G., additional, Pascual, M., additional, Passweg, J., additional, Pazeller, R., additional, Posfay-Barbe, K., additional, Rick, J., additional, Rosselet, A., additional, Rothlin, S., additional, Ruschitzka, F., additional, Schachtner, T., additional, Schanz, U., additional, Schaub, S., additional, Scherrer, A., additional, Schnyder, A., additional, Schuurmans, M., additional, Schwab, S., additional, Sengstag, T., additional, Simonetta, F., additional, Steiger, J., additional, Stirnimann, G., additional, Stürzinger, U., additional, Van Delden, C., additional, Venetz, J-P., additional, Villard, J., additional, Vionnet, J., additional, Wick, M., additional, Wilhelm, M., additional, and Yerly, P., additional

Published
2022
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15. The Role of Surgical Expertise and Surgical Access in Retroperitoneal Sarcoma Resection - A Retrospective Study

Author

Aeschbacher, P, Kollár, A, Candinas, D, Beldi, G, and Lachenmayer, A

Subjects
610 Medicine & health, Surgery
Abstract

BackgroundRetroperitoneal sarcoma (RPS) is a rare disease often requiring multi-visceral and wide margin resections for which a resection in a sarcoma center is advised. Midline incision seems to be the access of choice. However, up to now there is no evidence for the best surgical access. This study aimed to analyze the oncological outcome according to the surgical expertise and also the incision used for the resection.MethodsAll patients treated for RPS between 2007 and 2018 at the Department of Visceral Surgery and Medicine of the University Hospital Bern and receiving a RPS resection in curative intent were included. Patient- and treatment specific factors as well as local recurrence-free, disease-free and overall survival were analyzed in correlation to the hospital type where the resection occurred.ResultsThirty-five patients were treated for RPS at our center. The majority received their primary RPS resection at a sarcoma center (SC = 23) the rest of the resection were performed in a non-sarcoma center (non-SC = 12). Median tumor size was 24 cm. Resections were performed via a midline laparotomy (ML = 31) or flank incision (FI = 4). All patients with a primary FI (n = 4) were operated in a non-SC (p = 0.003). No patient operated at a non-SC received a multivisceral resection (p = 0.004). Incomplete resection (R2) was observed more often when resection was done in a non-SC (p = 0.013). Resection at a non-SC was significantly associated with worse recurrence-free survival and disease-free survival after R0/1 resection (2 vs 17 months; Log Rank p-value = 0.02 respectively 2 vs 15 months; Log Rank p-value ConclusionsResection at a non-SC is associated with more incomplete resection and worse outcome in RPS surgery. Inadequate access, such as FI, may prevent complete resection and multivisceral resection if indicated and demonstrates the importance of surgical expertise in the outcome of RPS resection.

Published
2022
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33. Rezidiv nach Hernienplastik: Komplikation oder natürlicher Verlauf?

Author

Kohler, A., Beldi, G., Kohler, A., and Beldi, G.

Abstract

Zusammenfassung: Die Rezidivhäufigkeit nach Hernienplastik ist ein Qualitätsmerkmal der chirurgischen Technik. Für eine korrekte Beurteilung der Rezidivrate muss zwischen einem klinisch relevanten, klinisch irrelevanten und einem Pseudorezidiv unterschieden werden. Bei der chirurgischen Therapie von Inguinalhernien werden mit den heutigen Techniken mittels laparoskopischer oder offener Netzeinlage sehr niedrige Rezidivraten erreicht. Somit soll bei einem Rezidiv nach einer Inguinalhernienoperation von einer chirurgischen Komplikation ausgegangen werden. Im Gegensatz zur Inguinalhernie liegt die Rezidivrate bei der Operation großer Narbenhernien trotz stetiger Optimierung der Technik weiterhin über 10 %. Um das Rezidivrisiko abzuschätzen, müssen nebst der Größe und Lokalisation der Hernie technische und patientenspezifische Aspekte beurteilt werden. Je nach Risikoprofil kann das Hernienrezidiv in seltenen Fällen dem natürlichen Verlauf entsprechen. Im Allgemeinen werden Hernienrezidive als Abweichung von der Norm wahrgenommen und können von der Indikation, Wahl der Operation und der chirurgischen Technik und Taktik abhängen. Somit soll der Chirurg ein postoperatives Rezidiv in erster Linie als Komplikation und nicht als natürlichen Verlauf ansehen, mit dem Ziel die Chirurgie kontinuierlich zu verbessern.

Published
2019

34. Impact of Team Familiarity in the Operating Room on Surgical Complications

Author

Kurmann, A., Keller, S., Tschan-Semmer, F., Seelandt, J., Semmer, N., Candinas, D., Beldi, G., Kurmann, A., Keller, S., Tschan-Semmer, F., Seelandt, J., Semmer, N., Candinas, D., and Beldi, G.

Abstract

Background: The quality of surgical performance depends on the technical skills of the surgical team as well as on non-technical skills, including teamwork. The present study evaluated the impact of familiarity among members of the surgical team on morbidity in patients undergoing elective open abdominal surgery. Methods: A retrospective analysis was performed to compare the surgical outcomes of patients who underwent major abdominal operations between the first month (period I) and the last month (period II) of a 6-month period of continuous teamwork (stable dyads of one senior and one junior surgeon formed every 6months). Of 117 patients, 59 and 58 patients underwent operations during period I and period II, respectively, between January 2010 and June 2012. Team performance was assessed via questionnaire by specialized work psychologists; in addition, intraoperative sound levels were measured. Results: The incidence of overall complications was significantly higher in period I than in period II (54.2 vs. 34.5%; P=0.041). Postoperative complications grade <3 were significantly more frequently diagnosed in patients who had operations during period I (39.0 vs. 15.5%; P=0.007), whereas no between-group differences in grade ≥3 complications were found (15.3 vs. 19.0%; P=0.807). Concentration scores from senior surgeons were significantly higher in period II than in period I (P=0.033). Sound levels during the middle third part of the operations were significantly higher in period I (median above the baseline 8.85dB [range 4.5-11.3dB] vs. 7.17dB [5.24-9.43dB]; P<0.001). Conclusions: Team familiarity improves team performance and reduces morbidity in patients undergoing abdominal surgery.

Published
2019

39. Laparoscopic ventral hernia repair is safe and cost effective

Author

Beldi, G., Ipaktchi, R., Wagner, M., Gloor, B., Candinas, D., Beldi, G., Ipaktchi, R., Wagner, M., Gloor, B., and Candinas, D.

Abstract

Background: Ventral hernia repair is increasingly performed by laparoscopic means since the introduction of dual-layer meshes. This study aimed to compare the early complications and cost effectiveness of open hernia repair with those associated with laparoscopic repair. Methods: Open ventral hernia repair was performed for 92 consecutive patients using a Vypro mesh, followed by laparoscopic repair for 49 consecutive patients using a Parietene composite mesh. Results: The rate of surgical-site infections was significantly higher with open ventral hernia repair (13 vs 1; p = 0.03). The median length of hospital stay was significantly shorter with laparoscopic surgery (7 vs 6 days; p = 0.02). For laparoscopic repair, the direct operative costs were higher (2,314 vs 2,853 euros; p = 0.03), and the overall hospital costs were lower (9,787 vs 7,654 euros; p = 0.02). Conclusions: Laparoscopic ventral hernia repair leads to fewer surgical-site infections and a shorter hospital stay than open repair. Despite increased operative costs, overall hospital costs are lowered by laparoscopic ventral hernia repair

Published
2018

41. Clostridium difficile infection is associated with graft loss in solid organ transplant recipients

Author

Cusini, A, Béguelin, C, Stampf, S, Boggian, K, Garzoni, C, Koller, M, Manuel, O, Meylan, P, Mueller, NJ, Hirsch, HH, Weisser, M, Berger, C, van Delden, C, Achermann, R, Amico, P, Aubert, JD, Banz, V, Beldi, G, Benden, C, Binet, I, Bochud, PY, Bucher, H, Bühler, L, Carell, T, Catana, E, Chalandon, Y, de Geest, S, de Rougemont, O, Dickenmann, M, Duchosal, M, Elkrief, L, Fehr, T, Ferrari-Lacraz, S, Gasche Soccal, P, Gaudet, C, Giostra, E, Golshayan, D, Hadaya, K, Halter, J, Heim, D, Hess, C, Hillinger, S, Hofbauer, G, Huynh-Do, U, Immer, F, Klaghofer, R, Laesser, B, Lehmann, R, Lovis, C, Marti, HP, Martin, PY, Mohacsi, P, Morel, P, Mueller, U, Mueller-McKenna, H, Müller, A, Müller, T, Müllhaupt, B, Nadal, D, Pascual, M, Passweg, J, Rick, J, Roosnek, E, Rosselet, A, Rothlin, S, Ruschitzka, F, Schanz, U, Schaub, S, Schnyder, A, Seiler, C, Steiger, J, Stirnimann, G, Toso, C, Venetz, JP, Villard, J, Wick, M, Wilhelm, M, Yerly, P, Gasche-Soccal, Paola Marina Alessandra, University of Zurich, and van Delden, C

Subjects
Graft Rejection, Male, genetic structures, 2747 Transplantation, 10265 Clinic for Endocrinology and Diabetology, 030230 surgery, 10234 Clinic for Infectious Diseases, 0302 clinical medicine, Postoperative Complications, Risk Factors, Medicine, 2736 Pharmacology (medical), Immunology and Allergy, Pharmacology (medical), 030212 general & internal medicine, Prospective Studies, 610 Medicine & health, Prospective cohort study, ddc:616, Incidence, Hazard ratio, Graft Survival, Clostridium difficile, Middle Aged, Prognosis, Anti-Bacterial Agents, Diarrhea, 10209 Clinic for Cardiology, 2723 Immunology and Allergy, Female, medicine.symptom, 10178 Clinic for Pneumology, Switzerland, Cohort study, medicine.medical_specialty, 03 medical and health sciences, Internal medicine, Humans, Transplantation, business.industry, Clostridioides difficile, Case-control study, Organ Transplantation, Confidence interval, Transplant Recipients, 10036 Medical Clinic, Case-Control Studies, Clostridium Infections, business, Follow-Up Studies
Abstract

© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons Clostridium difficile infection (CDI) is a leading cause of infectious diarrhea in solid organ transplant recipients (SOT). We aimed to assess incidence, risk factors, and outcome of CDI within the Swiss Transplant Cohort Study (STCS). We performed a case-control study of SOT recipients in the STCS diagnosed with CDI between May 2008 and August 2013. We matched 2 control subjects per case by age at transplantation, sex, and transplanted organ. A multivariable analysis was performed using conditional logistic regression to identify risk factors and evaluate outcome of CDI. Two thousand one hundred fifty-eight SOT recipients, comprising 87 cases of CDI and 174 matched controls were included. The overall CDI rate per 10 000 patient days was 0.47 (95% confidence interval ([CI] 0.38-0.58), with the highest rate in lung (1.48, 95% CI 0.93-2.24). In multivariable analysis, proven infections (hazard ratio [HR] 2.82, 95% CI 1.29-6.19) and antibiotic treatments (HR 4.51, 95% CI 2.03-10.0) during the preceding 3 months were independently associated with the development of CDI. Despite mild clinical presentations, recipients acquiring CDI posttransplantation had an increased risk of graft loss (HR 2.24, 95% CI 1.15-4.37; P =.02). These findings may help to improve the management of SOT recipients. ispartof: American Journal of Transplantation vol:18 issue:7 pages:1745-1754 ispartof: location:United States status: published

Published
2017

49. Laparoscopic techniques in liver surgery – how we do it

Author

Tinguely, P, Kohler, A, Candinas, D, and Beldi, G

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Background: In this video, we present indications and technical aspects of the laparoscopic approach for liver surgery. In particular, the impact of underlying disease and intrahepatic tumor location on decision making regarding the surgical strategy are described. Materials and methods: Resection[for full text, please go to the a.m. URL], 133. Kongress der Deutschen Gesellschaft für Chirurgie

Published
2016
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50. Preoperative von willebrand factor – antigen predicts clinical outcome after liver resection: a prospective, international, multicenter trial

Author

Starlinger, P., primary, Haegele, S., additional, Braeuer, P., additional, Oehlberger, L., additional, Primavesi, F., additional, Kohler, A., additional, Offensperger, F., additional, Pereyra, D., additional, Ferlitsch, A., additional, Beldi, G., additional, Staettner, S., additional, Brostjan, C., additional, and Gruenberger, T., additional

Published
2017
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