{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:06:50Z","timestamp":1792782410170,"version":"4.5.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"},{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"}],"funder":[{"name":"Universit\u00e4tsklinikum K\u00f6ln","id":[{"id":"https:\/\/ror.org\/05mxhda18","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Chirurgie"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Hintergrund<\/jats:title>\n                    <jats:p>Die Krankenhauszentralisierung und die Implementierung von Mindestmengen sind zentrale Aspekte der gegenw\u00e4rtigen Gesundheitspolitik, die die medizinische Versorgung beeinflussen und auch Auswirkungen auf die Versorgung im Fall von Komplikationen haben.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ziel der Arbeit (Fragestellung)<\/jats:title>\n                    <jats:p>Die vorliegende Fallstudie arbeitet auf, welche Ressourcen an einem terti\u00e4ren Zentrum f\u00fcr die Behandlung von extern komplikativ verlaufenden F\u00e4llen erforderlich sind.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material und Methoden<\/jats:title>\n                    <jats:p>In die prospektive Single-Center-Studie wurden Patient:innen (Pat.) eingeschlossen, die im Zeitraum vom 01.01.2023 bis zum 31.12.2024 extern eine komplikative Operation, Intervention oder Diagnostik im Bereich des oberen Gastrointestinaltraktes erhielten und anschlie\u00dfend in der Klinik und Poliklinik f\u00fcr Allgemein\u2011, Viszeral\u2011, Thorax- und Transplantationschirurgie der Uniklinik K\u00f6ln weiterbehandelt wurden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ergebnisse<\/jats:title>\n                    <jats:p>In unserem Zentrum wurden 39\u00a0Pat. (m\u00e4nnlich: 38,5\u202f%, weiblich: 61,5\u202f%; Durchschnittsalter: 68,1\u202fJahre) nach externen komplikativen Prim\u00e4reingriffen behandelt. Die f\u00fchrenden Komplikationen waren Perforationen, Nahtinsuffizienzen sowie inkomplette Resektionen\/Rekonstruktionen. Nach externem Auftreten einer Komplikation wurden 15\u00a0Pat. direkt verlegt. Bei 24\u00a0Pat. wurden extern interventionelle und\/oder operative Revisionen durchgef\u00fchrt. Zum Zeitpunkt der \u00dcbernahme waren 71,8\u202f% der Pat. intensivpflichtig. Nach Zentrumsverlegung erfolgten kumulativ 115 Operationen und 243 \u00d6sophagoduodenoskopien (\u00d6GDs) mit 171 endoskopischen Vakuumtherapie-(EndoVAC-)Wechseln. Im Verlauf konnten 25,6\u202f% der Pat. heimatnah verleget und 61,5\u202f% in die H\u00e4uslichkeit entlassen werden. Die Mortalit\u00e4t lag bei 12,8\u202f%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Diskussion<\/jats:title>\n                    <jats:p>Die Behandlung von Pat. mit extern komplikativ verlaufenden Prim\u00e4reingriffen erfordert erhebliche personelle, logistische und medizinische Ressourcen\u00a0\u2013 insbesondere f\u00fcr umfangreiche Diagnostik, komplexe operative Versorgung und intensivmedizinische Betreuung.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00104-026-02553-7","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T13:20:44Z","timestamp":1786368044000},"page":"901-910","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management von Komplikationen im oberen Gastrointestinaltrakt nach externen Prim\u00e4reingriffen","Management of complications of the upper gastrointestinal tract following external primary procedures"],"prefix":"10.1007","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9096-2139","authenticated-orcid":false,"given":"Loreen Sophie","family":"Rudek","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naita M.","family":"Wirsik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans A.","family":"Schl\u00f6\u00dfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane J.","family":"Bruns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"2553_CR1","unstructured":"Gemeinsamer Bundesausschuss (2004) Gemeinsamer Bundesausschuss \u00fcbernimmt Vertr\u00e4ge zur Qualit\u00e4tssicherung im Krankenhaus."},{"key":"2553_CR2","unstructured":"Institut f\u00fcr Qualit\u00e4tssicherung und Transparenz im Gesundheitswesen: Mindestmengenregelungen des G\u2011BA, https:\/\/www.iqtig.org. 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