{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T05:43:53Z","timestamp":1773294233245,"version":"3.50.1"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"},{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/deed.de"}],"funder":[{"name":"Private Universit\u00e4t Witten\/Herdecke gGmbH"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Urologie"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Hintergrund<\/jats:title>\n                    <jats:p>Urothelkarzinome des oberen Harntrakts (UTUC) sind selten und machen etwa 5\u201310\u202f% aller urothelialen Karzinome aus. Im Gegensatz zu Urothelkarzinomen der Harnblase sind UTUC bei Diagnosestellung oft bereits invasiv. Die radikale Nephroureterektomie (RNU) ist der Standard f\u00fcr die Behandlung, wobei minimalinvasive Verfahren zunehmend an Bedeutung gewinnen. Ziel dieser Studie war es, die Entwicklung der RNU in Hinblick auf Fallzahl, Operationsmethode, Behandlungsqualit\u00e4t und Leitlinienadh\u00e4renz herauszuarbeiten.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material und Methoden<\/jats:title>\n                    <jats:p>Die Studie basiert auf einer retrospektiven Analyse von G\u2011DRG-Abrechnungsdaten aus 87\u00a0Helios-Krankenh\u00e4usern in Deutschland f\u00fcr den Zeitraum 2016 bis 2022. Eingeschlossen wurden Patienten mit einer Hauptdiagnose UTUC, die sich einer RNU unterzogen hatten. Die Operationsverfahren wurden in offen-chirurgisch und minimalinvasiv (laparoskopisch oder roboterassistiert) unterteilt. Es wurden verschiedene Parameter wie Krankenhausverweildauer (KVD), Komplikationen und postoperative Ma\u00dfnahmen analysiert. Eine Post-hoc-Umfrage der Kliniken diente der Validierung der Abrechnungsdaten.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ergebnisse<\/jats:title>\n                    <jats:p>\n                      Insgesamt wurden 594 Patienten mit RNU behandelt. Der Anteil roboterassistierter RNU stieg kontinuierlich an, w\u00e4hrend die offen-chirurgischen Eingriffe abnahmen. Minimalinvasive Verfahren f\u00fchrten zu k\u00fcrzeren Krankenhausaufenthalten (9,9 vs.\u00a012,3 Tage;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090,001), weniger Komplikationen wie Blutungsan\u00e4mien (12\u202f% vs.\u00a026\u202f%;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090,001) und intensivmedizinischer Betreuung (57\u202f% vs.\u00a071\u202f%;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090,001). Die Resektion der Blasenmanschette wurde seltener bei der minimalinvasiven RNU in der Kodierung erfasst (6,6\u202f% vs.\u00a046\u202f%;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&lt;\u20090,001). Die intravesikale Rezidivprophylaxe wurde unabh\u00e4ngig von der Operationsmethode nur bei einem geringen Anteil der Patienten kodiert (10\u202f% vs.\u00a06,9\u202f%;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u20090,116), wobei die Post-hoc-Umfrage zeigte, dass die Blasenmanschettenresektion von 92\u202f% und postoperative Instillation von 52\u202f% der Helios-Kliniken durchgef\u00fchrt werden.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Schlussfolgerung<\/jats:title>\n                    <jats:p>Roboterassistierte Operationen zeigten Vorteile hinsichtlich k\u00fcrzerer Krankenhausaufenthalte und geringerer Komplikationsraten. Allerdings wurde eine unzureichende und verbesserungsw\u00fcrdige Leitlinienadh\u00e4renz bei der postoperativen Instillation festgestellt. Die Analyse zeigt eine deutliche Diskrepanz (\u201ereal world evidence gap\u201c) zwischen kodierten DRG-Daten und tats\u00e4chlicher klinischer Versorgung. Dieses Missverh\u00e4ltnis beeinflusst zentrale Struktur- und Leistungsentscheidungen im deutschen Gesundheitssystem und muss bei der Interpretation administrativer Datens\u00e4tze dringend ber\u00fccksichtigt werden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphic abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00120-025-02691-6","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T14:51:42Z","timestamp":1760021502000},"page":"288-297","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Selbstkritische, multizentrische Analyse der Behandlungs- und Kodierqualit\u00e4t am Beispiel der Nephroureterektomie anhand von Abrechnungsdaten","Self-critical, multicenter analysis of treatment and coding quality using the example of nephroureterectomy on the basis of billing data"],"prefix":"10.1007","volume":"65","author":[{"given":"Nici Markus","family":"Dreger","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine","family":"Lenhart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Friedrich-Carl","family":"von Rundstedt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Steiner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Schrader","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Protzel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Friedrich","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"J\u00e4ger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"vom Dorp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Roosen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olaf","family":"Reichelt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sven","family":"Hohenstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Degener","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"issue":"6","key":"2691_CR1","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1007\/s00120-023-02079-4","volume":"62","author":"J Kranz","year":"2023","unstructured":"Kranz\u00a0J, Hoffmann\u00a0M, Alexa\u00a0R, Kuppe\u00a0C, Gaisa\u00a0NT, Saar\u00a0M (2023) Urothelial carcinoma of the upper urinary tract. Urologie 62(6):640\u2013650","journal-title":"Urologie"},{"issue":"1","key":"2691_CR2","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.eururo.2023.03.013","volume":"84","author":"M Roupret","year":"2023","unstructured":"Roupret\u00a0M, Seisen\u00a0T, Birtle\u00a0AJ, Capoun\u00a0O, Comperat\u00a0EM, Dominguez-Escrig\u00a0JL et\u00a0al (2023) European Association of Urology Guidelines on Upper Urinary Tract Urothelial Carcinoma: 2023 Update. Eur Urol 84(1):49\u201364","journal-title":"Eur Urol"},{"issue":"2","key":"2691_CR3","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1007\/s00120-024-02422-3","volume":"64","author":"CM Rosenbaum","year":"2025","unstructured":"Rosenbaum\u00a0CM, Netsch\u00a0C, Filmar\u00a0S, Hook\u00a0S, Gross\u00a0AJ, Becker\u00a0B (2025) Organ-preserving treatment for urothelial carcinoma of the upper urinary tract. Urologie 64(2):182\u2013191","journal-title":"Urologie"},{"issue":"4","key":"2691_CR4","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1007\/s00345-019-03020-1","volume":"38","author":"A Veccia","year":"2020","unstructured":"Veccia\u00a0A, Antonelli\u00a0A, Francavilla\u00a0S, Simeone\u00a0C, Guruli\u00a0G, Zargar\u00a0H et\u00a0al (2020) Robotic versus other nephroureterectomy techniques: a\u00a0systematic review and meta-analysis of over 87,000 cases. World J Urol 38(4):845\u2013852","journal-title":"World J Urol"},{"issue":"4","key":"2691_CR5","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1016\/j.eururo.2011.05.064","volume":"60","author":"T O\u2019Brien","year":"2011","unstructured":"O\u2019Brien\u00a0T, Ray\u00a0E, Singh\u00a0R, Coker\u00a0B, Beard\u00a0R (2011) British Association of Urological Surgeons Section of O. Prevention of bladder tumours after nephroureterectomy for primary upper urinary tract urothelial carcinoma: a\u00a0prospective, multicentre, randomised clinical trial of a\u00a0single postoperative intravesical dose of mitomycin\u00a0C (the ODMIT\u2011C Trial). Eur Urol 60(4):703\u2013710","journal-title":"Eur Urol"},{"key":"2691_CR6","doi-asserted-by":"crossref","unstructured":"Elleisy M, Drager DL, Zettl H, Hakenberg OW (2024) COVID-19 pandemic impact on uro-oncological disease outcomes at a\u00a0German referral center. Urol Int: 1\u201318","DOI":"10.1159\/000541932"},{"issue":"11-12","key":"2691_CR7","doi-asserted-by":"publisher","first-page":"E845","DOI":"10.5489\/cuaj.1985","volume":"8","author":"A Kapoor","year":"2014","unstructured":"Kapoor\u00a0A, Dason\u00a0S, Allard\u00a0CB, Shayegan\u00a0B, Lacombe\u00a0L, Rendon\u00a0R et\u00a0al (2014) The impact of method of distal ureter management during radical nephroureterectomy on tumour recurrence. Can Urol Assoc\u00a0J 8(11-12):E845\u201352","journal-title":"Can Urol Assoc J"},{"issue":"3","key":"2691_CR8","doi-asserted-by":"publisher","first-page":"795","DOI":"10.4143\/crt.2020.919","volume":"53","author":"H Ryoo","year":"2021","unstructured":"Ryoo\u00a0H, Kim\u00a0J, Kim\u00a0T, Kang\u00a0M, Jeon\u00a0HG, Jeong\u00a0BC et\u00a0al (2021) Effects of Complete Bladder Cuff Removal on Oncological Outcomes Following Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma. Cancer Res Treat 53(3):795\u2013802","journal-title":"Cancer Res Treat"},{"issue":"11","key":"2691_CR9","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.urolonc.2024.06.001","volume":"42","author":"C Yong","year":"2024","unstructured":"Yong\u00a0C, Slaven\u00a0JE, Wu\u00a0Z, Margulis\u00a0V, Djaladat\u00a0H, Antonelli\u00a0A et\u00a0al (2024) The impact of bladder cuff excision on outcomes after nephroureterectomy for upper tract urothelial carcinoma: An analysis of the ROBUUST 2.0\u00a0registry. Urol Oncol 42(11):e1\u2013e7","journal-title":"Urol Oncol"},{"issue":"1","key":"2691_CR10","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1186\/s12894-024-01622-5","volume":"24","author":"JK Fang","year":"2024","unstructured":"Fang\u00a0JK, Yeh\u00a0HC, Lee\u00a0HY, Weng\u00a0HY, Tai\u00a0TY, Huang\u00a0CY et\u00a0al (2024) Outcomes of laparoscopic, robotic and open nephroureterectomy with bladder cuff excision in patients with T3T4 upper urinary tract urothelial carcinoma: a\u00a0multi-center retrospective study. BMC Urol 24(1):231","journal-title":"BMC Urol"},{"issue":"6","key":"2691_CR11","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1016\/j.eururo.2014.11.035","volume":"67","author":"T Seisen","year":"2015","unstructured":"Seisen\u00a0T, Granger\u00a0B, Colin\u00a0P, Leon\u00a0P, Utard\u00a0G, Renard-Penna\u00a0R et\u00a0al (2015) A\u00a0Systematic Review and Meta-analysis of Clinicopathologic Factors Linked to Intravesical Recurrence After Radical Nephroureterectomy to Treat Upper Tract Urothelial Carcinoma. Eur Urol 67(6):1122\u20131133","journal-title":"Eur Urol"},{"issue":"9","key":"2691_CR12","doi-asserted-by":"publisher","first-page":"2550","DOI":"10.1245\/s10434-018-6557-8","volume":"25","author":"MB Clements","year":"2018","unstructured":"Clements\u00a0MB, Krupski\u00a0TL, Culp\u00a0SH (2018) Robotic-Assisted Surgery for Upper Tract Urothelial Carcinoma: A\u00a0Comparative Survival Analysis. Ann Surg Oncol 25(9):2550\u20132562","journal-title":"Ann Surg Oncol"},{"key":"2691_CR13","doi-asserted-by":"crossref","unstructured":"Rajan K, Khalifa A, Geraghty R, Parmar K, KandaSwamy G, Gomez Rivas J et\u00a0al (2023) Oncological Efficacy of Robotic Nephroureterectomy vs. Open and Laparoscopic Nephroureterectomy for Suspected Non-Metastatic UTUC\u2014A Systematic Review and Meta-Analysis. Cancers (basel) 15(20)","DOI":"10.3390\/cancers15204926"},{"key":"2691_CR14","doi-asserted-by":"crossref","unstructured":"Ditonno F, Franco A, Wu Z, Wang L, Abdollah F, Simone G et\u00a0al (2024) Robot-assisted nephroureterectomy: surgical and mid-term oncological outcomes in over 1100 patients (ROBUUST 2.0 collaborative group). BJU Int","DOI":"10.1111\/bju.16526"},{"key":"2691_CR15","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.euros.2020.10.003","volume":"22","author":"TR Dobe","year":"2020","unstructured":"Dobe\u00a0TR, Califano\u00a0G, von Rundstedt\u00a0FC, Ouzaid\u00a0I, Albisinni\u00a0S, Aziz\u00a0A et\u00a0al (2020) Postoperative Chemotherapy Bladder Instillation After Radical Nephroureterectomy: Results of a\u00a0European Survey from the Young Academic Urologist Urothelial Cancer Group. Eur Urol Open Sci 22:45\u201350","journal-title":"Eur Urol Open Sci"},{"issue":"3","key":"2691_CR16","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.urolonc.2016.10.016","volume":"35","author":"DD Lu","year":"2017","unstructured":"Lu\u00a0DD, Boorjian\u00a0SA, Raman\u00a0JD (2017) Intravesical chemotherapy use after radical nephroureterectomy: A\u00a0national survey of urologic oncologists. Urol Oncol 35(3):e1\u2013e7","journal-title":"Urol Oncol"},{"key":"2691_CR17","unstructured":"5\u2011554. https:\/\/klassifikationen.bfarm.de\/ops\/kode-suche\/htmlops2024\/block-5-55...5-59.htm#code"}],"container-title":["Die Urologie"],"original-title":[],"language":"de","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00120-025-02691-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00120-025-02691-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00120-025-02691-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T12:50:29Z","timestamp":1773233429000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00120-025-02691-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,9]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["2691"],"URL":"https:\/\/doi.org\/10.1007\/s00120-025-02691-6","relation":{},"ISSN":["2731-7064","2731-7072"],"issn-type":[{"value":"2731-7064","type":"print"},{"value":"2731-7072","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,9]]},"assertion":[{"value":"25 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Einhaltung ethischer Richtlinien"}},{"value":"N.M.\u00a0Dreger, C.\u00a0Lenhart, F.-C.\u00a0von Rundstedt, T.\u00a0Steiner, M.\u00a0Schrader, C.\u00a0Protzel, M.\u00a0Friedrich, W.\u00a0J\u00e4ger, F.\u00a0vom Dorp, A.\u00a0Roosen, O.\u00a0Reichelt, S.\u00a0Hohenstein und S.\u00a0Degener geben an, dass kein Interessenkonflikt besteht.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}},{"value":"F\u00fcr diesen Beitrag wurden von den Autor\/-innen keine Studien an Menschen oder Tieren durchgef\u00fchrt. F\u00fcr die aufgef\u00fchrten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Die Analyse wurde von der Ethikkommission der Universit\u00e4t Leipzig best\u00e4tigt (eCaRe-COVID 19). Die Patientendaten wurden in anonymisierter Form gespeichert und die Datenverwendung wurde von der Datenschutzbeh\u00f6rde der Helios Kliniken GmbH genehmigt.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Interessenkonflikt"}}]}}