{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:22:44Z","timestamp":1786980164385,"version":"build-2736575974"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T00:00:00Z","timestamp":1724112000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T00:00:00Z","timestamp":1724112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Leipzig"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Complications are common after major visceral surgery. Besides the patients, also surgeons may experience negative feelings by the patients suffering. Some studies have evaluated the mental burden caused by complications, mainly focusing on residents in different surgical specialties. No evidence exists on the mental burden of board-qualified visceral surgeons in Germany.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A point prevalence study was conducted using an online questionnaire. For the inclusion of participants, all departments of visceral surgery at German university hospitals were addressed. The objective of the online questionnaire was to elaborate the perception of complications and the coping mechanisms used by the surgeons with the aim to characterize the mental burden and possible improvement strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 113 questionnaires were answered, 98 being complete. 73.2% of the participants were male, 46.9% were consultants and had a working experience of 11\u201320\u00a0years. Most common specialties were colorectal and general surgery and 91.7% claimed to have caused complications Clavien-Dindo grade IV or V. Subsequently, predominant feelings were anger, grief, self-doubt and guilt. The fear of being blamed by colleagues or to lose reputation were high. Especially female and younger surgeons showed those fears. Coping mechanisms used to overcome those negative feelings were interaction with friends and family (60.6%) or proactive training (59.6%). Only 17.2% of the institutions offered professional support. In institutions where no support was offered, 71.6% of the surgeons asked for support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Surgical complications cause major psychological burden in surgeons in German university hospitals. Main coping mechanisms are communication with friends and families and professional education. Vulnerable subgroups, such as younger surgeons, may be at risk of suffering more from perceived mental distress. Nonetheless, the majority did not receive but asked for professional counselling. Thus, structured institutional support may ameliorate care for both surgeon and patient.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00423-024-03447-0","type":"journal-article","created":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T00:02:06Z","timestamp":1724112126000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The psychological burden of major surgical complications in visceral surgery"],"prefix":"10.1007","volume":"409","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0047-368X","authenticated-orcid":false,"given":"Matthias","family":"Mehdorn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helge","family":"Danker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Sophie","family":"Mehdorn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,8,20]]},"reference":[{"issue":"2","key":"3447_CR1","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","volume":"240","author":"D Dindo","year":"2004","unstructured":"Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205\u2013213. https:\/\/doi.org\/10.1097\/01.sla.0000133083.54934.ae","journal-title":"Ann Surg"},{"issue":"44","key":"3447_CR2","doi-asserted-by":"publisher","first-page":"739","DOI":"10.3238\/arztebl.2019.0739","volume":"116","author":"P Baum","year":"2019","unstructured":"Baum P, Diers J, Lichthardt S et al (2019) Mortality and complications following visceral surgery: a nationwide analysis based on the diagnostic categories used in German hospital invoicing data. Dtsch Arztebl Int 116(44):739\u2013746. https:\/\/doi.org\/10.3238\/arztebl.2019.0739","journal-title":"Dtsch Arztebl Int"},{"issue":"9","key":"3447_CR3","doi-asserted-by":"publisher","first-page":"2187","DOI":"10.1007\/s00432-022-04088-w","volume":"148","author":"R Falz","year":"2022","unstructured":"Falz R, Bischoff C, Thieme R et al (2022) Effects and duration of exercise-based prehabilitation in surgical therapy of colon and rectal cancer: a systematic review and meta-analysis. J Cancer Res Clin Oncol 148(9):2187\u20132213. https:\/\/doi.org\/10.1007\/s00432-022-04088-w","journal-title":"J Cancer Res Clin Oncol"},{"key":"3447_CR4","doi-asserted-by":"publisher","unstructured":"Wei H, Wang J, Jiang Z et al (2023) Preoperative prognostic nutritional index associated with anastomotic leakage in colorectal cancer patients after surgery. Adv Clin Exp Med 33(4):351\u2013359.\u00a0https:\/\/doi.org\/10.17219\/acem\/169495","DOI":"10.17219\/acem\/169495"},{"issue":"7237","key":"3447_CR5","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1136\/bmj.320.7237.726","volume":"320","author":"AW Wu","year":"2000","unstructured":"Wu AW (2000) Medical error: the second victim. The doctor who makes the mistake needs help too. BMJ 320(7237):726\u20137. https:\/\/doi.org\/10.1136\/bmj.320.7237.726","journal-title":"BMJ"},{"issue":"3","key":"3447_CR6","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1055\/s-0043-1767830","volume":"33","author":"HD Le","year":"2023","unstructured":"Le HD, Wolinska JM, Baertschiger RM et al (2023) Complication is inevitable, but suffering is optional-psychological aspects of dealing with complications in surgery. Eur J Pediatr Surg 33(3):181\u2013190. https:\/\/doi.org\/10.1055\/s-0043-1767830","journal-title":"Eur J Pediatr Surg"},{"issue":"5","key":"3447_CR7","doi-asserted-by":"publisher","first-page":"e370","DOI":"10.1097\/SLA.0000000000004575","volume":"276","author":"A Elkbuli","year":"2022","unstructured":"Elkbuli A, Sutherland M, Shepherd A et al (2022) Factors influencing US physician and surgeon suicide rates 2003 to 2017: analysis of the CDC-national violent death reporting system. Ann Surg 276(5):e370\u2013e376. https:\/\/doi.org\/10.1097\/SLA.0000000000004575","journal-title":"Ann Surg"},{"issue":"1","key":"3447_CR8","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1007\/s10143-023-02088-z","volume":"46","author":"D Kalasauskas","year":"2023","unstructured":"Kalasauskas D, Ottenhausen M, Irene I et al (2023) How do spine surgeons cope with psychological distress: results of a cross-sectional study. Neurosurg Rev 46(1):182. https:\/\/doi.org\/10.1007\/s10143-023-02088-z","journal-title":"Neurosurg Rev"},{"issue":"6","key":"3447_CR9","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1093\/intqhc\/mzq056","volume":"22","author":"J Klein","year":"2010","unstructured":"Klein J, Grosse Frie K, Blum K et al (2010) Burnout and perceived quality of care among German clinicians in surgery. Int J Qual Health Care 22(6):525\u2013530. https:\/\/doi.org\/10.1093\/intqhc\/mzq056","journal-title":"Int J Qual Health Care"},{"issue":"3","key":"3447_CR10","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000004203","volume":"10","author":"I Khansa","year":"2022","unstructured":"Khansa I, Pearson GD (2022) Coping and Recovery in Surgical Residents after Adverse Events: The Second Victim Phenomenon. Plast Reconstr Surg Glob Open 10(3):e4203. https:\/\/doi.org\/10.1097\/GOX.0000000000004203","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"4","key":"3447_CR11","doi-asserted-by":"publisher","first-page":"1819","DOI":"10.1007\/s11845-022-03202-8","volume":"192","author":"S O'Meara","year":"2023","unstructured":"O\u2019Meara S, D\u2019Arcy F, Dowling C et al (2023) The psychological impact of adverse events on urology trainees. Ir J Med Sci 192(4):1819\u20131824. https:\/\/doi.org\/10.1007\/s11845-022-03202-8","journal-title":"Ir J Med Sci"},{"issue":"6","key":"3447_CR12","doi-asserted-by":"publisher","first-page":"1048","DOI":"10.1016\/j.jamcollsurg.2016.12.039","volume":"224","author":"K Han","year":"2017","unstructured":"Han K, Bohnen JD, Peponis T et al (2017) The surgeon as the second victim? Results of the boston intraoperative adverse events surgeons\u2019 attitude (BISA) Study. J Am Coll Surg 224(6):1048\u20131056. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2016.12.039","journal-title":"J Am Coll Surg"},{"issue":"7","key":"3447_CR13","doi-asserted-by":"publisher","first-page":"1401","DOI":"10.1016\/j.paid.2004.01.010","volume":"37","author":"PM Matud","year":"2004","unstructured":"Matud PM (2004) Gender differences in stress and coping styles. Personality Individ Differ 37(7):1401\u20131415. https:\/\/doi.org\/10.1016\/j.paid.2004.01.010","journal-title":"Personality Individ Differ"},{"issue":"9","key":"3447_CR14","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1111\/codi.15021","volume":"22","author":"S Biggs","year":"2020","unstructured":"Biggs S, Waggett HB, Shabbir J (2020) Impact of surgical complications on the operating surgeon. Colorectal Dis 22(9):1169\u20131174. https:\/\/doi.org\/10.1111\/codi.15021","journal-title":"Colorectal Dis"},{"issue":"8","key":"3447_CR15","doi-asserted-by":"publisher","first-page":"2179","DOI":"10.1097\/JS9.0000000000000463","volume":"109","author":"H He","year":"2023","unstructured":"He H, Lin C, Li R et al (2023) Surgeons\u2019 mental distress and risks after severe complications following radical gastrectomy in China: a nationwide cross-sectional questionnaire. Int J Surg 109(8):2179\u20132184. https:\/\/doi.org\/10.1097\/JS9.0000000000000463","journal-title":"Int J Surg"},{"issue":"7","key":"3447_CR16","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1308\/rcsann.2020.7058","volume":"103","author":"B Balendran","year":"2021","unstructured":"Balendran B, Bath MF, Awopetu AI et al (2021) Burnout within UK surgical specialties: a systematic review. Ann R Coll Surg Engl 103(7):464\u2013470. https:\/\/doi.org\/10.1308\/rcsann.2020.7058","journal-title":"Ann R Coll Surg Engl"},{"key":"3447_CR17","doi-asserted-by":"publisher","first-page":"153857442312099","DOI":"10.1177\/15385744231209914","volume":"103","author":"SH Choi","year":"2023","unstructured":"Choi SH, Yan TD, Misskey J et al (2023) The Emotional impact and coping mechanisms following adverse patient events among Canadian vascular surgeons and trainees. Vasc Endovascular Surg. 103:15385744231209914. https:\/\/doi.org\/10.1177\/15385744231209914","journal-title":"Vasc Endovascular Surg."},{"issue":"4","key":"3447_CR18","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1136\/bmjqs-2013-002035","volume":"23","author":"S Ullstrom","year":"2014","unstructured":"Ullstrom S, Andreen Sachs M, Hansson J et al (2014) Suffering in silence: a qualitative study of second victims of adverse events. BMJ Qual Saf 23(4):325\u2013331. https:\/\/doi.org\/10.1136\/bmjqs-2013-002035","journal-title":"BMJ Qual Saf"},{"key":"3447_CR19","doi-asserted-by":"publisher","first-page":"101680","DOI":"10.1016\/j.jvsv.2023.08.019","volume":"12","author":"JF Eidt","year":"2023","unstructured":"Eidt JF, Mannoia K (2023) A toolkit for individualizing interventions to mitigate second-victim syndrome in a diverse surgery community. J Vasc Surg Venous Lymphat Disord 12:101680. https:\/\/doi.org\/10.1016\/j.jvsv.2023.08.019","journal-title":"J Vasc Surg Venous Lymphat Disord"},{"issue":"5","key":"3447_CR20","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/j.jpedsurg.2020.12.031","volume":"56","author":"L Berman","year":"2021","unstructured":"Berman L, Rialon KL, Mueller CM et al (2021) Supporting recovery after adverse events: An essential component of surgeon well-being. J Pediatr Surg 56(5):833\u2013838. https:\/\/doi.org\/10.1016\/j.jpedsurg.2020.12.031","journal-title":"J Pediatr Surg"},{"issue":"6","key":"3447_CR21","doi-asserted-by":"publisher","first-page":"926","DOI":"10.1016\/j.jamcollsurg.2019.10.015","volume":"230","author":"MW El Hechi","year":"2020","unstructured":"El Hechi MW, Bohnen JD, Westfal M et al (2020) Design and impact of a novel surgery-specific second victim peer support program. J Am Coll Surg 230(6):926\u2013933. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2019.10.015","journal-title":"J Am Coll Surg"}],"container-title":["Langenbeck's Archives of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-024-03447-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00423-024-03447-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-024-03447-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T03:12:12Z","timestamp":1724296332000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00423-024-03447-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,20]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3447"],"URL":"https:\/\/doi.org\/10.1007\/s00423-024-03447-0","relation":{},"ISSN":["1435-2451"],"issn-type":[{"value":"1435-2451","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,20]]},"assertion":[{"value":"11 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 August 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None of the authors has any conflict of interest to declare in relation to the presented study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"255"}}