{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:33:54Z","timestamp":1740126834564,"version":"3.37.3"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Hintergrund In den letzten Jahrzehnten wurde eine Vielzahl von Techniken in den klinischen Alltag eingef\u00fchrt, um die Invasivit\u00e4t thoraxchirurgischer Operationen zu reduzieren.\n          Thoraxdrainagen stellen eine bedeutende Ursache f\u00fcr postoperativen Schmerz dar. Der Verzicht auf eine Thoraxdrainage (Tubeless-Technik) kann zu geringeren postoperativen Schmerzen und einer\n          verk\u00fcrzten Krankenhausverweildauer f\u00fchren. Welchen Stellenwert die Tubeless-Technik in Deutschland hat, ist jedoch unklar.<\/jats:p><jats:p>\n          Material und Methoden Mit einer bundesweiten Befragung, die von der Deutschen Gesellschaft f\u00fcr Thoraxchirurgie (DGT) unterst\u00fctzt wurde, sollte die Anwendung der Tubeless-Technik\n          evaluiert werden. Im Zeitraum von Juli bis September 2020 wurden alle leitenden Thoraxchirurgen mit DGT-Mitgliedschaft aufgerufen, einen digitalen Fragebogen zu beantworten.<\/jats:p><jats:p>\n          Ergebnisse 63 von 161 Angefragten sendeten den Fragebogen ausgef\u00fcllt zur\u00fcck, was einer R\u00fccklaufquote von 39% entspricht. Im Erfassungszeitraum von 1 Jahr wurden an den 63 Kliniken\n          mindestens 30\u200a930 thoraxchirurgische Eingriffe durchgef\u00fchrt, wovon 593 Eingriffe (1,9%) in Tubeless-Technik vorgenommen wurden. In 37 Kliniken (59%) wurden bisher Eingriffe in\n          Tubeless-Technik ausgef\u00fchrt, wovon 15 (24%) ebenfalls Lungenresektionen durchf\u00fchrten. 42 Befragte (67%) sehen unter bestimmten Voraussetzungen eine Indikation f\u00fcr die Tubeless-Technik und 7\n          (11%) sehen eine Vergesellschaftung mit einem hohen Komplikationsrisiko. F\u00fcr 50\u2009Teilnehmer (79%) verursacht die Tubeless-Technik weniger Schmerzen und 10 (16%) geben an, dass die\n          Tubeless-Technik keinen Vorteil bietet. Neben anderen Kontraindikationen wird ein Pleuraerguss am h\u00e4ufigsten angeben (48 Befragte, 76%). Bei den Anwendern besteht Konsens (100%), dass eine\n          fehlende Luftfistel Voraussetzung f\u00fcr die Durchf\u00fchrung der Tubeless-Technik ist. Der Gro\u00dfteil der Anwender f\u00fchrt zum Ausschluss einer Luftfistel eine \u201eFahrradschlauchprobe\u201c (73%) und\/oder\n          eine Kontrolle am digitalen Drainagesystem (53%) durch, teilweise unter druckkontrolliert ventilierter Lunge. 17 Anwender der Tubeless-Technik (46%) gaben an, bisher keine Komplikationen\n          beobachtet zu haben.<\/jats:p><jats:p>\n          Schlussfolgerung Die Vorteile der Tubeless-Technik sind wissenschaftlich gut belegt und in deutschen Kliniken bekannt. Gleichwohl wird sie in Deutschland nur von 59% der befragten\n          thoraxchirurgischen Einrichtungen durchgef\u00fchrt. Eine Verbesserung der Evidenz hinsichtlich der Selektionskriterien durch randomisierte klinische Studien k\u00f6nnte helfen, eine breitere\n          Anwendung zu bef\u00f6rdern.<\/jats:p>","DOI":"10.1055\/a-1502-8210","type":"journal-article","created":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T23:44:06Z","timestamp":1625528646000},"page":"270-277","source":"Crossref","is-referenced-by-count":1,"title":["Thoraxchirurgie ohne Thoraxdrainage \u2013 aktuelle Situation in Deutschland"],"prefix":"10.1055","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3390-735X","authenticated-orcid":false,"given":"Johannes","family":"Broschewitz","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral-, Thorax- und Gef\u00e4\u00dfchirurgie, Medizinische Hochschule Brandenburg Theodor Fontane, Neuruppin, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabella","family":"Metelmann","sequence":"first","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Viszeral-, Transplantations-, Thorax- und Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum Leipzig, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Steinert","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Viszeral-, Transplantations-, Thorax- und Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum Leipzig, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Kr\u00e4mer","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Viszeral-, Transplantations-, Thorax- und Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum Leipzig, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,7,5]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1007\/s00104-005-1058-2","article-title":"Fr\u00fche Drainagenentfernung nach videoassistierten thorakoskopischen Operationen. 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Zeitschrift f\u00fcr Allgemeine, Viszeral-, Thorax- und Gef\u00e4\u00dfchirurgie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1502-8210.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T23:15:50Z","timestamp":1685747750000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1502-8210"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,5]]},"references-count":16,"journal-issue":{"issue":"03","published-online":{"date-parts":[[2023,6,2]]},"published-print":{"date-parts":[[2023,6]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1502-8210","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0044-409X","1438-9592"],"issn-type":[{"type":"print","value":"0044-409X"},{"type":"electronic","value":"1438-9592"}],"subject":[],"published":{"date-parts":[[2021,7,5]]}}}