{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T23:53:13Z","timestamp":1791244393521,"version":"4.1.0"},"reference-count":50,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Eingriffe im oberen Gastrointestinaltrakt sind trotz technischer und perioperativer Fortschritte weiterhin mit einer relevanten Morbidit\u00e4t verbunden, insbesondere nach \u00d6sophagektomie und Gastrektomie. Der vorliegende \u00dcbersichtsartikel zeigt, dass Komplikationspr\u00e4vention nicht als Summe isolierter Einzelma\u00dfnahmen verstanden werden sollte, sondern als phasen\u00fcbergreifendes Konzept aus pr\u00e4operativer Optimierung, intraoperativer Qualit\u00e4tssicherung und postoperativer Standardisierung. Pr\u00e4habilitation, Ern\u00e4hrungsoptimierung und eine risikoadaptierte Patientenvorbereitung k\u00f6nnen das Risiko allgemeiner und pulmonaler Komplikationen senken und in ausgew\u00e4hlten Konstellationen auch Anastomoseninsuffizienzen reduzieren. Intraoperativ k\u00f6nnen minimalinvasive und robotische Verfahren die Morbidit\u00e4t, insbesondere respiratorische Komplikationen, vermindern; erg\u00e4nzend tragen Perfusionsbeurteilung, Dichtigkeitspr\u00fcfung, endoskopische Kontrolle und prozedurspezifische technische Strategien zur Sicherheit bei. Postoperativ f\u00f6rdern ERAS-Protokolle, fr\u00fchzeitige orale oder enterale Ern\u00e4hrung sowie strukturierte Rescue-Strategien eine raschere Erholung, ohne anastomosenbezogene Risiken zu erh\u00f6hen. Dar\u00fcber hinaus weisen Volume-Outcome-Daten darauf hin, dass Krankenhaus- und Operateurfallzahlen sowie die F\u00e4higkeit zum Failure-to-Rescue zentrale Systemdeterminanten des perioperativen Outcomes darstellen. Insgesamt spricht die aktuelle Evidenz daf\u00fcr, Komplikationspr\u00e4vention im oberen Gastrointestinaltrakt als konsequent organisierten perioperativen Behandlungspfad zu verstehen.<\/jats:p>","DOI":"10.1055\/a-2952-6177","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T23:05:51Z","timestamp":1791241551000},"source":"Crossref","is-referenced-by-count":0,"title":["Komplikationspr\u00e4vention bei Eingriffen im oberen Gastrointestinaltrakt"],"prefix":"10.1055","author":[{"given":"Richard","family":"Hummel","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsmedizin Greifswald, Deutschland","place":["Greifswald"],"department":["Klinik und Poliklinik f\u00fcr Allgemeine Chirurgie, Viszeral-, Thorax- und Gef\u00e4\u00dfchirurgie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maciej","family":"Patrzyk","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsmedizin Greifswald, Deutschland","place":["Greifswald"],"department":["Klinik und Poliklinik f\u00fcr Allgemeine Chirurgie, Viszeral-, Thorax- und Gef\u00e4\u00dfchirurgie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Langheinrich","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsmedizin Greifswald, Deutschland","place":["Greifswald"],"department":["Klinik und Poliklinik f\u00fcr Allgemeine Chirurgie, Viszeral-, Thorax- und Gef\u00e4\u00dfchirurgie"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Kersting","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsmedizin Greifswald, Deutschland","place":["Greifswald"],"department":["Klinik und Poliklinik f\u00fcr Allgemeine Chirurgie, Viszeral-, Thorax- und Gef\u00e4\u00dfchirurgie"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/doab027","article-title":"Impact of standardized clinical pathways on esophagectomy: a systematic review and meta-analysis","volume":"35","author":"F Puccetti","year":"2022","journal-title":"Dis Esophagus"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1016\/j.xjon.2025.09.001","article-title":"Evaluating failure to rescue after esophagectomy: The esophagectomy failure to rescue assessment, trends, and Evaluation (E-FATE) study","volume":"28","author":"CS Boutros","year":"2025","journal-title":"JTCVS Open"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1097\/SLA.0000000000003278","article-title":"Direct Oral Feeding Following Minimally Invasive Esophagectomy (NUTRIENT II trial): An International, Multicenter, Open-label Randomized Controlled Trial","volume":"27","author":"GHK Berkelmans","year":"2020","journal-title":"Ann Surg"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1093\/dote\/doad066","article-title":"Does prehabilitation before esophagectomy improve postoperative outcomes? 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