Benefizregatta

Rudern gegen Krebs by Prof Dr Dr Ernst Hanisch

Patientenakademie der Asklepios Klinik Langen

Patientenakademie der Asklepios Klinik Langen by Prof Dr Dr Ernst Hanisch

1. Benefizregatta in Mühlheim am Main

Rudern gegen Krebs by Prof Dr Dr Ernst Hanisch

Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial

n In selected patients with rectal cancer treated by skilled surgeons, laparoscopic surgery resulted in similar safety, resection margins, and completeness of resection to that of open surgery, and recovery was improved
after laparoscopic surgery. Results for the primary endpoint—locoregional recurrence—are expected by the end of 2013. Mehr

Familiärer Darmkrebs - Ein Ratgeber

BBSG Spezial 01 Darmkrebs Web X3 by Prof Dr Dr Ernst Hanisch

COLOR II

The surgeons in the COlorectal cancer Laparoscopic or Open Resection II (COLOR II) trial are to be congratulated for their second major clinical trial success.1 It is no minor accomplishment to design a proper study, recruit a league of surgeons, engage a broad community of patients, and maintain equipoise as the world of surgery undergoes rapid change. Indeed, undertaking trials, such as reported by van der Pas and colleagues, requires determination, dedication, and substantial fi nancial support. Have we learned enough from this trial and other trials like it to justify the time and eff ort? From the results of COLOR II trial, we learn that patients with rectal cancer treated with laparoscopic resection had small gains in short-term outcomes, specifi cally shorter times to their bowel function returning and discharge from hospital, but no decrease in perioperative complications. These results are consistent with previous fi ndings from the laparoscopic colectomy trials, which is understandable because of the similarities of the trial methods.2–4 Mehr

Wie misst man die individuelle Qualität von Chirurgen?

  Public Reporting of Surgeon Outcomes Low Numbers Of by Prof Dr Dr Ernst Hanisch

Revised guidelines for the clinical management of Lynch syndrome (HNPCC): recommendations by a group of European experts

Lynch syndrome (LS) (previously referred to as hereditary non-polyposis colorectal cancer; HNPCC) is an autosomal dominant condition caused by a defect in one of the mismatch repair (MMR) genes.1 The syndrome is characterised by the development of colorectal cancer (CRC), endometrial cancer (EC) and various other cancers frequently diagnosed at an early age. LS is probably the most common hereditary CRC syndrome accounting for approximately 1–3% of all CRC. It has been estimated that in Europe approximately one million individuals are carriers of an MMR defect.2

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10. Tagung der Rhein-Main AG. Minimal-Invasive Chirurgie. 21./22. Februar 2013, Asklepios-Klinik Langen.Photographiert von Marc Strohfeldt - www.nachelf.de

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Einladung zur 10. Tagung der Rhein-Main-AG Minimal Invasive Chirurgie

Einladung zur 10. Tagung der Rhein-Main-AG Minimal Invasive Chirurgie by Prof Dr Dr Ernst Hanisch

10. Tagung der Rhein-Main-AG Minimal Invasive Chirurgie

http://de.scribd.com/doc/120036394/Einladung-zur-10-Tagung-der-Rhein-Main-AG-Minimal-Invasive-Chirurgie

Empathie und Vertrauen als Grundlage jeder Arzt-Patienten-Beziehung

Die Empathie gegenüber dem Patienten steht bei Professor Ernst Hanisch immer im Vordergrund. Seit 2003 ist er ärztlicher Direktor und Chefarzt der Klinik für Allgemein-, Viszeral- und Endokrine Chirurgie in der Asklepios Klinik in Langen. "Dass ein Chirurg fachlich kompetent ist, sehe ich als Voraussetzung an. Aber mein Ziel ist es, dass sich der Patient bei uns fühlt, wie in einer guten Familie: angenommen und respektiert", erklärt Ernst Hanisch. Mehr

Morbus Crohn

A 63-year-old woman with a history of Crohn's disease presented with abdominal pain and diarrhea, findings consistent with a flare of her disease. One week after treatment with infliximab, she returned with worsening abdominal symptoms. An abdominal radiograph (Panel A) showed colonic dilatation and intraluminal polypoid filling defects that suggested the presence of innumerable inflammatory pseudopolyps. (In contrast, "thumbprinting" due to submucosal edema has a more uniform haustral distribution.) Colonography by means of volume-rendered computed tomography with an intraluminal perspective (virtual colonoscopy) (Panel B) generated the endoscopic appearance of inflammatory pseudopolyposis. Polyposis syndromes, such as familial adenomatous polyposis, could give rise to a similar appearance on imaging, although the clinical presentation would differ from that of inflammatory pseudopolyposis. A subtotal colectomy was performed, and on gross examination, areas of denuded mucosa surrounding multifocal islands of edematous mucosa were noted.

Kolonkarzinom

A 74-year-old man was referred for evaluation after a positive fecal occult-blood test. He had no history of cancer and no family history of colorectal cancer. A colonoscopy was performed with the use of a magnifying videoscope, and an irregularity of the colonic wall at the transverse colon was detected (Panel A). The laterally spreading tumor became clear after a 0.2 percent indigo carmine solution was sprayed in the area (Panel B, arrows). A radiograph obtained after the administration of a double-contrast barium enema showed a flat, radiolucent area (Panel C, arrows). The patient underwent a laparoscopically assisted colectomy, and a tumor 5 cm in diameter was removed. Histologic examination showed invasion of the cancer in the submucosa, without invasion of the vessels or involvement of the lymph nodes (Panel D, hematoxylin and eosin). Follow-up after discharge was uneventful. After eight months, there has been no evidence of metastasis.

Darmblutung - Invagination

An 80-year-old woman presented with a three-day history of passage of bright red blood from the rectum. She was afebrile and had a blood pressure of 70/52 mm Hg. The white-cell count was 10,100 per cubic millimeter, and the hematocrit was 32.5 percent. An abdominal radiograph showed minimal ileus. A colonoscopy revealed blood in the colon and a round, smooth, violaceous lesion in the ascending colon that nearly obstructed the colonic lumen and that could not be passed by the colonoscope. A single computed tomographic image of the abdomen showed two views of an intussusception. In a cross-sectional view (arrowhead), traces of contrast medium in the intussusceptum (the invaginated segment of the colon) formed a high-density center, the swollen wall of the intussusceptum and mesenteric fat formed a crescentic low-density layer, and contrast medium in the intussuscipiens (the portion of the bowel into which the intussusceptum telescopes) formed the outermost, high-density layer. In a longitudinal view (arrow), the swollen bowel walls formed the thickened outer layer, and the intraluminal mesenteric fat and vessels formed a denser signal than did the intraluminal air in the loop of bowel just above it. At surgery, the terminal ileum was found to have prolapsed into the cecum and up the ascending colon.

Rudern gegen Krebs

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Vermehrt Anastomoseninsuffizienzen unter Diclofenac...

With leakage rates of around 3% after colonic resections and 10% after rectal resections and with mortality rates of up to 32%,1 2 anastomotic leakage remains a serious challenge for colorectal surgeons worldwide. In the past few years, there has been increased focus on the possible effect of non-steroidal anti-inflammatory drugs (NSAIDs) on the risk of anastomotic leakage.3 4 5 6 Retrospective studies have shown an association between anastomotic leakage and postoperative treatment with diclofenac and celecoxib, two NSAIDs that are predominantly cyclo-oxygenase-2 selective.3 4 5 Mehr

Short-Course Radiation Versus Long-Course Chemoradiation for Rectal Cancer

There are two broad approaches to preoperative pelvic radiation

therapy for resectable rectal cancer: short-course radiation and longcourse

chemoradiotherapy. Although the radiation techniques are

similar, the fractionation and timing of surgery differ. In general,

short-course radiation delivers 25 Gy (5 Gy in five fractions) of radiation

followed by surgery 1 week later. Long-course chemoradiotherapy

delivers 50.4 Gy (1.8 Gy in 28 fractions) of radiation concurrently

with chemotherapy, followed by surgery 4 to 8 weeks later. Mehr

Sport gegen Krebs

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Challenge of Primary Tumor Management in Patients With Stage IV Colorectal Cancer

Optimal first-line therapy of patients who present with primary intact, unresectable stage IV colorectal cancer is controversial. Despite limited data, there are strong biases for either up-front primary tumor resection or for first-line systemic chemotherapy. The argument for up-front primary tumor resection is based on the desire to avoid potential complications of the intact primary tumor (IPT) such as bleeding, obstruction, or tumor perforation. Indeed the concern regarding the risk of primary tumor–related complications during systemic therapy, particularly with bevacizumab, has led both surgical and medical oncologists to advocate primary tumor resection at the time of diagnosis.^{1,2  Mehr}