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DOI: 10.1055/a-1885-5039
Mindestmengen und Zertifizierungen der onkologischen Viszeralchirurgie in Deutschland – Fluch oder Segen?
Neben der erhofften Verbesserung des Behandlungsergebnisses durch gesetzliche Mindestmengen und Zertifizierungen der onkologischen Viszeralchirurgie sind auch negative Effekte für Patienten und Behandler zu erwarten. Vor diesem Hintergrund soll in diesem Beitrag die Evidenzlage von Mindestmengen und Zertifizierungen in der Pankreas-, Ösophagus- und Kolorektalchirurgie dargestellt und anschließend auf Kritikpunkte an der zunehmenden Zentrumsbildung und Lösungsansätze eingegangen werden.
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Der Zusammenhang zwischen einem hohem Fallvolumen und einem besseren Behandlungsergebnis konnte in zahlreichen unabhängigen Studien nachgewiesen werden.
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Zertifizierungen fördern die Einhaltung von Behandlungsstandards und erzwingen eine selbstständige Qualitätskontrolle. Klinische Prozesse werden so stetig geprüft und optimiert.
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Die Zentrumsbildung wirkt sich erheblich auf die Weiterbildung in der speziellen Viszeralchirurgie aus: Ärztinnen und Ärzte an einem peripheren Krankenhaus werden ihren Operationskatalog häufig nicht mehr vollständig an ihrem Heimatkrankenhaus absolvieren können, sondern müssen Rotationen an größere Zentren einplanen.
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Zur erfolgreichen Vermittlung operativer Fertigkeiten muss das „Teilschrittekonzept“ der DGAV konsequent umgesetzt werden.
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Neben der exzellenten Vorbereitung des Weiterbildungsassistenten, z. B. durch Teilnahme an strukturierten Trainingskursen und Simulatorentraining, sind eine didaktische Schulung des Ausbilders sowie eine moderne Führungs- und Feedbackkultur hilfreich.
Schlüsselwörter
Zentrenbildung - Zertifizierung - Mindestmenge - Qualitätsmanagement - Viszeralchirurgie - WeiterbildungPublication History
Article published online:
08 February 2023
© 2023. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
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