Schmerzen sind einer der Hauptgründe, aufgrund derer Menschen Notaufnahmen aufsuchen. Obwohl die Schmerzerfassung und -therapie durch verschiedene Vorgaben und Leitlinien für Notfallsituationen gefordert werden, zeigen frühere Untersuchungen eine große Heterogenität. Das Ziel der vorliegenden Studie war die Ist-Analyse zur Schmerzerfassung und -therapie in deutschen Notaufnahmen anhand einer quantitativen Datenerhebung mittels einer Online-Umfrage. Es wurde eine quantitative und anwenderadaptierte Online-Befragung unter fünf Berufsgruppen in der Notfallversorgung durchgeführt. Die Rekrutierung erfolgte beim 20. DGINA-Kongress sowie über Fachverteiler, Onlineplattformen und Fachvorträge (08.05.–27.07.2025). Der Fragenkatalog beinhaltete funktions- und berufsgruppenspezifische Adaptationen. Insgesamt konnten 879 vollständige Fragebögen aus allen Notfallversorgungsstufen und Berufsgruppen ausgewertet werden. Die Ersteinschätzung erfolgte überwiegend durch Pflegefachpersonen (85,4–90,8
Previously, the treatment of colorectal anastomotic insufficiencies with endoluminal vacuum therapy (EVT) was not feasible without creating a diverting stoma, as the suction sponge typically obstructed the intestinal lumen. However, clinical use of the VacStent GI™ in the upper gastrointestinal tract has demonstrated that secure closure of intestinal wall defects or anastomotic leaks, along with effective drainage of associated wound cavities, is achievable via intraluminal EVT. The innovative concept of the VacStent GI™ was now transferred to the lower GI tract. A prospective multicenter feasibility study was conducted, with the primary endpoint being the safe and practical application of the device, complete coverage of the leak, and effective suction-based treatment of colorectal leaks. Secondary endpoints included the prevention of septic complications, avoidance of stoma creation, successful leak healing, and the assessment of adverse events such as stent migration, local erosion or ulceration, and bleeding. Fourteen patients with postoperative colorectal anastomotic leaks and one with iatrogenic instrumental perforation were enrolled in two German hospitals. A total of 43 VacStent GI™ Colon were implanted, with a median of three VacStent per patient and a median treatment duration of 14 days. The safe and practical application of the VacStent GI™ Colon was achieved in all implantations, resulting in a leak healing rate of 93.3
715 Background: The prospective phase 3 study EV-302 demonstrated superiority regarding efficacy of Enfortumab vedotin plus Pembrolizumab (EVP) compared to platinum-based chemotherapy in patients (pts) that received first-line (1L) therapy for metastatic urothelial carcinoma (mUC). Since presentation of the data in September 2023 EVP was considered a new standard of care (SOC) however only approved in Europe in August 2024. We analyzed efficacy and safety outcomes of pts treated with EVP outside of clinical trials. Methods: Retrospective data were collected from 19 German academic and community hospitals for pts with metastatic UC who received EVP as off-label therapy when reimbursed by their insurance company before European Medicines Agency (EMA) approval, or as SOC treatment after EMA approval. Imaging and therapy management were in accordance with local standards. Adverse events (AEs) were reported according to Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 criteria. Median progression-free survival (mPFS) and overall survival (mOS) were estimated using the Kaplan-Meier method by local investigators. Results: We identified 215 pts for the safety cohort (all pts who received EVP at least once) and 164 pts for the efficacy cohort (all pts who received at least one staging or died prior to first planned imaging).The median age for the eligible patients was 71 yr (range 25-89). The Eastern Cooperative Oncology Group performance status (ECOG PS) was 0/1/2/3-4/unknown for 46.0/31.6/17.2/4.7/0.5% of patients. The overall response rate was 60.7% (partial response 51.0%, complete response 9.7%). mOS was not reached and mPFS was 13 mo (95% confidence interval 4.5-21.5). Any-grade AEs were observed in 73.0% and CTCAE grade ≥3 AEs in 30.2%. Any-grade immune-related AEs were observed in 37.7% and CTCAE grade ≥3 AEs in 16.7%. The most common AEs were peripheral sensory neuropathy (all grade: 30.2%) and skin toxicity (all grade:24.2%). No treatment-related fatal event occurred. Limitations include the retrospective design and short follow-up. Conclusions: Administration of EVP in a real-world patient population showed promising effectiveness and an acceptable toxicity profile. No new safety signals were reported. Our results support the use of EVP in 1L in pts with mUC. Updated data with longer follow-up will be presented at the meeting.
