Background Metabolic bariatric surgery is the most effective obesity treatment, but high body mass index (BMI) and associated medical problems often pose surgical risks. Objectives This study compares the safety, feasibility, and efficacy of endoscopic sleeve gastroplasty (ESG) versus intragastric balloon (IGB) as bridge-to-surgery (BTS) procedures in patients with BMI ≥50 kg/m 2 and/or contraindications to primary metabolic bariatric surgery. Design A retrospective analysis (2017 – 2024) included patients with BMI ≥50 kg/m 2 undergoing ESG or IGB as a BTS procedure in a two-step approach at two German centers. Methods The primary outcome was total body weight loss (TBWL, %) at 6 months. Secondary outcomes included absolute weight loss, BMI reduction, excess body weight loss (EBWL, %), and adverse events between the two BTS procedures. Results Fourteen patients underwent ESG, 15 underwent IGB insertion as an intended BTS procedure. At 6 months, median %TBWL and %EBWL were significantly higher in the ESG group (17.8% (IQR, 14.5 – 22.1) vs. 8.99% (IQR, 4.6 – 14.0), p = 0.018; and 28.0% (IQR, 22.8 – 40.0) vs. 16.7% (IQR, 10.8 – 22.4), p = 0.035, respectively). IGB insertion was performed significantly faster (25 (IQR, 20.0 – 30.0) minutes (min) vs. 76 (IQR, 63.2 – 80.8) min; p < 0.01) but was associated with more mild-to-moderate adverse events (60.0% vs. 0%; p < 0.01). Conclusion In this retrospective cohort, ESG was associated with greater short-term weight loss and fewer mild-to-moderate adverse events than IGB as a BTS procedure for patients with BMI ≥50 kg/m 2 and/or contraindications to primary metabolic bariatric surgery (MBS).

BACKGROUND:Esophageal adenocarcinoma (EAC) represents one of the most increasing malignancies in Western countries. The disease is multifactorial, involving modifiable risk factors and genetic susceptibility variants. These variants can be aggregated to a polygenic risk score (PRS) that reflects individual genetic risk. Investigation of the effects of lifestyle factors, PRS, and co-medication on EAC age at onset (AAO) is critical for shaping prevention strategies. METHODS:A detailed questionnaire was used to assess pre-diagnostic exposure to lifestyle factors and clinical information from a large German EAC cohort. Linear regression analysis was performed to identify factors associated with EAC AAO in 1742 EAC patients. PRS was available for 1190 patients. Subgroup analyses were conducted to estimate the effects of the analyzed factors on AAO according to age group (early vs. late onset), sex, and prior diagnosis of Barrett's esophagus (BE). RESULTS:Earlier AAO was significantly associated with gastroesophageal reflux (GER), smoking and a higher PRS, whereas later AAO was associated with physical activity and higher consumption of fish and fruits. Among co-medication, combined use of proton pump inhibitors (PPIs) and acetylsalicylic acid (ASA) showed the most significant effect on AAO, whereas the use of PPIs and ASA alone showed weaker effects. DISCUSSION:This study represents the largest questionnaire-based analysis to date investigating factors influencing EAC development. Our findings show that the combined use of PPIs and ASA, both cost-effective medications, is associated with delayed EAC onset. In addition, lifestyle and genetics contribute to EAC AAO.

Abstract:Downhill esophageal varices due to superior vena cava (SVC) obstruction are a rare cause of upper gastrointestinal bleeding. An 87-year-old man presented with melena/hematemesis and severe anemia. Emergency endoscopy identified active bleeding from proximal downhill varices, controlled by endoscopic band ligation. Chest CT angiography demonstrated an SVC thrombus (3.7 × 9 mm) with a downstream short-segment high-grade stenosis/occlusion; venography confirmed complete short-segment occlusion at the level of cardiac resynchronisation therapy with defibrillator (CRT-D) leads. Because of the risk of compromising lead function, recanalization/thrombectomy was deferred and therapeutic anticoagulation (heparin, then apixaban) was initiated, with additional ligation of high-risk variceal columns on follow-up endoscopy. This case highlights the need for rapid CT angiographic evaluation for SVC obstruction in proximal varices, particularly in patients with intravascular devices.

BACKGROUND:Endoscopic closure techniques are essential for management of endoscopic defects and help prevent delayed bleeding and perforation. The SutuArt endoscopic hand-suturing system (EHS) is an innovative method for defect closure, but clinical data remain limited. METHODS:In a multicenter European registry study, all procedures using EHS from 14 centers were evaluated. The primary endpoint was technical success, defined as complete defect closure without additional closure techniques. Secondary endpoints were in-hospital clinical success (absence of post-interventional complications); overall defect closure rate (closure achieved with additional devices) and procedure time. RESULTS:Between February 2023 and January 2026, 338 procedures were included. Indications comprised 240 ESD (Endoscopic Submucosal Dissection), 32 EID (Endoscopic Intermuscular Dissection), 41 G-POEM (Gastric Peroral Endoscopic Myotomy), 10 fistulas, 6 EMR (Endoscopic Mucosa Resection), 3 STERs (Submucosal Tunneling Endoscopic Resection), 2 NEWS (Non-exposed Endoscopic Wall inversion Surgery), 1 anastomotic leak, 1 perforation, 1 EFTR (Endoscopic Full Thickness Resection) and 1 endoscopic hemostasis. The median defect size was 35 mm (range 4-155 mm), the median suturing time was 25 minutes (range: 4-120). Technical success was 96.2% (325/338). Overall defect closure rate was 96.7% (327/338). In-hospital clinical success was 97.9% (331/338). Defect size did not predict suturing time in the global size-time model, indicating that procedural complexity was not explained by size alone. Procedure-related adverse events occurred in 5/338 (1.5%), overall AEs were 10/338 (3%). CONCLUSION:EHS demonstrated high technical and in-hospital clinical success with a low observed short-term adverse event rate. Further studies are needed to assess the performance for complex defects.

Background Endoscopic vacuum therapy (EVT) is a minimally invasive therapy for managing transmural gastrointestinal defects and supports the control of local infection. The role of EVT in patients with infected walled-off necrosis (WON) resulting from acute necrotizing pancreatitis (ANP) has not yet been investigated. Methods A multicenter retrospective case analysis was conducted. Patients with infected WON due to severe ANP (Revised Atlanta Classification) in whom the standard step-up therapy was expanded to include EVT, were identified and included in the study. Results Sixteen patients (aged 22-81 years) were treated in addition to standard therapy with EVT in four tertiary care centers in Germany and Brazil. After a total of 108 EVT device exchanges, the clinical success (sepsis control, complete resolution of WON, and closure of fistula) was achieved in 14 of 16 patients. Two patients died as a direct result of ANP and WON, while one further patient died of pneumosepsis after complete resolution of WON.Intracavitary bleeding occurred during device exchange in two patients, corresponding to a per-procedure bleeding rate of 1.9%. Conclusions Intracavitary EVT is feasible and relatively safe in treating patients with WON. Larger prospective trials are necessary to evaluate a potential adjunctive benefit of EVT in this challenging patient cohort.

BACKGROUND:Carcinomas of the stomach and esophagogastric junction (EGJ) are the fifth leading cause of cancer-related deaths worldwide. In Germany, gastric cancer ranks tenth in incidence across both sexes. The new German national guideline aims to provide the most relevant evidence-based recommendations on diagnosis and treatment of gastric and EGJ adenocarcinomas and has been comprehensively updated by an interdisciplinary panel of experts from national medical societies. SUMMARY:The updated S3 guideline reflects the latest advances in diagnostics, improved palliative therapies, and supportive care. The objectives are to improve the quality of individual and broad care and to ensure consistent, evidence-based treatment strategies. KEY MESSAGES:New recommendations introduce preventive strategies, including management of familial risk due to microsatellite instability (MSI) and H. pylori eradication. The biomarkers HER2, PD-L1, MSI, and Claudin 18.2 enable the use of targeted therapies that improve long-term outcomes in advanced disease. Combinations of chemotherapy with immunotherapy nivolumab, pembrolizumab, or tislelizumab significantly prolong survival compared with chemotherapy alone (e.g., nivolumab 14.4 vs. 11.1 months, HR 0.71; pembrolizumab 13.0 vs. 11.4 months, HR 0.75; tislelizumab 17.2 vs. 12.6 months, HR 0.74) with 5-year survival rates up to 16%. In patients with high Claudin 18.2 expression, zolbetuximab plus chemotherapy improved median survival to 16.4 vs. 13.4 months (HR 0.77). For patients in good general condition, subsequent lines of therapy including biomarker-driven approaches (trastuzumab deruxtecan, pembrolizumab) or third-line therapies (e.g., trifluridine tipiracil) and advanced molecular diagnostics are recommended after treatment failure.

Background:Endoscopic submucosal dissection (ESD) is a minimally invasive and effective treatment for large nonpedunculated colorectal polyps; however, it carries a relevant risk of adverse events (AEs), such as delayed bleeding, as well as postprocedural perforation (PPP) and postelectrocoagulation syndrome (PECS). Systematic defect closure may reduce these risks, but its preventive efficacy remains uncertain. We conducted a meta-analysis of randomized controlled trials (RCTs) to assess the efficacy of prophylactic clipping after colorectal ESD. Methods:Following PRISMA guidelines, we searched MEDLINE, Embase, and SCOPUS through to June 2025 for RCTs comparing prophylactic clipping vs. no clipping after colorectal ESD in adults. The primary outcome was clinically significant delayed bleeding; secondary outcomes included PPP and PECS, as well as subanalysis by location and size. Random-effects models were used to compute risk ratios (RRs) and 95%CIs. Results:Four RCTs from Asia including 684 patients were analyzed (336 with clipping, 348 controls). Prophylactic clipping significantly reduced clinically significant delayed bleeding risk (0.3% vs. 3.4%; RR 0.26, 95%CI 0.08-0.88). No significant differences were found for PPP (0.4% vs. 1.0%; RR 0.74; 95%CI 0.23-2.35) or PECS (12.2% vs. 11.8%; RR 1.06; 95%CI 0.74-1.52). Subgroup analyses by lesion size (>30 mm vs. <30 mm) and location (proximal vs. distal colon) were not significant. Conclusions:A 74% decrease in the risk of clinically significant delayed bleeding is achieved by prophylactic clipping after colorectal ESD, supporting its adoption in routine practice.

BACKGROUND:The aim was to build a risk score (RS) for gastric and esophageal cancer (GEC) based on self-reported information as a first step to develop a risk-adapted screening modality for GEC or precursor lesions in a non-high incidence region in the framework of the RISC-GAP project. METHODS:Data from 375,280 participants aged 50 years and older in the UK Biobank project were used. The outcome was incident esophageal or gastric cancer. Various variables, including sociodemographic data, medical conditions, medication, lifestyle factors and diet, were initially considered. To be able to use the RS as a screening tool in the general population, only variables that can be determined by self-report were selected. For variable selection, we used COX regression models with LASSO penalization; the main criterion was 5- and 10-years AUC. RESULTS:The final score included the following eight variables: sex, age, smoking status, drinking status, body mass index, history of esophagitis, medication with gastric acid inhibitors and surgery in the stomach/esophagus area. 10-fold cross-validation revealed a discrimination of 0.740 (5-year AUC) and 0.724 (10-year AUC), respectively. High-risk individuals were defined as those with a 10-year cancer risk of 1% or more (around 6% of the study population). CONCLUSION:The RS allows a reasonable discrimination of individuals with an elevated risk of gastric or esophageal cancer. In further steps of the RISC-GAP project it will be evaluated whether selection of a high-risk population can be further improved by additional clinical and biomarker information.

BACKGROUND:Endoscopic submucosal dissection (ESD) enables en bloc resection of early gastrointestinal cancers and provides specimens suitable for precise pathological risk assessment. However, reporting remains variable for key parameters that determine curative resection and the need for additional treatment, including submucosal invasion depth and breadth, margin status, lymphovascular invasion, tumour budding, differentiation and use of ancillary stains. OBJECTIVE:To develop practical international standards for pathology assessment and reporting of invasive carcinoma in ESD specimens. DESIGN:An international panel of 42 experts, including 28 gastrointestinal pathologists and 14 therapeutic endoscopists from 15 countries, participated in a modified Delphi consensus process. Statements addressed measurement of invasion, margin assessment, staining, specimen handling, prognostic histological features and clinically relevant reporting. RESULTS:56 recommendations reached consensus across seven domains. The panel recommends using Sm1-Sm3 subclassification only when the muscularis propria is present; otherwise, submucosal invasion depth should be reported in micrometres, rounded to the nearest 100 µm. Submucosal invasion breadth should be reported in millimetres as an adjunct metric for future validation. Margin positivity should be defined as direct tumour contact with the inked surface, supported by standardised pinning, inking, complete embedding and parallel sectioning. H&E remains the baseline stain, with selective immunohistochemistry or elastic stains for equivocal lymphovascular invasion, distorted architecture or difficult margin interpretation. Tumour budding should be reported according to International Tumour Budding Consensus Conference criteria, and differentiation, histological subtype, lymphovascular invasion, perineural invasion and margin status should be integrated into composite risk assessment. CONCLUSIONS:These consensus standards provide immediately implementable, synoptic-ready pathology reporting criteria after ESD. By standardising measurement landmarks, margin terminology, ancillary stain use and reporting of adverse histological features, they aim to reduce interinstitutional variability, improve multidisciplinary decision-making and support future validation of risk models in early gastrointestinal cancer.

Introduction To evaluate the feasibility and outcomes of endoscopic intermuscular dissection (EID), we present a case series of patients with suspected deep submucosal invasive T1 rectal cancers based on pre-interventional assessment. The aim is to describe the potential role of EID within risk-adapted treatment strategies for early rectal cancer. Methods EID was performed in 16 patients at the University Hospitals Augsburg and Bochum. En bloc resection was achieved in all cases. In six patients, the resection site was closed using the Olympus SutuArt hand-suturing device (Olympus, Tokyo, Japan) Results All lesions were resected en bloc without major complications. Histopathology confirmed low-grade adenocarcinomas with deep submucosal invasion, low tumor budding, and no lymphovascular invasion in six cases, and superficial submucosal invasion without high-risk histologic features in one case. One pretreated adenocarcinoma showed low-grade T1 morphology with intermediate tumor budding and perineural invasion. One case was a poorly differentiated (G3) T2 carcinoma. Additional findings included tubular adenomas with high-grade dysplasia (n = 3), low-grade dysplasia (n = 2), one neuroendocrine tumor, and one vascular malformation. Fourteen resections had clear margins. In one deep submucosal invasive cancer (D-SMIC) case, an R1 deep margin was presumed due to specimen disruption. Subsequent transanal full-thickness resection showed no residual tumor. In one pretreated case, involvement of the deep resection margin resulted in an R1 classification. Conclusion This case series demonstrates that EID is a feasible and promising approach for managing rectal D-SMIC. Further data are needed to refine patient selection and strengthen its role as an organ-preserving alternative to radical surgery.

The EndoFLIP system is currently the only available impedance planimetry system, providing real-time, detailed information on the diameter, luminal area, distensibility, and compliance of the esophagogastric junction (EGJ), along with its 2D representation. EndoFLIP can support diagnosis and provide physiological feedback to potentially guide interventions for structural and functional gastroesophageal disorders. However, the lack of standardized usage protocols complicates the interpretation and comparability of results. This paper aims to establish a consensus on protocols to standardize the use of the EndoFLIP system in both diagnostic and intraoperative settings, so as to ensure consistent application across varied clinical and scientific settings. A multidisciplinary European Advisory Board (AB) comprising eight gastroenterologists and surgeons with extensive experience in EndoFLIP use undertook a structured international expert consensus process. Following a systematic literature review and a face-to-face expert meeting, candidate statements were developed and independently rated using an electronic survey. Consensus was predefined as ≥ 75

Background Metabolic bariatric surgery is the most effective obesity treatment, but high body mass index (BMI) and associated medical problems often pose surgical risks. Objectives This study compares the safety, feasibility, and efficacy of endoscopic sleeve gastroplasty (ESG) versus intragastric balloon (IGB) as bridge-to-surgery (BTS) procedures in patients with BMI ≥50 kg/m 2 and/or contraindications to primary metabolic bariatric surgery. Design A retrospective analysis (2017 – 2024) included patients with BMI ≥50 kg/m 2 undergoing ESG or IGB as a BTS procedure in a two-step approach at two German centers. Methods The primary outcome was total body weight loss (TBWL, %) at 6 months. Secondary outcomes included absolute weight loss, BMI reduction, excess body weight loss (EBWL, %), and adverse events between the two BTS procedures. Results Fourteen patients underwent ESG, 15 underwent IGB insertion as an intended BTS procedure. At 6 months, median %TBWL and %EBWL were significantly higher in the ESG group (17.8% (IQR, 14.5 – 22.1) vs. 8.99% (IQR, 4.6 – 14.0), p = 0.018; and 28.0% (IQR, 22.8 – 40.0) vs. 16.7% (IQR, 10.8 – 22.4), p = 0.035, respectively). IGB insertion was performed significantly faster (25 (IQR, 20.0 – 30.0) minutes (min) vs. 76 (IQR, 63.2 – 80.8) min; p < 0.01) but was associated with more mild-to-moderate adverse events (60.0% vs. 0%; p < 0.01). Conclusion In this retrospective cohort, ESG was associated with greater short-term weight loss and fewer mild-to-moderate adverse events than IGB as a BTS procedure for patients with BMI ≥50 kg/m 2 and/or contraindications to primary metabolic bariatric surgery (MBS).

BACKGROUND:In this trial, we previously showed per-oral endoscopic myotomy (POEM) to be non-inferior to laparoscopic Heller's myotomy (LHM) plus Dor fundoplication in managing symptoms in patients with idiopathic achalasia 2 years post-procedure. However, post-procedural gastro-oesophageal reflux was more common after POEM at 2 years. Here we report 5-year follow-up data. METHODS:This study is a multicentre, randomised, open-label, non-inferiority trial performed at eight centres in six European countries (Germany, Italy, Czech Republic, Sweden, the Netherlands, and Belgium). Patients with symptomatic primary achalasia were eligible for inclusion if they were older than 18 years and had an Eckardt symptom score higher than 3. Patients were randomly assigned (1:1; randomly permuted blocks of sizes 4, 8, or 12) to undergo either POEM or LHM plus Dor fundoplication. The primary endpoint was clinical success, defined by an Eckardt symptom score of 3 or less without the use of additional treatments, at 2 years, and was reported previously. Prespecified secondary endpoints at 5 years were clinical success; Eckardt symptom score; Gastrointestinal Quality of Life Index score; lower oesophageal sphincter function by high-resolution manometry; and parameters of post-procedural reflux (reflux oesophagitis according to the Los Angeles classification; pH-metry, and DeMeester clinical score). We hypothesised that POEM would be non-inferior (with a non-inferiority margin of -12·5 percentage points) to LHM plus Dor fundoplication with regards to clinical success. All analyses were performed on a modified intention-to-treat (mITT) population, which included all patients who underwent the assigned procedure. This study is registered with ClinicalTrials.gov (NCT01601678) and is complete. FINDINGS:Between Dec 7, 2012, and Oct 9, 2015, 241 patients were randomly assigned (120 to POEM and 121 to LHM) and 221 had the assigned treatment (112 POEM and 109 LHM; mITT). 5-year follow up data were available for 90 (80%) patients in the POEM group and 87 (80%) patients in the LHM group. Clinical success rate at 5 years was 75·0% (95% CI 66·2 to 82·1) after POEM and 70·8% (61·7 to 78·5) after LHM (difference 4·2 percentage points [95% CI -7·4 to 15·7]). The mean Eckardt symptom score decreased from baseline to 5 years in both groups and the overall difference in mean scores was -0·29 (95% CI -0·62 to 0·05). Change in Gastrointestinal Quality of Life Index scores, as well as in integrated relaxation pressure on manometry, from baseline to 5 years, did not differ significantly between the groups. At 5 years, 26 (41%) of 63 patients after POEM and 18 (31%) of 58 patients after LHM had reflux oesophagitis (difference 10·2 percentage points [95% CI -7·0 to 26·8]). Significant oesophagitis (Los Angeles classification grade B, C, or D) was observed in nine (14%) of 63 patients after POEM and in four (7%) of 58 patients after LHM. pH-metry was performed in 81 (37%) of 221 patients, with higher mean acid exposure time for POEM (10·2% [95% CI 7·6 to 14·2]) than for LHM (5·5% [3·1 to 11·8]). Significantly more patients in the POEM than in the LHM group had abnormal acid exposure time at 5 years (>4·5%; 28 [62%] of 45 vs 11 [31%] of 36; difference 31·7 percentage points [95% CI 9·8 to 50·5]). The presence of reflux symptoms at 5 years was similar in both groups, with a mean DeMeester clinical score of 1·3 (95% CI 1·0 to 1·6) after POEM and 1·1 (0·9 to 1·4) after LHM. The complications of peptic stricture, Barrett's oesophagus, and oesophageal adenocarcinoma were not reported. INTERPRETATION:Our long-term results support the role of POEM as a less invasive myotomy approach that is non-inferior to LHM in controlling symptoms of achalasia. Gastro-oesophageal reflux was common in both groups, but with a tendency towards higher rates in the POEM group. Thus, patients should be provided with the advantages and disadvantages of each approach in decision making. FUNDING:European Clinical Research Infrastructure Network, Hamburgische Stiftung für Wissenschaften, Entwicklung und Kultur Helmut und Hannelore Greve, Dr med Carl-August Skröder Stiftung, Dr Gerhard Büchtemann Stiftung, Agnes-Graefe Stiftung, Georg und Jürgen Rickertsen Stiftung, Reinhard Frank Stiftung, Johann Max Böttcher Stiftung, Richard und Annemarie Wolf Stiftung, Olympus Europa, German Society for Gastroenterology and Metabolism and Olympus Europe Foundation, United European Gastroenterology Week, Olympus EuroNOTES Research Fund Program, Harvard Catalyst, the Harvard Clinical and Translational Science Center, and Harvard University and its affiliated academic health-care centres.

Background:While artificial intelligence (AI) shows high potential in decision support for diagnostic gastrointestinal endoscopy, its role in therapeutic endoscopy remains unclear. Third-space endoscopic procedures pose the risk of intraprocedural bleeding. Therefore, we aimed to develop an AI algorithm for intraprocedural blood vessel detection. Methods:Using a test dataset of 101 standardized video clips containing 200 predefined submucosal blood vessels, 19 endoscopists were evaluated for vessel detection rate (VDR) and time (VDT) with and without support of an AI algorithm. Endoscopists were grouped according to experience in endoscopic submucosal dissection. Results:With AI support, endoscopist VDR increased from 56.4% (95%CI CI 54.1–58.6) to 72.4% (95%CI CI 70.3–74.4). Endoscopist VDT dropped from 6.7 seconds (95%CI 6.2–7.1) to 5.2 seconds (95%CI 4.8–5.7). False-positive readings appeared in 4.5% of frames and were marked for a significantly shorter time than true positives (0.7 seconds [95%CI 0.55–0.87] vs. 6.0 seconds [95%CI 5.28–6.70]). Conclusions:AI improved the VDR and VDT of endoscopists during third-space endoscopy. While these data need to be corroborated by clinical trials, AI may prove to be an invaluable tool for improving safety and speed of endoscopic interventions.

In den letzten Jahren haben sich die endoskopischen Resektionstechniken, insbesondere im Bereich der interventionellen Endoskopie, erheblich weiterentwickelt, so dass sich die Grenzen minimalinvasiver Therapien von der zuvor primär chirurgischen Therapie deutlich verschoben haben. Damit einher gehen eine signifikante Erweiterung der minimalinvasiven Interventionsmöglichkeiten, eine Verbesserung der Resektionsergebnisse, die Optimierung der endoskopischen Zugangswege und Instrumentenführung sowie die Verkürzung der Lernkurve durch standardisierte Techniken und Assistenzsysteme. Klinisch relevant sind v. a. organerhaltende Therapieoptionen mit onkologischer Sicherheit, die zu einer Reduktion von Morbidität und Mortalität, einer Verkürzung der Hospitalisationsdauer sowie einer schnelleren postinterventionellen Rekonvaleszenz beitragen. Bei sorgfältiger Patientenselektion können diese Verfahren zudem die Lebensqualität verbessern und potenziell die Kosteneffizienz im Gesundheitswesen erhöhen. Gleichzeitig bestehen nach wie vor bedeutende Herausforderungen. Die teilweise ausgeprägte Lernkurve komplexer endoskopischer Resektionstechniken, das Management prozedurbedingter Komplikationen wie Perforationen oder Blutungen sowie die Sicherstellung onkologisch adäquater Resektionsränder erfordern fundierte Expertise, strukturierte Trainingsprogramme und eine enge interdisziplinäre Zusammenarbeit mit der Chirurgie. Dies unterstreicht die Notwendigkeit eines kontinuierlichen interdisziplinären Dialogs. Die Implementierung interdisziplinärer Boards, gemeinsamer Trainingscurricula sowie klar definierter Kompetenzprofile stellt einen zentralen Baustein einer qualitativ hochwertigen Patientenversorgung dar.