The Ca Voi Xanh (CVX) gas field is located offshore Vietnam along the eastern margin of the southern Song Hong Basin. Reservoir rocks are carbonates of Middle Miocene (Langhian and Serravallian) age which developed on an isolated platform (length approximately 100 km, and width approximately 15 km) on top of the Triton Horst structural high. Shallow‐water corals and large and small benthic foraminifera are the main faunal constituents of the Langhian carbonates, whereas overlying Serravallian carbonates, the principal reservoir at CVX, are dominated by deeper‐water coralline red algae (rhodoliths) and large benthic foraminifera (LBF). The Serravallian carbonates consist of rhodolith‐LBF grainstones and packstones to mud‐lean packstones. Langhian carbonates consist of coral‐LBF grainstones‐packstone/rudstones.This paper documents the workflow used to develop an integrated sequence‐stratigraphic and reservoir rock‐type framework for the Ca Voi Xanh reservoir, and the impact of this work on reservoir quality prediction and modelling. Sequence stratigraphic interpretations of the Serravallian carbonates are based on data from three wells including detailed sedimentological core descriptions tied to well‐log character. The carbonate succession consists of three third‐order depositional sequences (Ser1, Ser2 and Ser3). Two well‐developed exposure surfaces can be identified: the base‐Serravallian sequence boundary (Ser1 SB), and the base‐Tortonian sequence boundary (Tor1 SB). The Serravallian shows an overall shallowing‐upward trend from carbonates with more horizontally‐oriented coralline red algae (encrusted and bored pavements/hardgrounds) in the lower part of the section, to carbonates with large, roundish irregular rhodoliths towards the upper part. Petrographic thin section, stable isotope (oxygen and carbon), and fluid inclusion analyses confirm a freshwater (vadose and phreatic) diagenetic overprint of the carbonates below the exposure surfaces (sequence boundaries).Partial dolomitization of the Serravallian carbonates was observed at Wells‐2 and ‐3 in the CaVoi Xanh field. Dolomite formation could be related to hydrodynamic fluid interactions associated with the development of a freshwater lense during the top‐Serravallian sea‐level fall (Tor1 SB), favoring dolomitization by sea water during the subsequent sea‐level rise. Alternatively, dolomitization could be related to CO2 and hydrocarbon charging, causing secondary leaching of the Mg‐rich coralline red algae and large benthic foraminifera, leading to an enrichment of the water with Mg‐ions and thus favoring downward dolomitization.A reservoir rock type (RRT) scheme was developed for the Langhian and Serravallian carbonates at the Ca Voi Xanh field based on a combination of depositional environment interpretations together with diagenetic characteristics and reservoir parameters (porosity and permeability).The Langhian is characterized by two RRTs depending on the degree of cementation (RRT‐3L) and dissolution (RRT‐5L). Serravallian RRTs are separated into dominantly packstone (RRT‐1) and dominantly grainstone textures (RRTs‐2, ‐3, ‐5 and ‐6). RRTs with grainstone texture show varying degrees of cementation (RRTs‐2 and ‐3) and dissolution (RRTs‐5 and ‐6). Early diagenetic dolomitization (RRT‐4) preferentially affects packstones (RRT‐1) but also grainstones (RRT‐2, ‐3 and‐5).The geologic (static) model consists of both matrix and non‐matrix components. Sequence stratigraphic concepts in combination with seismically‐derived palaeo‐reconstructions were used to guide the vertical and lateral distribution of reservoir rock types, which comprise the matrix component of the geological model. Different karst geometries and features consistent with known hydrogeologic processes were identified in the seismic discontinuity (variance) cube, and were used to interpret karst regions with different degrees (and/or types) of karst/fractures. These karst regions were used to populate the non‐matrix component of the geologic model along the Ser1 and Tor1 sequence boundaries.

Zusammenfassung Hintergrund Vor 2 Jahrzehnten wurde die Single-Incision-Chirurgie als neues Konzept in der minimalinvasiven Chirurgie etabliert. Die Cholezystektomie ist die am häufigsten durchgeführte Prozedur in dieser Technik. Die meisten Erkenntnisse beruhen auf randomisierten Studien. Es existieren keine groß angelegten multizentrischen Datenanalysen aus der klinischen Routine. Diese Analyse der klinischen Versorgungsforschung basiert auf der SILAP-Studie („single-incision multiport/single port laparoscopic abdominal surgery“). Patienten und Methode Die vorliegende Registerauswertung basiert auf Daten von 47 Kliniken im Zeitraum 2012 bis 2014. Die primären Endpunkte waren Gesamtmorbidität/Letalität. Multiple lineare und logistische Regressionsanalysen wurden durchgeführt. Die statistische Signifikanz war angegeben mit p < 0,05. Ergebnisse In der SILAP-Studie wurden die Daten von 975 Patienten mit Single Incision laparoscopic Cholecystectomy (SILC) in der klinischen Routine in einem Register erfasst. Die intraoperativen Komplikationen betrugen 3,2%. Die Rate der Gallengangverletzungen lag bei 0,1%. Postoperative Komplikationen traten in 3,7% der Fälle auf. Die Letalität war bei 0,2%. Die Operationszeit (Median) fiel im Studienverlauf von 60,0 auf 51,5 min (p = 0,001). Ein Zusatztrokar war in 10,3% der Fälle erforderlich. Die Konversionsrate zur konventionellen Cholezystektomie betrug 0,7%. In der multivariaten Analyse zeigten der Body-Mass-Index (p = 0,024), das männliche Geschlecht (p = 0,012) und die Operationszeit (p < 0,001) einen signifikanten Einfluss auf die intraoperativen Komplikationen. Patienten der ASA-Gruppe III (p = 0,001) und Patienten mit Zusatztrokaren oder der Konversion zur offenen Operation (p = 0,001) wurden als signifikante Faktoren bei den postoperativen Komplikationen ermittelt. Schlussfolgerung Die Registeranalyse dieser prospektiv multizentrisch erhobenen Daten zeigen, dass auch außerhalb der Selektionskriterien von randomisierten Studien die SILC in der klinischen Routine sicher durchführbar ist. Einzige Einschränkung ist ein BMI > 30 kg/m2, der einen signifikanten Einfluss auf die intraoperative Rate von Minorkomplikationen hatte.

Das Problem der Unter- und Mangelernährung rückt immer mehr in der Fokus der operativen Disziplin. Jeder 4. Patient ist bei Aufnahme ins Krankenhaus mangelernährt. In der chirurgischen Therapie ist die Vermeidung postoperativer Komplikationen von größter Bedeutung und ist wichtig für die chirurgische Qualität. Aufgrund eines präoperativen Zustands der Mangelernährung kann die Komplikationsrate steigen und damit auch die verbundenen erhöhten Behandlungs-Therapie-Kosten pro Patient. Die Folge ist natürlich auch eine geminderte postoperative Behandlungsqualität der behandelnden Klinik.

Einleitung/Ziele: Adenokarzinome des ösophagogastralen Übergangs (AEG) stellen eine eigene Tumorentität dar. Daten der Versorgungsforschung vergleichen perioperative Ergebnisse & das Langzeitüberleben von Zeiträumen mit chirurgischer Dominanz vs. nach Etablierung neoadjuvanter Verfahren.

Im Rahmen der Datenerhebung der prospektiv-multizentrischen Beobachtungsstudie zur operativen Therapie des Magenkarzinoms „Ostdeutsche Magenkarzinomstudie 2002 (EGGCS)“ wurde die Situation der chirurgischen Palliation beim Magenkarzinom im Erfassungszeitraum 01.01. bis 31.12.2002 analysiert.

an aggressive tumor due to higher incidence of lymphovascular and serosal invasion which are responsible for poor prognosis.Aggressive approach with radical surgical resection is recommended in the absence of distant metastasis.Surgery followed by combined adjuvant chemoradiation is recommended despite the absence of adequate data to support this strategy.

UNLABELLED Exact pretherapeutic staging is considered to be essential for decision-making in the therapeutic algorithm of gastric cancer. THE AIM OF THE STUDY was to characterize the role and value of EUS in the diagnostic and therapeutic management of gastric cancer in daily surgical practice. MATERIAL AND METHODS Thousand one hundred thirty nine patients with primary gastric cancer from 80 hospitals of each profile of care were enrolled in this systematic clinical prospective multicenter observational study over a time period of 12 months. The characteristics of the diagnostic management, in particular, of EUS were documented. The preoperative EUS findings were compared with the T stage (T1 to T4) and the N category (N+ or N-) revealed by the histopathologic investigation of the surgical specimen. By the mean of χ² test, the impact of EUS on the therapeutic decision-making was determined. RESULTS Pretherapeutic EUS was only performed in 27.4% (n=312) of all patients. Overall, the diagnostic accuracy for the T stage was 42.6% in average. The subgroup analysis showed the following results: T1, 31.5%; T2, 42.6%; T3, 65.2%; T4, 17.6%. The correct predictive value of the N category was 71.3% reaching a sensitivity of 69.7% and a specificity of 73.3%. Overstaging was observed in 45.8%, understaging in only 10.8%. Additional diagnostic information by EUS was only provided in 4.7% of subjects. CONCLUSIONS The present study indicates the variability, limited reliability and only moderate acceptance of EUS in diagnosing gastric cancer in daily practice. In particular, the prediction of the T stage does not reach the data reported in the literature, which were mostly achieved in specific EUS studies.

Gastric stump carcinoma after gastric surgery for benign disease is now widely recognized as a distinct clinical entity. An electronic literature search was performed in the MEDLINE database to identify relevant studies concerning epidemiology, prognosis, treatment, aetiology and pathology of gastric stump carcinoma. The references reported in these studies were used to complete the literature search. It can be assumed that approximately 10 % of patients who had undergone a distal gastric resection for benign disease will develop a carcinoma in the gastric remnant about 15 to 20 years after the primary procedure. The incidence is reported to be higher in males and following Billroth II resection. The site of tumour growth is predominantly in the anastomotic area, but may occur anywhere in the stump. Enterogastric reflux, achlorhydria, bacterial overgrowth, and genetic factors appear to be the major factors involved in the aetiopathogenesis of the gastric stump cancer. Unfortunately, a significant proportion of patients presents with synchronous metastases. Clinical symptoms are mainly attributed to locally advanced tumour growth. Surgical therapy comprises total removal of the gastric remnant and the jejunal segment including modified lymphadenectomy (D2 lymphadenectomy and jejunal mesentery). Surveillance of patients with endoscopy and multiple biopsies should be initiated from the tenth postoperative year and may provide the means to diagnose tumours at an early stage.

Gastric stump carcinoma after gastric surgery for benign disease is now widely recognized as a distinct clinical entity. An electronic literature search was performed in the MEDLINE database to identify relevant studies concerning epidemiology, prognosis, treatment, aetiology and pathology of gastric stump carcinoma. The references reported in these studies were used to complete the literature search. It can be assumed that approximately 10% of patients who had undergone a distal gastric resection for benign disease will develop a carcinoma in the gastric remnant about 15 to 20 years after the primary procedure. The incidence is reported to be higher in males and following Billroth II resection. The site of tumour growth is predominantly in the anastomotic area, but may occur anywhere in the stump. Enterogastric reflux, achlorhydria, bacterial overgrowth, and genetic factors appear to be the major factors involved in the aetiopathogenesis of the gastric stump cancer. Unfortunately, a significant proportion of patients presents with synchronous metastases. Clinical symptoms are mainly attributed to locally advanced tumour growth. Surgical therapy comprises total removal of the gastric remnant and the jejunal segment including modified lymphadenectomy (D2 lymphadenectomy and jejunal mesentery). Surveillance of patients with endoscopy and multiple biopsies should be initiated from the tenth postoperative year and may provide the means to diagnose tumours at an early stage.

Zur operativen Therapie des Magenkarzinoms besteht dringender Bedarf an sorgfältig aufgearbeiteten Langzeitergebnissen unselektionierter chirurgischer Patientenkollektive, wie sie die Nachsorgedaten der prospektiven Beobachtungsstudie zum Magenkarzinom aus dem Jahre 2002 liefern.

With constantly changing scientific knowledge and basic social conditions, interest in the qualitative results of therapeutic processes in everyday clinical use has increased over the last years. In view of the development of surgical treatment for gastric carcinoma in Germany, there are two prospective multicenter observational studies: the German Gastric Cancer Study (GGCS'92) and the quality assurance study of the East German study group for quality assurance and regional development in surgery from the year 2002 (EGGCS'02). Regarding study design, the two investigations are comparable. Altogether, the perioperative and early postoperative quality of treatment of stomach carcinoma increased in comparison to the GGCS '92 during the 12 years between the studies. Nevertheless, the oncological long-term results are still unsatisfactory, with an overall survival rate of approximately 40% after 5 years for the whole patient group. Over the last years, it has increasingly become apparent that with stomach carcinoma, multimodal therapy can provide a way to improve these results. These developments led to the initiation of a new quality assurance study for gastric carcinoma. With the reworking of the data collection procedures, special value was placed on information regarding concepts of multimodal therapy. With the support of the study by the leading hospital surgeons in January 2007, it was agreed that a high degree of data collection concerning treated stomach carcinomas all over the country should be possible.

The aim of the study was to investigate diagnostic, therapeutic & outcome measures of cardia Ca in daily surgical practice.

Die sich mit dem wissenschaftlichen Erkenntniszuwachs und den gesellschaftlichen Rahmenbedingungen ständig wandelnden Voraussetzungen für medizinische Behandlungsabläufe haben in den letzen Jahren das Interesse an der Ergebnisqualität dieser Prozesse unter klinischen Alltagsbedingungen verstärkt. Im Hinblick auf die Entwicklung der chirurgischen Therapie des Magenkarzinoms liegen in Deutschland zwei prospektive multizentrische Beobachtungsstudien vor, die Deutsche Magenkarzinomstudie (GGCS ’92) und die Qualitätssicherungsstudie der Ostdeutschen Arbeitsgruppe für Qualitätssicherung und regionale Entwicklung in der Chirurgie e.V. (EGGCS ’02). Aufgrund des Studiendesigns sind die beiden Untersuchungen gut vergleichbar. Insgesamt konnte im Vergleich mit der GGCS ‘92 eine Verbesserung der peri- und frühpostoperativen Behandlungsqualität des Magenkarzinoms in den zwischen den Studien liegenden 12 Jahren konstatiert werden. Die onkologischen Langzeitergebnisse sind jedoch für das gesamte Patientenkollektiv mit einer Fünfjahresüberlebenswahrscheinlichkeit von ca. 40% nach wie vor unbefriedigend. In den letzten Jahren hat sich zunehmend die Erkenntnis durchgesetzt, dass auch beim Magenkarzinom eine multimodale Therapie ein Weg zur Verbesserung dieser Resultate sein kann. Diese Entwicklungen waren der Anlass, die neue Qualitätssicherungsstudie für Magenkarzinome zu initiieren. Bei der Überarbeitung der Erfassungsbögen wurde besonderer Wert auf die gegenüber 2002 detaillierte Erfassung der multimodalen Therapiekonzepte gelegt. Mit Hilfe der im Januar 2007 beschlossenen Unterstützung der Studie durch den Konvent der leitenden Krankenhauschirurgen sollte ein hoher Erfassungsgrad der bundesweit behandelten Magenkarzinome möglich sein.

Einleitung: Der Anteil der Patienten mit einem neu diagnostizierten Magenkarzinom, die primär ein palliatives Therapiekonzept benötigen, liegt bei ca. 20%.