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Forschung: Upper GI (Oberer Gastrointestinaltrakt)

Im Fokus der wissenschaftlichen Arbeit der Arbeitsgruppe Upper GI (oberer Gastrointestinaltrakt) an der Klinik für Allgemein- und Viszeralchirurgie steht insbesondere das in den letzten Jahrzenten sprunghaft in seiner Inzidenz zunehmende Adenokarzinom des Ösophagus und des gastroösophagealen Übergangs.

Die chirurgische Behandlung stellt hier die zentrale Therapiemodalität dar. Durch die Anwendung multimodaler Therapieprotokolle konnte in den letzten Jahren eine deutliche Prognoseverbesserung für Patienten mit einem Adenokarzinom des Ösophagus und des gastroösophagealen Übergangs erzielt werden. In unserer Klinik werden die verschiedenen multimodalen Therapieprotokolle nicht nur angewandt, sondern auch wissenschaftlich evaluiert. Wir arbeiten dazu überwiegend klinisch, führen also eigene wie fremde randomisiert-kontrollierte Studien durch, erstellen Systematic Reviews und Metaanalysen.

Auszug Publikationen:

Postoperative Hiatal Hernia after Ivor Lewis Esophagectomy—A Growing Problem in the Age of Minimally Invasive Surgery

Kuvendjiska J, Jasinski R, Hipp J,Fink M, Fichtner-Feigl S, Diener M, Hoeppner  J. J Clin Med 2023, 12, 5724. https://doi.org/10.3390/jcm12175724

Pathological complete response in multimodal treatment of esophageal cancer: a retrospective cohort study.

Hipp J, Kuvendjiska J, Hillebrecht HC, Timme-Bronsert S, Fichtner-Feigl S, Hoeppner J, Diener MK. Dis Esophagus. 2022 Dec 27:doac095. doi: 10.1093/dote/doac095. Epub ahead of print. PMID: 36572398.

Systematic review and meta-analysis comparing proximal gastrectomy with double-tract-reconstruction and total gastrectomy in gastric and gastroesophageal junction cancer patients: Still no sufficient evidence for clinical decision-making

Hipp J, Hillebrecht HC, Kalkum E, Klotz R, Kuvendjiska J, Martini V, Fichtner-Feigl S, Diener MK. Surgery. 2022 Dec 19:S0039-6060(22)00990-4. doi: 10.1016/j.surg.2022.11.018. Epub ahead of print. PMID: 36543733.

Komplettresponse nach neoadjuvanter Therapie beim Ösophaguskarzinom : Implikationen für die Chirurgie

Hipp J, Thomaschewski M, Hummel R, Hoeppner J. Komplettresponse nach neoadjuvanter Therapie beim Ösophaguskarzinom.Chirurg 2022 · 93:132–137; https://doi.org/10.1007/s00104-021-01509-3; PMID: 34596707

Study Protocol of a Prospective Multicenter Study on Patient Participation for the Clinical Trial: Surgery as Needed Versus Surgery on Principle in Post-Neoadjuvant Complete Tumor Response of Esophageal Cancer (ESORES)

Weis J, Kiemen A, Schmoor C, Hipp J, Czornik M, Reeh M, Grimminger PP, Bruns C and Hoeppner J Front. Oncol 2022. 11:789155. doi: 10.3389/fonc.2021.789155

Postneoadjuvant surveillance and surgery as needed compared with postneoadjuvant surgery on principle in multimodal treatment for oesophageal cancer: a scoping review protocol

Schmucker C, Nagavci B, Hipp J, Schmoor C, Meerpohl J, Hoeppner J. BMJ Open. 2021 Jan 28;11(1):e044190. doi: 10.1136/bmjopen-2020-044190.

Post-Neoadjuvant Surveillance and Surgery as Needed Compared with Post-Neoadjuvant Surgery on Principle in Multimodal Treatment for Esophageal Cancer: A Scoping Review.

Hipp J, Nagavci B, Schmoor C, Meerpohl J, Hoeppner J, Schmucker C. Cancers (Basel). 2021 Jan 23;13(3):429. doi: 10.3390/cancers13030429. PMID: 33561090; PMCID: PMC7865772.

Hybrid Minimally Invasive Esophagectomy-Surgical Technique and Results.

Kuvendjiska J, Marjanovic G, Glatz T, Kulemann B, Hoeppner J. J Clin Med. 2019 Jul 5;8(7). pii: E978. doi: 10.3390/jcm8070978. PubMed PMID: 31284370; PubMed Central PMCID: PMC6678699. 491.

Non-Metastatic Esophageal Adenocarcinoma: Circulating Tumor Cells in the Course of Multimodal Tumor Treatment.

Kuvendjiska J, Bronsert P, Martini V, Lang S, Pitman MB, Hoeppner J, Kulemann B. Cancers (Basel). 2019 Mar 21;11(3). pii: E397. doi: 10.3390/cancers11030397. PubMed PMID: 30901891; PubMed Central PMCID: PMC6468610.

Oxaliplatin in perioperative chemotherapy for gastric and gastroesophageal junction (GEJ) adenocarcinoma

Fritsch R, Hoeppner J. Expert Rev Gastroenterol Hepatol. 2019 Apr;13(4):285-291. doi: 10.1080/17474124.2019.1573143. Epub 2019 Feb 4. Review. PubMed PMID: 30791774.

Treatment of a broncho-esophageal fistula complicated by severe ARDS

Tautz E, Wagner D, Wiesemann S, Jonaszik A, Bode C, Wengenmayer T, Staudacher D, Biever P, Hoeppner J, Duerschmied D. Infection. 2019 Jun;47(3):483-487. doi: 10.1007/s15010-018-1247-9. Epub 2018 Nov 11. PubMed PMID: 30417214.

Early esophageal cancer: the significance of surgery, endoscopy, and chemoradiation

Mönig S, Chevallay M, Niclauss N, Zilli T, Fang W, Bansal A, Hoeppner J.  Ann N Y Acad Sci. 2018 Dec;1434(1):115-123. doi: 10.1111/nyas.13955. Epub 2018 Aug 23. Review. PubMed PMID: 30138532.

Prävention und operative Therapie des Chylothorax

Glatz T, Marjanovic G, Hoeppner J. Zentralbl Chir. 2018 Jun;143(3):278-283. doi: 10.1055/a-0608-5082. Epub 2018 Jun 22. German. PubMed PMID: 29933480.

Chirurgische Strategie in der multimodalen Behandlung des Magen- und Ösophaguskarzinoms

Hoeppner J. Chirurg. 2017 Dec;88(12):1005-1009. doi: 10.1007/s00104-017-0545-6. Review. German. PubMed PMID: 29110040.

Pedicled and free flaps for intrathoracic fistula management.

Fricke A, Bannasch H, Klein HF, Wiesemann S, Samson-Himmelstjerna P, Passlick B, Beyersdorf F, Hoeppner J, Penna V, Eisenhardt SU, Stark BG, Koulaxouzidis G. Eur J Cardiothorac Surg. 2017 Dec 1;52(6):1211-1217. doi: 10.1093/ejcts/ezx216. PubMed PMID: 29106507.

Das Adenokarzinom des Ösophagus – Bestandsaufnahme einer drastisch zunehmenden Erkrankung

Hoeppner J, Glatz T, Claus R, Fischer A, Kraywinkel K, Brunner T. Dtsch Med Wochenschr. 2017 Sep;142(19):1453-1460. doi: 10.1055/s-0043-115777. Epub 2017 Sep 22. German. PubMed PMID: 28938509.

Is There a Rationale for Structural Quality Assurance in Esophageal Surgery?

Glatz T, Höppner J. Visc Med. 2017 May;33(2):135-139. doi: 10.1159/000458454. Epub 2017 Mar 24. Review. PubMed PMID: 28560229; PubMed Central PMCID: PMC5447175.

Postoperative fluid overload is a risk factor for adverse surgical outcome in patients undergoing esophagectomy for esophageal cancer: a retrospective study in 335 patients

Glatz T, Kulemann B, Marjanovic G, Bregenzer S, Makowiec F, Hoeppner J.  BMC Surg. 2017 Jan 13;17(1):6. doi: 10.1186/s12893-016-0203-9. PubMed PMID: 28086855; PubMed Central PMCID: PMC5237209.

Management and outcome of esophageal stenting for spontaneous esophageal perforations

Glatz T, Marjanovic G, Kulemann B, Hipp J, Theodor Hopt U, Fischer A, Richter-Schrag HJ, Hoeppner J. Dis Esophagus. 2017 Feb 1;30(3):1-6. doi: 10.1111/dote.12461. PubMed PMID: 27790804.

Radiofrequency ablation is a treatment option for early stages of verrucous esophageal carcinoma.

Knoop RF, Richter-Schrag HJ, Heeg S, Hoeppner J, Fischer A. VideoGIE. 2016 Oct 8;1(4):78-81. doi: 10.1016/j.vgie.2016.09.008. eCollection 2016 Dec. PubMed PMID: 29905227; PubMed Central PMCID: PMC5990324.

ESOPEC: prospective randomized controlled multicenter phase III trial comparing perioperative chemotherapy (FLOT protocol) to neoadjuvant chemoradiation (CROSS protocol) in patients with adenocarcinoma of the esophagus (NCT02509286)

Hoeppner J, Lordick F, Brunner T, Glatz T, Bronsert P, Röthling N, Schmoor C, Lorenz D, Ell C, Hopt UT, Siewert JR. BMC Cancer. 2016 Jul 19;16:503. doi: 10.1186/s12885-016-2564-y. PubMed PMID: 27435280; PubMed Central PMCID: PMC4952147.

Esophagogastric Bypass in Motion

Marjanovic G, Hoeppner J. N Engl J Med. 2016 Apr 21;374(16):e20. doi: 10.1056/NEJMicm1509754. PubMed PMID: 27096599.

Vacuum sponge therapy using the pull-through technique via a percutaneous endoscopic gastrostomy to treat iatrogenic duodenal perforation

Glatz T, Fischer A, Hoeppner J, Thimme R, Walker C, Richter-Schrag HJ. Endoscopy. 2015;47 Suppl 1:E567-8. doi: 10.1055/s-0034-1393369. Epub 2015 Nov 26. PubMed PMID: 26610087.

Perioperative platin-based chemotherapy for locally advanced esophagogastric adenocarcinoma: Postoperative chemotherapy has a substantial impact on outcome

Glatz T, Bronsert P, Schäfer M, Kulemann B, Marjanovic G, Sick O, Hopt UT, Zirlik K, Makowiec F, Hoeppner J.  Eur J Surg Oncol. 2015 Oct;41(10):1300-7. doi: 10.1016/j.ejso.2015.07.010. Epub 2015 Jul 29. PubMed PMID: 26253194.

Glatz T, Marjanovic G, Zirlik K, Brunner T, Hopt UT, Makowiec F, Hoeppner J.[Surgical treatment of esophageal cancer : Evolution of management and  prognosis over the last 3 decades]. Chirurg 2014 Oct 15. [Epub ahead  of print] German. PubMed PMID: 25312491.

Feuchtinger A, Stiehler T, Jütting U, Marjanovic G, Luber B, Langer R, WalchA. Image analysis of immunohistochemistry is superior to visual  scoring as shown for patient outcome of esophageal adenocarcinoma.  Histochem Cell Biol. 2014 Aug 26. [Epub ahead of print] PubMed PMID:  25156293.

Hoeppner J, Marjanovic G, Glatz T, Kulemann B, Hopt UT. [Hybrid laparoscopicthoracotomic esophagectomy with intrathoracic esophagogastric anastomosis].Chirurg. 2014 Jul;85(7):628-35. doi: 10.1007/s00104-014-2783-1. German. PubMedPMID: 25000930

Hoeppner J, Kulemann B, Hopt UT, Marjanovic G. [Laparoscopic total gastrectomywith extended lymphadenectomy and intracorporal circular stapledesophagojejunostomy]. Zentralbl Chir. 2014 Feb;139(1):17-9. doi:10.1055/s-0033-1360122. Epub 2014 Feb 28. German. PubMed PMID: 24585190.

Hoeppner J. [Upper GI Cancer in the 21st Century: Rise of Endoscopic,Minimally Invasive and Multimodal Therapeutic Strategies]. Zentralbl Chir. 2014 Feb;139(1):22. doi: 10.1055/s-0033-1360341. Epub 2014 Feb 28. German. PubMed PMID: 24585192.

Hoeppner J, Kulemann B, Seifert G, Marjanovic G, Fischer A, Hopt UT, Richter-Schrag HJ. Covered self-expanding stent treatment for anastomotic leakage: outcomes in esophagogastric and esophagojejunal anastomoses. Surg Endosc. 2014 Jan 1. [Epub ahead of print] PubMed PMID: 24380994.

Hoeppner J, Zirlik K, Brunner T, Bronsert P, Kulemann B, Sick O, Marjanovic G, Hopt UT, Makowiec F. Multimodal treatment of locally advanced esophageal adenocarcinoma: which regimen should we choose? Outcome analysis of perioperative chemotherapy versus neoadjuvant chemoradiation in 105 patients. J Surg Oncol. 2014 Mar;109(3):287-93. doi: 10.1002/jso.23498. Epub 2013 Nov 26. PubMed PMID:24277235

Hoeppner J, Hopt UT. Transabdominal mass ligation of the thoracic duct for the prevention of chylothorax following en bloc oesophagectomy. Eur J Cardiothorac Surg. 2013 Dec;44(6):1134-6. doi: 10.1093/ejcts/ezt287. Epub 2013 May 24. PubMed  PMID 23708695

Makowiec F, Baier P, Kulemann B, Marjanovic G, Bronsert P, Zirlik K, Henke M,Hopt UT, Hoeppner J. Improved long-term survival after esophagectomy for esophageal cancer: influence of epidemiologic shift and neoadjuvant therapy. J Gastrointest Surg. 2013 Jul;17(7):1193-201. doi: 10.1007/s11605-013-2212-7. Epub  2013 May 2. PubMed PMID: 23636882

Kulemann B, Fischer A, Hoeppner J. Esophageal stenosis caused by a rare entity. Gastroenterology. 2014 Mar;146(3):618-871. doi: 10.1053/j.gastro.2013.10.006. Epub 2014 Jan 23. PubMed PMID: 24462408.

Braun A, Richter-Schrag HJ, Fischer A, Hoeppner J. Minimally invasive therapy of perforations at the esophagogastric junction by over-the-scope clipping. Endoscopy. 2013;45 Suppl 2 UCTN:E133-4. doi: 10.1055/s-0032-1326449. Epub 2013 May 28. PubMed PMID: 23716097.

Marjanovic G, Schricker M, Walch A, zur Hausen A, Hopt UT, Imdahl A, Makowiec F. Detection of lymph node involvement by cytokeratin immunohistochemistry is an  independent prognostic factor after curative resection of esophageal cancer. J Gastrointest Surg. 2011 Jan;15(1):29-37.

Imdahl A, Hentschel M, Kleimaier M, Hopt UT, Brink I. Impact of FDG-PET for staging of oesophageal cancer. Langenbecks Arch Surg. 2004 Aug;389(4):283-8. Epub 2004 Jun 9. PubMed PMID: 15197549.

Imdahl A, Schoeffel U, Ruf G, Hopf UT. [Preoperative chemoradiation in esophageal cancer: experience of a single center in 102 patients]. Zentralbl Chir. 2004 Oct;129(5):350-5. German. PubMed PMID: 15486784.

Brink I, Hentschel M, Bley TA, Walch A, Mix M, Kleimaier M, Moser E, Imdahl A. Effects of neoadjuvant radio-chemotherapy on 18F-FDG-PET in esophageal carcinoma. Eur J Surg Oncol. 2004 Jun;30(5):544-50. PubMed PMID: 15135484.

Imdahl A, Schoeffel U, Ruf G. Impact of neoadjuvant therapy of perioperative morbidity in patients with esophageal cancer. Am J Surg. 2004 Jan;187(1):64-8. PubMed PMID:14706588.

Imdahl A, Bognar G, Schulte-Muenting J, Schoeffel U, Farthmann EH, Ihling C. Predictive factors for response to neoadjuvant therapy in patients with oesophageal cancer. Eur J Cardiothorac Surg. 2002 Apr;21(4):657-63. PubMed PMID:  11932164.

Team

Prof. Dr. med. Markus Diener
Dr. Christian Hillebrecht
Dr. Julian Hipp
Dr. Jasmina Kuvendjiska
Verena Martini