[Surgical information systems as instruments in quality assurance]. / OP-Informationssysteme als Instrumente zur Qualitätssicherung.

In various aspects, it is important to document medical procedures performed in surgical management. These records have become even more relevant because, in realizing the German health structure law, new forms of remuneration have been established, which are correlated with defined services. This means that data from medical documentation records today "rule" on financial compensation and, consequently, on the total economy of a hospital. Data are to be gathered considering multiple clinical and administrative requests; they have to register all pre-, intra- and postoperative details in their complex correlations; and, they are subject to strictly limited periods of compulsory availability. To meet these demands, data can only be recorded and evaluated by adequate computerized information systems. Starting out from a general data profile in response to questions from inside and outside of the hospitals, general criteria will be presented on what is to be recorded and how data are to be structured by surgery information systems. We will also refer to the interfaces required with information systems of other clinical departments that are part of the overall hospital information system. On this basis, guidelines are set up on how to plan, select, introduce and efficiently run these systems.

Relevance of DNA-fluorimetry and short-term resistance testing for adjuvant treatment of non-small cell lung carcinomas.

In a clinical study 127 patients with previously untreated stage III non-small cell lung carcinomas (NSCLC) were investigated using flow cytometry and an in vitro short-term test for predicting resistance to cytostatic agents. Patients with aneuploid tumors and tumors with high proliferative activity had significantly shorter survival times than those with diploid or low proliferating tumors. The aim of this study was to find out whether groups of patients classified according to the additionally observed prognostic factors, experience an advantage or disadvantage from particular modalities of treatment. Seventy-nine patients had surgery alone, 18 patients were treated additionally with chemotherapy, and 30 patients with radiation. Patients with aneuploid, low proliferating and in vitro resistant tumors showed no different survival rates after treatment with chemo- and radiotherapy adjuvant to surgery. In contrast, patients with high proliferating tumors died earlier under adjuvant chemotherapy and radiation. Patients with in vitro chemosensitive tumors had shorter survival times after irradiation than patients who had surgery alone or who were treated with adjuvant chemotherapy.