[Setting up an interdisciplinary cancer center between the poles of internal and external interests]. / Etablierung eines interdisziplinären Krebszentrums im Spannungsfeld interner und externer Interessen.

Excellence in oncology requires specialized centers covering a broad spectrum of oncological competence and technology. Such Comprehensive Cancer Centers, which in most cases are affiliated with a university, are well established in many countries, particularly North America. But despite their advantages, only few of these interdisciplinary cancer centers have so far been set up in Germany. The establishment of a Comprehensive Cancer Center covering patient care, cancer research as well as education and training in Germany will be discussed using the example of the Dresden University Cancer Center. Consideration will be given to the interests of the different groups involved and to critical success factors such as its mission, interdisciplinary leadership structures, interfaces, responsibilities and quality management.

Laparoscopic or open conventional cholecystectomy: clinical and economic considerations.

OBJECTIVE: To compare clinical aspects and financial costs of open conventional and laparoscopic cholecystectomy. DESIGN: Retrospective analysis of hospital records of patients who were operated on electively for symptomatic gallstone disease. SETTING: University clinic, Germany. SUBJECTS: 153 consecutive patients who had open conventional (1991-92) and 222 who had laparoscopic cholecystectomy (1993-96). A total of 251 cholecystectomies were done during 1991-92 and 523 cholecystectomies during 1993-96. INTERVENTION: Cholecystectomy. MAIN OUTCOME MEASURES: Clinical aspects: operating time, complications, postoperative stay; financial aspects: total cost of hospital stay after cholecystectomy. RESULTS: When open conventional was compared with laparoscopic cholecystectomy: operating time was 66 and 92 minutes; complications, 9 and 6 cases; postoperative stay, 8 and 3 days; and total cost of hospital stay, US $ 3434 and US $ 2808 respectively. CONCLUSION: The cost of laparoscopic cholecystectomy was 18% less than for open conventional cholecystectomy, principally because of the shorter postoperative stay.