The increasing centralisation of complex oncological procedures and the established relationship between surgical experience and patient outcomes necessitate new approaches in surgical training. The ACO curriculum provides a structured program that systematically integrates surgical expertise, interdisciplinary collaboration, and continuous professional development. Qualification requires defined clinical experience, theoretical knowledge, and successful completion of a standardised European examination. Upon completion, participants are awarded a certificate that is recognised within the certification processes of oncological centres. The curriculum thus represents a robust framework for quality-assured specialisation in surgical oncology.

Complex abdominal wall defects lead to significant morbidity and require interdisciplinary therapeutic approaches. Plastic surgical techniques and the evolvement of microsurgery can provide a reliable means of reconstruction. For large defects involving the M. rectus abdominis, the free functional M. latissimus dorsi flap serves as a workhorse. Through microsurgical tissue transplantation, the abdominal wall can be functionally reinforced and reinnervated, while also covering the associated soft tissue defect.This study presents an interdisciplinary approach to complex abdominal wall reconstruction using a case example.Particularly as a chimeric flap, in combination with the scapular/parascapular flap, even exceptionally large defects can be reconstructed safely. By utilising a common vascular pedicle, these flaps can be transferred together via the subscapular vessel axis. The coaptation of the thoracodorsal nerve, which innervates the latissimus dorsi muscle, with a motor nerve branch leading to the rectus abdominis muscle enables functional muscular stabilisation of the abdominal wall following reinnervation.To achieve the best possible outcome and reduce hospitalisation, the early integration of plastic surgery into interdisciplinary treatment concept is essential.

In recent years, we have witnessed remarkable progress in organ donation and the preservation of donor lungs. Several transformative innovations have been particularly influential:1. Normothermic ex vivo lung perfusion (EVLP): EVLP is a groundbreaking advancement in lung transplantation. This technology not only enables expansion of the donor pool by reconditioning marginal lungs, but also improves transplantation outcomes, through optimised assessment and therapeutic intervention prior to implantation. Lungs considered high-risk or initially unsuitable for transplantation can be evaluated and, in many cases, rehabilitated using EVLP, resulting in post-transplant outcomes comparable to those of conventionally selected lungs. With ongoing technological advancements and increasing clinical acceptance, EVLP could soon become the standard of care in lung transplantation.2. Donation after circulatory death (DCD): DCD has emerged as an essential strategy to address the shortage of transplantable lungs. Despite logistical challenges and ethical considerations, transplantation outcomes using DCD lungs are comparable to those achieved with traditional donation after brain death. As research and technology continue to advance, DCD donors are expected to play an increasingly significant role in lung transplantation.3. Controlled hypothermic preservation at 10°C: Controlled hypothermic storage at 10°C offers extended preservation times, reduces cold-induced injury, and enhances flexibility in transplant scheduling. This method has the potential to revolutionise the currently rigid logistics of lung transplantation, allowing semi-elective procedures to be integrated into daily surgical programs as research progresses.With a particular focus on these innovations, we aim to summarise the current state of knowledge regarding lung donors and donor lung preservation.

Lymphoedema is a chronic, progressive condition that may occur as a primary disorder or secondarily following lymphatic damage, such as after lymphadenectomy or radiotherapy. Conservative therapies often provide only limited relief, so that surgical approaches like vascularised omental lymph node transfer (VOLT) are increasingly relevant.We present two cases of advanced secondary lower-limb lymphoedema following lymphadenectomy. Both patients demonstrated severe lymphatic transport dysfunction on lymphoscintigraphy and MRI. A double microsurgical lymph node transfer using VOLT was performed in each case. The omentum, selected for its high lymph node density and lymphangiogenic potential, was divided intraoperatively to reconstruct both the groin and lower leg regions. In addition, a systematic literature review on omental lymph node transfer for lymphoedema was conducted using PubMed.In both cases, postoperative assessment confirmed adequate perfusion of the grafts and clinical improvement of lymphoedema symptoms. The literature review revealed consistent evidence of significant limb volume reduction, improved lymphatic drainage, and a marked decrease in the incidence of cellulitis following VOLT.VOLT is an effective surgical option for therapy-refractory lymphoedema and may substantially improve patient quality of life. Despite promising results, further standardised prospective long-term studies are required to validate its efficacy and safety.

Postoperative wound infections are a serious complication in thoracic surgery. At the same time, excessive use of antibiotics poses the risk of multi-resistant pathogens. The article highlights evidence-based strategies for perioperative antibiotic prophylaxis (PAP) and provides specific recommendations for action.

CT-guided transthoracic lung biopsy (CT-TTNB) is an essential method for the diagnosis of pulmonary nodules and masses. With a sensitivity of 85-97% and a specificity of 85-100%, it offers high diagnostic accuracy. By using core-needle biopsies, high-quality tissue samples can be obtained that enable molecular analyses for personalised therapy.At the same time, lung ablation has established itself as a valuable minimally invasive therapy. Procedures such as radiofrequency ablation (RFA), microwave ablation (MWA) and cryoablation enable targeted tumour destruction, particularly in inoperable patients with NSCLC or lung metastases. Studies have shown a high level of local tumour control with acceptable complication rates. The combination of imaging and interventional technique significantly improves patient safety and treatment outcomes and offers good results with low complication rates.Overall, CT-guided puncture and ablation are integral components of modern lung cancer diagnostics for primary and secondary lung tumours, while offering a new treatment option and therapy. They offer precise, low-risk alternatives to invasive procedures and can therefore make a significant contribution to effective patient care.