[Consequences from the reform of hospital structure for surgery: what does centralization offer university visceral surgery departments?].

The centralization of complex surgical procedures at universities improves treatment quality and prognosis. Numerous studies have confirmed that this is accompanied by a reduction in the length of hospital stays and treatment costs. In addition to the positive impact on patient care, the universities' roles in teaching and research are also experiencing changes; however, risks and limitations should also be addressed. Without extensive cooperation with outpatient and inpatient partners regarding diagnostics, emergency care and the implementation of multimodal treatment under the coordination of university visceral surgery departments, the effects on visceral surgery training must also be considered, so as not to negatively affect the attractiveness of the surgical profession and to avoid staff turnover. Significant changes and restructuring regarding new logistics requirements are emerging. There are indications of significant changes and restructuring regarding new requirements for logistics, interdisciplinary cooperation with portal clinics and collaboration in the interdisciplinary tumor board, which cannot yet be fully assessed.