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Zentralbl Chir 2015; 140(06): 651-659
DOI: 10.1055/s-0032-1328183
Übersicht
Georg Thieme Verlag KG Stuttgart · New York

Situationsadaptierte Therapie des Hämorrhoidenleidens

Situation-adjusted Treatment of Haemorrhoidal Disease
S. Kersting
Abteilung für Koloproktologie, Prosper-Hospital, Recklinghausen, Deutschland
,
E. Berg
Abteilung für Koloproktologie, Prosper-Hospital, Recklinghausen, Deutschland
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
03. Juli 2013 (online)

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Zusammenfassung

Viele Faktoren spielen neben der Größe der Hämorrhoiden eine entscheidende Rolle für die Wahl des geeigneten Verfahrens. Es ist nicht allein ausreichend, im Hinblick auf den Lokalbefund stadienadaptiert ein Verfahren zur Hämorrhoidentherapie festzulegen. Um eine effektive und komplikationsarme Behandlung zu erzielen, sollten Vorteile, Nachteile und Besonderheiten der einzelnen Behandlungsverfahren sowie das mögliche Komplikationsrisiko im Falle patientenspezifischer Risikofaktoren mit in die Evaluation einfließen. Auch Wünsche und Lebensumstände der Patienten und die persönlichen Erfahrungen sowie die Expertise des Arztes sind relevante Einflussfaktoren bei der situationsadaptierten Hämorrhoidentherapie. Nach Review der aktuellen Literatur wurde in dieser Arbeit ein „4-Säulen-Konzept“ der situationsadaptierten Hämorrhoidentherapie erarbeitet, das die schrittweise Erstellung eines individuellen Behandlungskonzepts ermöglicht. Das Fundament der situationsadaptierten Hämorrhoidentherapie wird hierbei gebildet aus den 4 Einflussgrößen/Säulen Befund, Therapieoptionen, Arzt und Patient, welche bei der Therapieplanung berücksichtigt werden sollten.

Abstract

In addition to the stage several factors influence the treatment of haemorrhoids. The adequate treatment of haemorrhoids is not solely dependent on the stage, thus a situation-adapted therapy should be preferred. Advantages, disadvantages and specific characteristics of different therapy strategies in addition to potential complication risks have to be evaluated in order to obtain an effective and low-risk course. Also requests and personal living conditions of the patient as well as the expertise and experience of the physician have to be considered. A review of the current literature has been performed and a “four columns concept” has been developed that constitutes the fundament of a situation-adjusted treatment of haemorrhoids. The “four columns” that should be considered when therapy strategies are determined are composed of the following key factors: diagnostic findings, treatment alternatives, physician, and patient.

Schlüsselwörter

Hämorrhoiden - chirurgische Technik - Gastrointestinalchirurgie - Kolonchirurgie - postoperative Komplikation

Key words

haemorrhoids - surgical technique - gastrointestinal surgery - colon surgery - postoperative complication
 

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