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Frauenheilkunde up2date 2016; 10(04): 311-330
DOI: 10.1055/s-0042-112440
Allgemeine Gynäkologie und gynäkologische Onkologie
Georg Thieme Verlag KG Stuttgart · New York

Die operative Therapie der Endometriose

Stefan P. Renner
,
Johannes Lermann
,
Stefanie Burghaus
,
Christine Fahlbusch
,
Katharina Heusinger
,
Simon Blum
,
Tobias Brodkorb
,
Thomas Hildebrandt
,
Matthias W. Beckmann
,
Janina Hackl
Further Information

Publication History

Publication Date:
19 August 2016 (online)

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Kernaussagen

Zur Behandlung der Endometriose stehen verschiedene Maßnahmen zur Verfügung wie die endokrine, die analgetische und die operative Therapie einzeln oder in Kombination. Die individuelle Situation der Patientin gilt es immer zu berücksichtigen. Vor Planung einer operativen Sanierung steht eine umfassende Diagnostik, um eine mögliche Untertherapie oder Übertherapie der zu Rezidiven neigenden Erkrankung zu vermeiden und um das Ausmaß der Endometriose vor den häufig komplexen Eingriffen zu erfassen und diese suffizient zu planen.

Bei Verdacht auf Endometriose sollte zur Diagnosesicherung die diagnostische Laparoskopie durchgeführt werden (Goldstandard) und im Falle nachweisbarer Endometriose zur sanierenden Operation erweitert werden. Ziel ist die Resektion in sano, die auch in fortgeschrittenen Stadien und bei tief infiltrierender Endometriose unter Einbeziehung anderer Fachrichtungen (Urologie, Chirurgie) sehr häufig laparoskopisch möglich ist. Für die unterschiedlich eingesetzten Techniken bei tief infiltrierender Endometriose liegen keine belastbaren Evidenzen vor. Neben der Operation spielt die medikamentöse Therapie eine nicht minder wichtige Rolle zur Vermeidung von Rezidiven und zur Symptomkontrolle.

 

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