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DOI: 10.1055/s-2003-37292
Aktuelle Aspekte zur Appendizitisbehandlung
Literaturanalyse und Ergebnisse zweier MultizenterstudienTreatment of Appendicitis Review of the Literature and Results of Two Multiventric Observational StudiesPublication History
Publication Date:
18 February 2003 (online)
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Zusammenfassung
Epidemiologische Daten zeigen einen Rückgang der Inzidenz einer akuten Appendizitis. Derzeit ist von einer Inzidenz von 110 - 200/100 000 Einwohner auszugehen. In der Diagnostik haben die Sonographie und die Computertomographie, insbesondere bei unklaren abdominellen Befunden, einen differenzialdiagnostischen Stellenwert. Die Laparoskopie stellt ein diagnostisches Verfahren mit therapeutischer Option dar und konnte ihren Stellenwert seit Anfang der 90er-Jahre zunehmend festigen. Im Falle einer nicht perforierten Appendizitis besteht die Therapie der Wahl in der laparoskopischen Appendektomie. Vorteile werden hierbei insbesondere hinsichtlich postoperativer Wundinfektionen und der Rekonvaleszenz gesehen. Bei perforierter Appendizitis und Peritonitis finden sich nach laparoskopischer Appendektomie höhere Raten postoperativer intraabdomineller Abszesse. In diesen Fällen sollte die Indikation zur offenen Appendektomie großzügig gestellt werden.
Abstract
Epidemiological data indicate a decrease in the incidence of acute appendicitis, which is currently estimated to be 110 - 200 per 100 000 of the population. In the diagnostic work-up, ultrasonography and computed tomography are of help in the differential diagnosis, in particular when the abdominal symptoms are unclear. Over the past decade, laparoscopy has become established as a diagnostic method offering an additional therapeutic option. In cases of non-perforated appendicitis, the treatment of choice is laparoscopic appendectomy, the particular benefits of which are to be seen in reduced postoperative wound infection and faster convalescence. In the event of perforated appendicitis and peritonitis, laparoscopic appendectomy is associated with a higher rate of postoperative intra-abdominal abscesses. In these cases, the preferred indication is for open appendectomy.
Schlüsselwörter
Appendizitis - Epidemiologie - Diagnostik - Appendektomie
Key words
Appendicitis - epidemiology - diagnosis - appendectomy
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Dr. med. Andreas Koch
Chirurgische Klinik, Carl-Thiem-Klinikum Cottbus
Thiemstraße 111
03048 Cottbus
Phone: + 49-355-462327
Fax: + 49-355-462337
Email: AKChirurg@aol.com