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Viszeralchirurgie 2007; 42(3): 145-151
DOI: 10.1055/s-2007-960718
Originalarbeit

© Georg Thieme Verlag Stuttgart · New York

Anastomosenprobleme in der Ösophaguschirurgie - Prophylaxe, Management und Ergebnisse

Anastomotic Problems in Esophageal Surgery - Prophylaxis - Management - ResultsA. H. Hölscher1 , D. Vallböhmer1 , M. Bludau1
  • 1Klinik und Poliklinik für Visceral- und Gefäßchirurgie der Universität zu Köln
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Publication History

Publication Date:
27 June 2007 (online)

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Zusammenfassung

Die wichtigsten Punkte bei Komplikationen nach Ösophagektomie sind die Prävention, die Früherkennung und die zielgerichtete Behandlung. Die Anastomoseninsuffizienz ist die häufigste chirurgische Komplikation nach Speiseröhrenoperation. Zur Frühdiagnostik zählt die Endoskopie, das Kontraströntgen und das CT. Die Prophylaxe umfasst die Vermeidung von Spannung an der Anastomose und Störung der Vaskularisation des Interponates sowie die Ausführung einer exakten Nahttechnik. Das Management beinhaltet die konservative Behandlung mit Magensonde und Antibiotika oder die endoskopische Stent-Einbringung einer abgedeckten Leckage sowie die Reoperation einer nicht gedeckten Insuffizienz. Bei frühem Einschreiten und konsequentem Management können heute die meisten Anastomosenprobleme nach Ösophaguschirurgie erfolgreich behandelt werden.

Schlüsselwörter

Ösophagektomie - Anastomoseninsuffizienz - Management

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Prof. Dr. A. H. Hölscher

Klinik und Poliklinik für Visceral- und Gefäßchirurgie der Universität zu Köln

Kerpener Str. 62

50937 Köln

Phone: 49/2 21/4 78 48 01

Fax: 49/2 21/4 78 48 43

Email: Arnulf.Hoelscher@uk-koeln.de

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