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Therapie der chronischen Mediastinitis

Treatment of chronic mediastinitis

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Zusammenfassung

Hintergrund

Die chronische Mediastinitis ist eine seltene Erkrankung, welche durch fortschreitende Proliferation fibrösen Gewebes im Mediastinum eine Kompression mediastinaler Strukturen verursacht.

Ziel der Arbeit

Übersicht zum derzeitigen Stand der Therapie der chronischen Mediastinitis.

Material und Methoden

Aktuelle Literaturrecherche.

Ergebnisse und Diskussion

Die Ursache der chronischen Mediastinitis ist bisher nicht geklärt. Insofern existiert keine zielgerichtete Therapie. Die medikamentöse Therapie (antimykotisch oder antiinflammatorisch) ist umstritten und wird nicht empfohlen. Bei klinischen Symptomen kommen dekomprimierende Verfahren zum Einsatz wie endovaskuläre oder endobronchiale Stentimplantation oder operative Verfahren wie dekomprimierende Eingriffe oder extraanatomische Bypassanlagen. Die Prognose ist beim einseitigen Befall günstiger als beim beidseitigen Befall.

Abstract

Background

Chronic mediastinitis is a rare disorder characterized by the proliferation of fibrous tissue within the mediastinum resulting in compression of mediastinal structures.

Objective

This article gives an overview of the treatment options for chronic mediastinitis.

Material and methods

A literature search was carried out regarding treatment options for chronic mediastinitis

Results and conclusion

Little is known about the pathogenesis of chronic mediastinitis, which has hampered the development of novel therapeutic approaches. There is no convincing evidence for the success of medicinal (antifungal or conventional anti-inflammatory) therapy and it is not recommended. In cases of clinical symptoms procedures for decompression, such as endovascular or endobronchial stents or surgical procedures, such as decompression interventions or extra-anatomic bypasses should be considered. The prognosis for unilateral involvement is better than for bilateral involvement if performed in specialized centers.

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Correspondence to R. Scheubel.

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R. Scheubel gibt an, dass kein Interessenkonflikt besteht

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Scheubel, R. Therapie der chronischen Mediastinitis. Chirurg 87, 486–488 (2016). https://doi.org/10.1007/s00104-016-0197-y

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