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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Scheubel, R. Therapie der chronischen Mediastinitis. Chirurg 87, 486–488 (2016). https://doi.org/10.1007/s00104-016-0197-y
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DOI: https://doi.org/10.1007/s00104-016-0197-y
Schlüsselwörter
- Fibrosierende Mediastinitis
- Stents
- Chirurgische Behandlung
- Antiinflammatorische Medikation
- Antifungale Medikation