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Therapeutische Endoskopie

  • Chapter
Praxis der Viszeralchirurgie

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Zusammenfassung

Die Begriffe „therapeutische“ und „operative« oder „chirurgische« Endoskopie werden heute überwiegend synonym für alle Eingriffe verwendet, die unter endoskopischer Kontrolle durchgeführt werden. Zahlreiche chirurgische Eingriffe können heute auf endoskopischem Wege mit dem damit verbundenen geringeren Risiko für den Patienten vorgenommen werden.

Die erste therapeutische Maßnahme, die über den Arbeitskanal des flexiblen Endoskops durchgeführt wurde, war die Abtragung von gestielten Polypen mit einer Drahtschlinge unter Verwendung von Hochfrequenzströmen (Deyhle et al. 1974). Das Spektrum der therapeutischen Endoskopie ist seitdem breiter geworden. Die Grundvoraussetzung dafür liefert die Industrie mit stetigen technischen Verbesserungen, z. B. durch die Produktion großlumiger Operationsendoskope oder durch die Weiterentwicklung der entsprechenden Hilfsinstrumente, wie Schlingen, Dormiakörbchen, Papillotomen, Zangen, Scheren, Injektionssonden und Clipapplikatoren.

Bei allen im Folgenden dargestellten Behandlungstechniken handelt es sich um klinisch etablierte Verfahren. Die Vorteile der therapeutischen Endoskopie sind:

  • Defensives Eingreifen ohne Eröffnung einer Körperhöhle

  • Minderung der Komplikationsrate

  • Möglichkeit der ambulanten Behandlung bzw. kürzere stationäre Aufenthaltsdauer

  • Niedrige Behandlungskosten

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Literatur

  • Alonso-Aguirre P, Aba-Garrote C, Estévez-Prieto E, Gonzáles-Conde B, Vázquez-Iglesias JL (2003) Treatment of achalasia with the Witzel dilator: A prospective randomised study of two methods. Endoscopy 35(5):379–382

    Article  PubMed  CAS  Google Scholar 

  • Bampton P, Yap LM, Hagan S et al. (2003) Argon plasma coagulation is safe and effective for acute bleeding peptic ulcer disease [abstract]. Gastrointest Endosc 57:AB 148

    Google Scholar 

  • Bardou M, Toubouti YM, Benhaberou-Brun D et al. (2003) High dose intravenous proton pump inhibitors decrease both re-bleeding and mortality in high-risk patients with acute peptic ulcer bleeding: a series of meta-analyses [abstract]. Gastroenterology 124(Suppl1): A 625

    Google Scholar 

  • Baron TH, Harewood GC, Morgan DE, Yates MR (2002) Outcome differences after endoscopic drainage of pancreatic necrosis, acute pancreatic pseudocysts, and chronic pancreatic pseudocysts. Gastrointest Endosc 56:7–17

    Article  PubMed  Google Scholar 

  • Bartelsman JF, Bruno MJ, Jensema AJ et al. (2000) Palliation of patients with esophagogastric neoplasms by insertion of a covered expandable modified Gianturco-Z endoprothesis: experiences in 153 patients. Gastrointest Endosc 51:134–138

    Article  PubMed  CAS  Google Scholar 

  • Barthet M, Lesavre N, Desjeux A, Gasmi M, Berthezene P, Berdah S, Viviand X, Grimaud JC (2002) Complications of endoscopic sphincterotomy: results from a single tertiary referral center. Endoscopy 34(12):991–997

    Article  PubMed  CAS  Google Scholar 

  • Bilsel Y, Bulut T, Yamaner S et al. (2003) ERCP in the diagnosis and management of complications after surgery for hepatic echinococcosis. Endoscopy 57:210–213

    Google Scholar 

  • Brenner H, Arndt V, Stürmer T, Stegmaier C, Ziegler H, Dhom G (2001) Long lasting reduction of risk of colorectal cancer following screening endoscopy. British Journal of Cancer 85:972–976

    Article  PubMed  CAS  Google Scholar 

  • Chan FK, To KF, Wu JC et al. (2002) Eradication of Helicobacter pylori and risk of peptic ulcers in patients starting a long-term treatment with non-steroidal anti-inflammatory drugs: a randomised trial. Lancet 359:9–13

    Article  PubMed  CAS  Google Scholar 

  • Cheng JLS, Bruno MJ, Bergman JJ et al. (2002) Endoscopic palliation of patients with biliary obstruction caused by non-resectable hiliar cholangiocarcinoma: efficacy of self-expandable metallic Wallstent. Gastrointest Endosc 56:33–39

    Article  PubMed  Google Scholar 

  • Christie NA, Buenaventura Po, Fernando HC et al. (2001) Results of expandable metal stents for malignant esophageal obstruction in 100 patients: short-term and long-term follow-up. Ann Thorac Surg 71:1797–1801

    Article  PubMed  CAS  Google Scholar 

  • Chung SCS (2003) Current management of acute gastrointestinal bleeding. Scand J Gastroenterol 38:Suppl 237:9–12

    Article  CAS  Google Scholar 

  • Citarda F, Tomaselli G, Capocaccia R et al. (2001) Efficacy in standard clinical practice of colonoscopic polypectomy in reducing colorectal cancer incidence. Gut 48:812–815

    Article  PubMed  CAS  Google Scholar 

  • Costamagna G, Tringali A, Shah SK, Mutignani M, Zuccalà G, Perri V (2002) Long-term follow-up of patients after endoscopic sphincterotomy for choledocholithiasis, and risk factors for recurrence. Endoscopy 34(4):273–279

    Article  PubMed  CAS  Google Scholar 

  • Deyhle H, Sulser H, Säuberli H (1974) Endoscopic snare ectomy of an early gastric cancer: a therapeutical method. Endoscopy 6 195–198

    Google Scholar 

  • Eickhoff A, Riemann JF (2004) Kolorektales Karzinom — Prophylaxe und Früherkennung. Endo heute 17:82–88

    Article  Google Scholar 

  • El-Khayat HR, Mousa M (2003) Prevalence of non-Helicobacter pylori, non-NSAIDs in bleeding peptic ulcer Egyptian patients: a prospective study [abstract]. Gastrointest Endosc 57:AB 155

    Google Scholar 

  • Forrest JA, Finlayson ND, Shearman DJ (1974) Endoscopy in gastrointestinal bleeding. Lancet 2:394

    Article  PubMed  CAS  Google Scholar 

  • Freeman ML, Overby C (2003) Selective MRCP and CT-targeted drainage of malignant hilar biliary obstruction with self-expanding metallic stents. Gastrointest Endosc 58:41–49

    Article  PubMed  Google Scholar 

  • Frühmorgen P, Pfähler A (1990) Komplikationen bei 39397 endoskopischen Untersuchungen — eine 7-jährige prospective Dokumentation über art und Häufigkeit. Leber Magen Darm 1:20–32

    Google Scholar 

  • Frühmorgen P, Rufle W, Kobras S et al. (2003) Endoscopic therapy of early colorectal cancer (pT1) — a prospective study. Z Gastroenterol 41:703–710

    Article  PubMed  Google Scholar 

  • Fujii Y, Koitabashi A, Sasai T et al. (2003) Clinical application of argon plasma coagulation in endoscopic hemostasis for bleeding peptic ulcerations [abstract]. Gastrointest Endosc 57:AB150

    Google Scholar 

  • Fujishiro M, Yahagi N, Kashimura K et al. (2004) Different mixtures of sodium hyaluronate and their ability to create submucosal fluid cushions for endoscopic mucosal resection. Endoscopy 36(7):584–589

    Article  PubMed  CAS  Google Scholar 

  • Fuke H, Sato H, Saito K et al. (1996) Benefits and limitations of endoscopic hemostasis for upper gastrointestinal bleeding with clipping and gelfoam. Gastrointest Endosc 38:1993–8

    Google Scholar 

  • Gauderer MWL, Ponsky JL, Izant RJ (1980) Gastrostomy without laparotomy: a percutaneous endosopic technique. J Pediatric Surg 15:872–875

    Article  CAS  Google Scholar 

  • Gelbmann CM, Ratiu NL, Rath HC, Rogler G, Lock G, Schölmerich J, Kullmann F (2004) Use of self-expandable plastic stents for the treatment of esophageal perforations and symptomatic anastomotic leaks. Endoscopy 36(8):695–699

    Article  PubMed  CAS  Google Scholar 

  • Grund KE, Lange V (2000) Stellenwert der flexiblen Endoskopie in der Chirurgie Teil I. Chirurg 71:1179–1190

    Article  PubMed  CAS  Google Scholar 

  • Hahne M, Frühmorgen P (2004) Polypenmanagement und endoskopische Therapie von Frühkarzinomen. Endo heute 17:92–96

    Article  Google Scholar 

  • Hamilton SR, Lauri AA (2000) World Health Organization Classification of tumors. Pathology and Genetics of the tumors of the digestive system. IARC Press, Lyon

    Google Scholar 

  • Hawes RH (2003) Endoscopic mangement of pseudocysts. Rev Gastroenterol Disord 3(3):135–141

    PubMed  Google Scholar 

  • Hermanek P (1992) Dysplasie-Karzinom-Sequenz im Kolorekzum. Zentrbl Chir 117:476–482

    CAS  Google Scholar 

  • Homs MY, Steyerberg EW, Kuipers EJ, van der Gaast A, Haringsma J, van Blankenstein M, Siersema PD (2004) Causes and treatment of re current dysphagia after self-expanding metal stent placement for palliation of esophageal carcinoma. Endoscopy 36(10):880–886

    Article  PubMed  CAS  Google Scholar 

  • Hoogerwerf WA, Pasricha PJ (2002) A decade of botulinum toxin injections for achalsia: where do we stand? Endoscopy 34(7):580–581

    Article  PubMed  CAS  Google Scholar 

  • Grund KE, Lange V (2000) Stellenwert der flexiblen Endoskopie in der Chirurgie Teil I. Chirurg 71:1179–1190

    Article  PubMed  CAS  Google Scholar 

  • Ianetti AU, Scamporrino A, Occhigrossi G (2003) Endoscopic treatment of bleeding peptic ulcer with adherent clot and flat pigmented spots by argon plasma coagulation. Gastrointest Endosc 57:AB151

    Google Scholar 

  • Inohue H, Takeshita K, Hori H et al. (1993) Endoscopic mucosal resection with a cap-fitted panendoscope for esophagus, stomach and colon mucosal lesions. Gastrointest Endosc 39:58–62

    Google Scholar 

  • Jensen DM (1999) Spots and clots: leave them or treat them? Why and how to treat. Can J Gastroenterol 13:413–5

    PubMed  CAS  Google Scholar 

  • Jensen DM, Mawas I, Lousuebsakul V et al. (2003) Changes in the prevalence of different diagnosis for UGI hemorrhage in the last two decades [abstract]. Gastrointest Endosc 57: AB 147

    Google Scholar 

  • Jensen DM, Savides T, Sitzer M et al. (2003) Demographics, risk factors, and outcome of peptic ulcer hemorrhage in the United States: results of a large multicenter study [abstract]. Gastroenterology 124(Suppl1): A17

    Article  Google Scholar 

  • Kaassis M, Boyer J, Dumas R et al. (2003) Plastic or metal stents for malignant stricture of the common duct? Results of a randomised prospective study. Gastrointest Endosc 57:178–182

    Article  PubMed  Google Scholar 

  • Kaneko E, Hanada H, Kasagui T (2000) The surgery of gastrointestinal endoscopic complications in Japan (1993–1997) Gastrointest Endosc 42:308–313

    Google Scholar 

  • Khuroo MS, Yattoo GN, Javid G et al. (1997) A comparison of omeprazole and placebo for bleeding peptic ulcer. N Engl J Med 336: 1054–8

    Article  PubMed  CAS  Google Scholar 

  • Kim JI, Kim SS, Park S et al. (2003) Endosopic hemoclipping using a transparent cap in technically difficult cases. Endoscopy 35(8):659–662

    Article  PubMed  CAS  Google Scholar 

  • Kojima T, Parra-Blanco A, Takahashii H et al. (1998) Outcome of endoscopic mucosal resection for early gastric cancer: review of the Japanese literature. Gastrointest Endosc 48:550–554

    PubMed  CAS  Google Scholar 

  • Kudo S, Kashida H, nakajima T et al. (1997) Endoscopic diagnosis and treatment of early colorectal cancer. World J Surg 21:694–701

    Article  PubMed  CAS  Google Scholar 

  • Laine L, Peterson WL (1994) Bleeding peptic ulcer. N Engl J Med 331:717

    Article  PubMed  CAS  Google Scholar 

  • Lin OS, France RE, Soon MS et al. (2003) Hot biopsy monopolar coagulation versus conventional endoscopic treatment for high-risk peptic ulcer bleeding: a prospective, randomised study [abstract]. Gastrointest Endosc 57:AB 180

    Google Scholar 

  • Marek TA (2003) Gastrointestinal Bleeding. Endoscopy 35(11):891–901

    Article  PubMed  CAS  Google Scholar 

  • Martin JE, Macaulay SS, Zarnke KB et al. (2003) Are proton pump inhibitors a viable alternative to endoscopic treatment of upper gastrointestinal bleeding? A meta-analysis [abstract]. Gastrointest Endosc 57: AB 153

    Google Scholar 

  • Martin JE, Macaulay SS, Zarnke KB et al. (2003) Proton pump inhibitors versus H2-antagonists or placebo for uppergastrointestinal bleeding with or without endoscopic hemostasis: a meta-analysis [abstract]. Gastroenterology 124(Suppl1):A 625

    Google Scholar 

  • Mayerle J, Stier A, Lerch MM, Heidecke C-D (2004) Chronische Pankreatitis. Diagnostik und Therapie. Chirurg 75(7):731–748

    Article  PubMed  CAS  Google Scholar 

  • Mutignani M, Tringali A, Costamagna G (2004) Therapeutic biliary endoscopy. Endoscopy 36(2):147–159

    Article  PubMed  CAS  Google Scholar 

  • Negri G, Cosentino F, Spina GP (1984) Fine-needle endoscopic percutaneous gastrostomy. Endoscopy 16(6):223–225

    PubMed  CAS  Google Scholar 

  • Netzer P, Forster C, Biral R, Ruchti C, Neuweiler J, Stauffer E, Schonegg R, Maurer C, Husler J, Halter F, Schmassmann A (1998) Risk factor assessment of endoscopically removed malignant colorectal polyps. Gut 43(5):669–674

    Article  PubMed  CAS  Google Scholar 

  • Neuhaus H (2003) Endoscopic and percutaneous treatment of difficult bile duct stones. Endoscopy 35(S1):S31–S34

    PubMed  CAS  Google Scholar 

  • Neuhaus H (2004) Therapeutic pancreatic endoscopy. Endoscopy 36(1): 8–16

    Article  PubMed  CAS  Google Scholar 

  • Ohkuwa M, Hosokawa K, Boku N et al. (2001) New endoscopic treatment of intramucosal gastric tumors using an insulated-tip diathermic knife. Endoscopy 33:221–226

    Article  PubMed  CAS  Google Scholar 

  • Okamoto H, Tawaka S (1996) Japanese review of complications and measure by endoscopic treatment for colorectal tumor between 1989–1993 (in Japanese). Hiroshimaigaku 49:585–591

    Google Scholar 

  • Pasricha PJ, Ravich WJ, Hendrix TR et al. (1994) Treatment of achalasia with intersphincteric injection of botulinum toxin: a pilot trial. Ann Intern Med 121:590

    PubMed  CAS  Google Scholar 

  • Rembacken BJ, Gotoda T, Fujii T, Axon ATR (2001) Endoscopic mucosal resection. Endoscopy 33(8):709–718

    Article  PubMed  CAS  Google Scholar 

  • Repici A, De Angelis C, Gaia S et al. (2003) Fibrin glue injection (with standard needle) works better than epinephrine in Forrest Ia and IIa bleeding ulcers: preliminary results of a randomised, controlled trial [abstract]. Gastrointest Endosc 57:AB 147

    Google Scholar 

  • Rey JF, Dumas R, Canard JM, Ponchon T et al. (2002) Guidelines of the french society of digestive endoscopy: biliary stenting. Endoscopy 34(2):169–173

    Article  PubMed  CAS  Google Scholar 

  • Saleh MMA, Nørregaaard P, Jørgensen HL et al. (2002) Preoperative endoscopic stent placement before pancreaticoduodenectomy: a metaanalysis of the effect on morbidity and mortality. Gastrointest Endosc 56:529–534

    Article  PubMed  Google Scholar 

  • Sauerbruch T, Stern M (1989) Fragmentationo of bile duct stones by extracorporeal shock waves. A new approach to biliary calculi after failure of routine endoscopic measures. Gastroenterology 96(1):146–152

    PubMed  CAS  Google Scholar 

  • Schmiegel W, Adler G, Frühmorgen P et al. (2000) Leitlinien der DGVS: Kolorektales Karzinom: Prävention und Früherkennung in der asymptomatischen Bevölkerung — Vorsorge bei Risikopatienten — Endo skopische Diagnostik, Therapie und Nachsorge von Polypen und Karzinomen. Z Gastroenterol 38:49–75

    Article  PubMed  CAS  Google Scholar 

  • Shah SK, Mutignani M, Costamagna G (2002) Therapeutic biliary endoscopy. Endoscopy 34(1):43–53

    Article  PubMed  CAS  Google Scholar 

  • Shida H, Ban K, Matsumoto M, Matsuda K et al. (1996) Asymptomatic colorectal cancer detected by screening. Dis Colon Rectum 16(3):483–498

    CAS  Google Scholar 

  • Shim CS. (2001) Endoscopic mucosal resection: an overview of the value of different techniques. Endoscopy 33(3):271–275

    Article  PubMed  CAS  Google Scholar 

  • Shimuzu S, Tada M, Kawai K (1995) Early gastric cancer: its surveillance and natural course. Endoscopy 27:27–31

    Article  Google Scholar 

  • Soehendra N, Sriram PV, Ponchon T, Chung SC (2001) Hemostatic clip in gastrointestinal bleeding. Endoscopy 33(2):172–180

    Article  PubMed  CAS  Google Scholar 

  • Soehendra N, Seitz U (2003) Chirurgische Endoskopie. In: Schumpelick V (Hrsg) Kurzlehrbuch Chirurgie, 6. Aufl. Thieme, Stuttgart

    Google Scholar 

  • Stiehl A (2004) Primär sklerosierende Cholangitis. Internist 45:27–32

    Article  PubMed  CAS  Google Scholar 

  • Tani M, Sakai P, Kondo H (2003) Endoscopic mucosal resection of superficial cancer in the stomach using the cap technique. Endoscopy 35(4):348–355

    Article  PubMed  CAS  Google Scholar 

  • Truong S (1993) Endoskopische Therapie gutartiger Anastomosenstenosen im Gastrointestinaltrakt mittels Elektroinzision und Ballondilatation. Habilitationsschrift

    Google Scholar 

  • Udd M, Palmu A, Miettinen P et al. (2003) Analysis of risk factors for peptic ulcer bleeding: a case-control study [abstract]. Gastroenterology 124(Suppl1): A626–627

    Article  Google Scholar 

  • Vaezi MF, Richter JE (1999) Diagnosis and management of achalasia. Am J Gastroenterol 94:3406–3412

    Article  PubMed  CAS  Google Scholar 

  • Vergara M, Calvet X, Brullet E et al. (2003) Adding a second hemostatic procedure after epinephrine injection reduces rebleeding, surgery, and mortality in bleeding peptic ulcer patients: a meta-analysis [abstract]. Gastrointest Endosc 57:AB 118

    Google Scholar 

  • Vestweber KH (1988) Die Gastrointestinostomie — der kurze Weg zur paraoralen Ernährung. Endoskopie heute 2:35

    Google Scholar 

  • Vilaichone RK, Kullavanijaya P, Thong-Ngam D et al. (2003) Helicobacter pylori infection and upper gastrointestinal bleeding in NSAIDs users [abstract]. Gastrointest Endosc 57:AB 150

    Google Scholar 

  • Wang MQ, Sze DY, Wang ZP et al. (2001) Delayed complications after esophageal stent placement for treatment of malignant esophageal obstructions and esophagorespiratory fistulas. J Vasc Interv Radiol 12:465–474

    PubMed  CAS  Google Scholar 

  • Winawer SJ et al. (1988) The national polyp study. In: Steele G et al., Basic and clinical perspectives of colorectal polyps and cancer. Alan R. Liss, Inc., New York

    Google Scholar 

  • Winawer SJ, Zauber AG, O’Brien MJ et al. (1993) Randomized comparison of surveillance intervals after colonoscopic removal of newly diagnosed adenomatous polyps. N Engl J Med 328:901–990

    Article  PubMed  CAS  Google Scholar 

  • Yoshinaka H, Shimazu H, Fukumoto T, Baba M (1991) Superficial esophageal carcinoma: a clinicopathological review of 59 cases. Am J Gastroenterol 861413–1418

    Google Scholar 

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Authors and Affiliations

  1. Chirurgische Klinik, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074, Aachen

    S. Truong (Prof. Dr.), O. Schumacher (Dr.) & N. Butz (Dr.)

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  1. S. Truong
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  2. O. Schumacher
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  3. N. Butz
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Editors and Affiliations

  1. Medizinische Fakultät der RWTH, Universitätsklinik und Poliklinik, Pauwelsstr. 30, 52057, Aachen

    Volker Schumpelick

  2. Chirurgische Klinik und Poliklinik, Technische Universität München Klinikum rechts der Isar, Ismaninger Str. 22, 81657, München

    Jörg Rüdiger Siewert

  3. Zentrum für Operative Medizin I, Klinikum der Philipps-Universität, Baldinger Straße, 35043, Marburg

    Matthias Rothmund

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Truong, S., Schumacher, O., Butz, N. (2006). Therapeutische Endoskopie. In: Schumpelick, V., Siewert, J.R., Rothmund, M. (eds) Praxis der Viszeralchirurgie. Springer, Berlin, Heidelberg . https://doi.org/10.1007/978-3-540-29042-1_10

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