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Kolorektale Chirurgie

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Evidenzbasiertes perioperatives Management in der Viszeralchirurgie

Part of the book series: Evidenzbasierte Chirurgie ((EC))

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Zusammenfassung

(ERAS®) Empfehlungen zum perioperativen Management in der kolorektalen Chirurgie sind in diesem Kapitel zusammengestellt. Eine alleinige mechanische Darmvorbereitung mit systemischer Antibiose hat keinen klinischen Vorteil und sollte in der Kolonchirurgie nicht routinemäßig angewandt werden, kann aber in der Rektumchirurgie verwendet werden. Empfohlen wird der Routineeinsatz einer Kombination von isoosmotischer mechanischer Darmvorbereitung mit oralen Antibiotika vor einem elektiven kolorektalen Eingriff. Bei tiefer Rektumresektion hat eine pelvine Drainage keinen Nutzen und sollte nicht platziert werden – außer bei Blutung und Resektion außerhalb der mesorektalen Ebene. In den NICE-Leitlinien wird in der Rektumchirurgie eine verlängerte VTE-Prophylaxe über 28 Tage postoperativ zumindest bei Karzinompatienten empfohlen. Spinalanästhesie und TAP-Blocks sind die Analgesieverfahren erster Wahl bei kolorektaler Resektion.

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Authors and Affiliations

  1. Berlin, Deutschland

    Reinhart T. Grundmann

  2. Hamburg, Deutschland

    E. Sebastian Debus

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  1. Reinhart T. Grundmann
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Correspondence to Reinhart T. Grundmann .

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Editors and Affiliations

  1. DIGG der DGG, Burghausen, Deutschland

    Reinhart T. Grundmann

  2. Klinik und Poliklinik für Gefäßmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    E. Sebastian Debus

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© 2021 Der/die Autor(en), exklusiv lizenziert durch Springer-Verlag GmbH, DE, ein Teil von Springer Nature

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Grundmann, R.T., Debus, E.S. (2021). Kolorektale Chirurgie. In: Grundmann, R.T., Debus, E.S. (eds) Evidenzbasiertes perioperatives Management in der Viszeralchirurgie. Evidenzbasierte Chirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-62848-5_17

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  • DOI: https://doi.org/10.1007/978-3-662-62848-5_17

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-62847-8

  • Online ISBN: 978-3-662-62848-5

  • eBook Packages: Medicine (German Language)

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