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Remote ischämische Präkonditionierung vor Rektumresektionen

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Präoperative Konditionierung des viszeralchirurgischen Risikopatienten

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Zusammenfassung

Die Anastomoseninsuffizienz nach Rektumresektionen bleibt eine gefürchtete und potenziell letale Komplikation. Bis zum heutigen Zeitpunkt konnten zur Prävention der Anastomoseninsuffizienz abgesehen von der Anlage einer protektiven Ileostomie keine effektiven Methoden etabliert werden. Ischämische Fernpräkonditionierung (engl. remote ischemic preconditioning, RIPC) wirkt an verschiedenen Organsystemen protektiv hinsichtlich eines Ischämie-Reperfusions-Schadens. Daher ist es naheliegend, dass diese Wirkung auch am Darm und insbesondere im Rahmen der Anastomosenheilung zum Tragen kommen könnte. Der Einsatz von RIPC zur Reduktion der Anastomoseninsuffizienzrate nach Rektumresektionen entspricht derzeit noch einem experimentellen Ansatz, welcher im Rahmen von Studien evaluiert werden muss. Im nachfolgenden Kapitel werden der aktuelle Stand der Evidenz beleuchtet und Ausblicke auf potenzielle Einsatzmöglichkeiten von RIPC zur Präkonditionierung in der modernen Rektumchirurgie gegeben.

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Authors and Affiliations

  1. Chirurgische Klinik, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland

    Julia Hardt & Nuh N. Rahbari

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  1. Julia Hardt
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  2. Nuh N. Rahbari
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Correspondence to Julia Hardt .

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Editors and Affiliations

  1. Abteilung für Allgemein-, Viszeral- und Onkologische Chirurgie, Klinikum St. Georg Leipzig, Leipzig, Deutschland

    Arved Weimann

  2. Klinik und Poliklinik für Viszeral-, Transplantations-, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig, Leipzig, Deutschland

    Ines Gockel

  3. Chirurgische Klinik, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland

    Christoph Reißfelder

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© 2022 Der/die Autor(en), exklusiv lizenziert an Springer-Verlag GmbH, DE, ein Teil von Springer Nature

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Hardt, J., Rahbari, N.N. (2022). Remote ischämische Präkonditionierung vor Rektumresektionen. In: Weimann, A., Gockel, I., Reißfelder, C. (eds) Präoperative Konditionierung des viszeralchirurgischen Risikopatienten. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-64257-3_23

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  • DOI: https://doi.org/10.1007/978-3-662-64257-3_23

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-64256-6

  • Online ISBN: 978-3-662-64257-3

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