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coloproctology

, Volume 41, Issue 1, pp 22–29 | Cite as

Behandlungsstrategien beim therapierefraktären Morbus Crohn in der Primär- und Rezidivsituation

  • J.-P. RitzEmail author
Leitthema
  • 34 Downloads

Zusammenfassung

Morbus Crohn ist eine zur Rezidiven neigende chronische Erkrankung, die bei vielen der betroffenen Patienten mit der Notwendigkeit einer chirurgischen Therapie einhergeht. Sowohl beim Ersteingriff als auch bei jedem Rezidiveingriff werden an den Chirurgen besondere Anforderungen gestellt, die dem rezidivierenden und panenterischen Charakter der Erkrankung Rechnung tragen. Die Crohn-Chirurgie ist eine spezialisierte Viszeralchirurgie, die immer in einem interdisziplinären Kontext mit der Gastroenterologie steht. Durch die präoperative Anpassung der Ernährungssituation und der immunsuppressiven Medikation lassen sich postoperative Komplikationen reduzieren. Die intraoperative Beachtung chirurgischer Prinzipien ermöglicht primär und beim Rezidiv eine geringe Invasivität, den weitgehenden Erhalt gesunden Darms, einen komplikationsarmen Verlauf und die Reduktion von Rezidiven.

Schlüsselwörter

Immunsuppressiva Chirurgische Verfahren Fistel Stenose Perioperative Versorgung 

Treatment strategies for refractory Crohn’s disease in the primary and relapse situation

Abstract

Crohn’s disease is a recurrent chronic disease that is associated with the need for surgical therapy in many affected patients. During the initial procedure and each recurrent procedure special requirements must be followed by the surgeon, taking into account the recurrent and pan-enteric nature of the disease. Crohn surgery is specialized visceral surgery, which must always stand in an interdisciplinary context with gastroenterology. The preoperative adaptation of the nutritional situation and the immunosuppressive medication allows a reduction of postoperative complications. Intraoperative observance of surgical principles allows a low invasiveness, the extensive preservation of intestine, a low-complication rate and the reduction of recurrences.

Keywords

Immunosuppressive agents Surgical procedures Fistula Stenosis Perioperative care 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

J.-P. Ritz gibt an, dass kein Interessenkonflikt besteht.

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

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Klinik für Allgemein- und ViszeralchirurgieHelios Kliniken SchwerinSchwerinDeutschland

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