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Der Chirurg

, Volume 79, Issue 5, pp 444–451 | Cite as

Rektumprolaps

Abdominelles oder lokales Vorgehen
  • K.E. Matzel
  • S. Heuer
  • W. Zhang
Leitthema

Zusammenfassung

Die chirurgische Behandlung des Rektumvollwandvorfalls zielt auf morphologische Korrektur und Funktionserhalt. Es gib keine eindeutige Methode der Wahl; eine Vielzahl von Operationen steht zur Verfügung. Abdominelle Verfahren unterscheiden sich hinsichtlich des Zugangsweges und der Art und Weise der Mobilisation und Fixation des reponierten Rektums sowie durch begleitende Resektion. Lokale (perineale/transanale) Techniken plikieren oder resezieren. Die Verfahrenswahl orientiert sich an der Belastbarkeit des Patienten, den Ergebnissen der Methoden im Hinblick auf Rezidivraten, Morbidität und der präoperativen sowie postoperativ zu erwartenden Funktion. Abdominelle Verfahren sind eher bei belastbaren Patienten angebracht, lokale Verfahren bei älteren. Die Übersichtsarbeit beschreibt vergleichend die Unterschiede der Techniken im Hinblick auf die Rezidivrate, die Morbidität und das funktionelle Ergebnis.

Schlüsselwörter

Rektumprolaps Funktionelle Störungen Anorektale Fehlfunktion Obstipation Inkontinenz 

Rectal prolapse

Abdominal or local approach

Abstract

Surgical treatment of rectal prolapse aims to correct morphology and restore function. Many techniques are available, but none can be considered a gold standard. Abdominal approaches differ with regard to abdominal access, extent of rectal mobilisation, technique of rectal pexy, and concomitant sigmoid resection. Local (perineal/transanal) procedures plicate or resect the rectum. The choice of operative approach is based on the patient‘s condition and expected outcome of the procedure, e.g. recurrence rate, morbidity, and function. Abdominal operations are favored in fit patients, while local procedures are considered for the elderly and frail. This review compares differences in the most common techniques, focussing on recurrence, morbidity, and functional outcome.

Keywords

Rectal prolapse Functional disorders Anorectal dysfunction Constipation Fecal incontinence 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer Medizin Verlag 2008

Authors and Affiliations

  1. 1.Chirurgische Klinik mit PoliklinikUniversität ErlangenErlangenDeutschland

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