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Der Chirurg

, Volume 86, Issue 5, pp 444–452 | Cite as

Komplikationen in der Therapie des Spontanpneumothorax

  • S. EggelingEmail author
Leitthema

Zusammenfassung

Die Behandlung des Spontanpneumothorax gehört zu den häufigen Erfordernissen in Krankenhäusern sämtlicher Versorgungshierarchien. Neben der suffizienten Erstversorgung durch Einlage einer Thoraxdrainage ist die Kenntnis komplizierender Konstellationen sowie das Erkennen von Komplikationen bzw. irregulären Verläufen während der Therapie des Spontanpneumothorax von elementarer Bedeutung, um zu einem zufriedenstellenden Behandlungsergebnis zu gelangen. Des Weiteren ist die Aufklärung des Patienten über die Pathogenese der Erkrankung, eventuelle Maßnahmen zur Beeinflussung der Rezidivhäufigkeit sowie Verhaltensvorgaben für das weitere Leben wichtig. Die wesentlichen Komplikationen während der Krankenhausbehandlung gliedern sich in Komplikationen der chirurgischen Anlage der Thoraxdrainage bzw. Entlastung des Pleuraraumes, Probleme im Management mit der pleuralen Unterdruckbehandlung, das unter Umständen anspruchsvolle Management einer persistierenden Luftleckage sowie die individuelle Entscheidungsfindung hinsichtlich einer ggf. interventionellen oder operativen Prozedur. Die häufigsten komplizierenden Konstellationen sowie Komplikationsmöglichkeiten während des stationären Krankenhausaufenthaltes werden beschrieben, deren Einflussfaktoren, ggf. Vorbeugung und Management dargestellt sowie die operativen Verfahren und die entsprechenden Operationsindikationen erläutert.

Schlüsselwörter

Erstversorgung Komplikationen Pathogenese Rezidivhäufigkeit Vorbeugung 

Complications in the therapy of spontaneous pneumothorax

Abstract

The therapy of spontaneous pneumothorax is a common necessity in hospitals of all care hierarchies In addition to sufficient primary treatment by placement of a thorax drainage, knowledge of complicationg constellations, recognition of complications and irregular courses during the therapy of spontaneous pneumothorax are of fundamental importance for achieving a satisfactory treatment outcome. Furthermore, the enlightenment of patients regarding the pathogenesis of the disease, possible measures for influencing the recurrence rate and information about future behavioral and lifestyle modifications are important. The principal complications during hospital treatment can be subdivided into complications of the surgical placement of the thorax drain and relief of the pleural cavity, problems in the management of treatment of the pleural negative pressure, the possibly demanding management of a persisting air leak and the individualized decision-making with respect to an interventional or operative procedure. The most common complicating constellations and possible complications during the inpatient hospital stay are described, the

Keywords

Primary care Complications Pathogenesis Recurrence rate Prophylaxis 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt. S. Eggeling gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.: keine Angaben

Supplementary material

Intraoperativer Situs des Patienten mit spontanem Hämopneumothorax. Kontinuierliche arterielle Blutung aus der abgerissenen apikalen strangförmigen Adhäsion (mpg, 14 MB)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Klinik für ThoraxchirurgieVivantes Lungenkrebszentrum, Vivantes-Klinikum NeuköllnBerlinDeutschland

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