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24. Chirurgische Aspekte nach Resektionen an Magen und Oesophagus

Surgical aspects after gastric resection

  • B. Wissenschaftliches Programm
  • I. Hauptthemen mit Rundgesprächen C. Gastrointestinale Chirugie - Postoperative Syndrome. Pathogenese, Diagnostik, Therapie a) Postoperative Syndrome an Speiseröhre und Magen
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Summary

Resection of digestive sphincters like the pylorus (antrum) or the cardia (terminal esophagus) means reflux. Reflux is, however, not to be confused with reflux disease. Only pathologically prolonged contact of regurgitation with mucosa provides presupposition of reflux symptoms. Bilious vomit and epigastric pain are clinical symptoms of gastral reflux disease; the morphological consequence is erythemia of the stomach. Whether gastritis is also a result of reflux must remain undecided at present. The proven surgical therapy of gastral reflux disease is the Roux-en-Y operation. Esophageal reflux consequences after total gastrectomy and cardia resection are of great clinical importance. Their prophylaxis should be a deciding factor for the method chosen.

Zusammenfassung

Die Resektion intestinaler Schleusensysteme (Pylorus - Antrum; Kardia - terminaler Oesophagus) bedeutet Reflux. Reflux ist aber nicht gleich Refluxkrankheit zu setzen. Nur ein pathologisch verlangerter Kontakt zwischen Regurgitat and Schleimhaut schafft die Voraussetzung fur die Entstehung von Refluxfolgen. Galleerbrechen and epigastrischer Schmerz sind klinische Symptome der gastralen Refluxkrankheit, das Magenerythem morphologische Folge. Ob auch die Gastritis Refluxfolge ist, muB z. Z. noch offen bleiben. Belegte chirurgische Therapie der gastralen Refluxkrankheit ist die Roux-Y-Ableitung des Duodenalinhaltes. Oesophageale Refluxfolgen sind nach totaler Gastrektomie and nach Kardiaresektion von groBer klinischer Bedeutung. Ihre Prophylaxe sollte Gegenstand der Verfahrenswahl scin.

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  1. Kfnik und Poliklinik für Allgemeinchirurgie der Universitat, Robert- Koch-Straße 40, D-3400, Gottingen

    R. Siewert

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Siewert, R. 24. Chirurgische Aspekte nach Resektionen an Magen und Oesophagus. Langenbecks Arch Chiv 352, 125–132 (1980). https://doi.org/10.1007/BF01291985

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