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Maligne Passagestörungen

Möglichkeiten des endoskopischen Stentings

Advantages of endoscopic stenting for malignant gastrointestinal obstructions

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Zusammenfassung

Selbstexpandierbare Stents spielen eine wesentliche Rolle in der interdisziplinären Versorgung gastrointestinaler Obstruktionen bei Patienten mit lokal nicht resektablen Tumoren, fortgeschrittener Metastasierung und ausgeprägter Komorbidität. Die Palliation ösophagealer Tumorkomplikationen durch Wiederherstellung der Passage und Abdichtung ösophagotrachealer Fisteln ist hoch effektiv. Auch bei hepatobiliären Tumorokklusionen ist die Erfolgsrate der Cholestaseentlastung hoch. Enterale und kolorektale Stents gewinnen zunehmend an Bedeutung. Voraussetzung ist ein erfahrenes Endoskopieteam und eine adäquate technische Einrichtung. Insgesamt ist die prozedurbedingte Komplikationsrate gering, seltene schwere Komplikationen wie Perforationen sind jedoch abzuwägen. Weitere Verbesserungen der Materialeigenschaften und der Konstruktion von Stents sind zu erwarten.

Abstract

Self-expanding stents play a major role in the interdisciplinary treatment of gastrointestinal obstructions in patients with local nonresectable tumors, advanced metastasis, and pronounced comorbidity. Reinstating the passage and sealing esophagotracheal fistulae is very effective as palliative treatment for esophageal tumor complications. In hepatobiliary occlusions, the success rate against cholestasis is also high. Enteral and colorectal stents are gaining favor. Required are an experienced endoscopy team and adequate equipment. The rate of procedural complications is generally low, but rare and severe complications such as perforation must be considered. Further improvements in the materials and construction of stents can be expected.

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Authors and Affiliations

  1. Abteilung Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover

    M. P. Manns

  2. Abteilung Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625 , Hannover

    P. N. Meier

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  1. P. N. Meier
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  2. M. P. Manns
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Correspondence to P. N. Meier.

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Meier, P.N., Manns, M.P. Maligne Passagestörungen. Chirurg 77, 203–209 (2006). https://doi.org/10.1007/s00104-006-1166-7

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  • DOI: https://doi.org/10.1007/s00104-006-1166-7

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