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Entwicklung der Adipositaschirurgie am Krankenhaus der Maximalversorgung

Über 20 Jahre Behandlungserfahrung

Twenty years of experience with bariatric surgery in a general hospital

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Zusammenfassung

Hintergrund

Seit 1983 werden am Klinikum Stuttgart, Krankenhaus Bad Cannstatt chirurgische Eingriffe bei Patienten zur Behandlung krankhafter Adipositas durchgeführt. Ziel dieser Arbeit war es, die Entwicklung der Adipositaschirurgie in einer Klinik der Maximalversorgung über einen Zeitraum von mehr als 20 Jahren zu untersuchen und darzustellen.

Methoden

Die Daten zur Adipositaschirurgie wurden retrospektiv erfasst. Die Entwicklung der Adipositaschirurgie wurde anhand der Parameter Anzahl der Eingriffe, Eingriffsart, Krankenhausverweildauer und postoperative Komplikationsrate analysiert.

Ergebnisse

Insgesamt wurden 1041 primäre adipositaschirurgische Eingriffe durchgeführt. Diese waren in frühen Jahren zunächst konventionelle Verfahren (horizontaler Bypass und vertikale Gastroplastik). 2003 wurden laparoskopische Verfahren eingeführt (Magenband und gastrojejunaler Bypass). Die Krankenhausverweildauer betrug durchschnittlich 14,7±5,1 Tage bei den konventionellen Eingriffen gegenüber 6,7±4,2 Tagen bei den laparoskopischen Eingriffen. Die 30-Tage-Mortalität lag bei 0,8% bzw. 0,0%. Frühe postoperative Komplikationen traten in 16,9% bzw. 7,8% der Fälle auf.

Schlussfolgerung

Die perioperative Komplikationsrate und die stationäre Verweildauer konnten durch die Anwendung der laparoskopischen Verfahren signifikant reduziert werden. Unsere Untersuchung belegt klar die Vorteile der Laparoskopie in der Adipositaschirurgie, die mittlerweile die Standardmethode darstellt und sich nahtlos in das übrige Spektrum der Maximalversorgung einfügt.

Abstract

Background

Bariatric surgery has been performed since 1983 at the Bad Cannstatt Hospital near Stuttgart, Germany. The aim of this study was to investigate the development of bariatric surgery during the past 25 years.

Methods

Data were collected retrospectively. The parameters were number of surgical procedures, hospital stay, and postoperative complications.

Results

In the 25-year period 1,041 primary bariatric operations were performed. Open horizontal bypass and open vertical banded gastroplasty were performed initially. Starting in 2003 there was a change to laparoscopic procedures (gastric banding and Roux-en-Y bypass). The mean hospital stays were 14.7±5.1 days for open procedures and 6.7±4.2 days for laparoscopic methods, with 30-day mortalities of 0.8% and 0.0% and short-term complications at 16.9% and 7.8%, respectively.

Conclusions

Perioperative complications and hospital stay were reduced by performing laparoscopic bariatric surgery. Our study emphasizes the advantages of the laparoscopic procedures which are standard at our hospital and fit in with the remaining operations in a department of visceral surgery.

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Authors and Affiliations

  1. Klinik für Allgemein- und Viszeralchirurgie, Krankenhaus Bad Cannstatt, Klinikum Stuttgart, Prießnitzweg 24, 70374, Stuttgart, Deutschland

    D. Gärtner, M. Guhl, K. Münz, A. Hornung, J. Hinderer, G. Kieninger &  U. Hesse

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  1. D. Gärtner
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  2. M. Guhl
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  3. K. Münz
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  4. A. Hornung
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  5. J. Hinderer
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  6. G. Kieninger
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  7. U. Hesse
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Correspondence to U. Hesse.

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Gärtner, D., Guhl, M., Münz, K. et al. Entwicklung der Adipositaschirurgie am Krankenhaus der Maximalversorgung. Chirurg 79, 866–873 (2008). https://doi.org/10.1007/s00104-008-1552-4

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  • DOI: https://doi.org/10.1007/s00104-008-1552-4

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