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Komplikationsmanagement bei Hämorrhoidenoperationen

Complication management following hemorrhoid operations

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Zusammenfassung

Hintergrund

Hämorrhoidenoperationen werden in Deutschland sehr häufig durchgeführt. Es kann bei dem Eingriff zu schwerwiegenden Komplikationen kommen, die ein entsprechendes Management erfordern.

Ziel der Arbeit

Darstellung der einzelnen Komplikationen einschließlich der entsprechenden Therapieoptionen.

Material und Methoden

Daten zu Operationsverfahren und Komplikationen aus der im Zeitraum vom 01.12.2009 bis zum 31.01.2010 durchgeführten elektronisch onlinebasierten Umfrage aller niedergelassenen oder angestellten viszeral- oder allgemeinchirurgisch tätigen Ärzte in Deutschland wurden ausgewertet sowie eine Recherche zur aktuellen Literatur (PubMed) durchgeführt.

Ergebnisse

Im Vergleich zur konventionellen Hämorrhoidektomie hat die Stapler-Hämorrhoidopexie Vorteile in der frühen postoperativen Phase. Patienten sollten allerdings vor Hämorrhoidopexie über die Möglichkeit postoperativer Defäkationsstörungen, eine erhöhte Rezidiv- und Reoperationsrate und das seltene Auftreten lebensbedrohlicher Komplikationen informiert werden.

Schlussfolgerungen

Ziel sollte es sein, durch Prävention, Patientenselektion, sorgfältige Indikationsstellung und entsprechende Expertise das Komplikationsrisiko gering zu halten. Im Falle von Komplikationen ist die frühzeitige Erkennung und direkte Einleitung einer adäquaten Behandlung entscheidend.

Abstract

Background

Hemorrhoid operations are performed frequently in Germany. After the operation severe complications can occur that require appropriate management.

Objective

Presentation of current complications and suitable therapeutic options.

Material and methods

Data including operative procedures and complications that have been collected in an electronic online-based survey of all resident, affiliated and private practice German surgeons during the period from 1 December 2009 to 31 January 2010 are presented. A review of the current literature in a PubMed search is given.

Results

Stapled hemorrhoidopexy has several benefits during the early postoperative phase in comparison to conventional hemorrhoidectomy; however, patients should be informed about the possibility of postoperative defecation disorders, elevated recurrence and reoperation rates and rare life-threatening complications.

Conclusion

The aim should be to keep risks at a low level by means of prevention, patient selection, careful analysis of indications and relevant expertise. In cases of complications early recognition and direct initiation of adequate treatment are crucial.

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Authors and Affiliations

  1. Abteilung für Koloproktologie, Prosper-Hospital, Mühlenstraße 27, 45659, Recklinghausen, Deutschland

    S. Kersting, K.-P. Jung & E. Berg

  2. End- und Dickdarm-Zentrum, Bismarckplatz 1, 65165, Mannheim, Deutschland

    A. Herold

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  1. S. Kersting
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  2. A. Herold
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  3. K.-P. Jung
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  4. E. Berg
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Correspondence to S. Kersting.

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Interessenkonflikt

S. Kersting, A. Herold, K.-P. Jung und E. Berg geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Kersting, S., Herold, A., Jung, KP. et al. Komplikationsmanagement bei Hämorrhoidenoperationen. Chirurg 86, 726–733 (2015). https://doi.org/10.1007/s00104-015-0018-8

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