Anastomosentechniken in der M.-Crohn-Chirurgie – Evidenz und Neuentwicklungen

Anastomotic techniques in surgery of Crohnʼs disease—Evidence and new developments

Zusammenfassung

Darmanastomosen bei M. Crohn sind ein kontrovers diskutiertes Thema. Im Vergleich der verschiedenen Anastomosenkonfigurationen scheint die laterolaterale Anastomose nach Kono‑S die geringste Rezidivrate zu haben. Auf die Insuffizienzrate haben weder die Anastomosenkonfiguration noch das Nahtmaterial einen Einfluss. Die Komplikationsrate kann durch Verbesserung des Ernährungszustands, Kortisonreduktion, Pausierung von Biologika und eine orale präoperative Antibiotikaprophylaxe gesenkt werden.

Abstract

Intestinal anastomoses in Crohnʼs disease are controversially discussed. In a comparison of the different types of anastomotic configuration the side-to-side anastomosis according to Kono‑S seems to have the lowest recurrence rate. Neither the configuration of the anastomosis nor the suture material have an influence on the anastomotic leakage rate. The overall complication rate can be reduced by an amelioration of the nutritional status, a reduction of corticoids, pausing biologicals and an oral preoperative antibiotic prophylaxis.

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Correspondence to Prof. Dr. Anton J. Kroesen.

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A.J. Kroesen gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Kroesen, A.J. Anastomosentechniken in der M.-Crohn-Chirurgie – Evidenz und Neuentwicklungen. Chirurg (2020). https://doi.org/10.1007/s00104-020-01310-8

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Schlüsselwörter

  • Rezidivrate
  • Anastomoseninsuffizienz
  • Kono‑S
  • Anastomosenkonfiguration
  • Nahtmaterial

Keywords

  • Recurrence rate
  • Anastomotic leakage
  • Kono‑S
  • Suture material
  • Anastomotic configuration