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Chirurgie bei nichtonkologischen entzündlichen Thoraxerkrankungen

Surgery in non-oncologic inflammatory thoracic diseases

  • Leitthema
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Der Pneumologe Aims and scope

Zusammenfassung

Nichtonkologische entzündliche Thoraxerkrankungen sind häufig infektiöser Genese. Ihr klinisches Bild variiert in Abhängigkeit von der Lokalisation, dem Verlauf und der Pathologie. Grundlage der Behandlung ist meist eine medikamentöse antiinfektive Therapie. Indikationen für thoraxchirurgische Interventionen können beispielsweise bei primär fehlender Erfolgsaussicht einer rein medikamentösen Therapie, z. B. beim Aspergillom, bei ungenügender Effektivität einer medikamentösen Therapie, z. B. bei persistierenden Hohlräumen nach Lungenabszessen oder bei Komplikationen wie der massiven Hämoptoe bei einer Tuberkulose bestehen. Dabei reicht das Spektrum der thoraxchirurgischen Interventionen von der alleinigen Drainagetherapie, über minimal-invasive Verfahren (Videothorakoskopie) bis hin zur offenen Chirurgie und Parenchymresektionen. In diesem Beitrag wird aus der Sicht der Thoraxchirurgie auf die Behandlung häufiger und relevanter nichtonkologischer, meist entzündlicher Thoraxerkrankungen eingegangen.

Abstract

Non-oncologic inflammatory disorders of the thorax are mainly of infectious origin. The clinical presentation depends on the localization, the course and the pathological picture. The basis of treatment is effective anti-infective drug therapy. Nevertheless thoracic surgery may be indicated in cases where medical therapy is primarily not effective, e.g. aspergilloma, in cases with remaining defects after drug therapy, e.g. persisting cavities after pulmonary abscesses, or when complications occur, e.g. massive hemoptysis in tuberculosis. The spectrum of surgical intervention ranges from chest tube placement to minimally invasive procedures (video-assisted thoracic surgery) and open surgery with parenchymal resection. This article reviews various non-oncologic inflammatory thoracic disorders from a thoracic surgery perspective.

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  1. Klinik für Herz- und Thoraxchirurgie, Medizinische Fakultät, Otto-von-Guericke-Universität Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Deutschland

    H. Busk & C. Huth

  2. Fachbereich für Pneumologie, Medizinische Fakultät , Otto-von-Guericke-Universität Magdeburg, Magdeburg, Deutschland

    J. Schreiber

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  1. H. Busk
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  2. C. Huth
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  3. J. Schreiber
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Correspondence to H. Busk.

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Busk, H., Huth, C. & Schreiber, J. Chirurgie bei nichtonkologischen entzündlichen Thoraxerkrankungen. Pneumologe 7, 253–264 (2010). https://doi.org/10.1007/s10405-009-0360-y

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