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Rekonstruktionsmöglichkeiten nach tiefer Rektumresektion

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Moderne Chirurgie des Rektumkarzinoms

Zusammenfassung

Die Rektumresektion beeinträchtigt die Kontinenzfunktion des Anorektums. Die moderne Rektumchirurgie versucht, die neorektale Funktion durch additive Operationstechniken in Form von Anastomosen- und Pouchvariationen zu optimieren. Die Kolon-J-Pouch-Rekonstruktion ist bislang durch eine Reihe von hochwertigen Studien am besten untersucht und wird in der deutschen S3-Leitlinie empfohlen. Die Seit-zu-End- Anastomose und die Koloplastie stellen interessante Alternativen zum Kolon-J-Pouch dar. Die aktuelle Studienlage favorisiert den 5 cm langen Kolon-J-Pouch als neorektales Rekonstruktionsverfahren. Die funktionellen Ergebnisse des Kolon-J-Pouches sind der geraden koloanalen Anastomose signifikant überlegen. Sofern eine Kolon-J-Pouch-Rekonstruktion aus anatomischen Gründen nicht möglich ist, bietet sich die Seit-zu- End-Anastomose als Ersatzverfahren an.

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Authors and Affiliations

  1. Klinik für Chirurgie, Caritas-Krankenhaus St. Josef, Landshuter Straße 65, 93053, Regensburg, Deutschland

    Alois Fürst Prof. Dr. med.

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  1. Alois Fürst Prof. Dr. med.
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Correspondence to Alois Fürst Prof. Dr. med. .

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Editors and Affiliations

  1. Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany

    Martin E. Kreis

  2. Klinik für Allgemein- und Viszeralchirurgie, Vivantes Klinikum im Friedrichshain, Berlin, Germany

    Joachim Straßburg

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Fürst, A. (2015). Rekonstruktionsmöglichkeiten nach tiefer Rektumresektion. In: Kreis, M., Straßburg, J. (eds) Moderne Chirurgie des Rektumkarzinoms. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40390-3_14

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  • DOI: https://doi.org/10.1007/978-3-642-40390-3_14

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-40389-7

  • Online ISBN: 978-3-642-40390-3

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