Zusammenfassung
Die laparoskopische Resektionsrektopexie ist ein bewährtes OP-Verfahren v. a. zur Sanierung eines Vollwandrektumprolapses III, aber auch bei obstruktiver Entleerungsstörung. Die drei therapeutischen Prinzipien und entscheidenden OP-Schritte sind a) die ausreichend tiefe, nervenschonende Mobilisation in der TME-Schicht bis zur intersphinktären Ebene, b) die tubuläre Resektion des überschüssigen Colon sigmoideum mit dem Ziel einer diskret gespannten End-End-Stapleranastomose und c) eine stabile dorsale Rektopexie an die Sakralfaszie. Majorkomplikationen sind mit 5 % selten. Die Prolapsrezidivraten liegen zwischen 0–26 %, die Verbesserungsraten für Inkontinenz und Obstipation zwischen 55–70 % bzw. 43–83 %. Im Evidenzvergleich transabdomineller vs. perinealer OP-Verfahren steht ein Beweis der oft vermuteten Überlegenheit der Resektionsrektopexie hinsichtlich der Rezidivrate weiterhin aus.
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Herrle, F., Kienle, P. (2017). Laparoskopische Resektionsrektopexie. In: Keck, T., Germer, C. (eds) Minimalinvasive Viszeralchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53204-1_31
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