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31. Mißerfolge und Korrektureingriffe

Postoperative syndromes of small intestine and large bowel: Faults and their repair

  • B. Wissenschaftliches Programm
  • I. Hauptthemen mit Rundgesprächen C. Gastrointestinale Chirugie - postoperative Syndrome. Pathogenese, Diagnostik, Therapie d) Postoperative Syndrome an Dünn- und Dickdarm
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Summary

The postoperative syndromes of small intestine and the large bowel are discussed, and corrective surgical procedures are demonstrated. The short bowel syndrome is found following massive resection (more than 50%). The best surgical corrective procedure is the anisoperistaltic segment, first described by Halsted (1887). The blind loop syndrome should be managed surgically by resection of the blind loop, stenosis, or fistula. Adhesions cannot be safely prevented by means of pharmacological agents; the best prophylactic procedure is ≫inner fixation≪ by a long intestinal tube.

Zusammenfassung

Die postoperativen Syndrome an Dünn- und Dickdarm werden im einzelnen dargestellt und auf Möglichkeiten chirurgischer Therapie hingewiesen. Das Kurzdarm-Syndrom findet sich nach über 50% Dünndarmresektion, häufig nur intermittierend aufgrund der guten Adaptationsfähigkeit des Darmes. Die Korrektur besteht in der Inversion einer Dünndarmschlinge als Peristaltikbremse. Das Blindsack-Syndrom erfordert die Resektion von Blindsäcken oder Auflösung von Kurzschlüssen und Stenosen. Adhäsionen lassen sich pharmakologisch nicht vermeiden, die geeignetste Korrektur ist die ≫Innere Schienung≪ durch eine Sonde.

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  1. Abteilung für Allgemeinchirurgie, Chirurgische Universitätsklinik, Martinistraße 52, D-2000, Hamburg 20

    V. Schumpelick & R. Winkler

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  1. V. Schumpelick
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  2. R. Winkler
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Schumpelick, V., Winkler, R. 31. Mißerfolge und Korrektureingriffe. Langenbecks Arch Chiv 352, 153–158 (1980). https://doi.org/10.1007/BF01291992

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