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Supportive Therapie nach proktologischen Eingriffen

Supportive treatment after anorectal surgery

  • Leitthema
  • Published:
coloproctology Aims and scope

Zusammenfassung

Hintergrund

Proktologische Operationen sind oft gekennzeichnet durch Schmerzen und einen langen Heilungsverlauf.

Ziel der Arbeit

Die aktuell möglichen und empfohlenen postoperativen supportiven Maßnahmen sollen dargestellt werden.

Methoden

Ausgewählte Originalartikel, Metaanalysen und Expertenmeinungen werden unter Berücksichtigung der eigenen Erfahrungen und Empfehlungen bewertet und diskutiert.

Ergebnisse

Die supportive Therapie umfasst die Schmerztherapie in Form von systemisch und lokal verabreichten Analgetika sowie Analgesie-unterstützenden Präparaten, die Stuhlregulation und Maßnahmen zur regelrechten Wundheilung. Zu einigen Aspekten der postoperativen Therapie ist die Evidenzlage gut, viele Empfehlungen der klinischen Routine entbehren jedoch einer zufriedenstellenden Datengrundlage. Dies stellt ihre Sinnhaftigkeit überwiegend nicht in Frage.

Diskussion

Eine suffiziente supportive postoperative Therapie ist bei proktologischen Operationen wichtig und umfasst diverse Möglichkeiten. Viele der empfohlenen Maßnahmen sollten durch zukünftige Studien eine überzeugende Evidenz erhalten.

Abstract

Background

Anorectal operations are often characterized by pain and a prolonged healing process.

Objective

This article presents a comprehensive overview of the currently possible and recommended postoperative treatment measures.

Methods

Evaluation and discussion of selected original articles, meta-analyses and expert opinions, taking own experiences and recommendations into account.

Results

Supportive treatment includes pain management in the form of systemically and locally administered analgesics and agents supporting analgesia, stool regulation and measures for a correct wound healing. The existing evidence for some aspects of the postoperative treatment is good but many routine recommendations derived from clinical experience lack a convincing data basis. This does not imply that they are unreasonable or without benefit for the patient.

Discussion

A sufficient supportive postoperative treatment is important in anorectal surgery and encompasses a variety of options. Many of the recommended measures should be strengthened by convincing evidence through future studies.

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Authors and Affiliations

  1. Proktologische Praxis Kiel, Beselerallee 67, 24105, Kiel, Deutschland

    T. Laubert &  J. Jongen

  2. Abteilung Chirurgische Proktologie, Park-Klinik, Goethestr. 11, 24116, Kiel, Deutschland

    T. Laubert &  J. Jongen

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T. Laubert und J. Jongen geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Laubert, T., Jongen, J. Supportive Therapie nach proktologischen Eingriffen. coloproctology 41, 170–178 (2019). https://doi.org/10.1007/s00053-019-0349-x

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