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Anastomosentechniken am GastrointestinaItrakt

Anastomotic techniques for the gastrointestinal tract

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Zusammenfassung

Die korrekte Nahttechnik ist eine grundlegende Voraussetzung für den Erfolg einer Operation. Ziel dieses Beitrags ist es, chirurgische Prinzipien häufig angewendeter Nahttechniken zur Erstellung einer Anastomose sowie den differenzierten Einsatz verschiedener Nahthilfsmittel im Gastrointestinaltrakt zusammenzufassen. Beschrieben werden die manuellen Verfahren und die Anwendung von Staplern. Dabei werden Wundheilung und organspezifische Besonderheiten und deren Auswirkungen auf die Anastomosentechnik berücksichtigt. Die Diskussion und die Frage nach der richtigen Technik bleiben offen, da es keinen verbindlichen Standard zur Erstellung einer gastrointestinalen Anastomose gibt und wahrscheinlich geben wird. Die Ansprüche an eine ideale Anastomose sind jedoch mit guter Durchblutung, Sicherheit, Spannungsfreiheit und sauberem Operationsgebiet klar definiert.

Abstract

The correct suture technique for anastomoses of the gastrointestinal (GI) tract is a major task in the daily practice of surgery and a basic requirement for a successful operation. This article provides an overview of the surgical principles and techniques involved in the creation of intestinal anastomoses, including the differentiated use of various suturing aids in the GI tract. Hand sewn and stapled anastomotic techniques are illustrated and discussed. The ongoing discussion and question as to which technique is best for GI anastomoses remains unanswered as there is no obligatory standard, even though the requirements are well defined. An ideal anastomosis should fulfil the following criteria: it must be well vascularized, safe, tension-free and spillage from the operation field should be avoided.

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Danksagung

Besonderer Dank gilt Herrn Wilfried Schroeder für die Erstellung und Bearbeitung der Graphiken.

Einhaltung ethischer Richtlinien

Interessenkonflikt. M.G. Laukötter und N. Senninger geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Allgemein- und Viszeralchirurgie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude W1, 48149, Münster, Deutschland

    M.G. Laukötter & N. Senninger

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  1. M.G. Laukötter
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  2. N. Senninger
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Correspondence to M.G. Laukötter.

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Laukötter, M., Senninger, N. Anastomosentechniken am GastrointestinaItrakt. Chirurg 84, 1085–1098 (2013). https://doi.org/10.1007/s00104-012-2392-9

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  • DOI: https://doi.org/10.1007/s00104-012-2392-9

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