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Sigmadivertikulitis: Indikation und Zeitpunkt zur Operation

Sigmoid diverticulitis: indications and timing of surgery

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Zusammenfassung

Hintergrund

Die Divertikelkrankheit stellt ein häufiges Problem im klinischen Alltag dar. Neben der Frage, wer stationär und wer ambulant behandelt werden soll, ist vor allem die Frage nach der Operationsindikation und dem Zeitpunkt zur Operation entscheidend. Da international die Erkrankung unterschiedlich klassifiziert wird, sind die Empfehlungen diesbezüglich nicht einheitlich.

Ziel der Arbeit (Fragestellung)

Im Folgenden werden die wesentlichen Aspekte bei der Indikationsstellung und Wahl des Operationszeitpunktes strukturiert und an der neuen S2K-Leitlinie orientiert abgearbeitet.

Ergebnisse

Erst in Zusammenschau aller essenziellen Informationen zur Divertikulitiserkrankung kann die Indikation und der Zeitpunkt für eine Operation sinnvoll festgelegt werden. Voraussetzung ist eine exakte, umfassende und prätherapeutisch anwendbare Klassifikation der Erkrankung. Die alleinige bildmorphologische Darstellung erlaubt keine ausreichende Beurteilung.

Diskussion

Die neue Einteilung der Sigmadivertikultis entsprechend der German guideline for diverticular disease classification (GGDDC) ermöglicht die geforderte Strategie bei der Indikationsstellung und der Wahl des Operationszeitpunktes.

Abstract

Background

Diverticular disease represents a common problem in the clinical routine. In addition to the question of who should be admitted to hospital for treatment and who can be treated as an outpatient, the questions of the indications and timing for surgery are decisive. Because the disease is internationally classified in different ways, the recommendations are also not uniform.

Objective

In this article the essential aspects of the indications for and timing of surgery are structured and oriented to the new S2K guidelines.

Results

The indications and timing of surgery can only be reasonably determined by evaluating all essential information on diverticular disease. A prerequisite is an exact, comprehensive and applicable classification of the disease before treatment. An adequate assessment cannot be made using morphological information obtained by imaging alone.

Discussion

The new classification of sigmoid diverticulitis corresponding to the German guidelines for diverticular disease classification (GGDDC) enables an appropriate strategy for evaluating the indications and selection of the time for surgery.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. C. Jurowich, F. Seyfried und CT Germer geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie, Zentrum für operative Medizin (ZOM), Universitätsklinikum Würzburg, Oberdürrbacherstr. 6, 97080, Würzburg, Deutschland

    C. Jurowich, F. Seyfried & C.T. Germer

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  1. C. Jurowich
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  2. F. Seyfried
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  3. C.T. Germer
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Correspondence to C. Jurowich.

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Jurowich, C., Seyfried, F. & Germer, C. Sigmadivertikulitis: Indikation und Zeitpunkt zur Operation. Chirurg 85, 304–307 (2014). https://doi.org/10.1007/s00104-013-2620-y

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