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DOI: 10.1055/s-0028-1098764
© Georg Thieme Verlag Stuttgart ˙ New York
Vakuumtherapie einer Anastomoseninsuffizienz am Ösophagus – ein Fallbericht
Vacuum Therapy of an Esophageal Anastomotic Leakage – A Case ReportPublikationsverlauf
Publikationsdatum:
22. April 2009 (online)
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Zusammenfassung
Hintergrund: Die Anastomoseninsuffizienz am Ösophagus ist eine der schwersten postoperativen Komplikationen. Bei Anastomoseninsuffizienzen am Rektum wird die endoskopische intrakavitäre Vakuumtherapie bereits erfolgreich eingesetzt. Wir wendeten die Vakuumtherapie bei einer Anastomoseninsuffizienz am Ösophagus an. Patient und Methodik: Bei einer 80-jährigen Patientin wurde am 6. postoperativen Tag nach Gastrektomie eine Anastomoseninsuffizienz diagnostiziert. Es erfolgte die intracavitäre Vakuumtherapie durch die endoskopische Einlage eines Polyurethanschwammes. Nach einer Behandlungsdauer von 14 Tagen mit 4-maligem Wechsel bei Wechselintervallen von 2 bis 4 Tagen war der Defekt abgeheilt. Eine Woche nach Therapieende wurde endoskopisch ein zweiter Defekt nachgewiesen, der in gleicher Technik behandelt wurde. Die postoperative Krankenhausverweildauer betrug 60 Tage. Folgerungen: Eine Anastomoseninsuffizienz am Ösophagus lässt sich erfolgreich mit der endoskopischen intrakavitären Vakuumtherapie behandeln. Der vorliegende Artikel gibt eine Handlungsanweisung zur Durchführung der Therapie.
Abstract
Background: Esophageal anastomotic leakage is a major complication. In rectal surgery, anastomotic dehiscence is successfully treated by endoscopically placed intracavitary vacuum sponge systems. We used this technique in a case of anastomotic dehiscence following transhiatal gastrectomy. Patient and Method: In an 80-year-old female patient esophageal anastomotic leakage was diagnosed endoscopically six days following transhiatal gastrectomy. Endocavitary treatment by endoscopic implantation of a vacuum sponge system was performed. After 14 days of treatment with 4 system changes and a change interval of 2–4 days complete healing was observed. A week later, a second wall defect was diagnosed and treated in the same way. The total hospital stay after operation was sixty days. Conclusion: Esophageal anastomotic leakage can be successfully treated by means of an endoscopically placed intracavitary vacuum sponge system. This paper describes the therapeutic technique.
Schlüsselwörter
Vakuumtherapie - Anastomoseninsuffizienz - Ösophagus - Stent
Key words
vacuum therapy - anastomotic leakage - esophagus - stent
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Dr. med. G. Loske
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