Zusammenfassung
Angeborene Fehlbildungen von Lunge und Zwerchfell stellen eine besondere Herausforderung der Kinderchirurgie dar. Sie zeigen ein breites Spektrum an Symptomen mit unterschiedlicher Ausprägung und variablem Manifestationsalter. Entsprechend vielseitig sind die diagnostischen und therapeutischen Möglichkeiten, die eine genaue Kenntnis der Pathologien erfordern. Die Behandlung sollte grundsätzlich in pädiatrischen Zentren erfolgen, die über ein interdisziplinäres Team aus Neonatologen, Pulmonologen, Kardiologen, HNO-Ärzten, Anästhesisten, Radiologen und Kinderchirurgen verfügen. Darüber hinaus werden einige Malformationen bereits intrauterin klinisch relevant und bedürfen einer pränatalen Therapie. Damit wird für die weitere Prognose die frühzeitige Anbindung an ein Perinatalzentrum entscheidend. Heutzutage stehen für Neugeborene und Säuglinge mit Malformationen der Lunge oder des Zwerchfells eine Vielzahl auch minimalinvasiver und endoluminaler Techniken zur Verfügung, die im nachfolgenden Artikel kritisch diskutiert werden sollen.
Abstract
Congenital malformations of the lung and diaphragm are a challenge in paediatric surgery. Depending on the malformation they show a broad spectrum of symptoms and a varying age at manifestation. Thus there are many diagnostic and therapeutic options, which require a good knowledge of the pathology. The treatment of these complex cases should lead to early referral to paediatric centres containing an interdisciplinary team with neonatologists, paediatric pulmonologists and cardiologists, ENT surgeons, anaesthesiologists, radiologists and paediatric surgeons. Some malformations are diagnosed prenatally and need intrauterine interventions. Decisive is the early diagnosis and treatment of these malformations. Nowadays the surgical therapy of neonates and infants with malformations of the lung and diaphragm is enriched by a number of endoscopic and endoluminal techniques, which are discussed critically in this article.
Schlüsselwörter
Thoraxchirurgie - Neugeborene - Säuglinge - angeborene Malformationen
Key words
thoracic surgery - newborn babies - infants - congenital malformations
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PD Dr. med. R. Metzger
Klinik und Poliklinik für Kinderchirurgie · Universität Leipzig
Liebigstr. 20 A
04103 Leipzig
Deutschland
Phone: +3 41 / 9 72 67 02
Fax: +3 41 / 9 72 64 09
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