Inzidenz, Risikofaktoren und Prävention der intestinalen Nahtinsuffizienz

Zusammenfassung

Hintergrund: Die intestinale Anastomoseninsuffizienz stellt eine schwerwiegende Komplikation mit relevanter Morbidität und Mortalität dar. Material und Methoden: Auf Grundlage einer Literaturrecherche in Medline / PubMed werden die Daten zum Thema im Überblick dargestellt, kritisch bewertet und zusammengefasst. Ergebnisse und Schlussfolgerung: Neben der ­Optimierung der chirurgischen Technik spielen patientenabhängige Risikofaktoren eine wesentliche Rolle für die Entwicklung einer Anasto­mosen­insuffizienz. Dazu gehören Begleiterkran­kungen, der Ernährungsstatus und die Einnahme bestimmter Medikamente oder eine vorangegangene Radio-Chemotherapie. Der Aufwand zur Optimierung dieser patientenbedingten Risikofaktoren findet im heutigen stationären Vergütungssystem keine Abbildung. 

Abstract

Background: Intestinal anastomotic leakage represents a major complication in visceral surgery with relevant morbidity and mortality. Material and Methods: Based on a literature ­search in Medline / PubMed the available data are presented, critically reviewed and summarised. Results and Conclusion: Beside optimisation of surgical technique, patient-dependent risk factors – such as relevant comorbidity, certain medica­tions or previous radiochemotherapy – play a major role in the development of anastomotic leak­age. The effort for optimisation of these patient-dependent risk factors is not incorporated within the compensation scheme in German hospitals. 

Schlüsselwörter

intestinale Ansatomoseninsuffizienz - intestinale Nahtinsuffizienz - Risikofaktoren - Inzidenz - Prävention

Key words

intestinal ansastomotic leakage - intestinal súrture failure - risk factors - incidence - prevention

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