Einflussfaktoren auf die Anastomosenheilung

G. Meyer; R. A. Lang; F. W. Schildberg

doi:10.1055/s-2001-12711

Viszeralchirurgie, Table of Contents

Viszeralchirurgie 2001; 36(2): 49-68
DOI: 10.1055/s-2001-12711

AKTUELLE CHIRURGIE

Einflussfaktoren auf die Anastomosenheilung

Factors that Influence Anastomis HealingG. Meyer, R. A. Lang, F. W. Schildberg

Chirurgische Klinik und Poliklinik im Klinikum Großhadern der Ludwig-Maximilians-Universität München

Abstract

Zusammenfassung.

Die Anastomosenheilung kann in ihrem regelhaften Verlauf von einer Vielzahl unterschiedlicher Faktoren beeinflusst werden. Dabei ist von übergeordneter Bedeutung die Herstellung einer primär gas- und luftdichten, spannungslosen und gut durchbluteten Naht. Der Operateur und seine individuelle Operationstechnik insgesamt, aber weniger die gewählte Anastomosierungstechnik an sich spielt somit eine entscheidende Rolle. Daneben kann das Heilungsergebnis durch eine Reihe weiterer lokaler und allgemeiner Faktoren beeinflusst werden, deren praktische Relevanz für die Klinik allerdings im Einzelnen nur zum Teil gesichert ist. Dennoch ist ihre Kenntnis und Beachtung wegen der durch den Faktorensynergismus bestimmte Einflussnahme auf das Heilungsergebnis wichtig. Der Wunsch nach einer medikamentösen Heilungsmodulation käme vor allem Risikoanastomosen zugute, konnte aber bislang nur partiell erfüllt werden.

Factors that Influence Anastomis Healing.

Normal anastomotic healing can be influenced by numerous different factors. Achieving a primary gas tight, tension free and well perfused suture is of major importance. This is why the surgeon and his own surgical technique rather than the chosen technique of anastomosis play the leading role in anastomotic healing. In addition to this, the healing result may be influenced by a number of other local or general factors. The clinical relevance of most of these factors, however, has not been proven in prospective studies. Nonetheless, it appears to be most important to know and obey these factors, since they do influence the healing result. The goal of drug assisted anastomotic healing is of special healing for anastomoses in risk patients. This goal, however, has only been reached partially until today.

Schlüsselwörter:

Anastomosen - Anastomosenheilung - Anastomosentechnik - Einflussfaktoren - Gastrointestinaltrakt

Key words:

Anastomoses - anastomotic healing - influencing factors - technique of anastomoses - gastro intestinal tract

Full Text

References

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PD Dr. G. Meyer

Chirurgische Klinik und Poliklinik
Klinikum Großhadern

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