Zusammenfassung
Das Zwerchfell befindet sich im wahrsten Sinne des Wortes im Randbereich verschiedener
chirurgischer Disziplinen. Die Grundprinzipien der Chirurgie des Zwerchfells werden
daher meist auch nur am Rande oder im Rahmen anderer Erkrankungen abgehandelt. In
diesem Artikel soll nun das Zwerchfell in das Zentrum der Betrachtungen gerückt werden
und chirurgische Aspekte von dessen häufigsten Erkrankungszuständen beleuchtet werden.
Abstract
Due to its importance as a central respiratory muscle as well as a separating layer
between the thorax and abdomen, the functional integrity of the diaphragm is crucial
in any case of surgical intervention. High demands are placed on surgical interventions
regarding the functional integrity of the diaphragm. The aim of surgery may even be
an improvement in the functional status of the patient. The surgery of the diaphragm
is performed according to the same basic principles, regardless of the indication
and the extent of the surgery. One of the most important principles concerns the suturing
of the diaphragm. Regardless of whether it is a large or small defect, a tension-free
suture is always required to prevent a secondary rupture or tearing of the suture
and thus of the diaphragm. If necessary, a non-resorbable patch should be used to
achieve a stress-free reconstruction. Because of the high physiological stress on
the suture, the use of a non-resorbable suture with a
high tear strength is recommended. Due to the position of the diaphragm between
the thorax and the abdomen, a multidisciplinary surgical team may be necessary in
surgical interventions depending on the state of the disease or the involvement of
abdominal or thoracic organs.
Schlüsselwörter
Zwerchfellchirurgie - Zwerchfellruptur - Zwerchfellhochstand - Zwerchfelltumor - Zwerchfellhernie
Key words
diaphragmatic hernia - diaphragm tumor - diaphragm paralysis - diaphragmatic rupture
