Anastomosenprobleme in der Ösophaguschirurgie - Prophylaxe, Management und Ergebnisse

Zusammenfassung

Die wichtigsten Punkte bei Komplikationen nach Ösophagektomie sind die Prävention, die Früherkennung und die zielgerichtete Behandlung. Die Anastomoseninsuffizienz ist die häufigste chirurgische Komplikation nach Speiseröhrenoperation. Zur Frühdiagnostik zählt die Endoskopie, das Kontraströntgen und das CT. Die Prophylaxe umfasst die Vermeidung von Spannung an der Anastomose und Störung der Vaskularisation des Interponates sowie die Ausführung einer exakten Nahttechnik. Das Management beinhaltet die konservative Behandlung mit Magensonde und Antibiotika oder die endoskopische Stent-Einbringung einer abgedeckten Leckage sowie die Reoperation einer nicht gedeckten Insuffizienz. Bei frühem Einschreiten und konsequentem Management können heute die meisten Anastomosenprobleme nach Ösophaguschirurgie erfolgreich behandelt werden.

Schlüsselwörter

Ösophagektomie - Anastomoseninsuffizienz - Management

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