nach oben

Journal of Gastrointestinal Surgery

Erschienen in:

01.06.2007

Surgical Treatment of Crohn’s Disease

verfasst von: Alessandro Fichera, Fabrizio Michelassi

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 6/2007

Einloggen, um Zugang zu erhalten

Excerpt

Crohn’s disease is an entity which comprises a heterogeneous spectrum of intestinal and extraintestinal manifestations, each one requiring individual approaches for diagnosis and management. Medical management has evolved greatly during the last decade: innovations have included the introduction of new therapeutical agents for prophylaxis and for management of complications. Yet, the introduction of new biologic agents, such as anti-TNF antibody1,2, or immunomodulators, such as azathioprine/6 mercaptopurine3, has not significantly changed the long-term prognosis and natural history of patients with Crohn’s disease4,5. Patients with Crohn’s disease still tend to require surgery as time progresses, and the timing of surgery is critical. This review article will focus on the indications for surgical treatment, on the preoperative evaluation of Crohn’s patients, on surgical options specific to different gastrointestinal locations affected by the disease, and on new minimally invasive approaches to this disease. …

Travassos WJ, Cheifetz AS. Infliximab: Use in inflammatory bowel disease. Curr Treatm Opt Gastroenterol 2005;8(3):187–196.

Present DH, Rutgeerts P, Targan S, et al. Infliximab for the treatment of fistulas in patients with Crohn’s disease. N Engl J Med 1999;340(18):1398–1405.PubMed

Summers RW, Switz DM, Sessions JT Jr, et al. National cooperative Crohn’s disease study: Results of drug treatment. Gastroenterology 1979;77(4 Pt 2):847–869.PubMed

Rhodes J, Bainton D, Beck P, Campbell H. Controlled trial of Azathioprine in Crohn’s disease. Lancet 1971;2(7737):1273–1276.PubMed

Cohen RD, Tsang JF, Hanauer SB. Infliximab in Crohn’s disease: First anniversary clinical experience. Am J Gastroenterol 2000;95(12):3469–3477.PubMed

Farmer RG, Hawk WA, Turnbull RB Jr. Clinical patterns in Crohn’s disease: A statistical study of 615 cases. Gastroenterology 1975;68(4 Pt 1):627–635.PubMed

Hurst RD, Molinari M, Chung TP, Rubin M, Michelassi F. Prospective study of the features, indications, and surgical treatment in 513 consecutive patients affected by Crohn’s disease. Surgery 1997;122(4):661–667.PubMed

Michelassi F, Block GE. Surgical management of Crohn’s disease. Adv Surg 1993;26:307–322.PubMed

Michelassi F, Balestracci T, Chappell R, Block GE. Primary and recurrent Crohn’s disease. Experience with 1,379 patients. Ann Surg 1991;214(3):230–238.PubMed

10.

Michelassi F, Stella M, Balestracci T, Giuliante F, Marogna P, Block GE. Incidence, diagnosis, and treatment of enteric and colorectal fistulae in patients with Crohn’s disease. Ann Surg 1993;218(5):660–666.PubMed

11.

Broe PJ, Bayless TM, Cameron JL. Crohn’s disease: Are enteroenteral fistulas an indication for surgery? Surgery 1982;91(3):249–253.PubMed

12.

Heyen F, Ambrose NS, Allan RN, Dykes PW, Alexander-Williams J, Keighley MR. Enterovesical fistulas in Crohn’s disease. Ann R Coll Surg Engl 1989;71(2):101–104.PubMed

13.

Blackett RL, Hill GL. Postoperative external small bowel fistulas: A study of a consecutive series of patients treated with intravenous hyperalimentation. Br J Surg 1978;65(11):775–778.PubMed

14.

Hawker PC, Givel JC, Keighley MR, Alexander-Williams J, Allan RN. Management of enterocutaneous fistulae in Crohn’s disease. Gut 1983;24(4):284–287.PubMed

15.

Heyen F, Winslet MC, Andrews H, Alexander-Williams J, Keighley MR. Vaginal fistulas in Crohn’s disease. Dis Colon Rectum 1989;32(5):379–383.PubMed

16.

Wilk PJ, Fazio V, Turnbull RB Jr. The dilemma of Crohn’s disease: Ileoduodenal fistula complicating Crohn’s disease. Dis Colon Rectum 1977;20(5):387–392.PubMed

17.

Gervais DA, Hahn PF, O’Neill MJ, Mueller PR. Percutaneous abscess drainage in Crohn’s disease: Technical success and short- and long-term outcomes during 14 years. Radiology 2002;222(3):645–651.PubMed

18.

Bernini A, Spencer MP, Wong WD, Rothenberger DA, Madoff RD. Computed tomography-guided percutaneous abscess drainage in intestinal disease: Factors associated with outcome. Dis Colon Rectum 1997;40(9):1009–1013.PubMed

19.

Greenstein AJ, Sachar DB, Mann D, Lachman P, Heimann T, Aufses AH Jr. Spontaneous free perforation and perforated abscess in 30 patients with Crohn’s disease. Ann Surg 1987;205(1):72–76.PubMed

20.

Sparberg M, Kirsner JB. Recurrent hemorrhage in regional enteritis. Report of 3 cases. Am J Dig Dis 1966;11(8):652–657.PubMed

21.

Belaiche J, Louis E, D’Haens G, et al. Acute lower gastrointestinal bleeding in Crohn’s disease: Characteristics of a unique series of 34 patients. Belgian IBD Research Group. Am J Gastroenterol 1999;94(8):2177–2181.PubMed

22.

Cirocco WC, Reilly JC, Rusin LC. Life-threatening hemorrhage and exsanguination from Crohn’s disease. Report of four cases. Dis Colon Rectum 1995;38(1):85–95.PubMed

23.

Darke SG, Parks AG, Grogono JL, Pollock DJ. Adenocarcinoma and Crohn’s disease. A report of 2 cases and analysis of the literature. Br J Surg 1973;60(3):169–175.PubMed

24.

Ribeiro MB, Greenstein AJ, Sachar DB, et al. Colorectal adenocarcinoma in Crohn’s disease. Ann Surg 1996;223(2):186–193.PubMed

25.

Richards ME, Rickert RR, Nance FC. Crohn’s disease-associated carcinoma. A poorly recognized complication of inflammatory bowel disease. Ann Surg 1989;209(6):764–773.PubMed

26.

Hamilton SR. Colorectal carcinoma in patients with Crohn’s disease. Gastroenterology 1985:89(2):398–407.PubMed

27.

Michelassi F, Testa G, Pomidor WJ, Lashner BA, Block GE. Adenocarcinoma complicating Crohn’s disease. Dis Colon Rectum 1993;36(7):654–661.PubMed

28.

Ribeiro MB, Greenstein AJ, Heimann TM, Yamazaki Y, Aufses AH Jr. Adenocarcinoma of the small intestine in Crohn’s disease. Surg Gynecol Obstet 1991;173(5):343–349.PubMed

29.

Greenstein AJ, Sachar D, Pucillo A, et al. Cancer in Crohn’s disease after diversionary surgery. A report of seven carcinomas occurring in excluded bowel. Am J Surg 1978;135(1):86–90.PubMed

30.

Cirincione E, Gorfine SR, Bauer JJ. Is Hartmann’s procedure safe in Crohn’s disease? Report of three cases. Dis Colon Rectum 2000;43(4):544–547.PubMed

31.

Yamazaki Y, Ribeiro MB, Sachar DB, Aufses AH Jr, Greenstein AJ. Malignant colorectal strictures in Crohn’s disease. Am J Gastroenterol 1991;86(7):882–885.PubMed

32.

Korelitz BI. Considerations of surveillance, dysplasia, and carcinoma of the colon in the management of ulcerative colitis and Crohn’s disease. Med Clin North Am 1990;74(1):189–199.PubMed

33.

Kelts DG, Grand RJ, Shen G, Watkins JB, Werlin SL, Boehme C. Nutritional basis of growth failure in children and adolescents with Crohn’s disease. Gastroenterology 1979;76(4):720–727.PubMed

34.

Chernish SM, Maglinte DD, O’Connor K. Evaluation of the small intestine by enteroclysis for Crohn’s disease. Am J Gastroenterol 1992;87(6):696–701.PubMed

35.

Buchman AL, Miller FH, Wallin A, Chowdhry AA, Ahn C. Videocapsule endoscopy versus barium contrast studies for the diagnosis of Crohn’s disease recurrence involving the small intestine. Am J Gastroenterol 2004;99(11):2171–2177.PubMed

36.

Schreyer AG, Seitz J, Feuerbach S, Rogler G, Herfarth H. Modern imaging using computer tomography and magnetic resonance imaging for inflammatory bowel disease (IBD). AU1. Inflamm Bowel Dis 2004;10(1):45–54.PubMed

37.

Murray JJ, Schoetz DJ Jr, Nugent FW, Coller JA, Veidenheimer MC. Surgical management of Crohn’s disease involving the duodenum. Am J Surg 1984;147(1):58–65.PubMed

38.

Yamamoto T, Allan RN, Keighley MR. An audit of gastroduodenal Crohn disease: Clinicopathologic features and management. Scand J Gastroenterol 1999;34(10):1019–1024.PubMed

39.

Reynolds HL Jr, Stellato TA. Crohn’s disease of the foregut. Surg Clin North Am 2001;81(1):117–135.PubMed

40.

Yamamoto T, Bain IM, Connolly AB, Allan RN, Keighley MR. Outcome of strictureplasty for duodenal Crohn’s disease. Br J Surg 1999;86(2):259–262.PubMed

41.

Worsey MJ, Hull T, Ryland L, Fazio V. Strictureplasty is an effective option in the operative management of duodenal Crohn’s disease. Dis Colon Rectum 1999;42(5):596–600.PubMed

42.

Tan WC, Allan RN. Diffuse jejunoileitis of Crohn’s disease. Gut 1993;34(10):1374–1378.PubMed

43.

Hellers G. Crohn’s disease in Stockholm county 1955–1974. A study of epidemiology, results of surgical treatment and long-term prognosis. Acta chir Scand Suppl 1979;490:1–84.PubMed

44.

Cooke WT, Mallas E, Prior P, Allan RN. Crohn’s disease: Course, treatment and long term prognosis. Q J Med 1980;49(195):363–384.PubMed

45.

Lee EC, Papaioannou N. Minimal surgery for chronic obstruction in patients with extensive or universal Crohn’s disease. Ann R Coll Surg Engl 1982;64(4):229–233.PubMed

46.

Alexander-Williams J, Haynes IG. Conservative operations for Crohn’s disease of the small bowel. World J Surg 1985;9(6):945–951.PubMed

47.

Katariya RN, Sood S, Rao PG, Rao PL. Stricture-plasty for tubercular strictures of the gastro-intestinal tract. Br J Surg 1977;64(7):496–498.PubMed

48.

Hurst RD, Michelassi F. Strictureplasty for Crohn’s disease: Techniques and long-term results. World J Surg 1998;22(4):359–363.PubMed

49.

Michelassi F. Side-to-side isoperistaltic strictureplasty for multiple Crohn’s strictures. Dis Colon Rectum 1996;39(3):345–349.PubMed

50.

Dietz DW, Laureti S, Strong SA, et al. Safety and long-term efficacy of strictureplasty in 314 patients with obstructing small bowel Crohn’s disease. J Am Coll Surg 2001;192(3):330–337.PubMed

51.

Ozuner G, Fazio VW. Management of gastrointestinal bleeding after strictureplasty for Crohn’s disease. Dis Colon Rectum 1995;38(3):297–300.PubMed

52.

Tichansky D, Cagir B, Yoo E, Marcus SM, Fry RD. Strictureplasty for Crohn’s disease: Meta-analysis. Dis Colon Rectum 2000;43(7):911–919.PubMed

53.

Michelassi F, Hurst RD, Melis M, et al. Side-to-side isoperistaltic strictureplasty in extensive Crohn’s disease: A prospective longitudinal study. Ann Surg 2000;232(3):401–408.PubMed

54.

Hoffman JP, Taft DA, Wheelis RF, Walker JH. Adenocarcinoma in regional enteritis of the small intestine. Arch Surg 1977;112(5):606–611.PubMed

55.

Marchetti F, Fazio VW, Ozuner G. Adenocarcinoma arising from a strictureplasty site in Crohn’s disease. Report of a case. Dis Colon Rectum 1996;39(11):1315–1321.PubMed

56.

Jaskowiak NT, Michelassi F. Adenocarcinoma at a strictureplasty site in Crohn’s disease: Report of a case. Dis Colon Rectum 2001;44(2):284–287.PubMed

57.

Bernell O, Lapidus A, Hellers G. Risk factors for surgery and postoperative recurrence in Crohn’s disease. Ann Surg 2000;231(1):38–45.PubMed

58.

Kim NK, Senagore AJ, Luchtefeld MA, et al. Long-term outcome after ileocecal resection for Crohn’s disease. Am Surgeon 1997;63(7):627–633.PubMed

59.

Yamamoto T, Keighley MR. Smoking and disease recurrence after operation for Crohn’s disease. Br J Surg 2000;87(4):398–404.PubMed

60.

Sahai A, Belair M, Gianfelice D, Cote S, Gratton J, Lahaie R. Percutaneous drainage of intra-abdominal abscesses in Crohn’s disease: Short and long-term outcome. Am J Gastroenterol 1997;92(2):275–278.PubMed

61.

Yamamoto T, Keighley MR. Long-term results of strictureplasty for ileocolonic anastomotic recurrence in Crohn’s disease. J Gastrointest Surg 1999;3(5):555–560.PubMed

62.

Pezim ME, Pemberton JH, Beart RW Jr, et al. Outcome of “indeterminate” colitis following ileal pouch–anal anastomosis. Dis Colon Rectum 1989;32(8):653–658.PubMed

63.

Deutsch AA, McLeod RS, Cullen J, Cohen Z. Results of the pelvic-pouch procedure in patients with Crohn’s disease. Dis Colon Rectum 1991;34(6):475–477.PubMed

64.

Edwards CM, Warren BF, Shepherd NA. Ileal pouch–anal anastomosis for Crohn’s disease. Gut 1999;44(6):896.PubMed

65.

Hyman NH, Fazio VW, Tuckson WB, Lavery IC. Consequences of ileal pouch–anal anastomosis for Crohn’s colitis. Dis Colon Rectum 1991;34(8):653–657.PubMed

66.

Keighley MR, Allan RN, Sanders DS. Ileal pouch–anal anastomosis for Crohn’s disease. Gut 1999;44(3):440–441.PubMedCrossRef

67.

Fazio VW, Wu JS. Surgical therapy for Crohn’s disease of the colon and rectum. Surg Clin North Am 1997;77(1):197–210.PubMed

68.

Allan A, Andrews H, Hilton CJ. Segmental colonic resection is an appropriate operation for short skip lesions due to Crohn’s disease in the colon. World J Surg 1989;13:611–616.PubMed

69.

Sanfey H, Bayless TM, Cameron JL. Crohn’s disease of the colon. Is there a role for limited resection? Am J Surg 1984;147:38–42.PubMed

70.

Fichera A, McCormack R, Rubin MA, Hurst RD, Michelassi F. Long-term outcome of surgically treated Crohn’s colitis: A prospective study. Dis Colon Rectum 2005;48(5):963–969.PubMed

71.

Longo WE, Ballantyne GH, Cahow CE. Treatment of Crohn’s colitis. Segmental or total colectomy? Arch Surg 1988;123(5):588–590.PubMed

72.

Prabhakar LP, Laramee C, Nelson H, Dozois RR. Avoiding a stoma: Role for segmental or abdominal colectomy in Crohn’s colitis. Dis Colon Rectum 1997;40(1):71–78.PubMed

73.

Nugent FW, Veidenheimer MC, Meissner WA, Haggitt RC. Prognosis after colonic resection for Crohn’s disease of the colon. Gastroenterology 1973;65(3):398–402.PubMed

74.

Korelitz BI, Present DH, Alpert LI, Marshak RH, Janowitz HD. Recurrent regional ileitis after ileostomy and colectomy for granulomatous colitis. N Engl J Med 1972;287(3):110–115.PubMedCrossRef

75.

Scammell BE, Andrews H, Allan RN, Alexander-Williams J, Keighley MR. Results of proctocolectomy for Crohn’s disease. Br J Surg 1987;74(8):671–674.PubMed

76.

Sagar PM, Dozois RR, Wolff BG. Long-term results of ileal pouch–anal anastomosis in patients with Crohn’s disease. Dis Colon Rectum 1996;39(8):893–898.PubMed

77.

Panis Y, Poupard B, Nemeth J, Lavergne A, Hautefeuille P, Valleur P. Ileal pouch/anal anastomosis for Crohn’s disease. Lancet 1996;347(9005):854–857.PubMed

78.

Greenstein AJ, Sachar DB, Gibas A, et al. Outcome of toxic dilatation in ulcerative and Crohn’s colitis. J Clin Gastroenterol 1985;7(2):137–143.PubMed

79.

Williams DR, Coller JA, Corman ML, Nugent FW, Veidenheimer MC. Anal complications in Crohn’s disease. Dis Colon Rectum 1981;24(1):22–24.PubMed

80.

Parks AG. A new classification of fistulae-in-ano. Br J Surg 1976;63:1–6.PubMed

81.

Sangwan YP, Schoetz DJ Jr, Murray JJ, Roberts PL, Coller JA. Perianal Crohn’s disease. Results of local surgical treatment. Dis Colon Rectum 1996;39(5):529–535.PubMed

82.

Levien DH, Surrell J, Mazier WP. Surgical treatment of anorectal fistula in patients with Crohn’s disease. Surg Gynecol Obstet 1989;169(2):133–136.PubMed

83.

Williams JG, Rothenberger DA, Nemer FD, Goldberg SM. Fistula-in-ano in Crohn’s disease. Results of aggressive surgical treatment. Dis Colon Rectum 1991;34(5):378–384.PubMed

84.

Sandborn W. Therapeutic efficacy in Crohn’s disease. Gastroenterology 2003;125:380–386.PubMed

85.

Regueiro M. Combination treatment for perineal Crohn’s disease. Inflamm Bowel Dis 2003;9(2):98–102.PubMed

86.

Williamson PR, Hellinger MD, Larach SW, Ferrara A. Twenty-year review of the surgical management of perianal Crohn’s disease. Dis Colon Rectum 1995;38(4):389–392.PubMed

87.

Radcliffe AG, Ritchie JK, Hawley PR, Lennard-Jones JE, Northover JM. Anovaginal and rectovaginal fistulas in Crohn’s disease. Dis Colon Rectum 1988;31(2):94–99.PubMed

88.

Scott NA, Nair A, Hughes LE. Anovaginal and rectovaginal fistula in patients with Crohn’s disease. The Br J Surg 1992;79(12):1379–1380.

89.

Joo JS, Weiss EG, Nogueras JJ, Wexner SD. Endorectal advancement flap in perianal Crohn’s disease. Am Surgeon 1998;64(2):147–150.PubMed

90.

Marchesa P, Hull TL, Fazio VW. Advancement sleeve flaps for treatment of severe perianal Crohn’s disease. Br J Surg 1998;85(12):1695–1698.PubMed

91.

Bauer JJ, Sher ME, Jaffin H, Present D, Gelerent I. Transvaginal approach for repair of rectovaginal fistulae complicating Crohn’s disease. Ann Surg 1991;213(2):151–158.PubMed

92.

Hesterberg R, Schmidt WU, Muller F, Roher HD. Treatment of anovaginal fistulas with an anocutaneous flap in patients with Crohn’s disease Int J Colorectal Dis 1993;8(1):51–54.PubMed

93.

Yamamoto T, Allan RN, Keighley MR. Effect of fecal diversion alone on perianal Crohn’s disease. World J Surg 2000;24(10):1258–1262.PubMed

94.

Michelassi F, Melis M, Rubin M, Hurst RD. Surgical treatment of anorectal complications in Crohn’s disease. Surgery 2000;128(4):597–603.PubMed

95.

Bemelman WA, Slors JF, Dunker MS, et al. Laparoscopic-assisted vs. open ileocolic resection for Crohn’s disease. A comparative study. Surg Endosc 2000;14(8):721–725.PubMed

96.

Alabaz O, Iroatulam AJ, Nessim A, Weiss EG, Nogueras JJ, Wexner SD. Comparison of laparoscopically assisted and conventional ileocolic resection for Crohn’s disease. Eur J Surg 2000;166(3):213–217.PubMed

97.

Chung CC, Tsang WW, Kwok SY, Li MK. Laparoscopy and its current role in the management of colorectal disease. Colorectal Dis 2003;5(6):528–543.PubMed

98.

Young-Fadok TM, HallLong K, McConnell EJ, Gomez Rey G, Cabanela RL. Advantages of laparoscopic resection for ileocolic Crohn’s disease. Improved outcomes and reduced costs. Surg Endosc 2001;15(5):450–454.PubMed

99.

von Allmen D, Markowitz JE, York A, Mamula P, Shepanski M, Baldassano R. Laparoscopic-assisted bowel resection offers advantages over open surgery for treatment of segmental Crohn’s disease in children. J Pediatr Surg 2003;38(6):963–965.

100.

Duepree HJ, Senagore AJ, Delaney CP, Brady KM, Fazio VW. Advantages of laparoscopic resection for ileocecal Crohn’s disease. Dis Colon Rectum 2002;45(5):605–610.PubMed

101.

Benoist S, Panis Y, Beaufour A, Bouhnik Y, Matuchansky C, Valleur P. Laparoscopic ileocecal resection in Crohn’s disease: A case-matched comparison with open resection. Surg Endosc 2003;17(5):814–818.PubMed

102.

Bergamaschi R, Pessaux P, Arnaud JP. Comparison of conventional and laparoscopic ileocolic resection for Crohn’s disease. Dis Colon Rectum 2003;46(8):1129–1133.PubMed

103.

Rosman AS, Melis M, Fichera A. Meta-analysis of trials comparing laparoscopic and open surgery for Crohn’s disease. Surg Endosc 2005;19:1549–1555.PubMed

104.

HALS Study Group. Hand-assisted laparoscopic surgery vs standard laparoscopic surgery for colorectal disease: A prospective randomized trial. Surg Endosc 2000;14(10):896–901.

105.

Hurst RD, Cohen RD. The role of laparoscopy and strictureplasty in the management of inflammatory bowel disease. Semin Gastrointest Dis 2000;11(1):10–17.PubMed

106.

Ludwig KA, Milsom JW, Church JM, Fazio VW. Preliminary experience with laparoscopic intestinal surgery for Crohn’s disease. Am J Surg 1996;171(1):52–55.PubMed

107.

Meijerink WJ, Eijsbouts QA, Cuesta MA, et al. Laparoscopically assisted bowel surgery for inflammatory bowel disease. The combined experiences of two academic centers. Surg Endosc 1999;13(9):882–886.PubMed

108.

Bemelman WA, van Hogezand RA, Meijerink WJ, Griffioen G, Ringers J. Laparoscopic-assisted bowel resections in inflammatory bowel disease: State of the art. Neth J Med 1998;53(6):S39–S46.PubMed

109.

Milsom JW, Hammerhofer KA, Bohm B, Marcello P, Elson P, Fazio VW. Prospective, randomized trial comparing laparoscopic vs. conventional surgery for refractory ileocolic Crohn’s disease. Dis Colon Rectum 2001;44(1):1–8, discussion 9.PubMed

Titel: Surgical Treatment of Crohn’s Disease
verfasst von: Alessandro Fichera
Fabrizio Michelassi
Publikationsdatum: 01.06.2007
Verlag: Springer-Verlag
Erschienen in: Journal of Gastrointestinal Surgery / Ausgabe 6/2007
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-006-0068-9

Neu im Fachgebiet Chirurgie

Vorsicht, erhöhte Blutungsgefahr nach PCI!

10.05.2024 Koronare Herzerkrankung Nachrichten

Nach PCI besteht ein erhöhtes Blutungsrisiko, wenn die Behandelten eine verminderte linksventrikuläre Ejektionsfraktion aufweisen. Das Risiko ist umso höher, je stärker die Pumpfunktion eingeschränkt ist.

Darf man die Behandlung eines Neonazis ablehnen?

08.05.2024 Gesellschaft Nachrichten

In einer Leseranfrage in der Zeitschrift Journal of the American Academy of Dermatology möchte ein anonymer Dermatologe bzw. eine anonyme Dermatologin wissen, ob er oder sie einen Patienten behandeln muss, der eine rassistische Tätowierung trägt.

Deutlich weniger Infektionen: Wundprotektoren schützen!

08.05.2024 Postoperative Wundinfektion Nachrichten

Der Einsatz von Wundprotektoren bei offenen Eingriffen am unteren Gastrointestinaltrakt schützt vor Infektionen im Op.-Gebiet – und dient darüber hinaus der besseren Sicht. Das bestätigt mit großer Robustheit eine randomisierte Studie im Fachblatt JAMA Surgery.

Chirurginnen und Chirurgen sind stark suizidgefährdet

07.05.2024 Suizid Nachrichten

Der belastende Arbeitsalltag wirkt sich negativ auf die psychische Gesundheit der Angehörigen ärztlicher Berufsgruppen aus. Chirurginnen und Chirurgen bilden da keine Ausnahme, im Gegenteil.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare

CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare

CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske

Dr. med. Benjamin Meyknecht

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare

CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric

Springer Medizin

Excerpt

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2007

Co-morbidity is a Strong Predictor of Early Death and Multi-organ System Failure among Patients with Acute Pancreatitis

Middle Segment Pancreatectomy: A Useful Tool in the Management of Pancreatic Neoplasms

Enteral Immunonutrition During Sepsis Prevents Pulmonary Dysfunction in a Rat Model

Effect of Location and Speed of Diagnosis on Anastomotic Leak Outcomes in 3828 Gastric Bypass Cases

Laparoscopic Medial-to-lateral Colon Dissection: How and Why

Intra-abdominal Esophageal Duplication Cysts: A Review

Update Chirurgie