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Erschienen in: Die Chirurgie 11/2022

29.08.2022 | Colitis ulcerosa | Leitthema

Dünndarmpouch nach restaurativer Proktokolektomie

verfasst von: S. Flemming, M. Kelm, C.-T. Germer, Prof. Dr. A. Wiegering

Erschienen in: Die Chirurgie | Ausgabe 11/2022

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Zusammenfassung

Die stetige Weiterentwicklung der Pouchchirurgie hat eine kontinenzerhaltende Therapie nach Koloproktektomie ermöglicht. Der ileoanale J‑Pouch ist heutzutage die Standardrekonstruktion nach restaurativer Koloproktektomie mit einem exzellenten funktionellen Langzeitergebnis. Unter Berücksichtigung relativer Kontraindikationen und bei geeigneter Patientenselektion kann eine Pouchanlage nicht nur bei der Colitis ulcerosa und der familiären adenomatösen Polyposis indiziert werden, sondern auch bei Patienten mit einer nicht fistulierenden Pankolitis Crohn. Aufgrund einer hohen Behandlungsdichte mit Immunsuppressiva ist das chirurgisch-therapeutische Regime in ein mehrzeitiges Vorgehen aufzugliedern, wobei nach aktuellen Daten ein modifiziertes zweizeitiges Prozedere zu favorisieren ist.
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Metadaten
Titel
Dünndarmpouch nach restaurativer Proktokolektomie
verfasst von
S. Flemming
M. Kelm
C.-T. Germer
Prof. Dr. A. Wiegering
Publikationsdatum
29.08.2022
Verlag
Springer Medizin
Erschienen in
Die Chirurgie / Ausgabe 11/2022
Print ISSN: 2731-6971
Elektronische ISSN: 2731-698X
DOI
https://doi.org/10.1007/s00104-022-01708-6

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