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Erschienen in:

17.06.2021 | Gastroenterostomie | CME

Palliative Endoskopie

verfasst von: Benno Arnstadt, Prof. Dr. med. Hans-Dieter Allescher

Erschienen in: Die Chirurgie | Ausgabe 3/2022

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Zusammenfassung

Die Endoskopie ist die führende Methode in der Diagnostik gastrointestinaler Malignome. Trotz zunehmender Vorsorgestrategien liegt bei steigenden Inzidenzen verschiedener Tumorentitäten bei zahlreichen Patienten schon eine palliative Therapiesituation vor. Die palliative Endoskopie kann hier maßgeblich zur Linderung tumorbedingter Symptome wie Dysphagie, Malnutrition, Cholestase, Ileus und Schmerz beitragen. Hierzu können verschiedene Ansätze zur Sicherung der Ernährung (perkutane endoskopische Gastrostomie, perkutane enterale Jejunostomie), der Aufrechterhaltung der Magen-Darm-Passage (Stents) und des Sekretabflusses oder zur Ableitung gestauter Hohlorgane angeboten werden. Endosonographisch gestützte Punktionen bieten darüber hinaus die Möglichkeit, bei fehlender Erreichbarkeit oder fehlender Passierbarkeit von Tumorstenosen durch Stenteinlage neue Abflussmöglichkeiten oder Kontinuitäten zu gewährleisten. Bei allen Interventionen sind mögliche Kontraindikationen und Komplikationen zu berücksichtigen.

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Titel: Palliative Endoskopie
verfasst von: Benno Arnstadt
Prof. Dr. med. Hans-Dieter Allescher
Publikationsdatum: 17.06.2021
Verlag: Springer Medizin
Schlagwörter: Gastroenterostomie
Jejunostomie
Endoskopie
Erschienen in: Die Chirurgie / Ausgabe 3/2022
Print ISSN: 2731-6971
Elektronische ISSN: 2731-698X
DOI: https://doi.org/10.1007/s00104-021-01426-5

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Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

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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

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Zusammenfassung

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Update Chirurgie