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coloproctology
Erschienen in: coloproctology 6/2021

24.08.2021 | Hämorrhoidektomie | Leitlinien

S3-Leitlinie Hämorrhoidalleiden

Kurzfassung

verfasst von: Andreas K. Joos, Dr. Johannes Jongen

Erschienen in: coloproctology | Ausgabe 6/2021

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Zusammenfassung

Hintergrund

Hämorrhoidalbeschwerden sind in den westlichen Industrienationen ein häufiger Grund, medizinische Hilfe in Anspruch zu nehmen. In Deutschland kann mit ca. 3,3 Mio. Behandlungsfällen jährlich gerechnet werden. Für die Therapie stehen viele konservative und operative Methoden zur Verfügung. Im Jahr 2008 wurde in Deutschland initial eine S1-Leitlinie erstellt, die nun von der vorliegenden S3-Leitlinie abgelöst wurde.

Methode

Es wurde ein systematisches Review der Literatur (bis 2017) vorgenommen.

Ergebnisse

Das Hämorrhoidalleiden kann am besten stadiengerecht behandelt werden, wobei nur vergrößerte Hämorrhoiden mit Beschwerden therapiert werden sollten. Die verschiedenen konservativen und operativen Therapiemöglichkeiten werden ausführlich erfasst und anhand der vorliegenden Literatur bewertet. Hämorrhoiden 1. und 2. Grades sind die Domäne der konservativen Therapie (Sklerosierungs- und Gummibandligaturtherapie), Hämorrhoiden 3. und 4. Grades bedürfen in der Regel einer Operation. Bei der Therapiewahl sind neben den Stadien auch patientenspezifische Faktoren (Nebenerkrankungen, Medikamenteneinnahme, Vorgeschichte u. ä.) zu berücksichtigen. Die verschiedenen Komplikationsmöglichkeiten der Methoden werden ausführlich diskutiert und auch spezifische Patientenkonstellationen angesprochen (Einnahme von Gerinnungshemmern, chronisch-entzündliche Darmerkrankungen (CED), Schwangerschaft, Analthrombosen, HIV).

Schlussfolgerung

Die neue S3-Leitlinie behandelt ausführlich alle evidenzbasierten Aspekte des Hämorrhoidealleidens mit dem Ziel einer korrekten Diagnostik sowie einer stadiengerechten und patientenadaptierten Therapie.
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Metadaten
Titel
S3-Leitlinie Hämorrhoidalleiden
Kurzfassung
verfasst von
Andreas K. Joos
Dr. Johannes Jongen
Publikationsdatum
24.08.2021
Verlag
Springer Medizin
Erschienen in
coloproctology / Ausgabe 6/2021
Print ISSN: 0174-2442
Elektronische ISSN: 1615-6730
DOI
https://doi.org/10.1007/s00053-021-00555-z

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