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Die Chirurgie
Erschienen in: Die Chirurgie 4/2019

22.03.2019 | Zwerchfellhernie | CME

Hiatushernie

Standards und Kontroversen in Diagnostik und Therapie

verfasst von: PD Dr. D. Weyhe, V. Uslar, J. Kühne, A. Kluge

Erschienen in: Die Chirurgie | Ausgabe 4/2019

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Zusammenfassung

Eine Hiatushernie ist als transdiaphragmale Protrusion/Migration intrabdominellen Inhaltes durch den Hiatus oesophageus des Zwerchfells definiert. Die Klassifikation erfolgt bei Hiatushernien durch eine anatomisch morphologische Differenzierung (Typ I–IV). Leitsymptome und Leidensdruck variieren zwischen Reflux- und Kompressionssymptomen. Gastroskopie und multikanal-intraluminale Impedanz-pH-Metrie sind obligate präoperative Funktionsdiagnostik. Es wird zwischen den häufigen Typ-I-Hernien (Antirefluxchirurgie), symptomatischen paraösophagealen, thorakalen und gemischten Hernientypen (II–IV) unterschieden. Operationsindikationen bestehen bei symptomatischen Typ-II- bis -IV-Hernien. Hiatale Netzaugmentation verringert Rezidive. Das Komplikationspotenzial synthetischer Netze muss dabei berücksichtigt werden. Biologische Implantate zeigen keine Vorteile.
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Metadaten
Titel
Hiatushernie
Standards und Kontroversen in Diagnostik und Therapie
verfasst von
PD Dr. D. Weyhe
V. Uslar
J. Kühne
A. Kluge
Publikationsdatum
22.03.2019
Verlag
Springer Medizin
Erschienen in
Die Chirurgie / Ausgabe 4/2019
Print ISSN: 2731-6971
Elektronische ISSN: 2731-698X
DOI
https://doi.org/10.1007/s00104-019-0932-2

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