Skip to main content

2016 | OriginalPaper | Buchkapitel

9. Minimalinvasive Chirurgie beim alten Patienten

verfasst von : C. Benecke, M. Strik

Erschienen in: Onkologische Chirurgie bei alten Patienten

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Die besonderen physiologischen Anforderungen im Rahmen laparoskopischer Operationen wurden lange für den Ausschluss des Einsatzes beim älteren Patienten gehalten. Mittlerweile hat sich in der chirurgischen Therapie gutartiger Erkrankungen bewiesen, dass gerade der ältere Patient von den Vorteilen geringeren intraoperativen Blutverlustes, weniger Wundkomplikationen und kürzerer postoperativer Paralyse durch eine Reduktion des Zugangstraumas profitiert. Dieser Vorteil ist umso eindrucksvoller bei Eingriffen, deren Zielorgan klein und das konventionelle Zugangstrauma in Relation groß ist (Goldstandard laparoskopische Cholezystektomie). Die Indikation zum laparoskopischen Vorgehen in der onkologischen Chirurgie des älteren Patienten ist abhängig von dieser Relation, der Komorbidität des Patienten, der onkologischen Sicherheit und der laparoskopischen Expertise des ausführenden Operateurs.
Literatur
Zurück zum Zitat Ballesta LC, Cid JA, Poves I, Bettonica C, Villegas L, Memon MA (2003) Laparoscopic surgery in the elderly patient. Surg Endosc 17 (2):333–337CrossRef Ballesta LC, Cid JA, Poves I, Bettonica C, Villegas L, Memon MA (2003) Laparoscopic surgery in the elderly patient. Surg Endosc 17 (2):333–337CrossRef
Zurück zum Zitat Biere SS, van Berge Henegouwen MI, Maas KW et al (2012) Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet 379:1887–1892CrossRefPubMed Biere SS, van Berge Henegouwen MI, Maas KW et al (2012) Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet 379:1887–1892CrossRefPubMed
Zurück zum Zitat Cuschieri A, Shimi S, Banting S (1992) Endoscopic oesophagectomy through a right thoracoscopic approach. J R Coll Surg Edinb Feb; 37(1):7–11 Cuschieri A, Shimi S, Banting S (1992) Endoscopic oesophagectomy through a right thoracoscopic approach. J R Coll Surg Edinb Feb; 37(1):7–11
Zurück zum Zitat Demyttenacre SV, Feldman IS, Bergman S (2006) Does aggressive hydration reverse the effects of pneumoperitoneum on renal perfusion? Surg Endosc 20:274–280CrossRef Demyttenacre SV, Feldman IS, Bergman S (2006) Does aggressive hydration reverse the effects of pneumoperitoneum on renal perfusion? Surg Endosc 20:274–280CrossRef
Zurück zum Zitat Faiz O, Haji A, Bottle A et al (2011) Elective colonic surgery for cancer in the elderly: an investigation into postoperative mortality in English NHS hospitals between 1996 and 2007. Colorectal Dis 13:779–785CrossRefPubMed Faiz O, Haji A, Bottle A et al (2011) Elective colonic surgery for cancer in the elderly: an investigation into postoperative mortality in English NHS hospitals between 1996 and 2007. Colorectal Dis 13:779–785CrossRefPubMed
Zurück zum Zitat Frasson M, Braga M, Vignali A, Zuliani W, Di Carlo V (2008) Benefits of laparoscopic colorectal resection are more pronounced in elderly patients. Dis Colon Rectum 51:296–300CrossRefPubMed Frasson M, Braga M, Vignali A, Zuliani W, Di Carlo V (2008) Benefits of laparoscopic colorectal resection are more pronounced in elderly patients. Dis Colon Rectum 51:296–300CrossRefPubMed
Zurück zum Zitat Gagner M, Pomp A, Herrera MF (1996) Early experience with laparoscopic resections of islet cell tumors. Surgery 120:1051e1054 Gagner M, Pomp A, Herrera MF (1996) Early experience with laparoscopic resections of islet cell tumors. Surgery 120:1051e1054
Zurück zum Zitat Harris SN, Ballantyne GH, Luther MA, Perrina AC Jr (1996) Alterations of cardiovascular performance during laparoscopic colectomy: a combined hemodynamic and echocardiographic analysis. Anaesth Analg 83:482–487CrossRef Harris SN, Ballantyne GH, Luther MA, Perrina AC Jr (1996) Alterations of cardiovascular performance during laparoscopic colectomy: a combined hemodynamic and echocardiographic analysis. Anaesth Analg 83:482–487CrossRef
Zurück zum Zitat Huscher CG, Mingoli A, Sgarzini G, Sansonetti A, Di Paola M et al (2005) Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg 241:232–237CrossRefPubMedPubMedCentral Huscher CG, Mingoli A, Sgarzini G, Sansonetti A, Di Paola M et al (2005) Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg 241:232–237CrossRefPubMedPubMedCentral
Zurück zum Zitat Kwon IG, Cho I, Kim HI, Noh SH, Hyun WJ (2015) Minimally invasive surgery as a treatment option for gastric cancer in the elderly: comparison with open surgery for patients 80 years and older. Surg Endosc 29 (8) 2321–2330CrossRefPubMed Kwon IG, Cho I, Kim HI, Noh SH, Hyun WJ (2015) Minimally invasive surgery as a treatment option for gastric cancer in the elderly: comparison with open surgery for patients 80 years and older. Surg Endosc 29 (8) 2321–2330CrossRefPubMed
Zurück zum Zitat Lazzarino AI, Nagpal K, Bottle A, Faiz O, Morthy K, Aylin P (2010) Oper versus minimally invasive esophagectomy. Trends of utilization and associated outcomes in England. Ann Surg 252 (2):292–298CrossRefPubMed Lazzarino AI, Nagpal K, Bottle A, Faiz O, Morthy K, Aylin P (2010) Oper versus minimally invasive esophagectomy. Trends of utilization and associated outcomes in England. Ann Surg 252 (2):292–298CrossRefPubMed
Zurück zum Zitat Li J, Shen Y, Tan L, Feng M, Wang H, Xi Y (2015) Is minimally invasive esophagectomy beneficial to elderly patients with esophageal cancer? Surg Endosc 29: 925–930CrossRefPubMed Li J, Shen Y, Tan L, Feng M, Wang H, Xi Y (2015) Is minimally invasive esophagectomy beneficial to elderly patients with esophageal cancer? Surg Endosc 29: 925–930CrossRefPubMed
Zurück zum Zitat Limongelli P et al (2012) Laparoscopic and open surgical treatment of left-sided pancreatic lesions: clinical outcomes and cost-effectiveness analysis. Surg Endosc 26 (7)1830–1836CrossRefPubMed Limongelli P et al (2012) Laparoscopic and open surgical treatment of left-sided pancreatic lesions: clinical outcomes and cost-effectiveness analysis. Surg Endosc 26 (7)1830–1836CrossRefPubMed
Zurück zum Zitat Mariette C, Meunier B, Pezet D, Dalban C, Collet D et al (2015) Gastrointestinal Cancers Symposium: Hybrid minimally invasive versus open oesophagectomy for patients with oesophageal cancer. A multicenter, open label, randomized phase III trial, the MIRO trial. J Clin Oncol 33 (suppl 3; abstr 5) Mariette C, Meunier B, Pezet D, Dalban C, Collet D et al (2015) Gastrointestinal Cancers Symposium: Hybrid minimally invasive versus open oesophagectomy for patients with oesophageal cancer. A multicenter, open label, randomized phase III trial, the MIRO trial. J Clin Oncol 33 (suppl 3; abstr 5)
Zurück zum Zitat Mehrabi A, Hafezi M, Arvin J et al (2015) A systematic review and meta-analysis of laparoscopic versus open distal pancreatectomy for benign and malignant lesions of the pancreas: It’s time to randomize. J Surgery 157 (1) 45–55 Mehrabi A, Hafezi M, Arvin J et al (2015) A systematic review and meta-analysis of laparoscopic versus open distal pancreatectomy for benign and malignant lesions of the pancreas: It’s time to randomize. J Surgery 157 (1) 45–55
Zurück zum Zitat Metha SS, Doumane G, Mura T et al (2006) Laparoscopic versus open distal pancreatectomy: a single –institution case control study. Surg Endosc 26:402–407 Metha SS, Doumane G, Mura T et al (2006) Laparoscopic versus open distal pancreatectomy: a single –institution case control study. Surg Endosc 26:402–407
Zurück zum Zitat Nagpal K, Ahmed K, Vats A et al (2010) Is minimally invasive surgery beneficial in the management of esophageal cancer?: a meta-analysis. Surg Endosc 24:1621–1629CrossRefPubMed Nagpal K, Ahmed K, Vats A et al (2010) Is minimally invasive surgery beneficial in the management of esophageal cancer?: a meta-analysis. Surg Endosc 24:1621–1629CrossRefPubMed
Zurück zum Zitat Nemoto M, Yeernuer T, Msutani Y (2014) Development of automatic visceral fat volume calculation software for CT volume data. J Obes Article ID 495084 Nemoto M, Yeernuer T, Msutani Y (2014) Development of automatic visceral fat volume calculation software for CT volume data. J Obes Article ID 495084
Zurück zum Zitat Ptok H, Gastinger I, Meyer F et al (2013) Kolorektale Chirurgie beim Hochbetagten. Der Chirurg 84 (4) 296–304CrossRefPubMed Ptok H, Gastinger I, Meyer F et al (2013) Kolorektale Chirurgie beim Hochbetagten. Der Chirurg 84 (4) 296–304CrossRefPubMed
Zurück zum Zitat Scheidbach H, Schneider C, Hügel O et al (2005) Laproscopic surgery in the old patient: do indications and outcomes differ? Langenbecks Arch Surg 390:328– 332CrossRefPubMed Scheidbach H, Schneider C, Hügel O et al (2005) Laproscopic surgery in the old patient: do indications and outcomes differ? Langenbecks Arch Surg 390:328– 332CrossRefPubMed
Zurück zum Zitat Seishima R, Okabayashi K, Hasegawa H et al (2015) Is laparoscopic colorectal surgery beneficial for elderly patients? A systematic review and meta-analysis. J Gastrointest Surg 19:756–765CrossRefPubMed Seishima R, Okabayashi K, Hasegawa H et al (2015) Is laparoscopic colorectal surgery beneficial for elderly patients? A systematic review and meta-analysis. J Gastrointest Surg 19:756–765CrossRefPubMed
Zurück zum Zitat Takashi A, Kuroyanagi H, Oya M et al (2009) Short-term outcomes of laparoscopic rectal surgery for primary rectal cancer in elderly patients: is it safe and beneficial? J Gastrointest Surg 13:1614–1618CrossRef Takashi A, Kuroyanagi H, Oya M et al (2009) Short-term outcomes of laparoscopic rectal surgery for primary rectal cancer in elderly patients: is it safe and beneficial? J Gastrointest Surg 13:1614–1618CrossRef
Zurück zum Zitat Zeng WG, Zhou ZX, Hou HR et al (2014) Outcome of laparoscopic versus open resection for rectal cancer in elderly patients. J Surg Res 2014 dx.doi.org/ 10.1016/ j.jss.2014.08.012 Zeng WG, Zhou ZX, Hou HR et al (2014) Outcome of laparoscopic versus open resection for rectal cancer in elderly patients. J Surg Res 2014 dx.doi.org/ 10.1016/ j.jss.2014.08.012
Metadaten
Titel
Minimalinvasive Chirurgie beim alten Patienten
verfasst von
C. Benecke
M. Strik
Copyright-Jahr
2016
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-48712-9_9

Update AINS

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