Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Konkret geht es um den Diabetes-Patienten mit kardiovaskulären Erkrankungen oder Risiken, die Herzinsuffizienz sowie die kardiovaskuläre Primär- und Sekundärprävention. Sind Sie hier schon auf dem neuesten Stand? Unsere Experten beleuchten, wo und warum das bisherige Procedere geändert werden soll und was in der Praxis sinnvoll ist. Holen Sie sich Ihr Update und 2 CME-Punkte beim MMW-Webinar am 24. April von 17.30 bis 19 Uhr. 
Erweiterte Suche
Anmelden
nach oben
Diseases of the Colon & Rectum
Erschienen in: Diseases of the Colon & Rectum 11/2004

01.11.2004 | Current Status

Primary Anastomosis or Hartmann’s Procedure for Patients With Diverticular Peritonitis? A Systematic Review

verfasst von: Leon Salem, M.D., David R. Flum, M.D., M.P.H.

Erschienen in: Diseases of the Colon & Rectum | Ausgabe 11/2004

Einloggen, um Zugang zu erhalten

PURPOSE

This systematic literature review was designed to summarize and compare the reported outcomes of one-stage and two-stage operations for the treatment of perforated diverticulitis with peritonitis.

METHODS

This review identified 98 published studies (1957–2003) dealing with the surgical management of perforated diverticulitis with peritonitis, either with primary resection and anastomosis or with the Hartmann’s procedure. Aggregated results of adverse outcomes were calculated but statistical comparisons were not appropriate because of data and design heterogeneity.

RESULTS

Operative mortality data from patients with diverticular peritonitis undergoing Hartmann’s procedure (n = 1,051) were derived from 54 studies. Considering the Hartmann’s procedure and its reversal procedures together, the mortality rate was 19.6 percent (18.8 percent for the Hartmann’s procedure and 0.8 percent for its reversal), the wound infection rate was 29.1 percent (24.2 percent for the Hartmann’s procedure and 4.9 percent for its reversal), and stoma complications and anastomotic leaks (in the reversal operation) occurred in 10.3 and 4.3 percent, respectively. Of 569 reported cases of primary anastomosis from 50 studies, the aggregated mortality rate was 9.9 (range, 0–75) percent with an anastomotic leak rate of 13.9 (range, 0–60) percent and a wound infection rate of 9.6 (range, 0–26) percent.

CONCLUSIONS

Reported mortality and morbidity in patients with diverticular peritonitis who underwent primary anastomosis were not higher than those in patients undergoing Hartmann’s procedure were. This suggests that primary anastomosis is a safe operative alternative in certain patients with peritonitis. Despite inclusion of only patients with peritonitis in this analysis, selection bias may have been a limitation and a prospective, randomized trial is recommended.
Literatur
1.
Wong, WD, Wexner, SD, Lowry, A,  et al. 2000Practice parameters for the treatment of sigmoid diverticulitis–supporting documentation. The Standards Task Force. The American Society of Colon and Rectal SurgeonsDis Colon Rectum432907PubMed
2.
Parks, TG 1969Natural history of diverticular disease of the colon. A review of 521 casesBMJ463942PubMed
3.
Kohler, L, Sauerland, S, Neugebauer, E 1999Diagnosis and treatment of diverticular disease: results of a consensusSurg Endosc134306PubMed
4.
5.
Krukowski, ZH, Matheson, NA 1984Emergency surgery for diverticular disease complicated by generalized and faecal peritonitis: a reviewBr J Surg719217PubMed
6.
Zeitoun, G, Laurent, A, Rouffet, F,  et al. 2000Multicentre, randomized clinical trial of primary versus secondary sigmoid resection in generalized peritonitis complicating sigmoid diverticulitisBr J Surg87136674CrossRefPubMed
7.
Nugent, KP, Daniels, P, Stewart, B, Patankar, R, Johnson, CD 1999Quality of life in stoma patientsDis Colon Rectum42156974PubMed
8.
Underwood, JW, Marks, CG 1984The septic complications of sigmoid diverticular diseaseBr J Surg7120911PubMed
9.
Belmonte, C, Klas, JV, Perez, JJ,  et al. 1996The Hartmann procedure. First choice or last resort in diverticular disease?Arch Surg1316125PubMed
10.
Ling, L, Aberg, T 1984Hartmann procedureActa Chir Scand1504137PubMed
11.
Haas, PA, Haas, GP 1988A critical evaluation of the Hartmann’s procedureAm Surg543805PubMed
12.
Bell, GA, Panton, ON 1984Hartmann resection for perforated sigmoid diverticulitis. A retrospective study of the Vancouver General Hospital experienceDis Colon Rectum272536PubMed
13.
Singer, MA, Nelson, RL 2002Primary repair of penetrating colon injuries: a systematic reviewDis Colon Rectum45157987CrossRefPubMed
14.
Dudley, HA, Racliffe, AG, McGeehan, D 1980Intraoperative irrigation of the colon to permit primary anastomosisBr J Surg67801PubMed
15.
16.
Fenger, C, Nyholm, K, Amdrup, E 1969Diverticulitis of the colonActa Chir Scand Suppl39611420PubMed
17.
Barabas, AP 1971Peritonitis due to diverticular disease of the colon: review of 44 casesProc R Soc Med642534PubMed
18.
Miller, DW,Jr, Wichern, WA,Jr 1971Perforated sigmoid diverticulitis. Appraisal of primary versus delayed resectionAm J Surg12153640PubMed
19.
Labow, SB, Salvati, EP, Rubin, RJ 1973The Hartman procedure in the treatment of diverticular diseaseDis Colon Rectum163924PubMed
20.
Nunes, GC, Robnett, AH, Kremer, RM, Ahlquist, RE,Jr 1979The Hartmann procedure for complications of diverticulitisArch Surg1144259PubMed
21.
Nilsson, LO 1976Surgical treatment of perforations of the sigmoid colonActa Chir Scand1424679PubMed
22.
Eng, K, Ranson, JH, Localio, SA 1977Resection of the perforated segment. A significant advance in treatment of diverticulitis with free perforation or abscessAm J Surg1336772CrossRefPubMed
23.
Sweatman, CA,Jr, Aldrete, JS 1977The surgical management of diverticular disease of the colon complicated by perforationSurg Gynecol Obstet1444750PubMed
24.
Nahrwold, DL, Demuth, WE 1977Diverticulitis with perforation into the peritoneal cavityAnn Surg185803PubMed
25.
Hinchey, EJ, Schaal, PG, Richards, GK 1978Treatment of perforated diverticular disease of the colonAdv Surg1285109PubMed
26.
Howe, HJ, Casali, RE, Westbrook, KC, Thompson, BW, Read, RC 1979Acute perforations of the sigmoid colon secondary to diverticulitisAm J Surg1371847CrossRefPubMed
27.
Haglund, U, Hellberg, R, Johnsen, C, Hulten, L 1979Complicated diverticular disease of the sigmoid colon. An analysis of short and long term outcome in 392 patientsAnn Chir Gynaecol68416PubMed
28.
Edelmann, G 1981Surgical treatment of colonic diverticulitis: a report of 205 casesInt Surg6611924PubMed
29.
Sakai, L, Daake, J, Kaminski, DL 1981Acute perforation of sigmoid diverticulaAm J Surg1427126CrossRefPubMed
30.
Killingback, M 1983Management of perforative diverticulitisSurg Clin North Am6397115PubMed
31.
Drumm, J, Clain, A 1984The management of acute colonic diverticulitis with suppurative peritonitisAnn R Coll Surg Engl66901PubMed
32.
Auguste, L, Borrero, E, Wise, L 1985Surgical management of perforated colonic diverticulitisArch Surg1204502PubMed
33.
Nagorney, DM, Adson, MA, Pemberton, JH 1985Sigmoid diverticulitis with perforation and generalized peritonitisDis Colon Rectum28715PubMed
34.
Shephard, AA, Keighley, MR 1986Audit on complicated diverticular diseaseAnn R Coll Surg Engl68810PubMed
35.
Hulkko, OA, Laitinen, ST, Haukipuro, KA, Stahlberg, MJ, Juvonen, TS, Kairaluoma, MI 1986The Hartmann procedure for the treatment of colorectal emergenciesActa Chir Scand1525315PubMed
36.
Finlay, IG, Carter, DC 1987A comparison of emergency resection and staged management in perforated diverticular diseaseDis Colon Rectum3092933PubMed
37.
38.
Mealy, K, Salman, A, Arthur, G 1988Definitive one-stage emergency large bowel surgeryBr J Surg7512169PubMed
39.
Christie, PM, Shaw, JH 1988Diverticular disease in AucklandANZ J Surg587959
40.
Kourtesis, GJ, Williams, RA, Wilson, SE 1988Surgical options in acute diverticulitis: value of sigmoid resection in dealing with the septic focusANZ J Surg589559
41.
Schein, M, Decker, G 1988The Hartmann procedure. Extended indications in severe intra-abdominal infectionDis Colon Rectum311269PubMed
42.
Berry, AR, Turner, WH, Mortensen, NJ, Kettlewell, MG 1989Emergency surgery for complicated diverticular disease. A five-year experienceDis Colon Rectum3284954PubMed
43.
Hold, M, Denck, H, Bull, P 1990Surgical management of perforating diverticular disease in AustriaInt J Colorectal Dis51959CrossRefPubMed
44.
Peoples, JB, Vilk, DR, Maguire, JP, Elliott, DW 1990Reassessment of primary resection of the perforated segment for severe colonic diverticulitisAm J Surg1592913PubMed
45.
Medina, VA, Papanicolaou, GK, Tadros, RR, Fielding, LP 1991Acute perforated diverticulitis: primary resection and anastomosis?Conn Med5525861PubMed
46.
Smirniotis, V, Tsoutsos, D, Fotopoulos, A, Pissiotis, AC 1992Perforated diverticulitis: a surgical dilemmaInt Surg77447PubMed
47.
Sarin, S, Boulos, PB 1991Evaluation of current surgical management of acute inflammatory diverticular diseaseAnn R Coll Surg Engl7327882PubMed
48.
Binda, GA, Saccomani, G, Gramegna, A 1993Emergency surgery of complicated colonic diverticulitisActa Chir Belg932537PubMed
49.
Nespoli, A, Ravizzini, C, Trivella, M, Segala, M 1993The choice of surgical procedure for peritonitis due to colonic perforationArch Surg1288148PubMed
50.
Totte, E, Creve, U, Hubens, A 1993The Hartmann procedure revisitedActa Chir Belg9315963PubMed
51.
Kronborg, O 1993Treatment of perforated sigmoid diverticulitis: a prospective randomized trialBr J Surg805057PubMed
52.
Kriwanek, S, Armbruster, C, Beckerhinn, P, Dittrich, K 1994Prognostic factors for survival in colonic perforationInt J Colorectal Dis915862CrossRefPubMed
53.
Tudor, RG, Farmakis, N, Keighley, MR 1994National audit of complicated diverticular disease: analysis of index casesBr J Surg817302PubMed
54.
Kressner, U, Antonsson, J, Ejerblad, S, Gerdin, B, Pahlman, L 1994Intraoperative colonic lavage and primary anastomosis–an alternative to Hartmann procedure in emergency surgery of the left colonEur J Surg16028792PubMed
55.
Desai, DC, Brennan, EJ,Jr, Reilly, JF, Smink, RD,Jr 1998The utility of the Hartmann procedureAm J Surg1751524CrossRefPubMed
56.
Isbister, WH, Prasad, J 1997Emergency large bowel surgery: a 15-year auditInt J Colorectal Dis1228590CrossRefPubMed
57.
Khan, AL, Ah-See, AK, Crofts, TJ, Heys, SD, Eremin, O 1995Surgical management of the septic complications of diverticular diseaseAnn R Coll Surg Engl771620PubMed
58.
Tucci, G, Torquati, A, Grande, M, Stroppa, I, Sianesi, M, Farinon, AM 1996Major acute inflammatory complications of diverticular disease of the colon: planning of surgical managementHepatogastroenterology4383945PubMed
59.
Faltyn, J, Jungwirth, J 1996Surgical treatment of the perforated colon with peritonitisAnn Ital Chir672113PubMed
60.
Wedell, J, Banzhaf, G, Chaoui, R, Fischer, R, Reichmann, J 1997Surgical management of complicated colonic diverticulitisBr J Surg843803CrossRefPubMed
61.
Gooszen, AW, Gooszen, HG, Veerman, W,  et al. 2001Operative treatment of acute complications of diverticular disease: primary or secondary anastomosis after sigmoid resectionEur J Surg167359CrossRefPubMed
62.
Schilling, MK, Maurer, CA, Kollmar, O, Buchler, MW 2001Primary vs. secondary anastomosis after sigmoid colon resection for perforated diverticulitis (Hinchey Stage III and IV): a prospective outcome and cost analysisDis Colon Rectum44699703PubMed
63.
Regenet, N, Pessaux, P, Hennekinne, S,  et al. 2003Primary anastomosis after intraoperative colonic lavage vs. Hartmann’s procedure in generalized peritonitis complicating diverticular disease of the colonInt J Colorectal Dis185037CrossRefPubMed
64.
Zorcolo, L, Covotta, L, Carlomagno, N, Bartolo, DC 2003Safety of primary anastomosis in emergency colo-rectal surgeryColorectal Dis.52629CrossRefPubMed
65.
Liebert, CW,Jr, DeWeese, BM 1981Primary resection without anastomosis for perforation of acute diverticulitisSurg Gynecol Obstet152302PubMed
66.
Bakker, FC, Hoitsma, HF, Otter, G 1982The Hartmann procedureBr J Surg695802PubMed
67.
Hackford, AW, Schoetz, DJ,Jr, Coller, JA, Veidenheimer, MC 1985Surgical management of complicated diverticulitis. The Lahey Clinic experience, 1967 to 1982Dis Colon Rectum2831721PubMed
68.
Mallonga, ET, Brummelkamp, WH, Gulik, TM, Taat, CW 1986The Hartmann procedure: its role in acute complicated diverticulitisNeth J Surg381714PubMed
69.
70.
Sweeney, JL, Hoffmann, DC 1987Restoration of continuity after Hartmann’s procedure for the complications of diverticular diseaseANZ J Surg578235
71.
Geoghegan, JG, Rosenberg, IL 1991Experience with early anastomosis after the Hartmann procedureAnn R Coll Surg Engl73802PubMed
72.
Eisenstat, TE, Rubin, RJ, Salvati, EP 1983Surgical management of diverticulitis. The role of the Hartmann procedureDis Colon Rectum2642932PubMed
73.
Khan, AL, Ah-See, AK, Crofts, TJ, Heys, SD, Eremin, O 1994Reversal of Hartmann’s colostomyJ R Coll Surg Edinb3923942PubMed
74.
Elliott, TB, Yego, S, Irvin, TT 1997Five-year audit of the acute complications of diverticular diseaseBr J Surg845359CrossRefPubMed
75.
Belding, HH,3rd 1957Acute perforated diverticulitis of the sigmoid colon with generalized peritonitisAMA Arch Surg745115PubMed
76.
77.
Giffin, JM, Butcher, HR,Jr, Ackerman, LV 1967Surgical management of colonic diverticulitisArch Surg9461926PubMed
78.
Ryan, P 1974Emergency resection and anastomosis for perforated sigmoid diverticulitisANZ J Surg441620
79.
Rodkey, GV, Welch, CE 1974Colonic diverticular disease with surgical treatment. A study of 338 casesSurg Clin North Am5465574PubMed
80.
Farkouh, E, Hellou, G, Allard, M, Atlas, H 1982Resection and primary anastomosis for diverticulitis with perforation and peritonitisCan J Surg253146PubMed
81.
Trillo, C, Paris, MF, Brennan, JT 1998Primary anastomosis in the treatment of acute disease of the unprepared left colonAm Surg648215PubMed
82.
Umbach, TW, Dorazio, RA 1999Primary resection and anastomosis for perforated left colon lesionsAm Surg659313PubMed
83.
Hoemke, M, Treckmann, J, Schmitz, R, Shah, S 1999Complicated diverticulitis of the sigmoid: a prospective study concerning primary resection with secure primary anastomosisDig Surg164204CrossRefPubMed
84.
Gooszen, AW, Tollenaar, RA, Geelkerken, RH,  et al. 2001Prospective study of primary anastomosis following sigmoid resection for suspected acute complicated diverticular diseaseBr J Surg886937CrossRefPubMed
85.
Blair, NP, Germann, E 2002Surgical management of acute sigmoid diverticulitisAm J Surg1835258CrossRefPubMed
86.
Makela, J, Kiviniemi, H, Laitinen, S 2002Prevalence of perforated sigmoid diverticulitis is increasingDis Colon Rectum4595561CrossRefPubMed
87.
Thow, GB 1980Emergency left colon resection with primary anastomosisDis Colon Rectum231724PubMed
88.
Biondo, S, Jaurrieta, E, Marti Rague, J,  et al. 2000Role of resection and primary anastomosis of the left colon in the presence of peritonitisBr J Surg8715804CrossRefPubMed
89.
Botsford, TW, Zollinger, RM,Jr, Hicks, R 1971Mortality of the surgical treatment of diverticulitisAm J Surg1217025CrossRefPubMed
90.
Landen, S, Nafteux, P 2002Primary anastomosis and diverting colostomy in diffuse diverticular peritonitisActa Chir Belg102249PubMed
91.
Koruth, NM, Hunter, DC, Krukowski, ZH, Matheson, NA 1985Immediate resection in emergency large bowel surgery: a 7 year auditBr J Surg727037PubMed
92.
Madden, JL, Tan, PY 1965Primary resection and anastomosis in the treatment of perforated lesions of the colon with abscess or diffusing peritonitisSurg Gynecol Obstet11364650
93.
Dandekar, NV, McCann, WJ 1969Primary resection and anastomosis in the management of perforation of diverticulitis of the sigmoid flexure and diffuse peritonitisDis Colon Rectum121725PubMed
94.
Roxburgh, RA, Dawson, JL, Yeo, R 1968Emergency resection in treatment of diverticular disease of colon complicated by peritonitisBMJ34656PubMed
95.
Tagart, RE 1969Diverticular disease of the colon. Clinical aspectsBr J Surg5641723PubMed
96.
Whelan, CS, Furcinitti, JF, Lavarreda, C 1971Surgical management of perforated lesions of the colon with diffusing peritonitisAm J Surg1213748CrossRefPubMed
97.
Endrey-Walder, P, Judd, ES 1973Acute perforating diverticulitis. Emergency surgical treatmentMinn Med562730PubMed
98.
Alanis, A, Papanicolaou, GK, Tadros, RR, Fielding, LP 1989Primary resection and anastomosis for treatment of acute diverticulitisDis Colon Rectum329339PubMed
99.
Saccomani, GE, Santi, F, Gramegna, A 1993Primary resection with and without anastomosis for perforation of acuteActa Chir Belg9316972PubMed
100.
Schwesinger, WH, Page, CP, Gaskill, HV,3rd,  et al. 2000Operative management of diverticular emergencies: strategies and outcomesArch Surg13555862CrossRefPubMed
101.
Murray, JJ 1991Nonelective colon resection. Alternatives to multistage resectionsSurg Clin North Am71118794PubMed
102.
Maddern, GJ, Nejjari, Y, Dennison, A, Siriser, F, Bardoxaglou, E, Launois, B 1995Primary anastomosis with transverse colostomy as an alternative to Hartmann’s procedureBr J Surg821701PubMed
103.
Biondo, S, Pares, D, Marti Rague, J,  et al. 2002Emergency operations for nondiverticular perforation of the left colonAm J Surg18325660CrossRefPubMed
104.
Poon, RT, Law, WL, Chu, KW, Wong, J 1998Emergency resection and primary anastomosis for left-sided obstructing colorectal carcinoma in the elderlyBr J Surg85153942CrossRefPubMed
105.
Nelson R, Singer M. Primary repair for penetrating colon injuries. Cochrane Database Syst Rev. 2003:CD002247.
106.
Illert, B, Engemann, R, Thiede, A 2001Success in treatment of complicated diverticular disease is stage relatedInt J Colorectal Dis162769CrossRefPubMed
107.
Schrock, TR, Deveney, CW, Dunphy, JE 1973Factors contributing to leakage of colonic anastomosesAnn Surg1775138PubMed
108.
Irvin, TT, Goligher, JC 1973Aetiology of disruption of intestinal anastomosesBr J Surg604614PubMed
109.
Ravo, B, Metwally, N, Castera, P, Polansky, PJ, Ger, R 1988The importance of intraluminal anastomotic fecal contact and peritonitis in colonic anastomotic leakages. An experimental studyDis Colon Rectum3186871PubMed
110.
Ravo, B, Metwall, N, Yeh, J, Polansky, P, Frattaroli, FM 1991Effect of fecal loading with/without peritonitis on the healing of a colonic anastomosis: an experimental studyEur Surg Res231007PubMed
111.
Gutman, M, Klausner, JM, Lelcuk, S 1993Fecal peritonitis–the effect on anastomotic healingEur Surg Res253669PubMed
112.
Feres, O, Monteiro dos Santos, JC,Jr, Andrade, JI 2001The role of mechanical bowel preparation for colonic resection and anastomosis: an experimental studyInt J Colorectal Dis163536CrossRefPubMed
113.
Phillips, RK, Hittinger, R, Fry, JS, Fielding, LP 1985Malignant large bowel obstructionBr J Surg72296302PubMed
114.
Duraker, N, Bender, O, Memisoglu, K, Yalciner, A 1998Intraoperative bowel irrigation improves anastomotic collagen metabolismInt J Colorectal Dis132324CrossRefPubMed
115.
Thomson, WH, Carter, SS 1986On-table lavage to achieve safe restorative rectal and emergency left colonic resection without covering colostomyBr J Surg73613PubMed
116.
Stewart, J, Diament, RH, Brennan, TG 1993Management of obstructing lesions of the left colon by resection, on-tableSurgery1145025PubMed
117.
Pollock, AV, Playforth, MJ, Evans, M 1987Preoperative lavage of the obstructed left colon to allow safe primaryDis Colon Rectum301713PubMed
118.
Allen-Mersh, TG 1993Should primary anastomosis and on-table colonic lavage be standardAnn R Coll Surg Engl751958PubMed
119.
Forloni, B, Reduzzi, R, Paludetti, A, Colpani, L, Cavallari, G, Frosali, D 1998Intraoperative colonic lavage in emergency surgical treatment of left-sided colonic obstructionDis Colon Rectum41237
120.
Murray, JJ, Schoetz, DJ,Jr, Coller, JA, Roberts, PL, Veidenheimer, MC 1991Intraoperative colonic lavage and primary anastomosis in nonelective colonDis Colon Rectum3452731PubMed
121.
Chiappa, A, Zbar, A, Biella, F, Staudacher, C 2000One-stage resection and primary anastomosis following acute obstruction ofAm Surg6661922PubMed
Metadaten
Titel
Primary Anastomosis or Hartmann’s Procedure for Patients With Diverticular Peritonitis? A Systematic Review
verfasst von
Leon Salem, M.D.
David R. Flum, M.D., M.P.H.
Publikationsdatum
01.11.2004
Erschienen in
Diseases of the Colon & Rectum / Ausgabe 11/2004
Print ISSN: 0012-3706
Elektronische ISSN: 1530-0358
DOI
https://doi.org/10.1007/s10350-004-0701-1

Weitere Artikel der Ausgabe 11/2004

Diseases of the Colon & Rectum 11/2004 Zur Ausgabe

Original Contributions

Informed Consent for Screening Sigmoidoscopy in a Veterans Administration Population

Original Contributions

Large Bowel Obstruction: Predictive Factors for Postoperative Mortality

OriginalPaper

SELF-ASSESSMENT QUIZ: ANSWERS, CRITIQUES, AND REFERENCES

Original Contributions

Characteristics and Survival Patterns of Solid Organ Transplant Patients Developing De Novo Colon and Rectal Cancer

Original Contributions

Dye Spraying and Magnifying Endoscopy for Dysplasia and Cancer Surveillance in Ulcerative Colitis

Original Contributions

Stapled Hemorrhoidopexy Compared With Conventional Hemorrhoidectomy: Systematic Review of Randomized, Controlled Trials

Neu im Fachgebiet Chirurgie

17.04.2024 | Postoperative nausea and vomiting | Nachrichten

Hochrisiko-Eingriffe für postoperative Übelkeit

16.04.2024 | HNO-Chirurgie | Nachrichten

HNO-Op. auch mit über 90?

16.04.2024 | Infektiologie | Nachrichten

Kein Abstrich bei chronischen Wunden ohne Entzündungszeichen!

10.04.2024 | Postoperative Schmerztherapie | Nachrichten

Chronische Schmerzen nach Op. oft mit neuropathischer Komponente
weitere anzeigen

Update Chirurgie

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

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom CME-Kurs
CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis 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
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur CME-Kurs
CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ 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
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis CME-Kurs
CME: 2 Punkte

Dr. med. Mihailo Andric
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
Berufsverband der Deutschen Chirurgie e.V.