Skip to main content
Erschienen in: Surgical Endoscopy 3/2008

01.03.2008

Transanal endoscopic tube decompression of acute colonic obstruction: experience with 51 cases

verfasst von: A. Fischer, H. J. Schrag, M. Goos, R. Obermaier, U. T. Hopt, P. K. Baier

Erschienen in: Surgical Endoscopy | Ausgabe 3/2008

Einloggen, um Zugang zu erhalten

Abstract

Background

Acute colorectal obstruction is a potentially life-threatening emergency that requires immediate surgical treatment. To avoid major postoperative complications, most surgeons advocate two-step surgery despite the increase in patient discomfort and cost. Various methods for performing one-step surgery have been reported including intraoperative colonic lavage, decompression with self-expandable metal stents, and transanal tube decompression.

Methods

The authors present their experience performing transanal colonic decompression for 51 patients.

Results

Endoscopic tube placement was successful for 43 (84%) of the 51 patients. The emergency clinical situation could be converted to semielective treatment in 37 cases (73%) (30 operations and 6 nonoperative interventions), and to an elective operation in 1 case. After successful colonic decompression, the rate of one-stage operations was 93% (28/30), as compared with 40% (4/10) if the decompression failed.

Conclusion

Endoscopic tube decompression of acute colonic obstruction is an easy and cost-effective possibility for avoiding emergency operations with all their sequelae. Emergency surgery can be converted to semielective or elective surgery, markedly reducing the rate of staged operations.
Literatur
1.
Zurück zum Zitat Ohman U (1982) Prognosis in patients with obstructing colorectal carcinoma. Am J Surg Jun 143:742–747CrossRef Ohman U (1982) Prognosis in patients with obstructing colorectal carcinoma. Am J Surg Jun 143:742–747CrossRef
2.
Zurück zum Zitat Deans GT, Krukowski ZH, Irwin ST (1994) Malignant obstruction of the left colon. Br J Surg 81:1270–1276PubMedCrossRef Deans GT, Krukowski ZH, Irwin ST (1994) Malignant obstruction of the left colon. Br J Surg 81:1270–1276PubMedCrossRef
3.
Zurück zum Zitat Umpleby HC, Williamson RC (1984) Survival in acute obstructing colorectal carcinoma. Dis Colon Rectum 27:299–304PubMedCrossRef Umpleby HC, Williamson RC (1984) Survival in acute obstructing colorectal carcinoma. Dis Colon Rectum 27:299–304PubMedCrossRef
4.
Zurück zum Zitat Deutsch AA, Zelikovski A, Sternberg A, Reiss R (1983) One-stage subtotal colectomy with anastomosis for obstructing carcinoma of the left colon. Dis Colon Rectum 26:227–230PubMedCrossRef Deutsch AA, Zelikovski A, Sternberg A, Reiss R (1983) One-stage subtotal colectomy with anastomosis for obstructing carcinoma of the left colon. Dis Colon Rectum 26:227–230PubMedCrossRef
5.
Zurück zum Zitat Barillari P, Aurello P, De AR, Valabrega S, Ramacciato G, D’Angelo F, Fegiz G (1992) Management and survival of patients affected with obstructive colorectal cancer. Int Surg 77:251–255PubMed Barillari P, Aurello P, De AR, Valabrega S, Ramacciato G, D’Angelo F, Fegiz G (1992) Management and survival of patients affected with obstructive colorectal cancer. Int Surg 77:251–255PubMed
6.
Zurück zum Zitat Griffith RS (1992) Preoperative evaluation: Medical obstacles to surgery. Cancer 70(5 Suppl):1333–1341PubMedCrossRef Griffith RS (1992) Preoperative evaluation: Medical obstacles to surgery. Cancer 70(5 Suppl):1333–1341PubMedCrossRef
7.
Zurück zum Zitat Binkert CA, Ledermann H, Jost R, Saurenmann P, Decurtins M, Zollikofer CL (1998) Acute colonic obstruction: clinical aspects and cost-effectiveness of preoperative and palliative treatment with self-expanding metallic stents--a preliminary report. Radiology 206:199–204PubMed Binkert CA, Ledermann H, Jost R, Saurenmann P, Decurtins M, Zollikofer CL (1998) Acute colonic obstruction: clinical aspects and cost-effectiveness of preoperative and palliative treatment with self-expanding metallic stents--a preliminary report. Radiology 206:199–204PubMed
8.
Zurück zum Zitat Murray JJ, Schoetz DJ Jr, Coller JA, Roberts PL, Veidenheimer MC (1991) Intraoperative colonic lavage and primary anastomosis in nonelective colon resection. Dis Colon Rectum 34:527–531PubMedCrossRef Murray JJ, Schoetz DJ Jr, Coller JA, Roberts PL, Veidenheimer MC (1991) Intraoperative colonic lavage and primary anastomosis in nonelective colon resection. Dis Colon Rectum 34:527–531PubMedCrossRef
9.
Zurück zum Zitat Vigder L, Tzur N, Huber M, Mahagna M, Amir I (1985) Management of obstructive carcinoma of the left colon. Comparative study of staged and primary resection. Arch Surg 120:825–828PubMed Vigder L, Tzur N, Huber M, Mahagna M, Amir I (1985) Management of obstructive carcinoma of the left colon. Comparative study of staged and primary resection. Arch Surg 120:825–828PubMed
10.
Zurück zum Zitat Terasaka R, Itoh H, Nakafusa Y, Matsuo K (1990) Effectiveness of a long intestinal tube in a one-stage operation for obstructing carcinoma of the left colon. Dis Colon Rectum 33:245–248PubMedCrossRef Terasaka R, Itoh H, Nakafusa Y, Matsuo K (1990) Effectiveness of a long intestinal tube in a one-stage operation for obstructing carcinoma of the left colon. Dis Colon Rectum 33:245–248PubMedCrossRef
11.
Zurück zum Zitat Adachi Y, Okita K, Nozoe T, Iso Y, Yoh R, Matsumata T (1999) Long tube for obstructing left-sided colon cancer. Dig Surg 16:178–179PubMedCrossRef Adachi Y, Okita K, Nozoe T, Iso Y, Yoh R, Matsumata T (1999) Long tube for obstructing left-sided colon cancer. Dig Surg 16:178–179PubMedCrossRef
12.
Zurück zum Zitat Baron TH, Kozarek RA (2004) Endoscopic stenting of colonic tumours. Best Pract Res Clin Gastroenterol 18:209–229PubMedCrossRef Baron TH, Kozarek RA (2004) Endoscopic stenting of colonic tumours. Best Pract Res Clin Gastroenterol 18:209–229PubMedCrossRef
13.
Zurück zum Zitat Camunez F, Echenagusia A, Simo G, Turegano F, Vazquez J, Barreiro-Meiro I (2000) Malignant colorectal obstruction treated by means of self-expanding metallic stents: effectiveness before surgery and in palliation. Radiology 216:492–497PubMed Camunez F, Echenagusia A, Simo G, Turegano F, Vazquez J, Barreiro-Meiro I (2000) Malignant colorectal obstruction treated by means of self-expanding metallic stents: effectiveness before surgery and in palliation. Radiology 216:492–497PubMed
14.
Zurück zum Zitat Martinez-Santos C, Lobato RF, Fradejas JM, Pinto I, Ortega-Deballon P, Moreno-Azcoita M (2002) Self-expandable stent before elective surgery vs emergency surgery for the treatment of malignant colorectal obstructions: comparison of primary anastomosis and morbidity rates. Dis Colon Rectum 45:401–406PubMedCrossRef Martinez-Santos C, Lobato RF, Fradejas JM, Pinto I, Ortega-Deballon P, Moreno-Azcoita M (2002) Self-expandable stent before elective surgery vs emergency surgery for the treatment of malignant colorectal obstructions: comparison of primary anastomosis and morbidity rates. Dis Colon Rectum 45:401–406PubMedCrossRef
15.
Zurück zum Zitat Khot UP, Lang AW, Murali K, Parker MC (2002) Systematic review of the efficacy and safety of colorectal stents. Br J Surg 89:1096–1102PubMedCrossRef Khot UP, Lang AW, Murali K, Parker MC (2002) Systematic review of the efficacy and safety of colorectal stents. Br J Surg 89:1096–1102PubMedCrossRef
16.
Zurück zum Zitat Baron TH, Harewood GC (2003) Enteral self-expandable stents. Gastrointest Endosc 58:421–433PubMedCrossRef Baron TH, Harewood GC (2003) Enteral self-expandable stents. Gastrointest Endosc 58:421–433PubMedCrossRef
17.
Zurück zum Zitat Suzuki N, Saunders BP, Thomas-Gibson S, Akle C, Marshall M, Halligan S (2004) Colorectal stenting for malignant and benign disease: outcomes in colorectal stenting. Dis Colon Rectum 47:1201–1207PubMedCrossRef Suzuki N, Saunders BP, Thomas-Gibson S, Akle C, Marshall M, Halligan S (2004) Colorectal stenting for malignant and benign disease: outcomes in colorectal stenting. Dis Colon Rectum 47:1201–1207PubMedCrossRef
18.
Zurück zum Zitat Baron TH, Dean PA, Yates MR III, Canon C, Koehler RE (1998) Expandable metal stents for the treatment of colonic obstruction: techniques and outcomes. Gastrointest Endosc 47:277–286PubMedCrossRef Baron TH, Dean PA, Yates MR III, Canon C, Koehler RE (1998) Expandable metal stents for the treatment of colonic obstruction: techniques and outcomes. Gastrointest Endosc 47:277–286PubMedCrossRef
19.
Zurück zum Zitat Mainar A, De Gregorio Ariza MA, Tejero E, Tobio R, Alfonso E, Pinto I, et al. (1999) Acute colorectal obstruction: treatment with self-expandable metallic stents before scheduled surgery: results of a multicenter study. Radiology 210:65–69PubMed Mainar A, De Gregorio Ariza MA, Tejero E, Tobio R, Alfonso E, Pinto I, et al. (1999) Acute colorectal obstruction: treatment with self-expandable metallic stents before scheduled surgery: results of a multicenter study. Radiology 210:65–69PubMed
20.
Zurück zum Zitat Knopfle E, Mayer H, Wamser G, Bohndorf K, Witte J (2001) Ileus in colorectal carcinoma: preoperative implantation of self-expanding metal stents and early elective surgery as an alternative to emergency surgery. Chirurg 72:1137–1143PubMedCrossRef Knopfle E, Mayer H, Wamser G, Bohndorf K, Witte J (2001) Ileus in colorectal carcinoma: preoperative implantation of self-expanding metal stents and early elective surgery as an alternative to emergency surgery. Chirurg 72:1137–1143PubMedCrossRef
21.
Zurück zum Zitat Mucci-Hennekinne S, Kervegant AG, Regenet N, Beaulieu A, Barbieux JP, Dehni N, Casa C, Arnaud JP (2007) Management of acute malignant large-bowel obstruction with self-expanding metal stent. Surg Endosc Mucci-Hennekinne S, Kervegant AG, Regenet N, Beaulieu A, Barbieux JP, Dehni N, Casa C, Arnaud JP (2007) Management of acute malignant large-bowel obstruction with self-expanding metal stent. Surg Endosc
22.
Zurück zum Zitat Jost RS, Jost R, Schoch E, Brunner B, Decurtins M, Zollikofer CL (2007) Colorectal stenting: an effective therapy for preoperative and palliative treatment. Cardiovasc Intervent Radiol 30:433–440PubMedCrossRef Jost RS, Jost R, Schoch E, Brunner B, Decurtins M, Zollikofer CL (2007) Colorectal stenting: an effective therapy for preoperative and palliative treatment. Cardiovasc Intervent Radiol 30:433–440PubMedCrossRef
23.
Zurück zum Zitat Ng KC, Law WL, Lee YM, Choi HK, Seto CL, Ho JW (2006) Self-expanding metallic stent as a bridge to surgery versus emergency resection for obstructing left-sided colorectal cancer: a case-matched study. J Gastrointest Surg 10:798–803PubMedCrossRef Ng KC, Law WL, Lee YM, Choi HK, Seto CL, Ho JW (2006) Self-expanding metallic stent as a bridge to surgery versus emergency resection for obstructing left-sided colorectal cancer: a case-matched study. J Gastrointest Surg 10:798–803PubMedCrossRef
24.
Zurück zum Zitat Eguchi T, Takahashi Y, Asai S, Ishii Y, Fujii M (1999) Study of long intestinal tube for decompression of obstructive left colon cancer. Hepatogastroenterology 46:2835–2838PubMed Eguchi T, Takahashi Y, Asai S, Ishii Y, Fujii M (1999) Study of long intestinal tube for decompression of obstructive left colon cancer. Hepatogastroenterology 46:2835–2838PubMed
25.
Zurück zum Zitat Yokohata K, Sumiyoshi K, Hirakawa K (2006) Merits and faults of transanal ileus tube for obstructing colorectal cancer. Asian J Surg 29:125–127PubMedCrossRef Yokohata K, Sumiyoshi K, Hirakawa K (2006) Merits and faults of transanal ileus tube for obstructing colorectal cancer. Asian J Surg 29:125–127PubMedCrossRef
26.
Zurück zum Zitat Horiuchi A, Nakayama Y, Tanaka N, Kajiyama M, Fujii H, Yokoyama T, Hayashi K (2005) Acute colorectal obstruction treated by means of transanal drainage tube: effectiveness before surgery and stenting. Am J Gastroenterol 100:2765–2770PubMedCrossRef Horiuchi A, Nakayama Y, Tanaka N, Kajiyama M, Fujii H, Yokoyama T, Hayashi K (2005) Acute colorectal obstruction treated by means of transanal drainage tube: effectiveness before surgery and stenting. Am J Gastroenterol 100:2765–2770PubMedCrossRef
27.
Zurück zum Zitat Tanaka T, Furukawa A, Murata K, Sakamoto T (2001) Endoscopic transanal decompression with a drainage tube for acute colonic obstruction: clinical aspects of preoperative treatment. Dis Colon Rectum 44:418–422PubMedCrossRef Tanaka T, Furukawa A, Murata K, Sakamoto T (2001) Endoscopic transanal decompression with a drainage tube for acute colonic obstruction: clinical aspects of preoperative treatment. Dis Colon Rectum 44:418–422PubMedCrossRef
28.
Zurück zum Zitat Nozoe T, Matsumata T (2000) Usefulness of preoperative colonic lavage using transanal ileus tube for obstructing carcinoma of left colon: device to perform one-stage operation safely. J Clin Gastroenterol 31:156–158PubMedCrossRef Nozoe T, Matsumata T (2000) Usefulness of preoperative colonic lavage using transanal ileus tube for obstructing carcinoma of left colon: device to perform one-stage operation safely. J Clin Gastroenterol 31:156–158PubMedCrossRef
29.
Zurück zum Zitat Horiuchi A, Maeyama H, Ochi Y, Morikawa A, Miyazawa K (2001) Usefulness of Dennis Colorectal Tube in endoscopic decompression of acute, malignant colonic obstruction. Gastrointest Endosc 54:229–232PubMed Horiuchi A, Maeyama H, Ochi Y, Morikawa A, Miyazawa K (2001) Usefulness of Dennis Colorectal Tube in endoscopic decompression of acute, malignant colonic obstruction. Gastrointest Endosc 54:229–232PubMed
30.
Zurück zum Zitat Araki Y, Isomoto H, Matsumoto A, Kaibara A, Yasunaga M, Hayashi K, Yatsugi H, Yamauchi K (2000) Endoscopic decompression procedure in acute obstructing colorectal cancer. Endoscopy 32:641–643PubMedCrossRef Araki Y, Isomoto H, Matsumoto A, Kaibara A, Yasunaga M, Hayashi K, Yatsugi H, Yamauchi K (2000) Endoscopic decompression procedure in acute obstructing colorectal cancer. Endoscopy 32:641–643PubMedCrossRef
31.
Zurück zum Zitat Lelcuk S, Merhav A, Klausner JM, Gutman M, Greif F, Rozin R (1987) Rectoscopic decompression of acute recto-sigmoid obstruction. Endoscopy 19:209–210PubMedCrossRef Lelcuk S, Merhav A, Klausner JM, Gutman M, Greif F, Rozin R (1987) Rectoscopic decompression of acute recto-sigmoid obstruction. Endoscopy 19:209–210PubMedCrossRef
32.
Zurück zum Zitat Lelcuk S, Ratan J, Klausner JM, Skornick Y, Merhav A, Rozin RR (1986) Endoscopic decompression of acute colonic obstruction: avoiding staged surgery. Ann Surg 203:292–294PubMedCrossRef Lelcuk S, Ratan J, Klausner JM, Skornick Y, Merhav A, Rozin RR (1986) Endoscopic decompression of acute colonic obstruction: avoiding staged surgery. Ann Surg 203:292–294PubMedCrossRef
33.
Zurück zum Zitat McGregor JR, O’Dwyer PJ (1993) The surgical management of obstruction and perforation of the left colon. Surg Gynecol Obstet 177:203–208PubMed McGregor JR, O’Dwyer PJ (1993) The surgical management of obstruction and perforation of the left colon. Surg Gynecol Obstet 177:203–208PubMed
34.
Zurück zum Zitat Sjodahl R, Franzen T, Nystrom PO (1992) Primary versus staged resection for acute obstructing colorectal carcinoma. Br J Surg 79:685–688PubMedCrossRef Sjodahl R, Franzen T, Nystrom PO (1992) Primary versus staged resection for acute obstructing colorectal carcinoma. Br J Surg 79:685–688PubMedCrossRef
35.
Zurück zum Zitat Merkel S, Meyer C, Papadopoulos T, Meyer T, Hohenberger W (2007) Urgent surgery in colon carcinoma. Zentralbl Chir 132:16–25PubMedCrossRef Merkel S, Meyer C, Papadopoulos T, Meyer T, Hohenberger W (2007) Urgent surgery in colon carcinoma. Zentralbl Chir 132:16–25PubMedCrossRef
36.
Zurück zum Zitat Riedl S, Wiebelt H, Bergmann U, Hermanek P Jr (1995) Postoperative complications and fatalities in surgical therapy of colon carcinoma: Results of the German multicenter study by the Colorectal Carcinoma Study Group. Chirurg 66:597–606PubMed Riedl S, Wiebelt H, Bergmann U, Hermanek P Jr (1995) Postoperative complications and fatalities in surgical therapy of colon carcinoma: Results of the German multicenter study by the Colorectal Carcinoma Study Group. Chirurg 66:597–606PubMed
37.
Zurück zum Zitat Runkel NS, Schlag P, Schwarz V, Herfarth C (1991) Outcome after emergency surgery for cancer of the large intestine. Br J Surg 78:183–188PubMedCrossRef Runkel NS, Schlag P, Schwarz V, Herfarth C (1991) Outcome after emergency surgery for cancer of the large intestine. Br J Surg 78:183–188PubMedCrossRef
38.
Zurück zum Zitat Tilney HS, Lovegrove RE, Purkayastha S, Sains PS, Weston-Petrides GK, Darzi AW, Tekkis PP, Heriot AG (2007) Comparison of colonic stenting and open surgery for malignant large bowel obstruction. Surg Endosc 21:225–233PubMedCrossRef Tilney HS, Lovegrove RE, Purkayastha S, Sains PS, Weston-Petrides GK, Darzi AW, Tekkis PP, Heriot AG (2007) Comparison of colonic stenting and open surgery for malignant large bowel obstruction. Surg Endosc 21:225–233PubMedCrossRef
39.
Zurück zum Zitat Tobaruela E, Camunas J, Enriquez-Navascues JM, Diez M, Ratia T, Martin A, Hernandez P, Lasa I, Martin A, Cambronero JA, Granell J (1997) Medical factors in the morbidity and mortality associated with emergency colorectal cancer surgery. Rev Esp Enferm Dig 89:13–22PubMed Tobaruela E, Camunas J, Enriquez-Navascues JM, Diez M, Ratia T, Martin A, Hernandez P, Lasa I, Martin A, Cambronero JA, Granell J (1997) Medical factors in the morbidity and mortality associated with emergency colorectal cancer surgery. Rev Esp Enferm Dig 89:13–22PubMed
40.
Zurück zum Zitat Baccari P, Bisagni P, Crippa S, Sampietro R, Staudacher C (2006) Operative and long-term results after one-stage surgery for obstructing colonic cancer. Hepatogastroenterology 53:698–701PubMed Baccari P, Bisagni P, Crippa S, Sampietro R, Staudacher C (2006) Operative and long-term results after one-stage surgery for obstructing colonic cancer. Hepatogastroenterology 53:698–701PubMed
41.
Zurück zum Zitat Biondo S, Perea MT, Rague JM, Pares D, Jaurrieta E (2001) One-stage procedure in non-elective surgery for diverticular disease complications. Colorectal Dis 3:42–45PubMedCrossRef Biondo S, Perea MT, Rague JM, Pares D, Jaurrieta E (2001) One-stage procedure in non-elective surgery for diverticular disease complications. Colorectal Dis 3:42–45PubMedCrossRef
42.
Zurück zum Zitat Tan SG, Nambiar R, Rauff A, Ngoi SS, Goh HS (1991) Primary resection and anastomosis in obstructed descending colon due to cancer. Arch Surg 126:748–751PubMed Tan SG, Nambiar R, Rauff A, Ngoi SS, Goh HS (1991) Primary resection and anastomosis in obstructed descending colon due to cancer. Arch Surg 126:748–751PubMed
43.
Zurück zum Zitat Saida Y, Sumiyama Y, Nagao J, Takase M (1996) Stent endoprosthesis for obstructing colorectal cancers. Dis Colon Rectum 39:552–555PubMedCrossRef Saida Y, Sumiyama Y, Nagao J, Takase M (1996) Stent endoprosthesis for obstructing colorectal cancers. Dis Colon Rectum 39:552–555PubMedCrossRef
44.
Zurück zum Zitat Hasegawa S, Ohta M, Mori R, Misuta K, Kobayashi S, Nakano A (2003) Perforation caused by a transanal decompression tube in large bowel obstruction. J Clin Gastroenterol 37:195–196PubMedCrossRef Hasegawa S, Ohta M, Mori R, Misuta K, Kobayashi S, Nakano A (2003) Perforation caused by a transanal decompression tube in large bowel obstruction. J Clin Gastroenterol 37:195–196PubMedCrossRef
45.
Zurück zum Zitat Hsu TC (2005) Comparison of one-stage resection and anastomosis of acute complete obstruction of left and right colon. Am J Surg 189:384–387PubMedCrossRef Hsu TC (2005) Comparison of one-stage resection and anastomosis of acute complete obstruction of left and right colon. Am J Surg 189:384–387PubMedCrossRef
Metadaten
Titel
Transanal endoscopic tube decompression of acute colonic obstruction: experience with 51 cases
verfasst von
A. Fischer
H. J. Schrag
M. Goos
R. Obermaier
U. T. Hopt
P. K. Baier
Publikationsdatum
01.03.2008
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 3/2008
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-007-9461-z

Weitere Artikel der Ausgabe 3/2008

Surgical Endoscopy 3/2008 Zur Ausgabe

Chirurginnen und Chirurgen sind stark suizidgefährdet

07.05.2024 Suizid Nachrichten

Der belastende Arbeitsalltag wirkt sich negativ auf die psychische Gesundheit der Angehörigen ärztlicher Berufsgruppen aus. Chirurginnen und Chirurgen bilden da keine Ausnahme, im Gegenteil.

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

07.05.2024 Medizinstudium Nachrichten

Extreme Arbeitsverdichtung und kaum Supervision: Dr. Andrea Martini, Sprecherin des Bündnisses Junge Ärztinnen und Ärzte (BJÄ) über den Frust des ärztlichen Nachwuchses und die Vorteile des Rucksack-Modells.

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren. 

Recycling im OP – möglich, aber teuer

05.05.2024 DCK 2024 Kongressbericht

Auch wenn sich Krankenhäuser nachhaltig und grün geben – sie tragen aktuell erheblich zu den CO2-Emissionen bei und produzieren jede Menge Müll. Ein Pilotprojekt aus Bonn zeigt, dass viele Op.-Abfälle wiederverwertet werden können.

Update Chirurgie

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

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
Berufsverband der Deutschen Chirurgie e.V.

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
Berufsverband der Deutschen Chirurgie e.V.

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
Berufsverband der Deutschen Chirurgie e.V.