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Leitthema 1 2 coloproctology 2018 · 40:187–194 J. Hardt ·P. Kienle https://doi.org/10.1007/s00053-018-0257-5 Chirurgische Klinik, Universitätsmedizin Mannheim (UMM), Medizinische Fakultät Mannheim, Universität Online publiziert: 23. Mai 2018 Heidelberg, Mannheim, Deutschland © Springer Medizin Verlag GmbH, ein Teil von Allgemein- und Viszeralchirurgie, Theresienkrankenhaus, Mannheim, Deutschland Springer Nature 2018 Chirurgische Therapie des Rektumprolapses Wertung der verschiedenen Verfahren auf Evidenzbasis Für die chirurgische Therapie des Rek- herwertiger Evidenz untermauern [1, ten Studien zwischen 0 und 9% bei Fol- tumvollwandprolapses (syn. externer 2]. low-up-Zeiträumen von 2bis 8Jahren Rektumprolaps/Rektumprolaps III°) lie- Im Folgenden werden die verschiede- [7, 8, 10]. Die größte verfügbare Serie gen nach heutigem Stand diverse operati- nenchirurgischenTherapieverfahrenan- analysierte eine Kohorte von 179 Patien- ve Verfahren zur Auswahl vor. Prinzipiell hand der dafür in der Literatur vorliegen- ten, die eine laparoskopische Nahtrekto- sind hiertransabdominelle vontransana- den Evidenz nach gängigem Schema be- pexie bei drittgradigem Rektumprolaps len/perinealen Verfahren mit oder ohne wertet (http://www.cebm.net/blog/2009/ erhalten hatten. Die Prolapsrezidivrate Einbringung von Netzmaterial zu un- 06/11/oxford-centre-evidence-based- lag nach 5 Jahren bei 6 % (10/172), nach terscheiden. Zudem stehen mittlerweile medicine-levels-evidence-march-2009/). 10 Jahren bei 20 %. Kontinenz und Le- diverse Zugangsoptionen zur Verfügung: bensqualität zeigten sich im Vergleich offen vs. konventionell laparoskopisch zum präoperativen Ausgangsniveau sig- Transabdominelle Verfahren
coloproctology – Springer Journals
Published: May 23, 2018
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