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Geschlechtsspezifische Aspekte in der Viszeralchirurgie

  • E. M. TeegenEmail author
  • B. Rau
  • I. Gockel
  • N. Kreuser
Schwerpunkt

Zusammenfassung

Gender-Medizin in der Chirurgie bedeutet nicht nur, dass Erkrankungen in Prävalenz, Erkrankungsalter und Schweregrad bei Männern und Frauen variieren, sondern dass die Behandlung durch die unterschiedliche Anatomie und Biologie erschwert werden kann. Hinzu kommen sozioökonomische und gesellschaftliche Aspekte, wie z. B. unterschiedliches Screeningverhalten und der Zugang zu ärztlichen Leistungen, die den Therapiebeginn beeinflussen können. Alle Facetten beeinflussen direkt Outcome, Prognose und Lebensqualität nach viszeralchirurgischen Eingriffen. Dennoch werden heutzutage Frauen und Männer in der Viszeralchirurgie nach denselben Strategien behandelt. Somit besteht die Notwendigkeit, das Bewusstsein und Wissen in Bezug auf geschlechtsspezifische Unterschiede auch in der Chirurgie zu schärfen, um eine patientenindividuellere Medizin anzubieten und beispielsweise Risiken und Benefit noch konkreter einschätzen zu können.

Schlüsselwörter

Gastroösophagealer Reflux Ösophaguskarzinom Kolorektale Chirurgie Pankreaskarzinom Magenkarzinom 

Gender-specific aspects in visceral surgery

Abstract

Gender medicine is not only related to a different prevalence, age and severity of common diseases in men of women, but is also impacted by variations in anatomy and biology. Furthermore, socioeconomic and social aspects like screening and access to medical services may influence the start of medical and surgical treatment. All factors directly affect outcome, prognosis and quality of life after visceral surgery. Nevertheless, women and men are still treated with the same strategies in visceral surgery. Therefore, there is a need to raise awareness and knowledge of gender-related differences in surgical treatment in order to offer patients more individualized medicine and, for example, to be able to more concretely assess surgical risks and benefits.

Keywords

Gastroesophageal reflux Esophageal cancer Colorectal surgery Pancreatic cancer Gastric cancer 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

E. M. Teegen, B. Rau, I. Gockel und N. Kreuser geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Literatur

  1. 1.
    Mayberry JF (2001) Epidemiology and demographics of achalasia. Gastrointest Endosc Clin N Am 11:235–248PubMedCrossRefGoogle Scholar
  2. 2.
    Tsuboi K, Omura N, Yano F et al (2016) Gender differences in both the pathology and surgical outcome of patients with esophageal achalasia. Surg Endosc 30:5465–5471PubMedCrossRefGoogle Scholar
  3. 3.
    Kim YS, Kim N, Kim GH (2016) Sex and gender differences in gastroesophageal reflux disease. J Neurogastroenterol Motil 22:575–588PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Banki F, Demeester SR, Mason RJ et al (2005) Barrett’s esophagus in females: a comparative analysis of risk factors in females and males. Am J Gastroenterol 100:560–567PubMedCrossRefGoogle Scholar
  5. 5.
    Chen Z, Thompson SK, Jamieson GG et al (2011) Effect of sex on symptoms associated with gastroesophageal reflux. Arch Surg 146:1164–1169PubMedCrossRefGoogle Scholar
  6. 6.
    El-Serag HB, Sweet S, Winchester CC et al (2014) Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 63:871–880PubMedCrossRefGoogle Scholar
  7. 7.
    Spechler SJ (2013) Barrett esophagus and risk of esophageal cancer: a clinical review. JAMA 310:627–636PubMedCrossRefGoogle Scholar
  8. 8.
    Pech O (2015) Gastro-esophageal reflux disease and malignant progression—equal risk for men and women? Z Gastroenterol 53:779–781PubMedCrossRefGoogle Scholar
  9. 9.
    Van Blankenstein M, Looman CW, Johnston BJ et al (2005) Age and sex distribution of the prevalence of Barrett’s esophagus found in a primary referral endoscopy center. Am J Gastroenterol 100:568–576PubMedCrossRefGoogle Scholar
  10. 10.
    Royston C, Bardhan KD (2017) Adam, Eve and the reflux enigma: age and sex differences across the gastro-oesophageal reflux spectrum. Eur J Gastroenterol Hepatol 29:634–639PubMedCrossRefGoogle Scholar
  11. 11.
    Honda J, Iijima K, Asanuma K et al (2016) Estrogen enhances esophageal barrier function by potentiating occludin expression. Dig Dis Sci 61:1028–1038PubMedCrossRefGoogle Scholar
  12. 12.
    Lagergren J, Nyren O (1998) Do sex hormones play a role in the etiology of esophageal adenocarcinoma? A new hypothesis tested in a population-based cohort of prostate cancer patients. Cancer Epidemiol Biomarkers Prev 7:913–915PubMedGoogle Scholar
  13. 13.
    Bhat S, Coleman HG, Yousef F et al (2011) Risk of malignant progression in Barrett’s esophagus patients: results from a large population-based study. J Natl Cancer Inst 103:1049–1057PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Litle VR, Rice TW (2011) The esophagus: do sex and gender matter? Semin Thorac Cardiovasc Surg 23:131–136PubMedCrossRefGoogle Scholar
  15. 15.
    Sukocheva OA, Li B, Due SL et al (2015) Androgens and esophageal cancer: What do we know? World J Gastroenterol 21:6146–6156PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Brown LM, Devesa SS, Chow WH (2008) Incidence of adenocarcinoma of the esophagus among white Americans by sex, stage, and age. J Natl Cancer Inst 100:1184–1187PubMedPubMedCentralCrossRefGoogle Scholar
  17. 17.
    Kauppila JH, Wahlin K, Lagergren P et al (2018) Sex differences in the prognosis after surgery for esophageal squamous cell carcinoma and adenocarcinoma. Int J Cancer 144(6):1284–1291PubMedCrossRefGoogle Scholar
  18. 18.
    Pandeya N, Olsen CM, Whiteman DC (2013) Sex differences in the proportion of esophageal squamous cell carcinoma cases attributable to tobacco smoking and alcohol consumption. Cancer Epidemiol 37:579–584PubMedCrossRefGoogle Scholar
  19. 19.
    Wu C, Wang Z, Song X et al (2014) Joint analysis of three genome-wide association studies of esophageal squamous cell carcinoma in Chinese populations. Nat Genet 46:1001–1006PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Stroh C, Weiner R, Wolff S et al (2015) Comment on gender-specific aspects in obesity and metabolic surgery—analysis of data from the German Bariatric Surgery Registry. Zentralbl Chir 140:285–293PubMedCrossRefGoogle Scholar
  21. 21.
    Lee YC, Chiang TH, Chou CK et al (2016) Association between Helicobacter Pylori eradication and gastric cancer incidence: a systematic review and meta-analysis. Gastroenterology 150:1113–1124 (e1115)PubMedCrossRefGoogle Scholar
  22. 22.
    Marques-Silva L, Areia M, Elvas L et al (2014) Prevalence of gastric precancerous conditions: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol 26:378–387PubMedCrossRefGoogle Scholar
  23. 23.
    Jemal A, Bray F, Center MM et al (2011) Global cancer statistics. Ca Cancer J Clin 61:69–90PubMedCrossRefGoogle Scholar
  24. 24.
    Sipponen P, Correa P (2002) Delayed rise in incidence of gastric cancer in females results in unique sex ratio (M/F) pattern: etiologic hypothesis. Gastric Cancer 5:213–219PubMedCrossRefGoogle Scholar
  25. 25.
    Chandanos E, Lagergren J (2008) Oestrogen and the enigmatic male predominance of gastric cancer. Eur J Cancer 44:2397–2403PubMedCrossRefGoogle Scholar
  26. 26.
    Kim HW, Kim JH, Lim BJ et al (2016) Sex disparity in gastric cancer: female sex is a poor prognostic factor for advanced gastric cancer. Ann Surg Oncol 23:4344–4351PubMedCrossRefGoogle Scholar
  27. 27.
    Antonacci N, Ricci C, Taffurelli G et al (2015) Laparoscopic appendectomy: Which factors are predictors of conversion? A high-volume prospective cohort study. Int J Surg 21:103–107PubMedCrossRefGoogle Scholar
  28. 28.
    Liang TJ, Liu SI, Tsai CY et al (2016) Analysis of recurrence management in patients who underwent nonsurgical treatment for acute appendicitis. Medicine (Baltimore) 95(12):e3159CrossRefGoogle Scholar
  29. 29.
    Rottoli M, Remzi FH, Shen B et al (2012) Gender of the patient may influence perioperative and long-term complications after restorative proctocolectomy. Colorectal Dis 14(3):336–341PubMedCrossRefGoogle Scholar
  30. 30.
    Tekkis PP, Fazio VW, Remzi F et al (2005) Risk factors associated with ileal pouch-related fistula following restorative proctocolectomy. Br J Surg 92(10):1270–1276PubMedCrossRefGoogle Scholar
  31. 31.
    Riber C, Søe K, Jørgensen T, Tønnesen H (1997) Intestinal obstruction after appendectomy. Scand J Gastroenterol 32(11):1125–1128PubMedCrossRefGoogle Scholar
  32. 32.
    Parker MC, Wilson MS, Menzies D et al (2005) Surgical and Clinical Adhesions Research (SCAR) Group. The SCAR-3 study: 5‑year adhesion-related readmission risk following lower abdominal surgical procedures. Colorectal Dis 7(6):551–558PubMedCrossRefGoogle Scholar
  33. 33.
    Barmparas G, Branco BC, Schnüriger B et al (2010) The incidence and risk factors of post-laparotomy adhesive small bowel obstruction. J Gastrointest Surg 14(10):1619–1628PubMedCrossRefGoogle Scholar
  34. 34.
    Paulson EC, Wirtalla C, Armstrong K, Mahmoud NN (2009) Gender influences treatment and survival in colorectal cancer surgery. Dis Colon Rectum 52(12):1982–1991PubMedCrossRefGoogle Scholar
  35. 35.
    McArdle CS, McMillan DC, Hole DJ (2003) Male gender adversely affects survival following surgery for colorectal cancer. Br J Surg 90(6):711–715PubMedCrossRefGoogle Scholar
  36. 36.
    Jemal A, Clegg LX, Ward E et al (2004) Annual report to the nation on the status of cancer, 1975–2001, with a special feature regarding survival. Cancer 101(1):3–27PubMedCrossRefGoogle Scholar
  37. 37.
    Gao RN, Neutel CI, Wai E (2008) Gender differences in colorectal cancer incidence, mortality, hospitalizations and surgical procedures in Canada. J Public Health 30(2):194–201CrossRefGoogle Scholar
  38. 38.
    Kleemann M, Benecke C, Helfrich D et al (2014) Prospective analysis of more than 1,000 patients with rectal carcinoma: Are there gender-related differences? Viszeralmedizin 30(2):118–124PubMedPubMedCentralCrossRefGoogle Scholar
  39. 39.
    Wichmann MW, Müller C, Hornung HM et al (2001) Gender differences in long-term survival of patients with colorectal cancer. Br J Surg 88(8):1092–1098PubMedCrossRefGoogle Scholar
  40. 40.
    Bufalari A, Giustozzi G, Burattini MF et al (2006) Rectal cancer surgery in the elderly: a multivariate analysis of outcome risk factors. J Surg Oncol 93(3):173–180PubMedCrossRefGoogle Scholar
  41. 41.
    Koo JH, Arasaratnam MM, Liu K et al (2010) Knowledge, perception and practices of colorectal cancer screening in an ethnically diverse population. Cancer Epidemiol 34(5):604–610PubMedCrossRefGoogle Scholar
  42. 42.
    Raine R, Wong W, Scholes S et al (2010) Social variations in access to hospital care for patients with colorectal, breast, and lung cancer between 1999 and 2006: retrospective analysis of hospital episode statistics. BMJ 14(340):b5479CrossRefGoogle Scholar
  43. 43.
    Chawla N, Butler EN, Lund J et al (2013) Patterns of colorectal cancer care in Europe, Australia, and New Zealand. J Natl Cancer Inst Monogr 2013(46):36–61PubMedPubMedCentralCrossRefGoogle Scholar
  44. 44.
    Tilney HS, Heriot AG, Purkayastha S et al (2008) A national perspective on the decline of abdominoperineal resection for rectal cancer. Ann Surg 247(1):77–84PubMedCrossRefGoogle Scholar
  45. 45.
    Majek O, Gondos A, Jansen L et al (2013) Sex differences in colorectal cancer survival: population-based analysis of 164,996 colorectal cancer patients in Germany. PLoS ONE 8(7):e68077PubMedPubMedCentralCrossRefGoogle Scholar
  46. 46.
    Cheung WY, Shi Q, O’Connell M et al (2013) The predictive and prognostic value of sex in early-stage colon cancer: a pooled analysis of 33,345 patients from the ACCENT database. Clin Colorectal Cancer 12(3):179–187PubMedPubMedCentralCrossRefGoogle Scholar
  47. 47.
    Hendifar A, Yang D, Lenz F et al (2009) Gender disparities in metastatic colorectal cancer survival. Clin Cancer Res 15(20):6391–6397PubMedPubMedCentralCrossRefGoogle Scholar
  48. 48.
    Dent OF, Chapuis PH, Renwick AA, Bokey EL (2009) The importance of tumor stage and relative survival analysis for the association between sex and survival after resection of colorectal cancer. Ann Surg 249(3):402–408PubMedCrossRefGoogle Scholar
  49. 49.
    Bos MM, Verburg IW, Dumaij I et al (2015) Intensive care admission of cancer patients: a comparative analysis. Cancer Med 4(7):966–976PubMedPubMedCentralCrossRefGoogle Scholar
  50. 50.
    Gonzalez EC, Roetzheim RG, Ferrante JM, Campbell R (2001) Predictors of proximal vs. distal colorectal cancers. Dis Colon Rectum 44(2):251–258PubMedCrossRefGoogle Scholar
  51. 51.
    Martling A, Granath F, Cedermark B et al (2009) Gender differences in the treatment of rectal cancer: a population based study. Eur J Surg Oncol 35(4):427–433PubMedCrossRefGoogle Scholar
  52. 52.
    van Leeuwen BL, Påhlman L, Gunnarsson U et al (2008) The effect of age and gender on outcome after treatment for colon carcinoma. A population-based study in the Uppsala and Stockholm region. Crit Rev Oncol Hematol 67(3):229–236PubMedCrossRefGoogle Scholar
  53. 53.
    Kang SB, Park JW, Jeong SY et al (2010) Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomised controlled trial. Lancet Oncol 11(7):637–645PubMedCrossRefGoogle Scholar
  54. 54.
    Masoomi H, Kang CY, Chen A et al (2012) Predictive factors of in-hospital mortality in colon and rectal surgery. J Am Coll Surg 215(2):255–261PubMedCrossRefGoogle Scholar
  55. 55.
    Law WI, Chu KW, Ho JW, Chan CW (2000) Risk factors for anastomotic leakage after low anterior resection with total mesorectal excision. Am J Surg 179(2):92–96PubMedCrossRefGoogle Scholar
  56. 56.
    Matthiessen P, Hallböök O, Rutegård J, Sjödahl R (2006) Population-based study of risk factors for postoperative death after anterior resection of the rectum. Br J Surg 93(4):498–503PubMedCrossRefGoogle Scholar
  57. 57.
    Seike K, Koda K, Oda K et al (2009) Gender differences in pelvic anatomy and effects on rectal cancer surgery. Hepatogastroenterology 56(89):111–115PubMedGoogle Scholar
  58. 58.
    Jeyarajah S, Sutton CD, Miller AS, Hemingway D (2007) Leicester Colorectal Specialist Group. Factors that influence the adequacy of total mesorectal excision for rectal cancer. Colorectal Dis 9(9):808–815PubMedCrossRefGoogle Scholar
  59. 59.
    Rivadeneira DE, Verdeja JC, Sonoda T (2012) Improved access and visibility during stapling of the ultra-low rectum: a comparative human cadaver study between two curved staplers. Ann Surg Innov Res 6(1):11PubMedPubMedCentralCrossRefGoogle Scholar
  60. 60.
    Xiong B, Ma L, Huang W, Zhao Q et al (2015) Robotic versus laparoscopic total mesorectal excision for rectal cancer: a meta-analysis of eight studies. J Gastrointest Surg 19(3):516–526PubMedCrossRefGoogle Scholar
  61. 61.
    Feinberg AE, Elnahas A, Bashir S et al (2016) Comparison of robotic and laparoscopic colorectal resections with respect to 30-day perioperative morbidity. Can J Surg 59(4):262–267PubMedPubMedCentralCrossRefGoogle Scholar
  62. 62.
    Wexner SD, Bergamaschi R, Lacy A et al (2009) The current status of robotic pelvic surgery: results of a multinational interdisciplinary consensus conference. Surg Endosc 23(8):438–443PubMedCrossRefGoogle Scholar
  63. 63.
    Kim SW, Song IH, An S et al (2017) Pancreatic serous cystic neoplasms accompanying other pancreatic tumors. Hum Pathol 60:104–113CrossRefGoogle Scholar
  64. 64.
    Hirabayashi K, Kurokawa S, Maruno A et al (2015) Sex differences in immunohistochemical expression and capillary density in pancreatic solid pseudopapillary neoplasm. Ann Diagn Pathol 19:45–49PubMedCrossRefGoogle Scholar
  65. 65.
    Quante AS, Ming C, Rottmann M et al (2016) Projections of cancer incidence and cancer-related deaths in Germany by 2020 and 2030. Cancer Med 5:2649–2656PubMedPubMedCentralCrossRefGoogle Scholar
  66. 66.
    Barnes B, Kraywinkel K, Nowossadeck E et al (2016) Bericht zum Krebsgeschehen in Deutschland 2016. Robert Koch-Institut, BerlinGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Klinik für ChirurgieCharité – Universitätsmedizin BerlinBerlinDeutschland
  2. 2.Klinik für Viszeral‑, Transplantations‑, Thorax- und GefäßchirurgieUniversitätsklinikum LeipzigLeipzigDeutschland

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