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Chronische postoperative Schmerzen nach Leistenhernienoperation

  • Wolfgang Reinpold
  • David C. Chen
  • Cigdem Berger

Zusammenfassung

Der chronische postoperative Schmerz ist die häufigste Komplikation nach Leistenbruchoperationen. Gemäß aktueller Leitlinien treten chronische Schmerzen mit 18 % nach offenen Leistenbruchoperation deutlich häufiger auf als nach laparoendoskopischem Eingriff (6%). Weitere signifikante Risikofaktoren für chronische Schmerzen sind starke präoperative Leistenschmerzen, Alter unter 50 Jahren, weibliches Geschlecht, Rezidivleistenbruchoperation und starke frühpostoperative Schmerzen. Eine starke Beeinträchtigung im täglichen Leben tritt in 0,5–6 % der Fälle auf. Zur Prävention chronischer Leistenschmerzen sind präzise Kenntnisse der Leistennervenanatomie bei jeder Operation unverzichtbar. Die Diagnostik und Therapie erfolgen interdisziplinär. Bei relevanten, die Lebensqualität beeinträchtigenden chronischen postoperativen Leistenschmerzen, die sich mit konservativen und interventionellen Therapiemaßnahmen nicht beherrschen lassen, kann eine Operation indiziert sein. Revisionsoperationen zur Schmerzkontrolle und insbesondere die Entfernung von Kunststoffimplantaten sollten spezialisierten Hernienchirurgen vorbehalten sein.

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Copyright information

© Springer-Verlag GmbH Deutschland 2018

Authors and Affiliations

  • Wolfgang Reinpold
    • 1
  • David C. Chen
    • 2
  • Cigdem Berger
    • 3
  1. 1.Abteilung für ChirurgieWilhelmsburger Krankenhaus Groß-SandHamburgDeutschland
  2. 2.Lichtenstein Amid Hernia Clinic at UCLASection of Minimally Invasive SurgeryLos AngelesUSA
  3. 3.Wilhelmsburger Krankenhaus Groß-SandAbteilung für ChirurgieHamburgDeutschland

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