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Laparo-endoskopische Hernienchirurgie pp 429–434Cite as

Komplikationen der Hiatushernienchirurgie und deren Vermeidung

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Zusammenfassung

Die am häufigsten auftretenden intraoperativen Komplikationen bei der Hiatushernienchirurgie stellen Blutungen, Kapseleinrisse der Leber und Milz, Perforationen des Ösophagus und/oder des Magens und Verletzungen der Pleura dar. Besonders große paraösophageale Hiatushernien Typ IV (Upside-down-Magen) sind vergesellschaftet mit intensiven intrathorakalen Verwachsungen mit dem Mediastinum und der Pleura und weisen ein hohes Risiko von Verletzungen der benachbarten Strukturen bei der Präparation auf. Die häufigsten frühpostoperativen Komplikationen stellen Pneumonien, thromboembolische Komplikationen und eine Herzinsuffizienz dar. Chirurgische Komplikationen wie Ösophagusperforationen oder Frührezidive sind sehr viel seltener. Postoperative Dysphagien können früh oder spät nach Hiatushernienoperationen auftreten. Im Fall einer frühen postoperativen Dysphagie kann zunächst abgewartet werden, ob es sich um eine Schwellung der Schleimhaut im Bereich des gastroösohagealen Übergangs handelt. Die Dysphagie stellt ein ernstes und relativ häufig beschriebenes spätpostoperatives Problem der Hiatushernienchirurgie dar. Die endoskopische Pneumodilatation führt in der Regel zu einer Verbesserung der dysphagischen Symptome. Eine Reoperation sollte den Fällen vorbehalten bleiben, bei denen eine konservative bzw. endoskopische Therapie nicht ausreichend wirksam ist.

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Authors and Affiliations

  1. Department of Surgery, St. Antonius Ziekenhuis, Koekoekslaan 1, 3435 CM, Nieuwegein, Niederlande

    MD Jelmer E. Oor & MD Eric J. Hazebroek

  2. Chirurgie – Visceral- und Gefäßchirurgie; Vivantes Klinikum Spandau, Zentrum für Minimal Invasive Chirurgie, Neue Bergstraße 6, 13585, Berlin, Deutschland

    Professor, Dr. med. Ferdinand Köckerling

  3. Max Institute of Minimal Access, Metabolic & Bariatric Surgery, Max Super Speciality Hospital, Saket, Press Enclave Road, Saket, 110017, New Delhi, DL, Indien

    Dr. Rajesh Khullar

Authors
  1. MD Jelmer E. Oor
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  2. Professor, Dr. med. Ferdinand Köckerling
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  3. Dr. Rajesh Khullar
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  4. MD Eric J. Hazebroek
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Editor information

Editors and Affiliations

  1. Stuttgart, Deutschland

    Reinhard Bittner

  2. Vivantes Klinikum Spandau, Berlin, Deutschland

    Ferdinand Köckerling

  3. Creighton University School of Medicine, Omaha, NE, USA

    Robert J. Fitzgibbons

  4. Our Lady of the Lake Physician Group, Baton Rouge, LA, USA

    Karl A. LeBlanc

  5. Creighton University School of Medicine, Omaha, NE, USA

    Sumeet Mittal

  6. Max Super Specialty Hospital Saket, New Delhi, India

    Pradeep Chowbey

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Oor, J.E., Köckerling, F., Khullar, R., Hazebroek, E.J. (2018). Komplikationen der Hiatushernienchirurgie und deren Vermeidung. In: Bittner, R., Köckerling, F., Fitzgibbons, R.J., LeBlanc, K.A., Mittal, S., Chowbey, P. (eds) Laparo-endoskopische Hernienchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-56090-7_40

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  • DOI: https://doi.org/10.1007/978-3-662-56090-7_40

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-56089-1

  • Online ISBN: 978-3-662-56090-7

  • eBook Packages: Medicine (German Language)

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