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„Watchful waiting“ als Behandlungsstrategie bei Patienten mit asymptomatischer Leistenhernie

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Book cover Laparo-endoskopische Hernienchirurgie

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Zusammenfassung

Die Leistenhernie ist eine der häufigsten der Menschheit bekannten Erkrankungen, und die Operation der Leistenhernie ist der am häufigsten durchgeführte Eingriff auf dem Gebiet der Allgemeinchirurgie weltweit. Ungefähr ein Drittel dieser Leistenhernien sind asymptomatisch oder minimal symptomatisch. Diese asymptomatischen Hernien sind in der Vergangenheit deshalb chirurgisch behandelt worden, weil man Komplikationen wie Einklemmung und Darmverschluss fürchtete. Dieses Konzept wurde in den letzten 10 Jahren aufgrund der Ergebnisse zweier randomisierter kontrollierter Studien, die eine Strategie des „watchful waiting“ (WW) für asymptomatische Hernien mit einer routinemäßigen Operation verglichen, infrage gestellt. Erste Ergebnisse aus beiden Studien zeigten keine signifikante Zunahme an Notfalleingriffen in der Gruppe des WW. Jedoch wurde in der Langzeitanalyse von beiden Gruppen unabhängig voneinander herausgefunden, dass die Mehrheit der Patienten in der WW-Gruppe wegen zunehmenden Symptomen, meistens Schmerz und Missempfinden, operiert werden musste.

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Literatur

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Authors and Affiliations

  1. Department of Surgery, Creighton University School of Medicine, 601 North 30th Street, Suite 3700, Omaha, NE, 68131, USA

    MD Brian Biggerstaff, MD Shreya Shetty & MD, Professor Robert J. Fitzgibbons Jr.

  2. Institute of Minimal Access, Metabolic & Bariatric Surgery, Max Super Speciality Hospital, 2 Press Enclave Road, Saket, 110017, New Delhi, Indien

    Dr. Dr. h.c. Pradeep Chowbey

  3. Supperstr. 19, 70565, Stuttgart, Deutschland

    Professor, Dr. med. Dr. h.c. mult. Reinhard Bittner

Authors
  1. MD Brian Biggerstaff
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  2. MD Shreya Shetty
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  3. MD, Professor Robert J. Fitzgibbons Jr.
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  4. Dr. Dr. h.c. Pradeep Chowbey
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  5. Professor, Dr. med. Dr. h.c. mult. Reinhard Bittner
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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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Biggerstaff, B., Shetty, S., Fitzgibbons Jr., R.J., Chowbey, P., Bittner, R. (2018). „Watchful waiting“ als Behandlungsstrategie bei Patienten mit asymptomatischer Leistenhernie. 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_7

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  • DOI: https://doi.org/10.1007/978-3-662-56090-7_7

  • 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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