Indikation, Technik und Ergebnisse der STARR-Operation
Zusammenfassung Die rektale Intussuszeption und die ventrale Rektozele sind häufige Befunde, die mit einem obstruktiven Defäkationssyndrom (ODS) assoziiert sein können. Nach frustraner konservativer Therapie kann ein chirurgischer Eingriff erörtert werden. Die STARR-Operation (transanale Stapler-Res...
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| Published in | Coloproctology Vol. 39; no. 5; pp. 316 - 323 |
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| Main Authors | , |
| Format | Journal Article |
| Language | German |
| Published |
Munich
Springer Medizin
01.09.2017
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0174-2442 1615-6730 |
| DOI | 10.1007/s00053-017-0189-5 |
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| Abstract | Zusammenfassung
Die rektale Intussuszeption und die ventrale Rektozele sind häufige Befunde, die mit einem obstruktiven Defäkationssyndrom (ODS) assoziiert sein können. Nach frustraner konservativer Therapie kann ein chirurgischer Eingriff erörtert werden. Die STARR-Operation (transanale Stapler-Resektion des distalen Rektums) stellt hierbei eine transanale Operationsmethode mit zwei zirkulären Klammernahtgeräten (PPH01) dar, bei der eine Vollwandresektion des distalen Rektums vorderwand- und hinterwandseitig durchgeführt wird. Sowohl retrospektive und prospektive Studien als auch die Daten des Deutschen STARR-Registers zeigten, dass die STARR-Operation eine sichere und effektive Therapieoption beim ODS infolge einer rektalen Intussuszeption im Kurzzeitverlauf darstellt. Jedoch wurden auch enttäuschende funktionelle Ergebnisse hinsichtlich Stuhlinkontinenz bzw. Urge-Inkontinenz, schwere Komplikationen sowie hohe Raten an Revisionsoperationen nach STARR publiziert. Die adäquate Differenzialdiagnostik und Therapie bleiben generell eine Herausforderung beim ODS infolge einer rektalen Intussuszeption, wobei die Patientenselektion der entscheidende Faktor für einen potenziellen Therapieerfolg der STARR-Operation ist. Vor diesem Hintergrund versucht diese Übersicht, Indikationen, chirurgische Technik, Ergebnisse, Kontroversen und aktuelle Trends der „herkömmlichen“ STARR-Operation mit zwei Zirkularstaplern (PPH01) zusammenzufassen und zu bewerten. |
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| AbstractList | Zusammenfassung
Die rektale Intussuszeption und die ventrale Rektozele sind häufige Befunde, die mit einem obstruktiven Defäkationssyndrom (ODS) assoziiert sein können. Nach frustraner konservativer Therapie kann ein chirurgischer Eingriff erörtert werden. Die STARR-Operation (transanale Stapler-Resektion des distalen Rektums) stellt hierbei eine transanale Operationsmethode mit zwei zirkulären Klammernahtgeräten (PPH01) dar, bei der eine Vollwandresektion des distalen Rektums vorderwand- und hinterwandseitig durchgeführt wird. Sowohl retrospektive und prospektive Studien als auch die Daten des Deutschen STARR-Registers zeigten, dass die STARR-Operation eine sichere und effektive Therapieoption beim ODS infolge einer rektalen Intussuszeption im Kurzzeitverlauf darstellt. Jedoch wurden auch enttäuschende funktionelle Ergebnisse hinsichtlich Stuhlinkontinenz bzw. Urge-Inkontinenz, schwere Komplikationen sowie hohe Raten an Revisionsoperationen nach STARR publiziert. Die adäquate Differenzialdiagnostik und Therapie bleiben generell eine Herausforderung beim ODS infolge einer rektalen Intussuszeption, wobei die Patientenselektion der entscheidende Faktor für einen potenziellen Therapieerfolg der STARR-Operation ist. Vor diesem Hintergrund versucht diese Übersicht, Indikationen, chirurgische Technik, Ergebnisse, Kontroversen und aktuelle Trends der „herkömmlichen“ STARR-Operation mit zwei Zirkularstaplern (PPH01) zusammenzufassen und zu bewerten. |
| Author | Schwandner, O. Hillemanns, P. |
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| Keywords | Obstruktives Defäkations-Syndrom PPH01 STARR Obstructed defecation syndrome rektale Intussuszeption rectal intussusception ODS |
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Die rektale Intussuszeption und die ventrale Rektozele sind häufige Befunde, die mit einem obstruktiven Defäkationssyndrom (ODS) assoziiert... |
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| Title | Indikation, Technik und Ergebnisse der STARR-Operation |
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