Zusammenfassung
Hintergrund
Komplikationen sind nicht immer vermeidbar und ihre Behandlung ist integraler Bestandteil einer hochwertigen medizinischen Versorgung. Komplikationen an großen Atemwegen sind selten, erfordern aber unbedingt die Mitbehandlung durch einen versierten Thoraxchirurgen.
Ziel der Arbeit
Der Leser soll Maßnahmen zur Komplikationsvermeidung, Früherkennung und zur Komplikationsbehandlung kennenlernen, um die Notwendigkeit für eine frühe interdisziplinäre Zusammenarbeit zu verstehen.
Material und Methoden
Eine selektive Literaturrecherche wurde durch eigene Erfahrungen ergänzt und mit prospektiv gewonnenem Bildmaterial ausgestattet.
Ergebnisse
Für das Auftreten aller genannten Komplikationen gibt es Risikokonstellationen, die der Chirurg erkennen sollte, um gezielt Maßnahmen der Früherkennung von Komplikationen zu ergreifen. Trachealverletzungen und Bronchusstumpfinsuffizienzen sind selten (< 5 %), dagegen kann eine Rekurrensparese nach linksseitiger Pneumonektomie in bis zu 30 % der Fälle auftreten.
Diskussion
Spätestens nach Auftreten einer Komplikation ist es wichtig, thoraxchirurgisch umgehend und konsequent zu handeln und, wenn erforderlich, andere Fachdisziplinen einzuschalten, um weiteren Schaden vom Patienten abzuwenden.
Abstract
Background
Complications cannot always be avoided and their treatment is an integral component of a high quality medical treatment. Complications of the central airways are rare but necessitate supportive treatment by an experienced thoracic surgeon.
Objective
The reader should become acquainted with measures to prevent complications, to recognize and treat complications early and should understand the necessity for an interdisciplinary approach.
Material and methods
A selective literature research was supplemented by personal experiences and complemented with prospectively collected photographs.
Results
There are risk constellations for the appearance of all the mentioned complications which the surgeon needs to know in order to be able to take measures for early detection of complications. Iatrogenic tracheal injuries and bronchial stump fistulae are rare (< 5 %) whereas recurrent laryngeal nerve palsy after left-sided pneumonectomy occurs in up to 30 % of cases.
Discussion
After the occurrence of complications at the latest, it is very important to include experienced thoracic surgeons and other specialists when necessary to protect the patient from further damage.
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Interessenkonflikt. S. Welter, D. Cheufou, K. Darwiche und G. Stamatis geben an, dass kein Interessenkonflikt besteht.
Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.
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Welter, S., Cheufou, D., Darwiche, K. et al. Tracheaverletzungen, Insuffizienz von Bronchusstumpf/-anastomose und Rekurrensparese. Chirurg 86, 410–418 (2015). https://doi.org/10.1007/s00104-014-2862-3
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DOI: https://doi.org/10.1007/s00104-014-2862-3