Sigma resection
The resection is an operation of the end portion of the large intestine .
surgery
The aim of the operation is the removal ( resection ) of the tumorous or diverticulum-bearing section of the intestine. The entire procedure can be carried out as an open operation or minimally invasive laparoscopically through several smaller incisions in the abdominal wall.
Before the operation, the bowel is cleaned thoroughly to reduce the risk of infection . The colon cleansing is carried out by an orthograde irrigation. Here, the patient is given 3-4 liters of irrigation fluid (laxative) orally on the day before the operation, and rectal cleansing enemas are also performed if necessary. The procedure is performed under general anesthesia . In some centers, the preparation of the intestine is dispensed with, as studies have shown that the preparation has no demonstrable benefit. In this way, the patients can be nourished until the operation and optimally prepared for the stress ( fast-track surgery ).
As a rule, the remaining parts of the intestine are sewn back together in an anastomosis . Sometimes the surgeon has to move the remaining intestine to the outside of the abdomen to create an artificial anus . The measure is z. B. necessary if the diverticulum has ruptured, the infection has spread and the healing of the anastomosis is impaired.
Risks and Complications
In addition to the general risks during surgery and general anesthesia, it may hurt in the specific case spleen ( Rinse ), the intestine or the stomach come. The kidneys , bladder and ureters, as well as the vessels in the abdomen, can also be injured.
Injury to these structures can be permanent and require further surgery, but this is very rare.
The incision in the abdomen can cause hernias that require another operation.
Another possible complication is rupture of the anastomosis, the area where the two ends of the intestine are joined. This can lead to infections in the abdomen ( peritonitis ) that would require surgery and an artificial anus.
With all the care taken by the surgeon, it can never be ruled out that intestinal dirt particles could get into the abdominal cavity during the procedure. This can lead to the formation of an abscess in the abdomen postoperatively . If such an abscess is diagnosed during the sonographic follow-up examination and an X-ray examination of the intestine can rule out that the surgical sutures are leaky, the abscess is punctured or drained with the aid of a CT .
literature
- Karl-Heinz Reutter (ed.), Reinhard Baumann et all: Surgical Essentials: Intensive course for further training . Georg Thieme Verlag, 5th edition, Stuttgart 2004 ( on Google Books )
- Thomas Carus: Operation Atlas Laparoscopic Surgery: Indications - Operation Procedure - Variants - Complications . Springer Verlag, 3rd edition, Berlin / Heidelberg 2014 ( on Google Books )
- Burkhard Paetz, Brigitte Benzinger-König: Surgery for nursing professions . Georg Thieme Verlag, 20th edition, Stuttgart ( on Google Books )
- Michael Korenkov, Christoph-Thomas Germer, Hauke Lang: Gastrointestinal operations and technical variants: surgical techniques of the experts . Springer Verlag, Berlin / Heidelberg 2013 ( on Google Books )
- Volker Schumpelick (Ed.): Practice of Visceral Surgery: Gastroenterological Surgery . Springer Verlag, Berlin / Heidelberg 2011 ( on Google Books )
Web links
- Sigmaresection , on klinikum.uni-muenchen.de
- Sigmaresection , on webop.de
Individual evidence
- ↑ a b c d Sigmaresection , on medizin-kompakt.de. Retrieved May 20, 2018.
