{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:33:56Z","timestamp":1740126836362,"version":"3.37.3"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Einleitung Eine Anastomoseninsuffizienz nach \u00d6sophagusresektion tr\u00e4gt wesentlich zu Morbidit\u00e4t und Mortalit\u00e4t der betroffenen Patienten bei. Eine sichere Operationstechnik kann das\n          Auftreten solcher Anastomoseninsuffizienzen reduzieren.<\/jats:p><jats:p>\n          Indikation Bei der Behandlung von \u00d6sophaguskarzinomen empfiehlt die deutsche Leitlinie minimalinvasive oder Hybrid-Operationsverfahren. Hierbei wird in den meisten F\u00e4llen eine\n          Ivor-Lewis-\u00d6sophagektomie und eine Kontinuit\u00e4tsrekonstruktion mittels Magenschlauch durchgef\u00fchrt. Die pr\u00e4ferierte Vorgehensweise scheint dabei die Zirkularstapleranastomose zu sein.<\/jats:p><jats:p>\n          Methode Die Vorbereitung der Anastomose beginnt bereits intraabdominell mit Mobilisation des Magens und Schonung der gastroepiploischen Gef\u00e4\u00dfe. Nach der anschlie\u00dfenden\n          intrathorakalen Mobilisation des \u00d6sophagus kann die eigentliche Anastomosenanlage erfolgen. Hierbei wird der \u00d6sophagus entweder mit einem Stapler durchtrennt oder offen mit der Schere\n          abgesetzt. Anschlie\u00dfend erfolgt eine Tabaksbeutelnaht am offenen \u00d6sophagusstumpf. Alternativ kann eine partielle \u00d6sophaguser\u00f6ffnung mit vorheriger Tabaksbeutelnaht sp\u00e4ter das Einbringen der\n          Staplerandruckplatte vereinfachen. Diese kann \u00fcber eine zur Minithorakotomie erweiterte Trokarstelle im \u00d6sophagusstumpf oder mithilfe eines speziellen Systems auch transoral platziert\n          werden. Die Fixation der Staplerandruckplatte erfolgt durch die Tabaksbeutelnaht. Nun kann der Magenschlauch nach intrathorakal hochgezogen werde. \u00d6sophagus und kleine Magenkurvatur werden\n          \u00fcber die Minithorakotomie nach extrathorakal verlagert und ein Zirkularstapler \u00fcber eine Er\u00f6ffnung der kleinen Kurvatur in den Magenschlauch eingef\u00fchrt. Die Anastomosenanlage erfolgt dann\n          fern der gastroepiploischen Arkade. Abschlie\u00dfend muss der Magenschlauch noch mittels Stapler abgesetzt werden. Erst jetzt k\u00f6nnen \u00d6sophagus und kleine Magenkurvatur komplett geborgen werden.\n          Optional k\u00f6nnen \u00dcbern\u00e4hungen an Anastomose und Magenschlauchabsetzungsrand erfolgen.<\/jats:p><jats:p>\n          Schlussfolgerung Die roboterassistierte Anastomosenanlage mittels Zirkularstapler im Rahmen der \u00d6sophagusresektion ist gut m\u00f6glich und standardisierbar. Dennoch sind innerhalb dieses\n          Verfahrens noch Variationen m\u00f6glich. Einen wissenschaftlich evidenten Vorteil gibt es hierbei jedoch f\u00fcr keine Methode im direkten Vergleich.<\/jats:p>","DOI":"10.1055\/a-1838-5170","type":"journal-article","created":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T23:59:32Z","timestamp":1656460772000},"page":"19-23","source":"Crossref","is-referenced-by-count":1,"title":["Roboterassistierte minimalinvasive \u00d6sophagektomie \u2013 Varianten der intrathorakalen \u00d6sophagogastrostomie mittels Zirkularstapler"],"prefix":"10.1055","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2180-7981","authenticated-orcid":false,"given":"Felix","family":"von Bechtolsheim","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Viszeral-, Thorax- und Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum Carl Gustav Carus, Dresden, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Benedix","sequence":"additional","affiliation":[{"name":"Klinik 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