{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T04:17:59Z","timestamp":1749010679526,"version":"3.41.0"},"reference-count":49,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>In der Behandlung von chronischem Darmversagen\/Kurzdarmsyndrom (CDV\/KDS) wird h\u00e4ufig die Frage nach der Indikationsstellung zur D\u00fcnndarmtransplantation gestellt. Die Ergebnisse der D\u00fcnndarm- und Multiviszeraltransplantation sind allerdings vor allem in Bezug auf die Langzeitergebnisse von Patienten- und Organ\u00fcberleben nicht zufriedenstellend. Nach Expertenkonsens f\u00fchrt die Aussch\u00f6pfung der alternativen, in Kombination mit hocheffektiven Behandlungsmethoden (Ern\u00e4hrungstherapie, autologe Darmrekonstruktion, Chymus-Reinfusion, Pharmakotherapie inkl. GLP-2-Analoga) zu einer guten Lebensqualit\u00e4t bei Patienten mit CDV\/KDS. Ziele all dieser gr\u00f6\u00dftenteils komplement\u00e4r zueinander einzusetzenden Therapieverfahren sind: Eine Optimierung der enteralen Absorption, eine bestm\u00f6gliche anatomische Situation f\u00fcr eine optimierte Resorption und die Organersatztherapie beim Darmversagen (heimparenterale Ern\u00e4hrung), sodass ein gutes Langzeit\u00fcberleben der Patienten mit gr\u00f6\u00dftm\u00f6glicher Lebensqualit\u00e4t\n      erreicht wird. Diese ganzheitliche Optimierung wird mit dem Begriff \u201eintestinale Rehabilitation\u201c beschrieben. Das Fernziel ist die Wiederherstellung der nutritiven Autonomie des Patienten mit einer Reduktion bis hin zur vollst\u00e4ndigen Entw\u00f6hnung von parenteraler Ern\u00e4hrung. Patienten mit einem drohenden Versagen der parenteralen Ern\u00e4hrung als lebenserhaltende Organersatztherapie sollten dennoch fr\u00fchzeitig an einem Transplantationszentrum mit Erfahrung in der Multiviszeral- und D\u00fcnndarmtransplantation vorgestellt werden, um rechtzeitig den Strategiewechsel zur dann lebensrettenden Transplantation vorzubereiten. Nach dem internationalen Standard sollten Patienten mit einem CDV\/KDS in einem interdisziplin\u00e4ren Zentrum unter Einbeziehung von Viszeralchirurgie, Gastroenterologie, Psychologie und Ern\u00e4hrungsmedizin behandelt werden.<\/jats:p>","DOI":"10.1055\/a-2593-9648","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T23:24:33Z","timestamp":1748993073000},"page":"213-222","source":"Crossref","is-referenced-by-count":0,"title":["Behandlung bei Darmversagen\/Kurzdarmsyndrom: Alternativen zur D\u00fcnndarmtransplantation \u2013 wie ist der internationale Standard?"],"prefix":"10.1055","volume":"150","author":[{"given":"Peter Sebastian","family":"Keller","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Allgemein-, Viszeral-, Thorax- und Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum Bonn Chirurgisches Zentrum, Bonn, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Verena","family":"Stolz","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Allgemein-, Viszeral-, Thorax- und Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum Bonn Chirurgisches Zentrum, Bonn, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Kupczyk","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Diagnostische und Interventionelle Radiologie, Universit\u00e4tsklinikum Bonn, Bonn, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gun-Soo","family":"Hong","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Allgemein-, Viszeral-, Thorax- und Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum Bonn Chirurgisches Zentrum, Bonn, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0705-2973","authenticated-orcid":false,"given":"Jan","family":"Arensmeyer","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Allgemein-, Viszeral-, Thorax- und Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum Bonn Chirurgisches Zentrum, Bonn, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00f6rg C","family":"Kalff","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Allgemein-, Viszeral-, Thorax- und Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum Bonn Chirurgisches Zentrum, Bonn, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"von Websky","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Allgemein-, Viszeral-, Kinder- und Transplantationschirurgie, Uniklinik RWTH Aachen, Aachen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1111\/ajt.12979","article-title":"Intestinal transplant registry report: global activity and trends","volume":"15","author":"D Grant","year":"2015","journal-title":"Am J Transplant"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1940","DOI":"10.1016\/j.clnu.2023.07.019","article-title":"ESPEN guideline on chronic intestinal failure in adults\u2013Update 2023","volume":"42","author":"L Pironi","year":"2023","journal-title":"Clin Nutr"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2596","DOI":"10.1038\/ajg.2009.329","article-title":"Oral rehydration solutions in non-cholera diarrhea: a review","volume":"104","author":"AN Atia","year":"2009","journal-title":"Am J Gastroenterol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1177\/0148607112469818","article-title":"Nutrition and fluid optimization for patients with short bowel syndrome","volume":"37","author":"LE Matarese","year":"2013","journal-title":"JPEN J Parenter Enteral Nutr"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e57","DOI":"10.1055\/s-0034-1369922","article-title":"S3-Leitlinie der Deutschen Gesellschaft f\u00fcr Ern\u00e4hrungsmedizin e.\u00a0V. in Zusammenarbeit mit der AKE, der GESKES und der DGVS. 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