{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T10:43:08Z","timestamp":1785580988412,"version":"3.56.0"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Die Behandlung anorektaler Karzinome erfordert eine multimodale Therapie. Durch moderne Fortschritte konnte die Rate an vollst\u00e4ndigen Rektumexstirpationen und permanenten Kolostomien auf unter 10% gesenkt werden. Dennoch bleibt die Versorgung anorektaler Defekte, insbesondere nach abdominoperinealer Exstirpation (APE) oder pelviner Exenteration, eine gro\u00dfe Herausforderung. Nicht zuletzt kommt es durch tiefe Defekte, neo- oder adjuvante Bestrahlungen und bakteriellen Kontaminationen zu einer schlechten Heilungstendenz mit Komplikationsraten von bis zu 60%.<\/jats:p>\n                  <jats:p>Im Rahmen dieser Arbeit wurden s\u00e4mtliche Patientinnen und Patienten einer maximalversorgenden, universit\u00e4ren plastischen Chirurgie, die sich mit anorektalen Defekten nach onkologischer Chirurgie im Jahr 2024 vorstellten, retrospektiv untersucht. Hierbei wurden u.\u00a0a. Einflussfaktoren wie Radiochemotherapie, Kachexie, Diabetes mellitus, Nikotinkonsum, Gef\u00e4\u00dferkrankungen oder Kortikosteroidtherapien analysiert. Zudem wurde der Einfluss der operativen Defektdeckung mittels gestielter M.-gracilis-Lappenplastik auf die Anzahl der notwendigen Eingriffe und Dauer bis zur vollst\u00e4ndigen Wundheilung und Mobilisation bewertet.<\/jats:p>\n                  <jats:p>Wesentliche Faktoren f\u00fcr die Entwicklung einer postoperativen Wundheilungsst\u00f6rung lagen in einer prolongierten intensivmedizinischen Behandlung oder vorangegangenen Radiochemotherapie. Zus\u00e4tzlich beeinflussten Faktoren wie Kachexie, Diabetes mellitus oder ein Nikotinabusus die Wundheilung negativ. Durch eine plastisch-chirurgische Defektdeckung mittels gestielter M.-gracilis-Lappenplastik konnten die Anzahl erforderlicher Eingriffe und die Genesungsdauer deutlich reduziert werden.<\/jats:p>\n                  <jats:p>Durch eine interdisziplin\u00e4re Zusammenarbeit und den zielgerichteten Einsatz rekonstruktiver, plastisch-chirurgischer Therapien kann die Versorgung von Patienten mit anorektalen Defekten nach onkologischer Chirurgie verbessert werden. Die M.-gracilis-Lappenplastik erwies sich als effektive Methode zur Defektdeckung und sollte fr\u00fchzeitig in entsprechende Behandlungskonzepte integriert werden. Um Eingang in entsprechende Leitlinien zu finden, empfehlen wir die Durchf\u00fchrung weiterer Studien, die insbesondere den optimalen Zeitpunkt der rekonstruktiven Therapie adressieren.<\/jats:p>","DOI":"10.1055\/a-2651-3201","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T22:35:40Z","timestamp":1753742140000},"page":"511-517","source":"Crossref","is-referenced-by-count":1,"title":["Rekonstruktion anorektaler Defekte nach onkologischer Resektion"],"prefix":"10.1055","volume":"150","author":[{"given":"Benedikt","family":"Fuchs","sequence":"first","affiliation":[{"name":"Abteilung f\u00fcr Handchirurgie, Plastische Chirurgie und \u00c4sthetische Chirurgie, LMU Klinikum, M\u00fcnchen, Deutschland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinan","family":"Mert","sequence":"first","affiliation":[{"name":"Abteilung f\u00fcr Handchirurgie, Plastische Chirurgie und \u00c4sthetische Chirurgie, LMU Klinikum, M\u00fcnchen, 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