Chirurgie Der Milz
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Kaum ein anderes Gebiet chirurgischer T�tigkeit ist mit den Arbeits- und Forschungsgebieten benachbarter Disziplinen, insbesondere der Inneren Medizin, aber auch der Physiologie und Biochemie, so eng verkn�pft wie die Milzchirurgie_ Da der Verlust der Milz mit dem Leben zu vereinbaren ist, ist seit dem Altertum bekannt. Die funktionelle Bedeutung des Organs wurde jedoch erst in den letzten Jahren weiter aufgekl�rt und ist noch Gegenstand der Forschung. Wir sehen die Milz heute nicht mehr als ein mehr oder minder �berfl�ssiges Organ an, sondern als ein sehr wichtiges, da es besonders bei Belastungen und in Notfallsituationen sehr n�tzlich ist. F�r die Indikation zur Entfernung des rupturierten Organs hat dies keine Konsequenz, da Naht und Tamponade ein wesentlich gr� eres Risiko in sich schlie en als die Exstirpation, wohl aber f�r die Entfernung einer pathologischen Milz. Hierbei ist das Verst�ndnis von oft schwierigen und komplexen Kreislauf- funktionen, von immunologischen und hormonalen Vorg�ngen sowie von Zell- bildungsst�rungen notwendig. F�r den Chirurgen bringt dies die Notwendigkeit mit sich, sich mit kreislaufphysiologischen, h�matologischen, immunbiologischen und endokrinologischen Fragen auseinanderzusetzen. Viele Fragen sind noch offen, alles ist im Flu . So fand man neuerdings z. B. bei den corpuscul�ren h�molytischen An�mien nicht nur abnorme Erythrocyten- formen, sondern von der Norm abweichende H�moglobinstrukturen oder bei der splenopathischen Markhemmung Antik�rper und Fermentstoffwechselst�rungen der Erythrocyten und Leukocyten, insbesondere eine St�rung der Glykolyse. Wir befinden uns mit unserer Betrachtungsweise von Krankheitsvorg�ngen ganz offen- sichtlich auf dem Wege von der Morphologie �ber die Physiologie zurBio- chemie hin.
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