Die Morbidität nach Magenresektion liegt auch in Zentren letztendlich bei 30%. Dabei sind die kardiopulmonalen Komplikationen und die Insuffizienz der proximalen Anastomose führend. Die allgemeinen Komplikationen lassen sich am besten durch eine gezielte präoperative Risikoerfassung und ein konsequentes postoperatives Management vermeiden. Schlüssel zum erfolgreichen Management der Anastomoseninsuffizienz ist die rasche und gezielte Diagnostik bei jeder Störung des normalen postoperativen Verlaufs. Daraus folgt die sofortige und aggressive Intervention bei Nachweis einer Insuffizienz. Ziel ist die Limitierung der Kontamination und die Minimierung der postoperativen Sepsis. Neben dem «Bekennen» auch des erfahrenen Operateurs zur Komplikation ist die enge und vertrauensvolle Zusammenarbeit des Chirurgen mit den Intensivmedizinern, Endoskopikern und interventionellen Radiologen die conditio sine qua non für ein erfolgreiches Management zum Wohle des Patienten.

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