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Erschienen in: Die Chirurgie 6/2019

18.04.2019 | Chirurgie des Retroperitoneums | Leitthema

Systematische Chirurgie retroperitonealer Sarkome

Bildgestützte Planung des Resektionsausmaßes

verfasst von: PD Dr. M. Ghadimi, Prof. Dr. med. C. J. Bruns

Erschienen in: Die Chirurgie | Ausgabe 6/2019

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Zusammenfassung

Abdominelle und retroperitoneale Sarkome stellen ca. 25–30 % aller Weichteilsarkome dar, zählt man neben klassischen retroperitonealen Tumoren auch gastrointestinale Stromasarkome (GIST) hinzu. Die chirurgische R0-En-bloc-Resektion ist grundsätzlich das einzige potenziell kurative Therapieverfahren. Bei der Wahl der richtigen Operationsstrategie spielen insbesondere die histopathologische Subentität und Lokalisation eine zentrale Rolle. Ziel bei der Wahl des chirurgischen Resektionsausmaßes sollte möglichst die chirurgische En-bloc-Resektion des Tumors mit negativen Resektionsrändern sein, was aufgrund der häufig großen Tumoren und den engen anatomischen Lagebeziehungen zu vitalen Strukturen nicht immer erreichbar ist. Trotz der Einführung multimodaler Therapieverfahren und der Entwicklung standardisierter erweiterter Operationsverfahren (systematische kompartimentelle Resektionen, SRKR) sind Lokalrezidive für die meisten tumorbedingten Todesfälle ursächlich. Nicht zuletzt die Ergebnisse der Transatlantic RPS Working Group konnten zeigen, dass die Behandlung in High-volume-Zentren zu einer Steigerung des Überlebens beiträgt. Insbesondere in Deutschland besteht nach wie vor großer Nachholbedarf bei der Zentralisierung der Versorgung von Sarkompatienten.
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Metadaten
Titel
Systematische Chirurgie retroperitonealer Sarkome
Bildgestützte Planung des Resektionsausmaßes
verfasst von
PD Dr. M. Ghadimi
Prof. Dr. med. C. J. Bruns
Publikationsdatum
18.04.2019
Verlag
Springer Medizin
Erschienen in
Die Chirurgie / Ausgabe 6/2019
Print ISSN: 2731-6971
Elektronische ISSN: 2731-698X
DOI
https://doi.org/10.1007/s00104-019-0952-y