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Erschienen in: Der Urologe 9/2018

24.07.2018 | Nierenkarzinom | Leitthema

Grenzen der Chirurgie in der Uroonkologie

verfasst von: Univ. Prof. Dr. Dr. h. c. A. Heidenreich

Erschienen in: Die Urologie | Ausgabe 9/2018

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Zusammenfassung

Die Grenzen der Tumorchirurgie in der Uroonkologie werden bestimmt durch eine Balance zwischen dem chirurgisch Machbaren und dem onkologisch Notwendigen. Die Grenzen der Tumorchirurgie in der Uroonkologie stellen keine feststehenden Dogmen dar, sondern verschieben sich auf der Grundlage aktueller wissenschaftlicher Erkenntnisse, verbesserter bildgebender Diagnostik, optimierter Operationstechniken und postoperativer Versorgungsstrukturen zunehmend. Bestimmt werden die Grenzen der Tumorchirurgie durch patientenspezifische Faktoren, die biologische Aggressivität des jeweiligen Tumors, die handwerkliche Expertise des Operateurs sowie eine adäquate, standardisierte prä-, peri- und postoperative Versorgung des Patienten. In Abhängigkeit der jeweiligen Karzinome aus dem oberen und unteren Urogenitaltrakt müssen die spezifischen Besonderheiten bezüglich der Prognose unter Berücksichtigung aktueller molekulare Erkenntnisse sowie moderner multimodaler Therapiekonzepte bekannt sein, um die für den Patienten gemeinsam mit dem Patienten richtigen Entscheidungen treffen zu können. In dem vorliegenden Artikel werden zunächst allgemeine, die Grenzen der urologischen Tumorchirurgie potentiell beeinflussende Faktoren durch den Patienten, den Tumor und den Chirurgen diskutiert, bevor beispielhaft die Grenzen der Tumorchirurgie für die organbegrenzten sowie die fortgeschrittenen Malignome der Niere, der Prostata und des Hodens anhand ausgewählter klinischer Szenarien besprochen werden.
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Metadaten
Titel
Grenzen der Chirurgie in der Uroonkologie
verfasst von
Univ. Prof. Dr. Dr. h. c. A. Heidenreich
Publikationsdatum
24.07.2018
Verlag
Springer Medizin
Erschienen in
Die Urologie / Ausgabe 9/2018
Print ISSN: 2731-7064
Elektronische ISSN: 2731-7072
DOI
https://doi.org/10.1007/s00120-018-0735-y

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