Skip to main content

11.03.2024

Efficacy of endoscopic surveillance for pharyngeal mucosa during endoscopic resection for pharyngeal carcinoma: a multicenter prospective study

verfasst von: Yuki Kimura, Yuichi Shimizu, Masanobu Taniguchi, Suguru Ito, Akira Dobashi, Kenichi Goda, Yusuke Nishimura, Keiko Yamamoto, Shin Ichihara, Akihito Watanabe

Erschienen in: Surgical Endoscopy

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Since patients with pharyngeal squamous cell carcinoma (SCC) often have multiple pharyngeal lesions, evaluation of pharyngeal lesions before endoscopic resection (ER) is important. However, detailed endoscopic observation of the entire pharyngeal mucosa under conscious sedation is difficult. We examined the usefulness of endoscopic surveillance with narrow band imaging (NBI) and lugol staining for detection of pharyngeal sublesions during ER for pharyngeal SCC under general anesthesia (endoscopic surveillance during treatment; ESDT).

Methods

From January 2021 through June 2022, we examined 78 patients who were diagnosed with superficial pharyngeal SCC and underwent ER. They underwent the ESDT and for patients who were diagnosed with new lesions of pharyngeal SCC or high-grade dysplasia (HGD) that were not detected in the endoscopic examination before treatment, ER were performed simultaneously for new lesions and the main lesions. The primary endpoint of this study was the detection rate of new lesions of pharyngeal SCC or HGD in the ESDT.

Results

Fifteen of the 78 patients were diagnosed as having undetected new pharyngeal lesions in the ESDT and 10 (12.8%) (95% CI 6.9–22.2%) were histopathologically confirmed to have new lesions of pharyngeal SCC or HGD. Among the 13 lesions of SCC or HGD, 8 were found by NBI observation; however, 5 were undetectable using NBI but detectable by lugol staining. All of the 13 lesions had endoscopic findings of pink color sign on lugol staining.

Conclusions

Endoscopic surveillance for pharyngeal sublesions during ER for pharyngeal SCC is feasible and useful.
Literatur
1.
Zurück zum Zitat Muto M, Nakane M, Katada C, Sano Y, Ohtsu A, Esumi H, Ebihara S, Yoshida S (2004) Squamous cell carcinoma in situ at oropharyngeal and hypopharyngeal mucosal sites. Cancer 101:1375–1381CrossRefPubMed Muto M, Nakane M, Katada C, Sano Y, Ohtsu A, Esumi H, Ebihara S, Yoshida S (2004) Squamous cell carcinoma in situ at oropharyngeal and hypopharyngeal mucosal sites. Cancer 101:1375–1381CrossRefPubMed
2.
Zurück zum Zitat Muto M, Minashi K, Yano T, Saito Y, Oda I, Nonaka S, Omori T, Sugiura H, Goda K, Kaise M, Inoue H, Ishikawa H, Ochiai A, Shimoda T, Watanabe H, Tajiri H, Saito D (2010) Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging: a multicenter randomized controlled trial. J Clin Oncol 28:1566–1572CrossRefPubMedPubMedCentral Muto M, Minashi K, Yano T, Saito Y, Oda I, Nonaka S, Omori T, Sugiura H, Goda K, Kaise M, Inoue H, Ishikawa H, Ochiai A, Shimoda T, Watanabe H, Tajiri H, Saito D (2010) Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging: a multicenter randomized controlled trial. J Clin Oncol 28:1566–1572CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Katada C, Tanabe S, Koizumi W, Higuchi K, Sasaki T, Azuma M, Katada N, Masaki T, Nakayama M, Okamoto M, Muto M (2010) Narrow band imaging for detecting superficial squamous cell carcinoma of the head and neck in patients with esophageal squamous cell carcinoma. Endoscopy 42:185–190CrossRefPubMed Katada C, Tanabe S, Koizumi W, Higuchi K, Sasaki T, Azuma M, Katada N, Masaki T, Nakayama M, Okamoto M, Muto M (2010) Narrow band imaging for detecting superficial squamous cell carcinoma of the head and neck in patients with esophageal squamous cell carcinoma. Endoscopy 42:185–190CrossRefPubMed
4.
Zurück zum Zitat Nakanishi H, Doyama H, Takemura K, Yoshida N, Tsuji K, Takeda Y, Asahina Y, Kito Y, Ito R, Hayashi T, Hirano K, Goto Y, Tominaga K, Inagaki S, Waseda Y, Tsuji S, Miwa K, Kaneko Y, Yamada S, Kurumaya H, Sakumoto M, Okada T (2014) Detection of pharyngeal cancer in the overall population undergoing upper GI endoscopy by using narrow-band imaging: a single-center experience, 2009–2012. Gastrointest Endosc 79:558–564ADSCrossRefPubMed Nakanishi H, Doyama H, Takemura K, Yoshida N, Tsuji K, Takeda Y, Asahina Y, Kito Y, Ito R, Hayashi T, Hirano K, Goto Y, Tominaga K, Inagaki S, Waseda Y, Tsuji S, Miwa K, Kaneko Y, Yamada S, Kurumaya H, Sakumoto M, Okada T (2014) Detection of pharyngeal cancer in the overall population undergoing upper GI endoscopy by using narrow-band imaging: a single-center experience, 2009–2012. Gastrointest Endosc 79:558–564ADSCrossRefPubMed
5.
Zurück zum Zitat Shimizu Y, Yamamoto J, Kato M, Yoshida T, Hirota J, Ono Y, Nakagawa M, Nakagawa S, Oridate N, Asaka M (2006) Endoscopic submucosal dissection for treatment of early stage hypopharyngeal carcinoma. Gastrointest Endosc 64:255–259CrossRefPubMed Shimizu Y, Yamamoto J, Kato M, Yoshida T, Hirota J, Ono Y, Nakagawa M, Nakagawa S, Oridate N, Asaka M (2006) Endoscopic submucosal dissection for treatment of early stage hypopharyngeal carcinoma. Gastrointest Endosc 64:255–259CrossRefPubMed
6.
Zurück zum Zitat Iizuka T, Kikuchi D, Hoteya S, Nakamura M, Yamashita S, Mitani T, Takeda H, Yahagi N (2011) Clinical advantage of endoscopic submucosal dissection over endoscopic mucosal resection for early mesopharyngeal and hypopharyngeal cancers. Endoscopy 43:839–843CrossRefPubMed Iizuka T, Kikuchi D, Hoteya S, Nakamura M, Yamashita S, Mitani T, Takeda H, Yahagi N (2011) Clinical advantage of endoscopic submucosal dissection over endoscopic mucosal resection for early mesopharyngeal and hypopharyngeal cancers. Endoscopy 43:839–843CrossRefPubMed
7.
Zurück zum Zitat Kuwabara T, Hiyama T, Oka S, Urabe Y, Tanaka S, Yoshihara M, Arihiro K, Shimamoto F, Chayama K (2012) Clinical features of pharyngeal intraepithelial neoplasias and outcomes of treatment by endoscopic submucosal dissection. Gastrointest Endosc 76:1095–1103CrossRefPubMed Kuwabara T, Hiyama T, Oka S, Urabe Y, Tanaka S, Yoshihara M, Arihiro K, Shimamoto F, Chayama K (2012) Clinical features of pharyngeal intraepithelial neoplasias and outcomes of treatment by endoscopic submucosal dissection. Gastrointest Endosc 76:1095–1103CrossRefPubMed
8.
Zurück zum Zitat Satake H, Yano T, Muto M, Minashi K, Yoda Y, Kojima T, Oono Y, Ikematsu H, Aoyama I, Morita S, Miyamoto S, Fujii S, Yoshizawa A, Ochiai A, Hayashi R, Kaneko K (2015) Clinical outcome after endoscopic resection for superficial pharyngeal squamous cell carcinoma invading the subepithelial layer. Endoscopy 47:11–18PubMed Satake H, Yano T, Muto M, Minashi K, Yoda Y, Kojima T, Oono Y, Ikematsu H, Aoyama I, Morita S, Miyamoto S, Fujii S, Yoshizawa A, Ochiai A, Hayashi R, Kaneko K (2015) Clinical outcome after endoscopic resection for superficial pharyngeal squamous cell carcinoma invading the subepithelial layer. Endoscopy 47:11–18PubMed
9.
Zurück zum Zitat Hanaoka N, Ishihara R, Takeuchi Y, Suzuki M, Otozai S, Kida K, Yoshii T, Fujii T, Yoshino K, Sugawa T, Kitamura K, Kanemura R, Koike R, Uedo N, Higashino K, Akasaka T, Yamashina T, Kanesaka T, Matsuura N, Aoi K, Yamasaki Y, Hamada K, Iishi H, Tomita Y (2015) Endoscopic submucosal dissection as minimally invasive treatment for superficial pharyngeal cancer: a phase II study (with video). Gastrointest Endosc 82:1002–1008CrossRefPubMed Hanaoka N, Ishihara R, Takeuchi Y, Suzuki M, Otozai S, Kida K, Yoshii T, Fujii T, Yoshino K, Sugawa T, Kitamura K, Kanemura R, Koike R, Uedo N, Higashino K, Akasaka T, Yamashina T, Kanesaka T, Matsuura N, Aoi K, Yamasaki Y, Hamada K, Iishi H, Tomita Y (2015) Endoscopic submucosal dissection as minimally invasive treatment for superficial pharyngeal cancer: a phase II study (with video). Gastrointest Endosc 82:1002–1008CrossRefPubMed
10.
Zurück zum Zitat Muto M, Satake H, Yano T, Minashi K, Hayashi R, Fujii S, Ochiai A, Ohtsu A, Morita S, Horimatsu T, Ezoe Y, Miyamoto S, Asato R, Tateya I, Yoshizawa A, Chiba T (2011) Long-term outcome of transoral organ-preserving pharyngeal endoscopic resection for superficial pharyngeal cancer. Gastrointest Endosc 74:477–484CrossRefPubMed Muto M, Satake H, Yano T, Minashi K, Hayashi R, Fujii S, Ochiai A, Ohtsu A, Morita S, Horimatsu T, Ezoe Y, Miyamoto S, Asato R, Tateya I, Yoshizawa A, Chiba T (2011) Long-term outcome of transoral organ-preserving pharyngeal endoscopic resection for superficial pharyngeal cancer. Gastrointest Endosc 74:477–484CrossRefPubMed
11.
Zurück zum Zitat Tateya I, Muto M, Morita S, Miyamoto S, Hayashi T, Funakoshi M, Aoyama I, Higuchi H, Hirano S, Kitamura M, Ishikawa S, Kishimoto Y, Morita M, Ito J (2016) Endoscopic laryngo-pharyngeal surgery for superficial laryngo-pharyngeal cancer. Surg Endosc 30:323–329CrossRefPubMed Tateya I, Muto M, Morita S, Miyamoto S, Hayashi T, Funakoshi M, Aoyama I, Higuchi H, Hirano S, Kitamura M, Ishikawa S, Kishimoto Y, Morita M, Ito J (2016) Endoscopic laryngo-pharyngeal surgery for superficial laryngo-pharyngeal cancer. Surg Endosc 30:323–329CrossRefPubMed
12.
Zurück zum Zitat Watanabe A, Taniguchi M, Kimura Y, Hosokawa M, Ito S, Tsukamoto S, Sasaki S (2017) Synopsis transoral endoscopic laryngopharyngeal surgery for superficial pharyngeal cancers. Head Neck 39:1779–1787CrossRefPubMed Watanabe A, Taniguchi M, Kimura Y, Hosokawa M, Ito S, Tsukamoto S, Sasaki S (2017) Synopsis transoral endoscopic laryngopharyngeal surgery for superficial pharyngeal cancers. Head Neck 39:1779–1787CrossRefPubMed
13.
Zurück zum Zitat Iizuka T, Kikuchi D, Suzuki Y, Tanaka M, Takeda H (2021) Clinical relevance of endoscopic treatment for superficial pharyngeal cancer: feasibility of techniques corresponding to each location and long-term outcomes. Gastrointest Endosc 93:818–827CrossRefPubMed Iizuka T, Kikuchi D, Suzuki Y, Tanaka M, Takeda H (2021) Clinical relevance of endoscopic treatment for superficial pharyngeal cancer: feasibility of techniques corresponding to each location and long-term outcomes. Gastrointest Endosc 93:818–827CrossRefPubMed
14.
Zurück zum Zitat Sakaguchi Y, Saito Y, Ando M, Yoshida M, Fukuoka O, Kobayashi K, Kubota D, Ohki D, Mizutani H, Niimi K, Tsuji Y, Fujishiro M, Yamasoba T (2023) Risk factors for incomplete resection with pharyngeal endoscopic submucosal dissection and long-term prognosis after resection. Surg Endosc 37:3593–3601CrossRefPubMedPubMedCentral Sakaguchi Y, Saito Y, Ando M, Yoshida M, Fukuoka O, Kobayashi K, Kubota D, Ohki D, Mizutani H, Niimi K, Tsuji Y, Fujishiro M, Yamasoba T (2023) Risk factors for incomplete resection with pharyngeal endoscopic submucosal dissection and long-term prognosis after resection. Surg Endosc 37:3593–3601CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Takahashi M, Shimizu Y, Ono M, Suzuki M, Omori S, Yoshida T, Mori Y, Nakagawa M, Ono S, Nakagawa S, Mabe K, Kato M, Hatanaka K, Asaka M, Sakamoto N (2014) Endoscopic diagnosis of early neoplasia of the esophagus with narrow band imaging: correlations among background coloration and iodine staining findings. J Gastroenterol Hepatol 29:762–768CrossRefPubMed Takahashi M, Shimizu Y, Ono M, Suzuki M, Omori S, Yoshida T, Mori Y, Nakagawa M, Ono S, Nakagawa S, Mabe K, Kato M, Hatanaka K, Asaka M, Sakamoto N (2014) Endoscopic diagnosis of early neoplasia of the esophagus with narrow band imaging: correlations among background coloration and iodine staining findings. J Gastroenterol Hepatol 29:762–768CrossRefPubMed
16.
Zurück zum Zitat Shimizu Y, Omori T, Yokoyama A, Yoshida T, Hirota J, Ono Y, Yamamoto J, Kato M, Asaka M (2008) Endoscopic diagnosis of early squamous neoplasia of the esophagus with iodine staining: high-grade intra-epithelial neoplasia turns pink within a few minutes. J Gastroenterol Hepatol 23:546–550CrossRefPubMed Shimizu Y, Omori T, Yokoyama A, Yoshida T, Hirota J, Ono Y, Yamamoto J, Kato M, Asaka M (2008) Endoscopic diagnosis of early squamous neoplasia of the esophagus with iodine staining: high-grade intra-epithelial neoplasia turns pink within a few minutes. J Gastroenterol Hepatol 23:546–550CrossRefPubMed
17.
Zurück zum Zitat Bugter O, Ven SEM, Hardillo JA, Bruno MJ, Koch AD, Baatenburg de Jong RJ (2019) Early detection of esophageal second primary tumors using lugol chromoendoscopy in patients with head and neck cancer: a systematic review and meta-analysis. Head Neck 41:1122–1130CrossRefPubMed Bugter O, Ven SEM, Hardillo JA, Bruno MJ, Koch AD, Baatenburg de Jong RJ (2019) Early detection of esophageal second primary tumors using lugol chromoendoscopy in patients with head and neck cancer: a systematic review and meta-analysis. Head Neck 41:1122–1130CrossRefPubMed
18.
Zurück zum Zitat Liu M, Zhou R, Guo C, Xu R, Liu A, Yang H, Li F, Duan L, Shen L, Wu Q, Liu Z, Liu F, Liu Y, Pan Y, Cai H, Weiss NS, He Z, Ke Y (2021) Size of lugol-unstained lesions as a predictor for risk of progression in premalignant lesions of the esophagus. Gastrointest Endosc 93:1074–1076CrossRef Liu M, Zhou R, Guo C, Xu R, Liu A, Yang H, Li F, Duan L, Shen L, Wu Q, Liu Z, Liu F, Liu Y, Pan Y, Cai H, Weiss NS, He Z, Ke Y (2021) Size of lugol-unstained lesions as a predictor for risk of progression in premalignant lesions of the esophagus. Gastrointest Endosc 93:1074–1076CrossRef
19.
Zurück zum Zitat Kanzaki H, Ishihara R, Ishiguro S, Nagai K, Matsui F, Yamashina T, Ohta T, Yamamoto S, Hanaoka N, Hanafusa M, Takeuchi Y, Higashino K, Uedo N, Iishi H, Tomita Y (2013) Histological features responsible for brownish epithelium in squamous neoplasia of the esophagus by narrow band imaging. J Gastroenterol Hepatol 28:274–278CrossRefPubMed Kanzaki H, Ishihara R, Ishiguro S, Nagai K, Matsui F, Yamashina T, Ohta T, Yamamoto S, Hanaoka N, Hanafusa M, Takeuchi Y, Higashino K, Uedo N, Iishi H, Tomita Y (2013) Histological features responsible for brownish epithelium in squamous neoplasia of the esophagus by narrow band imaging. J Gastroenterol Hepatol 28:274–278CrossRefPubMed
20.
Zurück zum Zitat Ishihara R, Yamada T, Iishi H, Kato M, Yamamoto S, Yamamoto S, Masuda E, Tatsumi K, Takeuchi Y, Higashino K, Uedo N, Tatsuta M, Ishiguro S (2009) Quantitative analysis of the color change after iodine staining for diagnosing esophageal high-grade intraepithelial neoplasia and invasive cancer. Gastrointest Endosc 69:213–218CrossRefPubMed Ishihara R, Yamada T, Iishi H, Kato M, Yamamoto S, Yamamoto S, Masuda E, Tatsumi K, Takeuchi Y, Higashino K, Uedo N, Tatsuta M, Ishiguro S (2009) Quantitative analysis of the color change after iodine staining for diagnosing esophageal high-grade intraepithelial neoplasia and invasive cancer. Gastrointest Endosc 69:213–218CrossRefPubMed
21.
Zurück zum Zitat Gale N, Hille J, Jordan RC (2017) Precursor lesions. In: El-Naggar AK, Chan JKC, Grandis JR et al (eds) WHO classification of head and neck tumours, 4th edn. IARC, Lyon, pp 91–95 Gale N, Hille J, Jordan RC (2017) Precursor lesions. In: El-Naggar AK, Chan JKC, Grandis JR et al (eds) WHO classification of head and neck tumours, 4th edn. IARC, Lyon, pp 91–95
22.
Zurück zum Zitat Slaughter DP, Southwick HW, Smejkal W (1953) “Field cancerization” in oral stratified epithelium. Cancer 6:963–968CrossRefPubMed Slaughter DP, Southwick HW, Smejkal W (1953) “Field cancerization” in oral stratified epithelium. Cancer 6:963–968CrossRefPubMed
23.
Zurück zum Zitat Lee YC, Wang HP, Wang CP, Ko JY, Lee JM, Chiu HM, Lin JT, Yamashita S, Oka D, Watanabe N, Matsuda Y, Ushijima T, Wu MS (2011) Revisit of field cancerization in squamous cell carcinoma of upper aerodigestive tract: better risk assessment with epigenetic markers. Cancer Prev Res 4:1982–1992CrossRef Lee YC, Wang HP, Wang CP, Ko JY, Lee JM, Chiu HM, Lin JT, Yamashita S, Oka D, Watanabe N, Matsuda Y, Ushijima T, Wu MS (2011) Revisit of field cancerization in squamous cell carcinoma of upper aerodigestive tract: better risk assessment with epigenetic markers. Cancer Prev Res 4:1982–1992CrossRef
24.
Zurück zum Zitat Katada C, Yokoyama T, Yano T, Kaneko K, Oda I, Shimizu Y, Doyama H, Koike T, Takizawa K, Hirao M, Okada H, Yoshii T, Konishi K, Yamanouchi T, Tsuda T, Omori T, Kobayashi N, Shimoda T, Ochiai A, Amanuma Y, Ohashi S, Matsuda T, Ishikawa H, Yokoyama A, Muto M (2016) Alcohol consumption and multiple dysplastic lesions increase risk of squamous cell carcinoma in the esophagus, head, and neck. Gastroenterology 151:860–869CrossRefPubMed Katada C, Yokoyama T, Yano T, Kaneko K, Oda I, Shimizu Y, Doyama H, Koike T, Takizawa K, Hirao M, Okada H, Yoshii T, Konishi K, Yamanouchi T, Tsuda T, Omori T, Kobayashi N, Shimoda T, Ochiai A, Amanuma Y, Ohashi S, Matsuda T, Ishikawa H, Yokoyama A, Muto M (2016) Alcohol consumption and multiple dysplastic lesions increase risk of squamous cell carcinoma in the esophagus, head, and neck. Gastroenterology 151:860–869CrossRefPubMed
25.
Zurück zum Zitat Takenaka R, Kawahara Y, Okada H, Hori K, Inoue M, Kawano S, Tanioka D, Tsuzuki T, Uemura M, Ohara N, Tominaga S, Onoda T, Yamamoto K (2009) Narrow-band imaging provides reliable screening for esophageal malignancy in patients with head and neck cancers. Am J Gastroenterol 104:2942–2948ADSCrossRefPubMed Takenaka R, Kawahara Y, Okada H, Hori K, Inoue M, Kawano S, Tanioka D, Tsuzuki T, Uemura M, Ohara N, Tominaga S, Onoda T, Yamamoto K (2009) Narrow-band imaging provides reliable screening for esophageal malignancy in patients with head and neck cancers. Am J Gastroenterol 104:2942–2948ADSCrossRefPubMed
26.
Zurück zum Zitat Kawada K, Arima M, Miyahara R, Tsunomiya M, Kikuchi M, Yamamoto F, Hoshino A, Nakajima Y, Kinugasa Y, Kawano T (2021) Effect of adding magnifying BLI, magnifying NBI, and iodine staining to white light imaging in diagnosis of early esophageal cancer. Endosc Int Open 09:E1877-1885CrossRef Kawada K, Arima M, Miyahara R, Tsunomiya M, Kikuchi M, Yamamoto F, Hoshino A, Nakajima Y, Kinugasa Y, Kawano T (2021) Effect of adding magnifying BLI, magnifying NBI, and iodine staining to white light imaging in diagnosis of early esophageal cancer. Endosc Int Open 09:E1877-1885CrossRef
27.
Zurück zum Zitat Ono S, Dobashi A, Furuhashi H, Koizumi A, Matsui H, Hara Y, Sumiyama K (2021) Characteristics of superficial esophageal squamous cell carcinomas undetectable with narrow-band imaging endoscopy. Gastroenterol Rep 9:402–407CrossRef Ono S, Dobashi A, Furuhashi H, Koizumi A, Matsui H, Hara Y, Sumiyama K (2021) Characteristics of superficial esophageal squamous cell carcinomas undetectable with narrow-band imaging endoscopy. Gastroenterol Rep 9:402–407CrossRef
Metadaten
Titel
Efficacy of endoscopic surveillance for pharyngeal mucosa during endoscopic resection for pharyngeal carcinoma: a multicenter prospective study
verfasst von
Yuki Kimura
Yuichi Shimizu
Masanobu Taniguchi
Suguru Ito
Akira Dobashi
Kenichi Goda
Yusuke Nishimura
Keiko Yamamoto
Shin Ichihara
Akihito Watanabe
Publikationsdatum
11.03.2024
Verlag
Springer US
Erschienen in
Surgical Endoscopy
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-024-10747-5

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 Ablationstherapie Nachrichten

Nach der Katheterablation von Vorhofflimmern kommt es bei etwa einem Drittel der Patienten zu Rezidiven, meist binnen eines Jahres. Wie sich spätere Rückfälle auf die Erfolgschancen einer erneuten Ablation auswirken, haben Schweizer Kardiologen erforscht.

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 Appendizitis Nachrichten

Schmerzen im Unterbauch, aber sonst nicht viel, was auf eine Appendizitis hindeutete: Ein junger Mann hatte Glück, dass trotzdem eine Laparoskopie mit Appendektomie durchgeführt und der Wurmfortsatz histologisch untersucht wurde.

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 Operationsvorbereitung Nachrichten

Derzeit wird empfohlen, eine Therapie mit GLP-1-Rezeptoragonisten präoperativ zu unterbrechen. Eine neue Studie nährt jedoch Zweifel an der Notwendigkeit der Maßnahme.

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 EAU 2024 Kongressbericht

Die Ureterstriktur ist eine relativ seltene Komplikation, trotzdem bedarf sie einer differenzierten Versorgung. In komplexen Fällen wird dies durch die roboterassistierte OP-Technik gewährleistet. Erste Resultate ermutigen.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.