Skip to main content
Erschienen in: Annals of Surgical Oncology 8/2015

01.08.2015 | Breast Oncology

Long-Term Comparison of Aesthetical Outcomes After Oncoplastic Surgery and Lumpectomy in Breast Cancer Patients

verfasst von: Gabriela Santos, MD, PhD, Cicero Urban, MD, PhD, Maria Isabel Edelweiss, MD, PhD, Gustavo Zucca-Matthes, MD, PhD, Vilmar Marques de Oliveira, MD, PhD, Gabriel Hubner Arana, MD, Marco Iera, MD, Mario Rietjens, MD, PhD, Rubens Silveira de Lima, MD, Cleverton Spautz, MD, Flávia Kuroda, MD, Karina Anselmi, MD, Edison Capp, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 8/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

Lumpectomy may result in major deformities and asymmetries in approximately one-third of patients. Although oncoplastic surgery (OP) could be a useful alternative to avoid them, lack of strong data is causing some debate. The purpose of this study was to compare aesthetic outcomes in patients undergoing OP versus lumpectomy using three different assessment methods.

Methods

A total of 122 patients were included in this cross-sectional multicentric study; 57 underwent OP (46.7 %), and 65 underwent lumpectomy (53.3 %). Two breast surgeons and two plastic surgeons from different institutions using the Garbay scale independently evaluated aesthetic outcomes. BCCT.core software was applied in both groups, and the patients evaluated their aesthetic outcomes answering a questionnaire about their satisfaction rate.

Results

OP group had a higher proportion of excellent aesthetic results according to the BCCT.core software analysis (p = 0.028) and the specialists (p = 0.002). Multifactorial analyses showed that age ≥70 years (RP = 6.02; 95 % confidence interval [CI] 1.73–21.0; p = 0.005), tumors in the medial, inferior, and central quadrants (RP = 4.21; 95 % CI 1.88–9.44; p < 0.001), and large breasts (RP = 7.55; 95 % CI 2.48–23.0; p < 0.001) were significant risk factors for poor aesthetic outcomes after lumpectomy. The patients classified their results as better than those by the specialists and by the software, with no statistical difference between the groups.

Conclusions

Excellent aesthetic results were more frequent in the OP group according to BCCT.core software analysis and specialists. In addition, some clinical conditions and tumor locations in the breast can be considered risky factors for poor aesthetic outcomes in lumpectomy.
Literatur
1.
Zurück zum Zitat Veiga DF, Veiga-Filho J, Ribeiro LM, Archangelo-Junior I, Mendes DA, Andrade VO, et al. Evaluations of aesthetic outcomes of oncoplastic surgery by surgeons of different gender and specialty: a prospective controlled study. Breast. 2011;20(5):407–12.PubMedCrossRef Veiga DF, Veiga-Filho J, Ribeiro LM, Archangelo-Junior I, Mendes DA, Andrade VO, et al. Evaluations of aesthetic outcomes of oncoplastic surgery by surgeons of different gender and specialty: a prospective controlled study. Breast. 2011;20(5):407–12.PubMedCrossRef
2.
Zurück zum Zitat Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347(16):1227–32.PubMedCrossRef Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347(16):1227–32.PubMedCrossRef
3.
Zurück zum Zitat Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347(16):1233–41.PubMedCrossRef Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347(16):1233–41.PubMedCrossRef
4.
Zurück zum Zitat Cardoso MJ, Cardoso J, Amaral N, Azevedo I, Barreau L, Bernardo M, et al. Turning subjective into objective: the BCCT.core software for evaluation of cosmetic results in breast cancer conservative treatment. Breast. 2007;16(5):456–61.PubMedCrossRef Cardoso MJ, Cardoso J, Amaral N, Azevedo I, Barreau L, Bernardo M, et al. Turning subjective into objective: the BCCT.core software for evaluation of cosmetic results in breast cancer conservative treatment. Breast. 2007;16(5):456–61.PubMedCrossRef
5.
Zurück zum Zitat Garbay JR, Rietjens M, Petit JY. Esthetic results of breast reconstruction after amputation for cancer. 323 cases. J Gynecol Obstet Biol Reprod (Paris). 1992;21(4):405–12.PubMed Garbay JR, Rietjens M, Petit JY. Esthetic results of breast reconstruction after amputation for cancer. 323 cases. J Gynecol Obstet Biol Reprod (Paris). 1992;21(4):405–12.PubMed
6.
Zurück zum Zitat Veiga DF, Neto MS, Garcia EB, Filho JV, Juliano Y, Ferreira LM, et al. Evaluations of the aesthetic results and patient satisfaction with the late pedicled TRAM flap breast reconstruction. Ann Plast Surg. 2002;48(5):515–20.PubMedCrossRef Veiga DF, Neto MS, Garcia EB, Filho JV, Juliano Y, Ferreira LM, et al. Evaluations of the aesthetic results and patient satisfaction with the late pedicled TRAM flap breast reconstruction. Ann Plast Surg. 2002;48(5):515–20.PubMedCrossRef
7.
Zurück zum Zitat Lowery JC, Wilkins EG, Kuzon WM, Davis JA. Evaluations of aesthetic results in breast reconstruction: an analysis of reliability. Ann Plast Surg. 1996;36(6):601–6; discussion 7.PubMedCrossRef Lowery JC, Wilkins EG, Kuzon WM, Davis JA. Evaluations of aesthetic results in breast reconstruction: an analysis of reliability. Ann Plast Surg. 1996;36(6):601–6; discussion 7.PubMedCrossRef
8.
Zurück zum Zitat Heil J, Dahlkamp J, Golatta M, Rom J, Domschke C, Rauch G, et al. Aesthetics in breast conserving therapy: do objectively measured results match patients’ evaluations? Ann Surg Oncol. 2011;18(1):134–8.PubMedCrossRef Heil J, Dahlkamp J, Golatta M, Rom J, Domschke C, Rauch G, et al. Aesthetics in breast conserving therapy: do objectively measured results match patients’ evaluations? Ann Surg Oncol. 2011;18(1):134–8.PubMedCrossRef
9.
Zurück zum Zitat Cardoso MJ, Cardoso J, Santos AC, Barros H, Cardoso de Oliveira M. Interobserver agreement and consensus over the esthetic evaluation of conservative treatment for breast cancer. Breast. 2006;15(1):52–7.PubMedCrossRef Cardoso MJ, Cardoso J, Santos AC, Barros H, Cardoso de Oliveira M. Interobserver agreement and consensus over the esthetic evaluation of conservative treatment for breast cancer. Breast. 2006;15(1):52–7.PubMedCrossRef
10.
Zurück zum Zitat Curran D, van Dongen JP, Aaronson NK, Kiebert G, Fentiman IS, Mignolet F, et al. Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: results of EORTC Trial 10801. The European Organization for Research and Treatment of Cancer (EORTC), Breast Cancer Co-operative Group (BCCG). Eur J Cancer. 1998;34(3):307–14.PubMedCrossRef Curran D, van Dongen JP, Aaronson NK, Kiebert G, Fentiman IS, Mignolet F, et al. Quality of life of early-stage breast cancer patients treated with radical mastectomy or breast-conserving procedures: results of EORTC Trial 10801. The European Organization for Research and Treatment of Cancer (EORTC), Breast Cancer Co-operative Group (BCCG). Eur J Cancer. 1998;34(3):307–14.PubMedCrossRef
11.
Zurück zum Zitat Kronowitz SJ, Feledy JA, Hunt KK, Kuerer HM, Youssef A, Koutz CA, et al. Determining the optimal approach to breast reconstruction after partial mastectomy. Plast Reconstr Surg. 2006;117(1):1–11; discussion 2–4.PubMedCrossRef Kronowitz SJ, Feledy JA, Hunt KK, Kuerer HM, Youssef A, Koutz CA, et al. Determining the optimal approach to breast reconstruction after partial mastectomy. Plast Reconstr Surg. 2006;117(1):1–11; discussion 2–4.PubMedCrossRef
12.
Zurück zum Zitat Asgeirsson KS, Rasheed T, McCulley SJ, Macmillan RD. Oncological and cosmetic outcomes of oncoplastic breast conserving surgery. Eur J Surg Oncol. 2005;31(8):817–23.PubMedCrossRef Asgeirsson KS, Rasheed T, McCulley SJ, Macmillan RD. Oncological and cosmetic outcomes of oncoplastic breast conserving surgery. Eur J Surg Oncol. 2005;31(8):817–23.PubMedCrossRef
13.
Zurück zum Zitat Berry MG, Fitoussi AD, Curnier A, Couturaud B, Salmon RJ. Oncoplastic breast surgery: a review and systematic approach. J Plast Reconstr Aesth Surg. 2010;63(8):1233–43.CrossRef Berry MG, Fitoussi AD, Curnier A, Couturaud B, Salmon RJ. Oncoplastic breast surgery: a review and systematic approach. J Plast Reconstr Aesth Surg. 2010;63(8):1233–43.CrossRef
14.
Zurück zum Zitat Chang E, Johnson N, Webber B, Booth J, Rahhal D, Gannett D, et al. Bilateral reduction mammoplasty in combination with lumpectomy for treatment of breast cancer in patients with macromastia. Am J Surg. 2004;187(5):647–50; discussion 50–1.PubMedCrossRef Chang E, Johnson N, Webber B, Booth J, Rahhal D, Gannett D, et al. Bilateral reduction mammoplasty in combination with lumpectomy for treatment of breast cancer in patients with macromastia. Am J Surg. 2004;187(5):647–50; discussion 50–1.PubMedCrossRef
15.
Zurück zum Zitat Clough KB, Lewis JS, Couturaud B, Fitoussi A, Nos C, Falcou MC. Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg. 2003;237(1):26–34.PubMedCentralPubMedCrossRef Clough KB, Lewis JS, Couturaud B, Fitoussi A, Nos C, Falcou MC. Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas. Ann Surg. 2003;237(1):26–34.PubMedCentralPubMedCrossRef
16.
Zurück zum Zitat Dixon JM, Venizelos B, Chan P. Latissimus dorsi mini-flap: a technique for extending breast conservation. Breast. 2002;11(1):58–65.PubMedCrossRef Dixon JM, Venizelos B, Chan P. Latissimus dorsi mini-flap: a technique for extending breast conservation. Breast. 2002;11(1):58–65.PubMedCrossRef
17.
Zurück zum Zitat Galimberti V, Zurrida S, Zanini V, Callegari M, Veronesi P, Catania S, et al. Central small size breast cancer: how to overcome the problem of nipple and areola involvement. Eur J Cancer. 1993;29A(8):1093–6.PubMedCrossRef Galimberti V, Zurrida S, Zanini V, Callegari M, Veronesi P, Catania S, et al. Central small size breast cancer: how to overcome the problem of nipple and areola involvement. Eur J Cancer. 1993;29A(8):1093–6.PubMedCrossRef
18.
Zurück zum Zitat Gendy RK, Able JA, Rainsbury RM. Impact of skin-sparing mastectomy with immediate reconstruction and breast-sparing reconstruction with miniflaps on the outcomes of oncoplastic breast surgery. Br J Surg. 2003;90(4):433–9.PubMedCrossRef Gendy RK, Able JA, Rainsbury RM. Impact of skin-sparing mastectomy with immediate reconstruction and breast-sparing reconstruction with miniflaps on the outcomes of oncoplastic breast surgery. Br J Surg. 2003;90(4):433–9.PubMedCrossRef
19.
Zurück zum Zitat Kat CC, Darcy CM, O’Donoghue JM, Taylor AR, Regan PJ. The use of the latissimus dorsi musculocutaneous flap for immediate correction of the deformity resulting from breast conservation surgery. Br J Plast Surg. 1999;52(2):99–103.PubMedCrossRef Kat CC, Darcy CM, O’Donoghue JM, Taylor AR, Regan PJ. The use of the latissimus dorsi musculocutaneous flap for immediate correction of the deformity resulting from breast conservation surgery. Br J Plast Surg. 1999;52(2):99–103.PubMedCrossRef
20.
Zurück zum Zitat Masetti R, Pirulli PG, Magno S, Franceschini G, Chiesa F, Antinori A. Oncoplastic techniques in the conservative surgical treatment of breast cancer. Breast Cancer. 2000;7(4):276–80.PubMedCrossRef Masetti R, Pirulli PG, Magno S, Franceschini G, Chiesa F, Antinori A. Oncoplastic techniques in the conservative surgical treatment of breast cancer. Breast Cancer. 2000;7(4):276–80.PubMedCrossRef
21.
Zurück zum Zitat Nano MT, Gill PG, Kollias J, Bochner MA. Breast volume replacement using the latissimus dorsi miniflap. ANZ J Surg. 2004;74(3):98–104.PubMedCrossRef Nano MT, Gill PG, Kollias J, Bochner MA. Breast volume replacement using the latissimus dorsi miniflap. ANZ J Surg. 2004;74(3):98–104.PubMedCrossRef
22.
Zurück zum Zitat Newman LA, Kuerer HM, McNeese MD, Hunt KK, Gurtner GC, Vlastos GS, et al. Reduction mammoplasty improves breast conservation therapy in patients with macromastia. Am J Surg. 2001;181(3):215–20.PubMedCrossRef Newman LA, Kuerer HM, McNeese MD, Hunt KK, Gurtner GC, Vlastos GS, et al. Reduction mammoplasty improves breast conservation therapy in patients with macromastia. Am J Surg. 2001;181(3):215–20.PubMedCrossRef
23.
Zurück zum Zitat Noguchi M, Taniya T, Miyazaki I, Saito Y. Immediate transposition of a latissimus dorsi muscle for correcting a postquadrantectomy breast deformity in Japanese patients. Int Surg. 1990;75(3):166–70.PubMed Noguchi M, Taniya T, Miyazaki I, Saito Y. Immediate transposition of a latissimus dorsi muscle for correcting a postquadrantectomy breast deformity in Japanese patients. Int Surg. 1990;75(3):166–70.PubMed
24.
Zurück zum Zitat Nos C, Fitoussi A, Bourgeois D, Fourquet A, Salmon RJ, Clough KB. Conservative treatment of lower pole breast cancers by bilateral mammoplasty and radiotherapy. Eur J Surg Oncol. 1998;24(6):508–14.PubMedCrossRef Nos C, Fitoussi A, Bourgeois D, Fourquet A, Salmon RJ, Clough KB. Conservative treatment of lower pole breast cancers by bilateral mammoplasty and radiotherapy. Eur J Surg Oncol. 1998;24(6):508–14.PubMedCrossRef
25.
Zurück zum Zitat Papp C, Wechselberger G, Schoeller T. Autologous breast reconstruction after breast-conserving cancer surgery. Plast Reconstr Surg. 1998;102(6):1932–6; discussion 7–8.PubMedCrossRef Papp C, Wechselberger G, Schoeller T. Autologous breast reconstruction after breast-conserving cancer surgery. Plast Reconstr Surg. 1998;102(6):1932–6; discussion 7–8.PubMedCrossRef
26.
Zurück zum Zitat Petit J, Rietjens M, Garusi C. Breast reconstructive techniques in cancer patients: which ones, when to apply, which immediate and long term risks? Crit Rev Oncol Hematol. 2001;38(3):231–9.PubMedCrossRef Petit J, Rietjens M, Garusi C. Breast reconstructive techniques in cancer patients: which ones, when to apply, which immediate and long term risks? Crit Rev Oncol Hematol. 2001;38(3):231–9.PubMedCrossRef
27.
Zurück zum Zitat Spear SL, Pelletiere CV, Wolfe AJ, Tsangaris TN, Pennanen MF. Experience with reduction mammaplasty combined with breast conservation therapy in the treatment of breast cancer. Plast Reconstr Surg. 2003;111(3):1102–9.PubMedCrossRef Spear SL, Pelletiere CV, Wolfe AJ, Tsangaris TN, Pennanen MF. Experience with reduction mammaplasty combined with breast conservation therapy in the treatment of breast cancer. Plast Reconstr Surg. 2003;111(3):1102–9.PubMedCrossRef
28.
Zurück zum Zitat Urban C, Lima R, Schunemann E, Spautz C, Rabinovich I, Anselmi K. Oncoplastic principles in breast conserving surgery. Breast. 2011;20(Suppl 3):S92–5.PubMedCrossRef Urban C, Lima R, Schunemann E, Spautz C, Rabinovich I, Anselmi K. Oncoplastic principles in breast conserving surgery. Breast. 2011;20(Suppl 3):S92–5.PubMedCrossRef
29.
Zurück zum Zitat Veronesi U, Zurrida S. Breast conservation: current results and future perspectives at the European Institute of Oncology. Int J Cancer. 2007;120(7):1381–6.PubMedCrossRef Veronesi U, Zurrida S. Breast conservation: current results and future perspectives at the European Institute of Oncology. Int J Cancer. 2007;120(7):1381–6.PubMedCrossRef
30.
Zurück zum Zitat Haloua MH, Krekel NM, Winters HA, Rietveld DH, Meijer S, Bloemers FW, et al. A systematic review of oncoplastic breast-conserving surgery: current weaknesses and future prospects. Ann Surg. 2013;257(4):609–20.PubMedCrossRef Haloua MH, Krekel NM, Winters HA, Rietveld DH, Meijer S, Bloemers FW, et al. A systematic review of oncoplastic breast-conserving surgery: current weaknesses and future prospects. Ann Surg. 2013;257(4):609–20.PubMedCrossRef
31.
Zurück zum Zitat Losken A, Ghazi B. An update on oncoplastic surgery. Plast Reconstr Surg. 2012;129(2):382e–3e.PubMedCrossRef Losken A, Ghazi B. An update on oncoplastic surgery. Plast Reconstr Surg. 2012;129(2):382e–3e.PubMedCrossRef
32.
Zurück zum Zitat Cardoso MJ, Cardoso JS, Vrieling C, Macmillan D, Rainsbury D, Heil J, et al. Recommendations for the aesthetic evaluation of breast cancer conservative treatment. Breast Cancer Res Treat. 2012;135(3):629–37.PubMedCrossRef Cardoso MJ, Cardoso JS, Vrieling C, Macmillan D, Rainsbury D, Heil J, et al. Recommendations for the aesthetic evaluation of breast cancer conservative treatment. Breast Cancer Res Treat. 2012;135(3):629–37.PubMedCrossRef
33.
Zurück zum Zitat Christie D, O’Brien M, Christie J, Kron T, Ferguson S, Hamilton C, et al. A comparison of methods of cosmetic assessment in breast conservation treatment. Breast. 1996;5:358–67.CrossRef Christie D, O’Brien M, Christie J, Kron T, Ferguson S, Hamilton C, et al. A comparison of methods of cosmetic assessment in breast conservation treatment. Breast. 1996;5:358–67.CrossRef
34.
Zurück zum Zitat Clarke D, Martinez A, Cox RS. Analysis of cosmetic results and complications in patients with stage I and II breast cancer treated by biopsy and irradiation. Int J Radiat Oncol Biol Phys. 1983;9(12):1807–13.PubMedCrossRef Clarke D, Martinez A, Cox RS. Analysis of cosmetic results and complications in patients with stage I and II breast cancer treated by biopsy and irradiation. Int J Radiat Oncol Biol Phys. 1983;9(12):1807–13.PubMedCrossRef
35.
Zurück zum Zitat Cardoso MJ, Cardoso JS, Wild T, Krois W, Fitzal F. Comparing two objective methods for the aesthetic evaluation of breast cancer conservative treatment. Breast Cancer Res Treat. 2009;116(1):149–52.PubMedCrossRef Cardoso MJ, Cardoso JS, Wild T, Krois W, Fitzal F. Comparing two objective methods for the aesthetic evaluation of breast cancer conservative treatment. Breast Cancer Res Treat. 2009;116(1):149–52.PubMedCrossRef
36.
Zurück zum Zitat Vrieling C, Collette L, Bartelink E, Borger JH, Brenninkmeyer SJ, Horiot JC, et al. Validation of the methods of cosmetic assessment after breast-conserving therapy in the EORTC “boost versus no boost” trial. EORTC Radiotherapy and Breast Cancer Cooperative Groups. European Organization for Research and Treatment of Cancer. Int J Radiat Oncol Biol Phys. 1999;45(3):667–76.PubMedCrossRef Vrieling C, Collette L, Bartelink E, Borger JH, Brenninkmeyer SJ, Horiot JC, et al. Validation of the methods of cosmetic assessment after breast-conserving therapy in the EORTC “boost versus no boost” trial. EORTC Radiotherapy and Breast Cancer Cooperative Groups. European Organization for Research and Treatment of Cancer. Int J Radiat Oncol Biol Phys. 1999;45(3):667–76.PubMedCrossRef
Metadaten
Titel
Long-Term Comparison of Aesthetical Outcomes After Oncoplastic Surgery and Lumpectomy in Breast Cancer Patients
verfasst von
Gabriela Santos, MD, PhD
Cicero Urban, MD, PhD
Maria Isabel Edelweiss, MD, PhD
Gustavo Zucca-Matthes, MD, PhD
Vilmar Marques de Oliveira, MD, PhD
Gabriel Hubner Arana, MD
Marco Iera, MD
Mario Rietjens, MD, PhD
Rubens Silveira de Lima, MD
Cleverton Spautz, MD
Flávia Kuroda, MD
Karina Anselmi, MD
Edison Capp, MD, PhD
Publikationsdatum
01.08.2015
Verlag
Springer US
Erschienen in
Annals of Surgical Oncology / Ausgabe 8/2015
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-4301-6

Weitere Artikel der Ausgabe 8/2015

Annals of Surgical Oncology 8/2015 Zur Ausgabe

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Traumatologische Notfälle Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

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.