Skip to main content
Erschienen in: Annals of Surgical Oncology 9/2013

01.09.2013 | Head and Neck Oncology

mTHPC-mediated Photodynamic Therapy of Early Stage Oral Squamous Cell Carcinoma: A Comparison to Surgical Treatment

Erschienen in: Annals of Surgical Oncology | Ausgabe 9/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

mTHPC-mediated photodynamic therapy (PDT) is used for treatment of early head and neck squamous cell carcinoma. This study is a retrospective comparison of PDT with transoral surgery in the treatment of early primary squamous cell carcinoma of the oral cavity/oropharynx.

Methods

PDT data were retrieved from four study databases; surgical results were retrieved from our institutional database. To select similar primary tumors, infiltration depth was restricted to 5 mm for the surgery group. A total of 126 T1 and 30 T2 tumors were included in the PDT group, and 58 T1 and 33 T2 tumors were included in the surgically treated group.

Results

Complete response rates with PDT and surgery were 86 and 76 % for T1, respectively, and for T2 63 and 78 %. Lower local disease-free survival for PDT compared to surgery was found. However, when comparing the need for local retreatment, no significant difference for T1 tumors was found, while for T2 tumors surgery resulted in significantly less need for local retreatment. No significant differences in overall survival between surgery and PDT were observed.

Conclusions

PDT for T1 tumors results in a similar need for retreatment compared to surgery, while for T2 tumors PDT performs worse. Local disease-free survival for surgery is better than for PDT. This may be influenced by the benefit surgery has of having histology available. This allows an early decision on reintervention, while for PDT one has to follow a wait-and-see policy. Future prospective studies should compare efficacy as well as morbidity.
Literatur
1.
Zurück zum Zitat Haddad RI, Shin DM. Recent advances in head and neck cancer. N Engl J Med. 2008;359:1143–54.PubMedCrossRef Haddad RI, Shin DM. Recent advances in head and neck cancer. N Engl J Med. 2008;359:1143–54.PubMedCrossRef
2.
Zurück zum Zitat Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008;371:1695–709.PubMedCrossRef Argiris A, Karamouzis MV, Raben D, Ferris RL. Head and neck cancer. Lancet. 2008;371:1695–709.PubMedCrossRef
3.
Zurück zum Zitat Brown JS, Shaw RJ, Bekiroglu F, Rogers SN. Systematic review of the current evidence in the use of postoperative radiotherapy for oral squamous cell carcinoma. Br J Oral Maxillofac Surg. 2012;50:481–9.PubMedCrossRef Brown JS, Shaw RJ, Bekiroglu F, Rogers SN. Systematic review of the current evidence in the use of postoperative radiotherapy for oral squamous cell carcinoma. Br J Oral Maxillofac Surg. 2012;50:481–9.PubMedCrossRef
4.
Zurück zum Zitat Inagi K, Takahashi H, Okamoto M, Nakayama M, Makoshi T, Nagai H. Treatment effects in patients with squamous cell carcinoma of the oral cavity. Acta Otolaryngol Suppl. 2002;(547):25–9.PubMedCrossRef Inagi K, Takahashi H, Okamoto M, Nakayama M, Makoshi T, Nagai H. Treatment effects in patients with squamous cell carcinoma of the oral cavity. Acta Otolaryngol Suppl. 2002;(547):25–9.PubMedCrossRef
5.
Zurück zum Zitat Wolfensberger M, Zbaeren P, Dulguerov P, Muller W, Arnoux A, Schmid S. Surgical treatment of early oral carcinoma-results of a prospective controlled multicenter study. Head Neck. 2001;23:525–30.PubMedCrossRef Wolfensberger M, Zbaeren P, Dulguerov P, Muller W, Arnoux A, Schmid S. Surgical treatment of early oral carcinoma-results of a prospective controlled multicenter study. Head Neck. 2001;23:525–30.PubMedCrossRef
6.
Zurück zum Zitat Shah JP, Gil Z. Current concepts in management of oral cancer—surgery. Oral Oncol. 2009;45:394–401.PubMedCrossRef Shah JP, Gil Z. Current concepts in management of oral cancer—surgery. Oral Oncol. 2009;45:394–401.PubMedCrossRef
7.
Zurück zum Zitat Bessell A, Glenny AM, Furness S, et al. Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment. Cochrane Database Syst Rev. 2011;(9):CD006205. Bessell A, Glenny AM, Furness S, et al. Interventions for the treatment of oral and oropharyngeal cancers: surgical treatment. Cochrane Database Syst Rev. 2011;(9):CD006205.
8.
Zurück zum Zitat Capote A, Escorial V, Munoz-Guerra MF, Rodriguez-Campo FJ, Gamallo C, Naval L. Elective neck dissection in early-stage oral squamous cell carcinoma—does it influence recurrence and survival? Head Neck. 2007;29:3–11.PubMedCrossRef Capote A, Escorial V, Munoz-Guerra MF, Rodriguez-Campo FJ, Gamallo C, Naval L. Elective neck dissection in early-stage oral squamous cell carcinoma—does it influence recurrence and survival? Head Neck. 2007;29:3–11.PubMedCrossRef
9.
Zurück zum Zitat Fasunla AJ, Greene BH, Timmesfeld N, Wiegand S, Werner JA, Sesterhenn AM. A meta-analysis of the randomized controlled trials on elective neck dissection versus therapeutic neck dissection in oral cavity cancers with clinically node-negative neck. Oral Oncol. 2011;47:320–4.PubMedCrossRef Fasunla AJ, Greene BH, Timmesfeld N, Wiegand S, Werner JA, Sesterhenn AM. A meta-analysis of the randomized controlled trials on elective neck dissection versus therapeutic neck dissection in oral cavity cancers with clinically node-negative neck. Oral Oncol. 2011;47:320–4.PubMedCrossRef
10.
Zurück zum Zitat Biazevic MG, Antunes JL, Togni J, de Andrade FP, de Carvalho MB, Wunsch-Filho V. Immediate impact of primary surgery on health-related quality of life of hospitalized patients with oral and oropharyngeal cancer. J Oral Maxillofac Surg. 2008;66:1343–50.PubMedCrossRef Biazevic MG, Antunes JL, Togni J, de Andrade FP, de Carvalho MB, Wunsch-Filho V. Immediate impact of primary surgery on health-related quality of life of hospitalized patients with oral and oropharyngeal cancer. J Oral Maxillofac Surg. 2008;66:1343–50.PubMedCrossRef
11.
Zurück zum Zitat Chandu A, Smith AC, Rogers SN. Health-related quality of life in oral cancer: a review. J Oral Maxillofac Surg. 2006;64:495–502.PubMedCrossRef Chandu A, Smith AC, Rogers SN. Health-related quality of life in oral cancer: a review. J Oral Maxillofac Surg. 2006;64:495–502.PubMedCrossRef
12.
Zurück zum Zitat Copper MP, Tan IB, Oppelaar H, Ruevekamp MC, Stewart FA. Meta-tetra(hydroxyphenyl)chlorin photodynamic therapy in early-stage squamous cell carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg. 2003;129:709–11.PubMedCrossRef Copper MP, Tan IB, Oppelaar H, Ruevekamp MC, Stewart FA. Meta-tetra(hydroxyphenyl)chlorin photodynamic therapy in early-stage squamous cell carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg. 2003;129:709–11.PubMedCrossRef
13.
Zurück zum Zitat Copper MP, Triesscheijn M, Tan IB, Ruevekamp MC, Stewart FA. Photodynamic therapy in the treatment of multiple primary tumours in the head and neck, located to the oral cavity and oropharynx. Clin Otolaryngol. 2007;32:185–9.PubMedCrossRef Copper MP, Triesscheijn M, Tan IB, Ruevekamp MC, Stewart FA. Photodynamic therapy in the treatment of multiple primary tumours in the head and neck, located to the oral cavity and oropharynx. Clin Otolaryngol. 2007;32:185–9.PubMedCrossRef
14.
Zurück zum Zitat Hopper C, Kubler A, Lewis H, Tan IB, Putnam G. mTHPC-mediated photodynamic therapy for early oral squamous cell carcinoma. Int J Cancer. 2004;111:138–46.PubMedCrossRef Hopper C, Kubler A, Lewis H, Tan IB, Putnam G. mTHPC-mediated photodynamic therapy for early oral squamous cell carcinoma. Int J Cancer. 2004;111:138–46.PubMedCrossRef
15.
Zurück zum Zitat Karakullukcu B, van Oudenaarde K, Copper MP, et al. Photodynamic therapy of early stage oral cavity and oropharynx neoplasms: an outcome analysis of 170 patients. Eur Arch Otorhinolaryngol. 2011;268:281–8.PubMedCrossRef Karakullukcu B, van Oudenaarde K, Copper MP, et al. Photodynamic therapy of early stage oral cavity and oropharynx neoplasms: an outcome analysis of 170 patients. Eur Arch Otorhinolaryngol. 2011;268:281–8.PubMedCrossRef
16.
Zurück zum Zitat Karakullukcu B, Stoker SD, Wildeman AP, Copper MP, Wildeman MA, Tan IB. A matched cohort comparison of mTHPC-mediated photodynamic therapy and trans-oral surgery of early stage oral cavity squamous cell cancer. Eur Arch Otorhinolaryngol. 2013;270:1093–7.PubMedCrossRef Karakullukcu B, Stoker SD, Wildeman AP, Copper MP, Wildeman MA, Tan IB. A matched cohort comparison of mTHPC-mediated photodynamic therapy and trans-oral surgery of early stage oral cavity squamous cell cancer. Eur Arch Otorhinolaryngol. 2013;270:1093–7.PubMedCrossRef
17.
Zurück zum Zitat European Medicines Agencies. H-C-318 Foscan European public assessment report, 2009. European Medicines Agencies. H-C-318 Foscan European public assessment report, 2009.
18.
Zurück zum Zitat Kubler AC, de Carpentier J, Hopper C, Leonard AG, Putnam G. Treatment of squamous cell carcinoma of the lip using Foscan-mediated photodynamic therapy. Int J Oral Maxillofac Surg. 2001;30:504–9.PubMedCrossRef Kubler AC, de Carpentier J, Hopper C, Leonard AG, Putnam G. Treatment of squamous cell carcinoma of the lip using Foscan-mediated photodynamic therapy. Int J Oral Maxillofac Surg. 2001;30:504–9.PubMedCrossRef
19.
Zurück zum Zitat de Visscher SA, Dijkstra PU, Tan IB, Roodenburg JL, Witjes MJ. mTHPC mediated photodynamic therapy (PDT) of squamous cell carcinoma in the head and neck: a systematic review. Oral Oncol. 2013;49:192–210.PubMedCrossRef de Visscher SA, Dijkstra PU, Tan IB, Roodenburg JL, Witjes MJ. mTHPC mediated photodynamic therapy (PDT) of squamous cell carcinoma in the head and neck: a systematic review. Oral Oncol. 2013;49:192–210.PubMedCrossRef
20.
Zurück zum Zitat Weishaupt KR, Gomer CJ, Dougherty TJ. Identification of singlet oxygen as the cytotoxic agent in photoinactivation of a murine tumor. Cancer Res. 1976;36:2326–9.PubMed Weishaupt KR, Gomer CJ, Dougherty TJ. Identification of singlet oxygen as the cytotoxic agent in photoinactivation of a murine tumor. Cancer Res. 1976;36:2326–9.PubMed
21.
Zurück zum Zitat Dewaele M, Maes H, Agostinis P. ROS-mediated mechanisms of autophagy stimulation and their relevance in cancer therapy. Autophagy. 2010;6:838–54.PubMedCrossRef Dewaele M, Maes H, Agostinis P. ROS-mediated mechanisms of autophagy stimulation and their relevance in cancer therapy. Autophagy. 2010;6:838–54.PubMedCrossRef
22.
Zurück zum Zitat Buytaert E, Dewaele M, Agostinis P. Molecular effectors of multiple cell death pathways initiated by photodynamic therapy. Biochim Biophys Acta. 2007;1776:86–107.PubMed Buytaert E, Dewaele M, Agostinis P. Molecular effectors of multiple cell death pathways initiated by photodynamic therapy. Biochim Biophys Acta. 2007;1776:86–107.PubMed
23.
Zurück zum Zitat Dougherty TJ, Gomer CJ, Henderson BW, et al. Photodynamic therapy. J Natl Cancer Inst. 1998;90:889–905.PubMedCrossRef Dougherty TJ, Gomer CJ, Henderson BW, et al. Photodynamic therapy. J Natl Cancer Inst. 1998;90:889–905.PubMedCrossRef
24.
Zurück zum Zitat Henderson BW, Dougherty TJ. How does photodynamic therapy work? Photochem Photobiol. 1992;55:145–57.PubMedCrossRef Henderson BW, Dougherty TJ. How does photodynamic therapy work? Photochem Photobiol. 1992;55:145–57.PubMedCrossRef
25.
Zurück zum Zitat Senge MO, Brandt JC. Temoporfin (Foscan(R), 5,10,15,20-tetra(m-hydroxyphenyl)chlorin)—a second-generation photosensitizer. Photochem Photobiol. 2011;87:1240–96.PubMedCrossRef Senge MO, Brandt JC. Temoporfin (Foscan(R), 5,10,15,20-tetra(m-hydroxyphenyl)chlorin)—a second-generation photosensitizer. Photochem Photobiol. 2011;87:1240–96.PubMedCrossRef
26.
Zurück zum Zitat Plaetzer K, Krammer B, Berlanda J, Berr F, Kiesslich T. Photophysics and photochemistry of photodynamic therapy: fundamental aspects. Lasers Med Sci. 2009;24:259–68.PubMedCrossRef Plaetzer K, Krammer B, Berlanda J, Berr F, Kiesslich T. Photophysics and photochemistry of photodynamic therapy: fundamental aspects. Lasers Med Sci. 2009;24:259–68.PubMedCrossRef
27.
Zurück zum Zitat D’Cruz AK, Robinson MH, Biel MA. mTHPC-mediated photodynamic therapy in patients with advanced, incurable head and neck cancer: a multicenter study of 128 patients. Head Neck. 2004;26:232–40.PubMedCrossRef D’Cruz AK, Robinson MH, Biel MA. mTHPC-mediated photodynamic therapy in patients with advanced, incurable head and neck cancer: a multicenter study of 128 patients. Head Neck. 2004;26:232–40.PubMedCrossRef
28.
Zurück zum Zitat Hopper C. Photodynamic therapy: a clinical reality in the treatment of cancer. Lancet Oncol. 2000;1:212–9.PubMedCrossRef Hopper C. Photodynamic therapy: a clinical reality in the treatment of cancer. Lancet Oncol. 2000;1:212–9.PubMedCrossRef
29.
Zurück zum Zitat Fan KF, Hopper C, Speight PM, Buonaccorsi GA, Bown SG. Photodynamic therapy using mTHPC for malignant disease in the oral cavity. Int J Cancer. 1997;73:25–32.PubMedCrossRef Fan KF, Hopper C, Speight PM, Buonaccorsi GA, Bown SG. Photodynamic therapy using mTHPC for malignant disease in the oral cavity. Int J Cancer. 1997;73:25–32.PubMedCrossRef
30.
Zurück zum Zitat Henderson BW. Photodynamic therapy—coming of age. Photodermatology. 1989;6:200–11.PubMed Henderson BW. Photodynamic therapy—coming of age. Photodermatology. 1989;6:200–11.PubMed
31.
Zurück zum Zitat Yow CM, Chen JY, Mak NK, Cheung NH, Leung AW. Cellular uptake, subcellular localization and photodamaging effect of temoporfin (mTHPC) in nasopharyngeal carcinoma cells: comparison with hematoporphyrin derivative. Cancer Lett. 2000;157:123–31.PubMedCrossRef Yow CM, Chen JY, Mak NK, Cheung NH, Leung AW. Cellular uptake, subcellular localization and photodamaging effect of temoporfin (mTHPC) in nasopharyngeal carcinoma cells: comparison with hematoporphyrin derivative. Cancer Lett. 2000;157:123–31.PubMedCrossRef
32.
Zurück zum Zitat Kubler AC, Stenzel W, Ruhling M, Meul B, Fischer J. Experimental evaluation of possible side effects of intra-operative photodynamic therapy on rabbit blood vessels and nerves. Lasers Surg Med. 2003;33:247–55.PubMedCrossRef Kubler AC, Stenzel W, Ruhling M, Meul B, Fischer J. Experimental evaluation of possible side effects of intra-operative photodynamic therapy on rabbit blood vessels and nerves. Lasers Surg Med. 2003;33:247–55.PubMedCrossRef
33.
Zurück zum Zitat Wright KE, Liniker E, Loizidou M, Moore C, Macrobert AJ, Phillips JB. Peripheral neural cell sensitivity to mTHPC-mediated photodynamic therapy in a 3D in vitro model. Br J Cancer. 2009;101:658–65.PubMedCrossRef Wright KE, Liniker E, Loizidou M, Moore C, Macrobert AJ, Phillips JB. Peripheral neural cell sensitivity to mTHPC-mediated photodynamic therapy in a 3D in vitro model. Br J Cancer. 2009;101:658–65.PubMedCrossRef
34.
Zurück zum Zitat Hornung R, Walt H, Crompton NE, et al. m-THPC-mediated photodynamic therapy (PDT) does not induce resistance to chemotherapy, radiotherapy or PDT on human breast cancer cells in vitro. Photochem Photobiol. 1998;68:569–74.PubMedCrossRef Hornung R, Walt H, Crompton NE, et al. m-THPC-mediated photodynamic therapy (PDT) does not induce resistance to chemotherapy, radiotherapy or PDT on human breast cancer cells in vitro. Photochem Photobiol. 1998;68:569–74.PubMedCrossRef
36.
Zurück zum Zitat Nieuwenhuis EJ, Castelijns JA, Pijpers R, et al. Wait-and-see policy for the N0 neck in early-stage oral and oropharyngeal squamous cell carcinoma using ultrasonography-guided cytology: is there a role for identification of the sentinel node? Head Neck. 2002;24:282–9.PubMedCrossRef Nieuwenhuis EJ, Castelijns JA, Pijpers R, et al. Wait-and-see policy for the N0 neck in early-stage oral and oropharyngeal squamous cell carcinoma using ultrasonography-guided cytology: is there a role for identification of the sentinel node? Head Neck. 2002;24:282–9.PubMedCrossRef
37.
Zurück zum Zitat Altman DG, Machin D, Bryant T, Gardner S. Statistics with confidence: confidence intervals and statistical guidelines. 2nd ed. London: BMJ Books; 2000. Altman DG, Machin D, Bryant T, Gardner S. Statistics with confidence: confidence intervals and statistical guidelines. 2nd ed. London: BMJ Books; 2000.
38.
Zurück zum Zitat Hicks WL Jr, Loree TR, Garcia RI, et al. Squamous cell carcinoma of the floor of mouth: a 20-year review. Head Neck. 1997;19:400–5.PubMedCrossRef Hicks WL Jr, Loree TR, Garcia RI, et al. Squamous cell carcinoma of the floor of mouth: a 20-year review. Head Neck. 1997;19:400–5.PubMedCrossRef
39.
Zurück zum Zitat Nason RW, Binahmed A, Pathak KA, Abdoh AA, Sandor GK. What is the adequate margin of surgical resection in oral cancer? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107:625–9.PubMedCrossRef Nason RW, Binahmed A, Pathak KA, Abdoh AA, Sandor GK. What is the adequate margin of surgical resection in oral cancer? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107:625–9.PubMedCrossRef
40.
Zurück zum Zitat Sutton DN, Brown JS, Rogers SN, Vaughan ED, Woolgar JA. The prognostic implications of the surgical margin in oral squamous cell carcinoma. Int J Oral Maxillofac Surg. 2003;32:30–4.PubMedCrossRef Sutton DN, Brown JS, Rogers SN, Vaughan ED, Woolgar JA. The prognostic implications of the surgical margin in oral squamous cell carcinoma. Int J Oral Maxillofac Surg. 2003;32:30–4.PubMedCrossRef
41.
Zurück zum Zitat Woolgar JA. Histopathological prognosticators in oral and oropharyngeal squamous cell carcinoma. Oral Oncol. 2006;42:229–39.PubMedCrossRef Woolgar JA. Histopathological prognosticators in oral and oropharyngeal squamous cell carcinoma. Oral Oncol. 2006;42:229–39.PubMedCrossRef
42.
Zurück zum Zitat Spiro RH, Huvos AG, Wong GY, Spiro JD, Gnecco CA, Strong EW. Predictive value of tumor thickness in squamous carcinoma confined to the tongue and floor of the mouth. Am J Surg. 1986;152:345–50.PubMedCrossRef Spiro RH, Huvos AG, Wong GY, Spiro JD, Gnecco CA, Strong EW. Predictive value of tumor thickness in squamous carcinoma confined to the tongue and floor of the mouth. Am J Surg. 1986;152:345–50.PubMedCrossRef
43.
Zurück zum Zitat Shingaki S, Suzuki I, Nakajima T, Kawasaki T. Evaluation of histopathologic parameters in predicting cervical lymph node metastasis of oral and oropharyngeal carcinomas. Oral Surg Oral Med Oral Pathol. 1988;66:683–8.PubMedCrossRef Shingaki S, Suzuki I, Nakajima T, Kawasaki T. Evaluation of histopathologic parameters in predicting cervical lymph node metastasis of oral and oropharyngeal carcinomas. Oral Surg Oral Med Oral Pathol. 1988;66:683–8.PubMedCrossRef
44.
Zurück zum Zitat O-charoenrat P, Pillai G, Patel S, et al. Tumour thickness predicts cervical nodal metastases and survival in early oral tongue cancer. Oral Oncol. 2003;39:386–90.PubMedCrossRef O-charoenrat P, Pillai G, Patel S, et al. Tumour thickness predicts cervical nodal metastases and survival in early oral tongue cancer. Oral Oncol. 2003;39:386–90.PubMedCrossRef
45.
Zurück zum Zitat Po Wing Yuen A, Lam KY, Lam LK, et al. Prognostic factors of clinically stage I and II oral tongue carcinoma—a comparative study of stage, thickness, shape, growth pattern, invasive front malignancy grading, Martinez-Gimeno score, and pathologic features. Head Neck. 2002; 24:513–20.PubMedCrossRef Po Wing Yuen A, Lam KY, Lam LK, et al. Prognostic factors of clinically stage I and II oral tongue carcinoma—a comparative study of stage, thickness, shape, growth pattern, invasive front malignancy grading, Martinez-Gimeno score, and pathologic features. Head Neck. 2002; 24:513–20.PubMedCrossRef
46.
Zurück zum Zitat Melchers LJ, Schuuring E, van Dijk BA, et al. Tumour infiltration depth >/=4 mm is an indication for an elective neck dissection in pT1cN0 oral squamous cell carcinoma. Oral Oncol. 2012;48:337–42.PubMedCrossRef Melchers LJ, Schuuring E, van Dijk BA, et al. Tumour infiltration depth >/=4 mm is an indication for an elective neck dissection in pT1cN0 oral squamous cell carcinoma. Oral Oncol. 2012;48:337–42.PubMedCrossRef
47.
Zurück zum Zitat Batsakis JG. Surgical excision margins: a pathologist’s perspective. Adv Anat Pathol. 1999;6:140–8.PubMedCrossRef Batsakis JG. Surgical excision margins: a pathologist’s perspective. Adv Anat Pathol. 1999;6:140–8.PubMedCrossRef
48.
Zurück zum Zitat Woolgar JA, Triantafyllou A. A histopathological appraisal of surgical margins in oral and oropharyngeal cancer resection specimens. Oral Oncol. 2005;41:1034–43.PubMedCrossRef Woolgar JA, Triantafyllou A. A histopathological appraisal of surgical margins in oral and oropharyngeal cancer resection specimens. Oral Oncol. 2005;41:1034–43.PubMedCrossRef
Metadaten
Titel
mTHPC-mediated Photodynamic Therapy of Early Stage Oral Squamous Cell Carcinoma: A Comparison to Surgical Treatment
Publikationsdatum
01.09.2013
Erschienen in
Annals of Surgical Oncology / Ausgabe 9/2013
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3006-6

Weitere Artikel der Ausgabe 9/2013

Annals of Surgical Oncology 9/2013 Zur Ausgabe

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.