Skip to main content
Erschienen in: Annals of Surgical Oncology 9/2016

04.04.2016 | Gynecologic Oncology

The Survival Rate and Surgical Morbidity of Abdominal Radical Trachelectomy Versus Abdominal Radical Hysterectomy for Stage IB1 Cervical Cancer

verfasst von: Xiaoqi Li, MD, Jin Li, MD, Hao Wen, MD, Xingzhu Ju, MD, PhD, Xiaojun Chen, MD, PhD, Lingfang Xia, MD, Guihao Ke, MD, PhD, Jia Tang, MD, Xiaohua Wu, MD, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 9/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To compare the survival rates and morbidities of abdominal radical trachelectomy (ART) to abdominal radical hysterectomy (ARH) for stage IB1 cervical cancer and to evaluate the safety of ART for tumors measuring 2–4 cm.

Methods

We performed a retrospective study to compare the outcomes of patients with stage IB1 cervical cancer who underwent ART to patients treated with ARH who met the inclusion criteria of a fertility-sparing surgery. All of the patients were treated by the same surgeon at our institution in the same period.

Results

Of the 107 and 141 patients who underwent ART and ARH, respectively, 61 and 82 patients had a tumor ≥2 cm (P = NS). With a median follow-up of 30 and 49 months, 2 patients treated with ART and 3 patients treated with ARH recurred: the 5-year RFS rate was 96.5 and 94.8%, respectively, for tumors ≥2 cm (P = NS). Only 3 patients died in the ARH group: the 5-year OS rate was 100% for the ART and 94.8% for the ARH group for tumors ≥2 cm (P = NS). Incidence rates of intraoperative complications were similar in the two groups (1.9% for ART and 0.7% for ARH, P = NS). However, incidence rates of postoperative complications were higher in the ART group (36.4% for ART and 19.1% for ARH, P < 0.05).

Conclusions

ART appears to have equal survival rates to ARH and can be performed safely in stage IB1 cervical cancers ≥2 cm. However, ART is associated with more postoperative morbidities compared with ARH.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Covens A, Rosen B, Murphy J, et al. Changes in the demographics and perioperative care of stage IA(2)/IB(1) cervical cancer over the past 16 years. Gynecol Oncol. 2001;81(2):133–7.CrossRefPubMed Covens A, Rosen B, Murphy J, et al. Changes in the demographics and perioperative care of stage IA(2)/IB(1) cervical cancer over the past 16 years. Gynecol Oncol. 2001;81(2):133–7.CrossRefPubMed
2.
Zurück zum Zitat Sonoda Y, Abu-Rustum NR, Gemignani ML, et al. A fertility-sparing alternative to radical hysterectomy: how many patients may be eligible? Gynecol Oncol. 2004;95(3):534–8.CrossRefPubMed Sonoda Y, Abu-Rustum NR, Gemignani ML, et al. A fertility-sparing alternative to radical hysterectomy: how many patients may be eligible? Gynecol Oncol. 2004;95(3):534–8.CrossRefPubMed
3.
Zurück zum Zitat Plante M, Gregoire J, Renaud MC, Roy M. The vaginal radical trachelectomy: an update of a series of 125 cases and 106 pregnancies. Gynecol Oncol. 2011;121(2):290–7.CrossRefPubMed Plante M, Gregoire J, Renaud MC, Roy M. The vaginal radical trachelectomy: an update of a series of 125 cases and 106 pregnancies. Gynecol Oncol. 2011;121(2):290–7.CrossRefPubMed
4.
Zurück zum Zitat Cao DY, Yang JX, Wu XH, et al. Comparisons of vaginal and abdominal radical trachelectomy for early-stage cervical cancer: preliminary results of a multi-center research in China. Brit J Cancer. 2013;109(11):2778–82.CrossRefPubMedPubMedCentral Cao DY, Yang JX, Wu XH, et al. Comparisons of vaginal and abdominal radical trachelectomy for early-stage cervical cancer: preliminary results of a multi-center research in China. Brit J Cancer. 2013;109(11):2778–82.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Li J, Wu X, Li X, Ju X. Abdominal radical trachelectomy: Is it safe for IB1 cervical cancer with tumors ≥2 cm? Gynecol Oncol. 2013;131(1):87–92.CrossRefPubMed Li J, Wu X, Li X, Ju X. Abdominal radical trachelectomy: Is it safe for IB1 cervical cancer with tumors ≥2 cm? Gynecol Oncol. 2013;131(1):87–92.CrossRefPubMed
6.
Zurück zum Zitat Lintner B, Saso S, Tarnai L, et al. Use of abdominal radical trachelectomy to treat cervical cancer greater than 2 cm in diameter. Int J Gynecol Cancer. 2013;23(6):1065–70.CrossRefPubMed Lintner B, Saso S, Tarnai L, et al. Use of abdominal radical trachelectomy to treat cervical cancer greater than 2 cm in diameter. Int J Gynecol Cancer. 2013;23(6):1065–70.CrossRefPubMed
7.
Zurück zum Zitat Wethington SL, Sonoda Y, Park KJ, et al. Expanding the indications for radical trachelectomy: a report on 29 patients with stage IB1 tumors measuring 2 to 4 centimeters. Int J Gynecol Cancer. 2013;23(6):1092–98.CrossRefPubMed Wethington SL, Sonoda Y, Park KJ, et al. Expanding the indications for radical trachelectomy: a report on 29 patients with stage IB1 tumors measuring 2 to 4 centimeters. Int J Gynecol Cancer. 2013;23(6):1092–98.CrossRefPubMed
8.
Zurück zum Zitat Li J, Li Z, Wang H, et al. Radical abdominal trachelectomy for cervical malignancies: surgical, oncological and fertility outcomes in 62 patients. Gynecol Oncol. 2011;121(3):565–70.CrossRefPubMed Li J, Li Z, Wang H, et al. Radical abdominal trachelectomy for cervical malignancies: surgical, oncological and fertility outcomes in 62 patients. Gynecol Oncol. 2011;121(3):565–70.CrossRefPubMed
9.
Zurück zum Zitat Zhang D, Li J, Ge H, et al. Surgical and pathological outcomes of abdominal radical trachelectomy versus hysterectomy for early-stage cervical cancer. Int J Gynecol Cancer. 2014;24(7):1312–18.CrossRefPubMed Zhang D, Li J, Ge H, et al. Surgical and pathological outcomes of abdominal radical trachelectomy versus hysterectomy for early-stage cervical cancer. Int J Gynecol Cancer. 2014;24(7):1312–18.CrossRefPubMed
10.
Zurück zum Zitat Tang J, Li J, Wang S, Zhang D, Wu X. On what scale does it benefit the patients if uterine arteries were preserved during ART? Gynecol Oncol. 2014;134(1):154–9.CrossRefPubMed Tang J, Li J, Wang S, Zhang D, Wu X. On what scale does it benefit the patients if uterine arteries were preserved during ART? Gynecol Oncol. 2014;134(1):154–9.CrossRefPubMed
11.
Zurück zum Zitat Einstein MH, Park KJ, Sonoda Y, et al. Radical vaginal versus abdominal trachelectomy for stage IB1 cervical cancer: a comparison of surgical and pathologic outcomes. Gynecol Oncol. 2009;112(1):73–7.CrossRefPubMed Einstein MH, Park KJ, Sonoda Y, et al. Radical vaginal versus abdominal trachelectomy for stage IB1 cervical cancer: a comparison of surgical and pathologic outcomes. Gynecol Oncol. 2009;112(1):73–7.CrossRefPubMed
12.
Zurück zum Zitat Kucukmetin A, Biliatis I, Ratnavelu N, et al. Laparoscopic radical trachelectomy is an alternative to laparotomy with improved perioperative outcomes in patients with early-stage cervical cancer. Int J Gynecol Cancer. 2014;24(1):135–40.CrossRefPubMed Kucukmetin A, Biliatis I, Ratnavelu N, et al. Laparoscopic radical trachelectomy is an alternative to laparotomy with improved perioperative outcomes in patients with early-stage cervical cancer. Int J Gynecol Cancer. 2014;24(1):135–40.CrossRefPubMed
13.
Zurück zum Zitat Nick AM, Frumovitz MM, Soliman PT, Schmeler KM, Ramirez PT. Fertility sparing surgery for treatment of early-stage cervical cancer: open vs. robotic radical trachelectomy. Gynecol Oncol. 2012;124(2):276–80.CrossRefPubMed Nick AM, Frumovitz MM, Soliman PT, Schmeler KM, Ramirez PT. Fertility sparing surgery for treatment of early-stage cervical cancer: open vs. robotic radical trachelectomy. Gynecol Oncol. 2012;124(2):276–80.CrossRefPubMed
14.
Zurück zum Zitat Covens A, Rosen B, Murphy J, et al. How important is removal of the parametrium at surgery for carcinoma of the cervix? Gynecol Oncol. 2002;84(1):145–9.CrossRefPubMed Covens A, Rosen B, Murphy J, et al. How important is removal of the parametrium at surgery for carcinoma of the cervix? Gynecol Oncol. 2002;84(1):145–9.CrossRefPubMed
15.
Zurück zum Zitat Wright JD, Grigsby PW, Brooks R, et al. Utility of parametrectomy for early stage cervical cancer treated with radical hysterectomy. Cancer. 2007;110(6):1281–6.CrossRefPubMed Wright JD, Grigsby PW, Brooks R, et al. Utility of parametrectomy for early stage cervical cancer treated with radical hysterectomy. Cancer. 2007;110(6):1281–6.CrossRefPubMed
16.
Zurück zum Zitat Frumovitz M, Sun CC, Schmeler KM, et al. Parametrial involvement in radical hysterectomy specimens for women with early-stage cervical cancer. Obstetr. Gynecol. 2009;114(1):93–9.CrossRefPubMed Frumovitz M, Sun CC, Schmeler KM, et al. Parametrial involvement in radical hysterectomy specimens for women with early-stage cervical cancer. Obstetr. Gynecol. 2009;114(1):93–9.CrossRefPubMed
17.
Zurück zum Zitat Steed H, Capstick V, Schepansky A, Honore L, Hiltz M, Faught W. Early cervical cancer and parametrial involvement: is it significant? Gynecol Oncol. 2006;103(1):53–7.CrossRefPubMed Steed H, Capstick V, Schepansky A, Honore L, Hiltz M, Faught W. Early cervical cancer and parametrial involvement: is it significant? Gynecol Oncol. 2006;103(1):53–7.CrossRefPubMed
18.
Zurück zum Zitat Benedetti-Panici P, Maneschi F, D’Andrea G, et al. Early cervical carcinoma: the natural history of lymph node involvement redefined on the basis of thorough parametrectomy and giant section study. Cancer. 2000;88(10):2267–74.CrossRefPubMed Benedetti-Panici P, Maneschi F, D’Andrea G, et al. Early cervical carcinoma: the natural history of lymph node involvement redefined on the basis of thorough parametrectomy and giant section study. Cancer. 2000;88(10):2267–74.CrossRefPubMed
19.
Zurück zum Zitat Zhang D, Ge H, Li J, Wu X. A new method of surgical margin assuring for abdominal radical trachelectomy in frozen section. Eur J Cancer (Oxford, England: 1990). 2015;51(6):734–41. Zhang D, Ge H, Li J, Wu X. A new method of surgical margin assuring for abdominal radical trachelectomy in frozen section. Eur J Cancer (Oxford, England: 1990). 2015;51(6):734–41.
20.
Zurück zum Zitat Marchiole P, Benchaib M, Buenerd A, Lazlo E, Dargent D, Mathevet P. Oncological safety of laparoscopic-assisted vaginal radical trachelectomy (LARVT or Dargent’s operation): a comparative study with laparoscopic-assisted vaginal radical hysterectomy (LARVH). Gynecol Oncol. 2007;106(1):132–41.CrossRefPubMed Marchiole P, Benchaib M, Buenerd A, Lazlo E, Dargent D, Mathevet P. Oncological safety of laparoscopic-assisted vaginal radical trachelectomy (LARVT or Dargent’s operation): a comparative study with laparoscopic-assisted vaginal radical hysterectomy (LARVH). Gynecol Oncol. 2007;106(1):132–41.CrossRefPubMed
21.
Zurück zum Zitat Sedlis A, Bundy BN, Rotman MZ, Lentz SS, Muderspach LI, Zaino RJ. A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: A Gynecologic Oncology Group Study. Gynecol Oncol. 1999;73(2):177–83.CrossRefPubMed Sedlis A, Bundy BN, Rotman MZ, Lentz SS, Muderspach LI, Zaino RJ. A randomized trial of pelvic radiation therapy versus no further therapy in selected patients with stage IB carcinoma of the cervix after radical hysterectomy and pelvic lymphadenectomy: A Gynecologic Oncology Group Study. Gynecol Oncol. 1999;73(2):177–83.CrossRefPubMed
22.
Zurück zum Zitat Delgado G, Bundy B, Zaino R, Sevin BU, Creasman WT, Major F. Prospective surgical-pathological study of disease-free interval in patients with stage IB squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study. Gynecol Oncol. 1990;38(3):352–7.CrossRefPubMed Delgado G, Bundy B, Zaino R, Sevin BU, Creasman WT, Major F. Prospective surgical-pathological study of disease-free interval in patients with stage IB squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study. Gynecol Oncol. 1990;38(3):352–7.CrossRefPubMed
23.
Zurück zum Zitat Noyes N, Knopman JM, Long K, Coletta JM, Abu-Rustum NR. Fertility considerations in the management of gynecologic malignancies. Gynecol Oncol. 2011;120(3):326–33.CrossRefPubMed Noyes N, Knopman JM, Long K, Coletta JM, Abu-Rustum NR. Fertility considerations in the management of gynecologic malignancies. Gynecol Oncol. 2011;120(3):326–33.CrossRefPubMed
24.
Zurück zum Zitat Du XL, Sheng XG, Jiang T, et al. Sentinel lymph node biopsy as guidance for radical trachelectomy in young patients with early stage cervical cancer. BMC Cancer. 2011;11:157.CrossRefPubMedPubMedCentral Du XL, Sheng XG, Jiang T, et al. Sentinel lymph node biopsy as guidance for radical trachelectomy in young patients with early stage cervical cancer. BMC Cancer. 2011;11:157.CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Nishio H, Fujii T, Kameyama K, et al. Abdominal radical trachelectomy as a fertility-sparing procedure in women with early-stage cervical cancer in a series of 61 women. Gynecol Oncol. 2009;115(1):51–5.CrossRefPubMed Nishio H, Fujii T, Kameyama K, et al. Abdominal radical trachelectomy as a fertility-sparing procedure in women with early-stage cervical cancer in a series of 61 women. Gynecol Oncol. 2009;115(1):51–5.CrossRefPubMed
26.
Zurück zum Zitat Chen Y, Xu H, Zhang Q, Li Y, Wang D, Liang Z. A fertility-preserving option in early cervical carcinoma: laparoscopy-assisted vaginal radical trachelectomy and pelvic lymphadenectomy. Eur J Obstetr Gynecol Reprodue Biol. 2008;136(1):90–3.CrossRefPubMed Chen Y, Xu H, Zhang Q, Li Y, Wang D, Liang Z. A fertility-preserving option in early cervical carcinoma: laparoscopy-assisted vaginal radical trachelectomy and pelvic lymphadenectomy. Eur J Obstetr Gynecol Reprodue Biol. 2008;136(1):90–3.CrossRefPubMed
27.
Zurück zum Zitat Park JY, Joo WD, Chang SJ, et al. Long-term outcomes after fertility-sparing laparoscopic radical trachelectomy in young women with early-stage cervical cancer: an Asan Gynecologic Cancer Group (AGCG) study. J Surg Oncol. 2014;110(3):252–7.CrossRefPubMed Park JY, Joo WD, Chang SJ, et al. Long-term outcomes after fertility-sparing laparoscopic radical trachelectomy in young women with early-stage cervical cancer: an Asan Gynecologic Cancer Group (AGCG) study. J Surg Oncol. 2014;110(3):252–7.CrossRefPubMed
28.
Zurück zum Zitat Curtin JP, Hoskins WJ, Venkatraman ES, et al. Adjuvant chemotherapy versus chemotherapy plus pelvic irradiation for high-risk cervical cancer patients after radical hysterectomy and pelvic lymphadenectomy (RH-PLND): a randomized phase III trial. Gynecol Oncol. 1996;61(1):3–10.CrossRefPubMed Curtin JP, Hoskins WJ, Venkatraman ES, et al. Adjuvant chemotherapy versus chemotherapy plus pelvic irradiation for high-risk cervical cancer patients after radical hysterectomy and pelvic lymphadenectomy (RH-PLND): a randomized phase III trial. Gynecol Oncol. 1996;61(1):3–10.CrossRefPubMed
29.
Zurück zum Zitat Takeshima N, Umayahara K, Fujiwara K, Hirai Y, Takizawa K, Hasumi K. Treatment results of adjuvant chemotherapy after radical hysterectomy for intermediate- and high-risk stage IB-IIA cervical cancer. Gynecol Oncol. 2006;103(2):618–22.CrossRefPubMed Takeshima N, Umayahara K, Fujiwara K, Hirai Y, Takizawa K, Hasumi K. Treatment results of adjuvant chemotherapy after radical hysterectomy for intermediate- and high-risk stage IB-IIA cervical cancer. Gynecol Oncol. 2006;103(2):618–22.CrossRefPubMed
30.
Zurück zum Zitat Iwasaka T, Kamura T, Yokoyama M, Matsuo N, Nakano H, Sugimori H. Adjuvant chemotherapy after radical hysterectomy for cervical carcinoma: a comparison with effects of adjuvant radiotherapy. Gynecol Oncol. 1998;91(6):977–81.PubMed Iwasaka T, Kamura T, Yokoyama M, Matsuo N, Nakano H, Sugimori H. Adjuvant chemotherapy after radical hysterectomy for cervical carcinoma: a comparison with effects of adjuvant radiotherapy. Gynecol Oncol. 1998;91(6):977–81.PubMed
31.
Zurück zum Zitat Hosaka M, Watari H, Kato T, et al. Clinical efficacy of paclitaxel/cisplatin as an adjuvant chemotherapy for patients with cervical cancer who underwent radical hysterectomy and systematic lymphadenectomy. J Surg Oncol. 2012;105(6):612–16.CrossRefPubMed Hosaka M, Watari H, Kato T, et al. Clinical efficacy of paclitaxel/cisplatin as an adjuvant chemotherapy for patients with cervical cancer who underwent radical hysterectomy and systematic lymphadenectomy. J Surg Oncol. 2012;105(6):612–16.CrossRefPubMed
32.
Zurück zum Zitat Ijaz T, Eifel PJ, Burke T, Oswald MJ. Radiation therapy of pelvic recurrence after radical hysterectomy for cervical carcinoma. Gynecol Oncol. 1998;70(2):241–6.CrossRefPubMed Ijaz T, Eifel PJ, Burke T, Oswald MJ. Radiation therapy of pelvic recurrence after radical hysterectomy for cervical carcinoma. Gynecol Oncol. 1998;70(2):241–6.CrossRefPubMed
33.
Zurück zum Zitat Maneo A, Landoni F, Cormio G, et al. Concurrent carboplatin/5-fluorouracil and radiotherapy for recurrent cervical carcinoma. Ann Oncol 1999;10(7):803–7.CrossRefPubMed Maneo A, Landoni F, Cormio G, et al. Concurrent carboplatin/5-fluorouracil and radiotherapy for recurrent cervical carcinoma. Ann Oncol 1999;10(7):803–7.CrossRefPubMed
34.
Zurück zum Zitat Kitagawa R, Katsumata N, Shibata T, et al. Paclitaxel plus carboplatin versus paclitaxel plus cisplatin in metastatic or recurrent cervical cancer: the open-label randomized phase III trial JCOG0505. J Clin Oncol. Mar 2 2015. Kitagawa R, Katsumata N, Shibata T, et al. Paclitaxel plus carboplatin versus paclitaxel plus cisplatin in metastatic or recurrent cervical cancer: the open-label randomized phase III trial JCOG0505. J Clin Oncol. Mar 2 2015.
35.
Zurück zum Zitat Monk BJ, Sill MW, McMeekin DS, et al. Phase III trial of four cisplatin-containing doublet combinations in stage IVB, recurrent, or persistent cervical carcinoma: a Gynecologic Oncology Group study. J Clin Oncol. 2009;27(28):4649–55.CrossRefPubMedPubMedCentral Monk BJ, Sill MW, McMeekin DS, et al. Phase III trial of four cisplatin-containing doublet combinations in stage IVB, recurrent, or persistent cervical carcinoma: a Gynecologic Oncology Group study. J Clin Oncol. 2009;27(28):4649–55.CrossRefPubMedPubMedCentral
Metadaten
Titel
The Survival Rate and Surgical Morbidity of Abdominal Radical Trachelectomy Versus Abdominal Radical Hysterectomy for Stage IB1 Cervical Cancer
verfasst von
Xiaoqi Li, MD
Jin Li, MD
Hao Wen, MD
Xingzhu Ju, MD, PhD
Xiaojun Chen, MD, PhD
Lingfang Xia, MD
Guihao Ke, MD, PhD
Jia Tang, MD
Xiaohua Wu, MD, PhD
Publikationsdatum
04.04.2016
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 9/2016
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5216-1

Weitere Artikel der Ausgabe 9/2016

Annals of Surgical Oncology 9/2016 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.