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Systematik in der Operationsplanung bei Weichgewebesarkomen der Extremitäten

Systematic planning of surgery for soft tissue sarcoma of the extremities

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Zusammenfassung

Extremitätensarkome sind seltene bösartige Tumoren. Die Behandlung erfordert ein erfahrenes Team. Die Primärdiagnostik mit adäquater lokaler Bildgebung und Biopsie hat einen sehr hohen Stellenwert. Vor der Operation sollten die multimodale Behandlung und das Ausmaß der Resektion und ggf. Rekonstruktion interdisziplinär festgelegt werden. Ziel der Resektion ist immer die vollständige R0-Resektion unter optimalem Funktionserhalt. Im multimodalen Therapiesetting kann im erfahrenen Team ein Erhalt funktionskritischer Strukturen (z. B. Nervus ischiadicus) durch eine fokal-marginale Resektion erreicht werden.

Abstract

Soft tissue sarcomas of the extremities are rarely malignant tumors. They are best treated by an experienced interdisciplinary sarcoma team. A preoperative biopsy and imaging are prerequisites for successful sarcoma treatment. Before surgery the multimodal treatment and the extent of resection and, if necessary, plastic reconstruction should be discussed in a multidisciplinary tumor board. The aim is always a complete R0 resection with optimal preservation of function. The preservation of critical structures (e. g. sciatic nerve) by a planned focal marginal resection along the critical structure can be performed by an experienced team in a multidisciplinary treatment setting.

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Authors and Affiliations

  1. Klinik für Allgemein‑, Viszeral- und Kinderchirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland

    J. Jakob

  2. Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinik Bonn, Bonn, Deutschland

    J. Schmolders

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Correspondence to J. Jakob.

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Interessenkonflikt

J. Jakob erhielt Vortragshonorare der Firma Lilly Deutschland. J. Schmolders gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Jakob, J., Schmolders, J. Systematik in der Operationsplanung bei Weichgewebesarkomen der Extremitäten. Chirurg 90, 441–446 (2019). https://doi.org/10.1007/s00104-019-0921-5

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  • DOI: https://doi.org/10.1007/s00104-019-0921-5

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