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Abdominoperineale Rektumexstirpationen

  • Sigmar StelznerEmail author
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Zusammenfassung

Die abdominoperineale Rektumexstirpation gehört seit mehr als 140 Jahren zum Armamentarium der Rektumkarzinomchirurgie. Zunächst etablierte sie sich als Standardeingriff, wurde dann wegen funktionell und onkologisch schlechterer Ergebnisse deutlich zurückgedrängt und stellt heute einen hochspezialisierten Eingriff für lokal weit fortgeschrittene Tumoren dar. Neben den technischen Verbesserungen gibt die moderne Bildgebung, insbesondere die MRT, dem Chirurgen das Rüstzeug an die Hand, den Tumor in Bezug auf die umgebenden Strukturen genau zu lokalisieren, eine sichere Differenzialindikation zwischen Sphinktererhalt oder notwendiger Exstirpation zu stellen und den Eingriff im Sinne der „MRI-guided surgery“ durchzuführen. Das folgende Kapitel erörtert diese Stichpunkte und stellt die chirurgische Technik dar.

Notes

Danksagung

Mein ausdrücklicher Dank gilt Herrn Professor Thilo Wedel, Zentrum für Klinische Anatomie, Anatomisches Institut der Christian-Albrechts-Universität zu Kiel, für die gemeinsame Erstellung der anatomischen Präparate, welche im Rahmen des Körperspendeprogrammes der Universität Kiel zur Verfügung gestellt wurden. Der Autor bedankt sich weiterhin bei Herrn Professor Thomas Kittner, Radiologische Klinik des Städtischen Klinikums Dresden, für die freundliche Überlassung der MRT-Bilder und bei Herrn Florian Keller für die Erstellung der Abb. 11.1a.

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Copyright information

© Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature 2020

Authors and Affiliations

  1. 1.Städtisches Klinikum DresdenDresdenDeutschland

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