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Chirurgische Therapie von Lebermetastasen

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Praxis der Viszeralchirurgie

Zusammenfassung

Der Großteil heutzutage onkologisch sinnvoll resezierter Lebermetastasen ist kolorektalen Ursprungs, sodass hierzu die größte Erfahrung existiert. Im Verlauf der Tumorerkrankung kolorektaler Karzinome scheint ein Zeitfenster zu existieren, in der die Metastasierung in die Leber einen „lokoregionären Charakter“ besitzt und damit die Resektion das Potenzial der Kuration bei signifikant verbesserter Lebensverlängerung beinhaltet. Die 5-Jahres-Überlebensrate nach kurativer Resektion wird mit 30–40% angegeben. Die Abklärung der Resektabilität erfolgt über Spiral-CT oder MRT. Zum Ausschluss von extrahepatischem Tumorbefall steht die Positronenemissionstomographie zur Verfügung. Präoperativ abzuschätzen ist die Restleberfunktion. Trotz einer Vielzahl anerkannter Prognosefaktoren bleibt die Indikationsstellung zur Lebermetastasenresektion oftmals eine individuelle Entscheidung. Ziel des operativen Vorgehens ist die kurative Resektion (R0-Resektion). Neoadjuvante Therapiekonzepte werden gegenwärtig in Studien evaluiert. Eine eindeutige Indikation zur adjuvanten Chemotherapie nach kurativer Lebermetastasenresektion ist gegenwärtig nicht gegeben.

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Authors
  1. R. Rosenberg
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  2. M. Stangl
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  3. J. R. Siewert
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Editor information

Editors and Affiliations

  1. Chirurgische Klinik und Poliklinik, Technische Universität München Klinikum rechts der Isar, Ismaninger Str. 22, 81657, München, Germany

    Jörg Rüdiger Siewert

  2. Zentrum für Operative Medizin I, Klinikum der Philipps-Universität, Baldinger Straße, 35043, Marburg, Germany

    Matthias Rothmund

  3. Medizinische Fakultät der RWTH, Universitätsklinik und Poliklinik, Pauwelsstr. 30, 52057, Aachen, Germany

    Volker Schumpelick

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© 2006 Springer Medizin Verlag Heidelberg

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Rosenberg, R., Stangl, M., Siewert, J.R. (2006). Chirurgische Therapie von Lebermetastasen. In: Siewert, J.R., Rothmund, M., Schumpelick, V. (eds) Praxis der Viszeralchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-30036-8_43

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  • DOI: https://doi.org/10.1007/3-540-30036-8_43

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-21914-9

  • Online ISBN: 978-3-540-30036-6

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