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Entwicklungsstand in der Thoraxchirurgie

  • Conference paper
Qualitätssicherung durch Zusammenarbeit in der Chirurgie

Part of the book series: Langenbecks Archiv für Chirurgie ((KONGRESSBAND,volume 1995))

  • 36 Accesses

Zusammenfassung

Dominierten zu Beginn der minimal-invasiven Ära noch kleinere Eingriffe im pleuralen Bereich sowie an der Lungenperipherie, sind inzwischen komplexe lungenresezierende Verfahren ebenso wie Eingriffe beim Lungenemphysem und die Dekortikation der viszeralen Pleura beim Empyem möglich geworden. Mit dem Einsatz der neuen dreidimensionalen Übertragungstechnik (3D-System) gewinnt die minimal-invasive Chirurgie die Tiefenschärfe und Plastizität des intraoperativen Situs zurück, was sich in präziser und zügiger Präparation niederschlägt. Die weiterhin fehlende Palpationsmöglichkeit versucht man intraoperativ mittels Mini- oder Arbeitsthorakotomie, über welche bis zu einem gewissen Maße eine digitale Austastung erfolgen kann, und zunehmend durch Verwendung von Ultraschallsonden zu kompensieren. Technisch machbare, große thorakoskopische Eingriffe — Lobektomie, Pneumonektomie, partielle Lymphknotendissektion — sind Ursache aktueller Diskussionen über die Sinnfälligkeit onkologischer Eingriffe an der Lunge. Die mögliche Tumor-Aussaat, die fehlende Palpationsmöglichkeit der gesamten Lunge und die Undurchführbarkeit einer exakten mediastinalen Lymphknotendissektion verbieten die MIC vorläufig als Methode in der Behandlung maligner Lungenerkrankungen.

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Author information

Authors and Affiliations

  1. Chirurgische Klinik, Spital Limmattal, CH-8952, Schlieren-Zürich, Schweiz

    R. Inderbitzi

  2. Colorectal Department, Cleveland Clinic Florida, Fort Lauderdale, FL, 33309, USA

    A. Ulrich, S. M. Cohen & S. D. Wexner

  3. Chirurgische Klinik, Stadtspital Waid, Tièchestraße, CH-8037, Zürich, Schweiz

    P. Buchmann, D. Christen & U. Bischofberger

  4. Institut für Pathologie, Universitätsspital, CH-8091, Zürich, Schweiz

    R. Flury

  5. Chirurgische Klinik, Evangelische Diakonissenanstalt Bremen, Gröpelinger Heerstraße 406/408, 28239, Bremen, Deutschland

    A. Franke, K. Lebrecht & H. A. Richter

  6. Chirurgische Klinik, Klinikum Großhadern, LMU München, Marchioninistraße 15, 81377, München, Deutschland

    M. M. Heiss, G. Meyer, C. P. Böllinger, K. U. Grützner & F. W. Schildberg

  7. Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Carl Gustav Carus, TU Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland

    U. Wehrmann, E. Stoelben, B. Schilling, M. Nagel & H. D. Saeger

  8. Abteilung für Abdominal-, Thorax-und endokrine Chirurgie, Städtisches Klinikum Nürnberg Nord, Flurstraße 17, 90419, Nürnberg, Deutschland

    M. Kästel & Ch. Gebhardt

  9. Chirurgische Abteilung, Bundeswehrkrankenhaus, 89085, Ulm, Deutschland

    F. Gebhard, H. P. Becker & H. Gerngroß

  10. Sektion Chirurgische Forschung, Chirurgische Klinik I, Universität Ulm, Parkstraße 11, 89073, Ulm, Deutschland

    U. B. Brückner

  11. Robert-Rössle-Klinik am Max-Delbrück-Centrum für Molekulare Medizin, Virchow-Klinikum, Humboldt-Universität zu Berlin, Lindenberger Weg 80, 13125, Berlin, Deutschland

    P. Hohenberger, B. Rau, M. Hünerbein & P. M. Schlag

  12. Abteilung für Allgemeine Chirurgie, Universitätsklinikum, Hufelandstraße 55, 45122, Essen, Deutschland

    K. Peitgen, M. K. Walz, M. V. Walz & F.-W. Eigler

  13. Sektion für Minimal Invasive Chirurgie, Eberhard-Karls-Universität, Geissweg 3, 72076, Tübingen, Deutschland

    K. Roth, H. Schrimm, J. P. Sieber & G. Bueß

  14. Sektion für Klinikhygiene, Eberhard-Karls-Universität, Geissweg 3, 72076, Tübingen, Deutschland

    P. Heeg

  15. Naturwissenschaftliches-Medizinisches Institut (NMI) Reutlingen, Deutschland

    R. Reichl

Authors
  1. R. Inderbitzi
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  2. A. Ulrich
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  3. S. M. Cohen
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  13. G. Meyer
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  15. K. U. Grützner
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  27. U. B. Brückner
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  28. P. Hohenberger
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  29. B. Rau
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  30. M. Hünerbein
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  31. P. M. Schlag
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  32. K. Peitgen
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  33. M. K. Walz
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  34. M. V. Walz
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  35. F.-W. Eigler
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  36. K. Roth
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  37. H. Schrimm
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  38. J. P. Sieber
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  39. P. Heeg
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  40. R. Reichl
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  41. G. Bueß
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Editor information

Editors and Affiliations

  1. Steinhölzle 16, D-89197, Westerstetten-Vorderdenkental, Deutschland

    W. Hartel

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Inderbitzi, R. et al. (1995). Entwicklungsstand in der Thoraxchirurgie. In: Hartel, W. (eds) Qualitätssicherung durch Zusammenarbeit in der Chirurgie. Langenbecks Archiv für Chirurgie, vol 1995. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-85235-0_14

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  • DOI: https://doi.org/10.1007/978-3-642-85235-0_14

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