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Part of the book series: Evidenzbasierte Chirurgie ((EC))

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Zusammenfassung

Die peritoneale Metastasierung gastrointestinaler Tumoren wurde früher grundsätzlich palliativ behandelt. Die kombinierte Behandlungsstrategie der „zytoreduktiven Chirurgie“ und „hyperthermen intraperitonealen Chemotherapie“ (HIPEC) nutzt Verfahren der Peritonektomie und viszeralen Organresektionen, um Tumorformationen vollständig zu entfernen oder zu reduzieren. Im Anschluss wird die HIPEC durchgeführt, um potenziell verbliebene minimale Tumormasse zu beseitigen. Für das Pseudomyxoma peritonei und das maligne peritoneale Mesotheliom hat sich die Kombinationstherapie inzwischen als Therapiestandard etabliert. Viele Autoren plädieren auch dafür, diese Therapieform bei Peritonealkarzinose kolorektaler Tumoren und Tumoren der Appendix als Therapiestandard zu sehen. Für aggressivere Tumoren wie z. B. das peritoneal metastasierte Magenkarzinom ist die Studienlage weniger deutlich. Zur Behandlung peritoneal metastasierter Pankreas- oder Dünndarmkarzinome liegen kaum Studien vor.

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Yurttas, C., Struller, F., Horvath, P., Königsrainer, A., Beckert, S. (2018). Peritonektomie und HIPEC. In: Germer, CT., Keck, T., Grundmann, R.T. (eds) Evidenzbasierte Viszeralchirurgie maligner Erkrankungen. Evidenzbasierte Chirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-56533-9_14

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