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Chirurgie des Kolonkarzinoms

Surgery for colon cancer

  • Leitthema
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Die onkologische Resektion mit zentraler Ligatur der versorgenden Gefäße und radikulärer Lymphadenektomie ist Standard in der Chirurgie des Kolonkarzinoms. Die laparoskopische Therapie stellt eine alternative Therapieform beim Kolonkarzinom dar, wobei hier jedoch gewisse Einschränkungen hinsichtlich Tumorgröße, Lokalisation und Selektion der Patienten bestehen. Bei lokal fortgeschrittenen Kolonkarzinomen wird eine multiviszerale Resektion mit Entfernung der befallenen Nachbarorgane durchgeführt, da Patienten nach einer kurativen (R0) multiviszeralen Resektion eine gute Prognose aufweisen. Neueste Daten legen nahe, dass nicht nur beim Rektumkarzinom, sondern auch beim Kolonkarzinom die Prognose der Patienten signifikant von der adäquaten chirurgischen Therapie und Erfahrung des behandelnden Zentrums abhängt. Das früher eher konservative postoperative Management hat sich in den letzten Jahren im Rahmen des „Fast-Track“-Konzepts mit sofortigem enteralem Kostaufbau und rascher Mobilisation sowie Entlassung der Patienten deutlich verändert.

Abstract

Radical resection with central ligation of the vessels and radical lymphadenectomy remains the surgical standard for treating colon cancer. It has been shown that laparoscopic surgery for colon cancer can be an alternative treatment option, although there are still limitations for the use of this technique. A multivisceral resection with resection of the involved organs is the treatment of choice for locally advanced colon cancer. The prognosis for these patients is very good if a curative (R0) resection can be achieved. Recent data suggest that the quality of surgery with an adequate dissection plane is important not only for rectal cancer but also for colon cancer. It has also been shown that the prognosis for colon cancer patients depends significantly on the surgeon’s experience and the patient volume of the treating institution. The postoperative management has now changed to a fast-track concept with immediate enteral nutrition and early recovery of the patients.

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Authors and Affiliations

  1. Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Chirurgische Universitätsklinik Heidelberg, INF 110, 69120, Heidelberg, Deutschland

    M. Koch & J. Weitz

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  1. M. Koch
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  2. J. Weitz
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Correspondence to M. Koch.

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Koch, M., Weitz, J. Chirurgie des Kolonkarzinoms. Onkologe 15, 1206–1214 (2009). https://doi.org/10.1007/s00761-009-1721-1

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