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Chirurgische Therapie von Lungenmetastasen

Surgical therapy of lung metastases

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Zusammenfassung

Die chirurgische Therapie von Lungenmetastasen extrathorakaler Malignome ist etabliert. Eine pulmonale Metastasierung ist häufig. In der Regel sind Lungenmetastasen peripher gelegen und asymptomatisch. Durch Tumoreinbruch in das Bronchialsystem oder die Brustwand kann es zu Beschwerden kommen. Die Indikation zur Resektion wird interdisziplinär gestellt. Sie kann in kurativer und palliativer Intention erfolgen. Voraussetzung hierfür ist, dass der Primärtumor kontrolliert ist, dass extrathorakale Metastasen sowie alternative Erfolg versprechende Therapieformen fehlen und alle Metastasen komplett, mit vertretbarem allgemeinem und funktionellem Risiko, resezierbar sind. Es dominieren extraanatomische Resektionen. Die perioperative Morbidität und Mortalität ist niedrig. Es besteht bei einem selektionierten Patientenkollektiv die Möglichkeit der Kuration.

Abstract

Surgical treatment of lung metastases from extrathoracic malignancies is an established procedure. Pulmonary metastases are common. Generally, lung metastases are located peripherally and are asymptomatic. Involvement of the bronchial system or infiltration of the chest wall can be symptomatic. The indications for resection are an interdisciplinary decision. Metastasectomy can be with curative or palliative intent. Prerequisitess for pulmonary metastasectomy are primary tumor under control, the absence of extrathoracic metastases, the lack of other promising treatment options, the possibility for complete resection and low perioperative risk. Extra-anatomic resections are common. Perioperative morbidity and mortality is low. A cure is possible in selected patients.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Schirren, S. Bölükbas, S. Oguzhan, S. Sponholz und J. Schirren geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Thoraxchirurgie, Dr. Horst Schmidt Klinik, Ludwig-Erhard-Str. 100, 65199, Wiesbaden, Deutschland

    M. Schirren, S. Bölükbas, S. Oguzhan, S. Sponholz &  J. Schirren

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  1. M. Schirren
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  2. S. Bölükbas
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  3. S. Oguzhan
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  4. S. Sponholz
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  5. J. Schirren
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Correspondence to J. Schirren.

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Schirren, M., Bölükbas, S., Oguzhan, S. et al. Chirurgische Therapie von Lungenmetastasen. Chirurg 85, 833–844 (2014). https://doi.org/10.1007/s00104-013-2685-7

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  • DOI: https://doi.org/10.1007/s00104-013-2685-7

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