Zusammenfassung
Ein wesentlicher Bestandteil der Thoraxonkologie ist die korrekte Diagnosesicherung sowie die präzise Stadieneinteilung der zugrunde liegenden Tumorerkrankung. Dabei stehen verschiedenste anatomische und metabolische bildgebende Verfahren sowie endoskopische und minimalinvasiv-chirurgische Prozeduren zur Verfügung, welche wohlbedacht und in sinnvoll sequenziellem Arrangement mit einem zunehmenden Maße an Invasivität zur Anwendung kommen sollten. Ein adäquater Algorithmus zum präoperativen mediastinalen Staging sieht daher in der Reihenfolge der Untersuchungsmethoden häufig endosonografische Techniken (EUS-FNA, EBUS-FNA) vor dem chirurgisch-invasiven Staging mittels videoassistierter mediastinoskopischer Lymphadenektomie (VAMLA) vor. Da das Grundprinzip der systematischen Lymphknotendissektion mittels VAMLA in der kompletten Entfernung aller potenziell involvierten Lymphknoten sowie des sie umgebenden lymphatischen Fettgewebes besteht und somit der feingewebliche Untersuchungsbefund den höchsten Genauigkeitsgrad aller Untersuchungsmethoden besitzt, ist die VAMLA unverzichtbarer Goldstandard in der Thoraxonkologie.
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Hartert, M., Hürtgen, M. (2021). Chirurgisch-invasive Diagnostik in der Thoraxchirurgie. In: Hoffmann, H., Ludwig, C., Passlick, B. (eds) Thoraxchirurgie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-59159-8_10-1
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