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Minimal-invasive Therapie "früher" Tumoren

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Der Begriff eines "frühen Tumors" ist nicht eindeutig definiert. In Rahmen dieser Übersicht werden darunter Adenome verstanden, die nach der allgemein akzeptierten Theorie der "Adenom-Karzinom-Sequenz" Vorläufer des Karzinoms sind, Adenome mit schwerer Dysplasie und maligne Polypen. Im Folgenden werden die flexibel-endoskopischen und die kombiniert flexibel-endoskopischen/minimal-invasiv chirurgischen Therapieverfahren besprochen. Die rein chirurgischen Methoden, die transanale endoskopische Mikrochirurgie (TEM; [4]), die "klassische" minimal invasive Chirurgie und die Resektion im Rahmen der offenen Laparotomie werden hier nicht behandelt.

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Literatur

  1. Ahmad NA, Kochman ML, Long WB et al. (2002) Efficacy, safety, and clinical outcomes of endoscopic mucosal resection: a study of 101 cases. Gastrointest Endosc 55: 390

    Google Scholar 

  2. Beck DE, Karnulf RE (1993) Laparoscopic-assisted full-thickness endoscopic polypectomy. Dis Colon Rectum 36: 693–695

    Google Scholar 

  3. Binmoeller KF, Bohnacker S, Seifert H et al.(1996) Endoscopic snare excision of "giant" colorectal polyps. Gastrointest Endosc 43: 183–188

    Google Scholar 

  4. Buess G, Kipfmüller K, Hack G, Grussner R, Heintz A, Junginger T (1988) Technique of transanal endoscopic microsurgery. Surg Endosc 2: 51–55

    Google Scholar 

  5. Christie JP, Marrazzo J (1991) "Mini-perforation" of the colon—not all postpolypectomy perforations require laparotomy. Dis Colon Rectum 34: 132–135

    Google Scholar 

  6. Coverlizza S, Risio M, Ferrari A et al.(1989) Colorectal adenomas containing invasive carcinoma: pathologic assessement of lymph node metastatic potential. Cancer 64: 1937

  7. Dell'Abate P, Iosca A, Galimberti A et al.(2001) Endoscopic treatment of colorectal benign-appearing lesions 3 cm or larger: techniques and outcome. Dis Colon Rectum 44: 112–118

    Google Scholar 

  8. Docherty JG, McGegor JR, Murat Akyol A et al.(1995) Comparison of manually constructed and stapled anastomoses in colorectal surgery. Ann Surg 221: 176–184

    Google Scholar 

  9. Dollhopf M, Heldwein W, Schmidtsdorff P et al.(2002) Risk facors for perforation after polypectomy: results of the Munich polypectomy study (MUPS) (Part 1). Gastrointest Endosc 55: 596 (abstract)

    Google Scholar 

  10. Feussner H, Allescher HD, Harms J (2000) Rationale und Selektion für Kombinationsvorgehen bei Colondysplasien und T1-Carcinomen. Chirurg 71: 1202–1206

    Google Scholar 

  11. Fingerhut A, Hay JM, Elhadad A, Lacaine F, Flamant Y, The French Association for surgical research (1995) Supraperitoneal colorectal anastomosis: hand-sewn versus circular staples. A controlled clinical trial. Surgery 118: 479–495

  12. Franklin ME, Diaz JA, Abrego D et al.(2000) Laparoscopic-assisted colonoscopic polypectomy: the Texas Endosurgery Institute experience. Dis Colon Rectum 43: 1246–1249

    Google Scholar 

  13. Frühmorgen P, Kriel L (1998) Guidelines of the German Society of Digestive and Metabolic Diseases. Guidelines for endoscopic colorectal polypectomy with the sling. Z Gastroenterol 36: 117–119

    Google Scholar 

  14. Gibbs DH, Opelka FG, Beck DE et al.(1996) Postpolypectomy colonic hemorrhage. Dis Colon Rectum 10: 666–667

    Google Scholar 

  15. Gunaratnam NT, M Kathawala, C Gostout et al.(2002) Overview of endoscopic mucosal resection of gatrointestinal tumors. UpToDate 1–8

  16. Habr-Gama, Waye JD (1989) Complications and hazards of gastrointestinal endoscopy. World J Surg 13: 193–201

  17. Hachisu T (1988) Evaluation of endoscopic hemostasis using an improved clipping apparatus. Surg Endosc 2: 13–17

    Google Scholar 

  18. Hart AR, Kudo S, Mackay EH, Mayberry JF, Atkin WS (1998) Flat adenomas exist in asymptomatic people: important implications for colorectal cancer screening programmes. Gut 43: 229–231

    Google Scholar 

  19. Heldwein W, Dollhopf M, Schmidtsdorff P et al. (2002) Risk facors for bleeding after polypectomy: results of the Munich polypectomy study (MUPS) (Part 2). Gastrointest Endosc 55: 597 (abstract)

    Google Scholar 

  20. Hensman C, Luck AJ, Hewett PJ (1999) Laparoscopic-assisted colonoscopic polypectomy: technique and preliminary experience. Surg Endosc 13: 231–232

    Google Scholar 

  21. Inoue H, Takeshita K, Hori H et al.(1993) Endoscopic mucosal resection with a cap-fitted panendoscope for esophagus, stomach, and colon mucosal lesions. Gastrointest Endosc 39: 58–62

    Google Scholar 

  22. Ishiguro A, Uno Y, Ishiguro Y, Munakata A, Morita T (1999) Correlation of lifting versus non-lifting and microscopic depth of invasion in early colorectal cancer. Gastrointest Endosc 50: 329–333

    Google Scholar 

  23. Itzkowitz SH (2002) Colonic polyps and polyposis syndromes. In: Feldmann M, Friedmann LS, Sleisenger LH (eds) Gastrointestinal and liver disease. Saunders, Philadelphia, pp 2175–2214

  24. Jaramillo E, Watanabe M, Slezak P, Rubio C (1995) Flat neoplastic lesions of the clon and rectum detected by high-resolution video endoscopy and chromoscopy. Gastrointest Endosc 42: 114–122

    Google Scholar 

  25. Kim J, Chung M, Shim M, Kwun K (1996) Laparoscopic wedge resection of the cecum, assisted by colonoscopy. Coloproctology18: 158

  26. Mal F, Perniceni T, Levard H et al.(1998) Polypes coliques considérés comme non réséctables endoscopiquement. Gastroenterol Clin Biol 22: 425–430

    Google Scholar 

  27. Mann B, Kleinschmidt S, Stremmel W (1996) Prospective study of hand sutured anastomosis after colorectal resection. Br J Surg 83: 29–31

    Google Scholar 

  28. Miller RE, Bossart PM, Tiszenkel HI, Kimmelstiel FM (1991) Surgical management of complications fiberoptic colonoscopy. Surg Laparosc Endosc 1: 236–239

    Google Scholar 

  29. Muto T, Mamiya J, Sawada T et al.(1985) Small "flat adenoma" of the large bowel, with special reference to its clinicopathologic features. Dis Colon Rectum 28: 847–851

    Google Scholar 

  30. Nahas SC, Alves PR, BorbaMR et al.(1999) Polypectomies: colonic endoscopic resections. Arq Gastroenterol 36: 133–138

  31. Parra-Blanco A, Kaminage N, Kojima T, Endo Y et al.(2000) Hemoclipping for postpolypectomy and postbiopsy colonic bleeding. Gastrointest Endosc 51: 37–41

    Google Scholar 

  32. Prifti SK, Benjamin SB (1997) Complications of gastrointestinal endoscopy. In: Di Marino AJ, Benjamin SB (eds) Gastrointestinal disease: an endoscopic approach. Blackwell, Oxford, pp 57–92

  33. Rankin GB (1987) Indications, contraindications and complications of colonoscopy. In: Sivak MV (eds) Gastroenterologic endoscopy. Saunders, Philadelphia

  34. Schlemper RJ, Kato Y, Stolte M (1999) Welldifferentiated adenocarcinoma or dysplasia of the gastric epithelium: rationale for a new classification system. Verh Dtsch Ges Pathol 83: 62–70

    Google Scholar 

  35. Schlemper RJ, Ridell RH, Kato Y et al.(2000) The Vienna classification of gastrointestinal epitheliae neoplasia. Gut 47: 251–255

    Google Scholar 

  36. Schlemper RJ, Hirata I, Dixon MF (2002) The macroscopic classification of early neoplasia of the digestive tract. Endoscopy 34: 163–168

    Google Scholar 

  37. Schmiegel W, Adler G, Fruhmorgen P et al.(2000) Colorectal carcinoma: prevention and early detection in an asymptomatic population—prevention in patients at risk—endoscopic diagnosis, therapy and after-care of polyps and carcinomas. German Society of Digestive and Metabolic Diseases/Study Group for Gastrointestinal Oncology. Z Gastroenterol 38: 49–75

    Google Scholar 

  38. Schmitt W, Gospos J, Heid T, Dollhopf M (2001) Endoskopische Therapie der kolorektalen Neoplasie—neue Technik. Dtsch Med Wochenschr 126: S150–154

  39. Shinya H (1982) Complications prevention and management. In: Shinya H (ed) Colonoscopy: diagnostic and treatment of colonic diseases. Igaku-Shoin, New York, pp 199–208

  40. Slim K, Pezet D, Riff Y et al. (1995) High morbidity rate after converted laparoscopic colorectal surgery. Br J Surg 82: 1402–1408

    Google Scholar 

  41. Stolte M (2001) Die neue "Wien Klassifikation" der epithelialen Neoplasien des Gastrointestinaltrakts. Pathologe 22: 4–12

    Google Scholar 

  42. Tanaka S, Haruma K, Nagata S et al.(2000) Clinical significance of magnifying observation using videocoloscope for the invasion depth diagnosis of colorectal neoplasia. Gastrointest Endosc 51: AB 80

  43. Uno Y, Munakata A (1994)The non-lifting sign of invasive colon cancer. Gastrointest Endosc 40: 485–489

    Google Scholar 

  44. Waye JD, Lewis BS, Yessayan S (1992) Colonoscopy: a prospective report of complications. J Clin Gastroenterol 15: 347–351

    Google Scholar 

  45. Waye JD (1997) New methods of polypectomy. Gastrointest Endosc Clin N Am 7: 413–422

    Google Scholar 

  46. Waye JD. Colonoscopic Polypectomy (2002) In: Classen M, GNJ Tytgat, CJ Lightdale (eds) Gastroenterological endoscopy. Thieme, Stuttgart

  47. Wolber RA, Owen DA (1991) Flat adenomas of the colon. Hum Pathol 22: 70–74

    Google Scholar 

  48. Yoshikane H, Hidano H, Sakakibara A et al.(1999) Endoscopic resection of laterally spreading tumors of the large intestine using a distal attachement. Endoscopy 31: 426–430

    Google Scholar 

  49. Zuro LM, Mc Culloch CS, Saclarides TJ (1992) Laparoscopic colotomy, polypectomy. Innovative minimally invasive procedure. AORN J 56: 1068

    Google Scholar 

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Für die Unterstützung der LEP-Evaluation danken wir der Fa. Olympus Optical, Hamburg.

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Frimberger, E., Feussner, H., Allescher, H. et al. Minimal-invasive Therapie "früher" Tumoren . Internist 44, 302–310 (2003). https://doi.org/10.1007/s00108-003-0868-x

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