Konzept der chirurgischen Behandlung des Lymphabflusses bei malignen Tumoren des Kopf-Hals-Bereiches

  • J. A. Werner
Chapter

Zusammenfassung

In diesem Kapitel sollen gegenwärtig zur Anwendung kommende operative Behandlungskonzepte des Lymphabflusses bei malignen Kopf-Hals-Tumoren diskutiert werden. Die zu dieser Thematik vorliegende Vielzahl gegensätzlicher Literaturmitteilungen drückt die Uneinheitlichkeit der operativen Behandlungsstrategien bei zuvor genannter Indikation aus. Diese Problematik erklärt sich nicht zuletzt durch zahlreiche, mittlerweile mehr oder weniger anerkannte Varianten der Neck dissection, die in der Zwischenzeit um zusätzliche, so genannte limitierte selektive Neck-dissection-Formen (z.B. isolierte Ausräumung der Regionen II und III beim Pharynxkarzinom beim Nooder auch N+-Hals) ergänzt wurden. Eben dieses breite Behandlungsspektrum macht es zum gegenwärtigen Zeitpunkt sehr schwierig, einen allgemein gültigen Vorschlag zur Therapie des Lymphabflusses bei Kopf-Hals-Malignomen zu erarbeiten. So gilt es zunächst, nach onkologischen Gesichtspunkten anerkannte Behandlungsvorschläge zur operativen Therapie des No-Halses, des N+-Halses sowie von Lymphknotenmetastasen bei unbekanntem Primärtumor zu erfassen und auf deren Grundlage eine Diskussion mit den erwähnten, im Behandlungsausmaß reduzierten chirurgischen Konzepten zu führen.

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