Zusammenfassung
Klinische Outcome-Studien und systematische Analysen entnommener Operationspräparate weisen auf notwendige Verbesserungen bei Rektumkarzinomen des unteren Drittels (LRC) hin. Der Vermeidung eines tumorbefallenen Resektionsrandes (CRM) kommt dabei besondere prognostische Bedeutung zu. Enge Kooperationen in multidisziplinären Teams (MDT) sind hier besonders erfolgreich. Als Beispiel wird die europäische MERCURY-Gruppe vorgestellt. Außerdem stellt dieses Kapitel eine neue, speziell auf LRC fokussierte MRT Bildgebung vor. Diese erstellt präoperative Warnhinweise für das operative Vorgehen und ermöglicht in bisher nicht bekannter Weise differenzierte und risikoangepasste Therapieentscheidungen. Chirurgen sind besonders gefordert, daher wird hier des weiteren eine eigene neu konzipierte Operationstechnik für eine abdominoperineale Rektumexstirpation (APE) vorgestellt.
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Straßburg, J., Püttcher, O., Reichelt, U. (2015). Tief gelegenes Rektumkarzinom: neue Herangehensweisen. In: Kreis, M., Straßburg, J. (eds) Moderne Chirurgie des Rektumkarzinoms. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40390-3_4
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