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Chirurgische Therapie von Lebermetastasen

  • Chapter
Praxis der Viszeralchirurgie

Zusammenfassung

Die meisten Erfahrungen mit der chirurgischen Therapie von Lebermetastasen existieren weltweit mit Metastasen kolorektaler Karzinome. Trotz fehlender randomisierter Studien muss den Resektionsverfahren eine Prognoseverbesserung zugebilligt werden. Das Fünfjahresüberleben kurativ operierter Patienten mit Lebermetastasen beträgt zwischen 24 und 40%. Spontanverläufe ohne Operation überleben fast nie die 5 Jahre nach Diagnosestellung. Einschränkungen in der chirurgischen Therapie dieser Absiedlungen werden zunehmend liberaler gehandhabt. Jede Lebermetastase, die sich technisch und funktionell entfernen lässt, kann einer Leberresektion zugeführt werden, vorausgesetzt jeglicher extrahepatischer Tumor ist beherrscht. Diese weitreichende Indikationsstellung wird zunehmend auf andere Tumorentitäten übertragen. Hier fehlen jedoch noch verlässliche Zahlen. Je aggressiver die Indikationsstellung erfolgt, desto exakter muss die Planung der Resektion sein, um ein größtmögliches Restlebervolumen mit maximaler Funktion zu erhalten. Dies wird bereits an einzelnen Zentren mit Hilfe virtueller OP-Planung am Computer durchgeführt.

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Authors
  1. W. Lamadé
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  2. C. Herfarth
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Editors and Affiliations

  1. Chirurgische Klinik und Poliklinik, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland

    J. R. Siewert

  2. Department für Chirurgie, Kantonsspital Basel, Spitalstraße 21, 4031, Basel, Schweiz

    F. Harder

  3. Klinik für Allgemeinchirurgie, Zentrum für Operative Medizin I, Baldingerstraße, 35043, Marburg, Deutschland

    M. Rothmund

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Lamadé, W., Herfarth, C. (2001). Chirurgische Therapie von Lebermetastasen. In: Siewert, J.R., Harder, F., Rothmund, M. (eds) Praxis der Viszeralchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-09420-4_33

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  • DOI: https://doi.org/10.1007/978-3-662-09420-4_33

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