Zusammenfassung
Auch bei ausgedehnten abdominellen Tumoroperationen wie der Zytoreduktion und der hyperthermen intraperitonealen Chemotherapie (HIPEC) sollten heute die Prinzipien der Enhanced-Recovery-After-Surgery-Programme (ERAS) verfolgt werden. Dies beginnt mit der Kooperation des gut informierten und vorbereiteten Patienten. So ist für Patienten mit kolorektalem Karzinom bei guter Adhärenz im Rahmen des ERAS-Protokolls eine signifikante Verlängerung des Langzeitüberlebens gezeigt worden (Gustafson et al. 2016). Metabolisches Problem ist das besonders ausgedehnte Operationstrauma mit der nachfolgend immunsupprimierenden intraoperativen Chemotherapie bei einer durch Tumorlast und/oder vorausgegangene Chemotherapie oftmals bereits präoperativ geschwächten Immunabwehr.
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Weimann, A., Mantovani-Löffler, L. (2018). Präoperatives Management bei Tumoren des Peritoneums. In: Rau, B., Piso, P., Königsrainer, A. (eds) Peritoneale Tumoren und Metastasen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54500-3_31
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