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Gastrointestinale Stromatumoren (GIST)

Chirurgische Therapie

Gastrointestinal Stromal Tumors (GIST)

Surgical therapy

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Zusammenfassung

Gastrointestinale Stromatumoren (GIST) sind die häufigsten mesenchymalen Tumoren des tubulären Gastrointestinaltraktes. Sie kommen insbesondere im Magen vor, in geringerer Häufigkeit im extraduodenalen Dünndarm, Kolon und Rektum und nur in Einzelfällen im Ösophagus und Duodenum. Primärziel der Therapie eines lokalisierten primären GIST ist die komplette Resektion, wobei aufgrund der Biologie dieser Tumorentität in der Regel keine Lymphadenektomie oder Resektion mit weitem Sicherheitsabstand erforderlich ist. Daher sind Wedge-Resektionen des Magens oder Segmentresektionen des Dünndarms die häufigsten Eingriffe zur Therapie eines primären GIST. Insbesondere die chirurgische Therapie von primär ausgedehnten Tumoren, von GIST-Metastasen und -Rezidiven sollte in ein multimodales Therapiekonzept unter Anwendung von Tyrosinkinaseinhibitoren, wie z. B. Imatinib, integriert werden.

Abstract

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal neoplasms of the gastrointestinal tract. GIST occur predominantly in the stomach and less frequently in the extraduodenal small bowel, the colon, and the rectum; rarely, GIST can be found in the esophagus and the duodenum. Due to their biological behavior, the primary treatment goal for localized primary GIST is complete resection, without the need for lymphadenectomy or wide resection margins. Thus, gastric wedge resections and segmental resections of the small bowel are the most common surgical procedures for treating primary GIST. Surgical therapy of extensive primary tumors or of metastatic or recurrent GIST should be integrated into a multimodal therapeutic concept that includes targeted therapy with tyrosine kinase inhibitors, such as imatinib.

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  1. Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    M.N. Wente M.Sc., M.W. Büchler & J. Weitz

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  1. M.N. Wente M.Sc.
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  2. M.W. Büchler
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  3. J. Weitz
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Correspondence to M.N. Wente M.Sc..

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Wente, M., Büchler, M. & Weitz, J. Gastrointestinale Stromatumoren (GIST). Chirurg 79, 638–643 (2008). https://doi.org/10.1007/s00104-008-1527-5

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