Zusammenfassung
Intrathorakale Tumormanifestationen vermögen die Integrität der Herz- und Lungenfunktion akut zu beeinträchtigen. Blutungen, Ergussansammlungen und der Pneumothorax stehen pathogenetisch im Vordergrund, seltener sind die akute obere Einflussstauung oder intrakardiale Tumormanifestationen mit der Gefahr der Embolisierung. Nur durch rasche Erkennung, korrekte Interpretation und gezielte Erstversorgung kann der Patient stabilisiert werden. Unerlässlich sind dabei Erfahrungen in der Anwendung der Tracheobronchoskopie und der Pleura- und Perikarddrainageneinlage. Eine definitive operative Versorgung des Patienten muss stets erwogen werden, sofern dies in Anbetracht der tumorbedingten Prognose geboten scheint. Der Eingriff gehört aber in die Hand eines erfahrenen Thoraxchirurgen, zumal im Einzelfall ein kurativer Ansatz nicht a priori ausgeschlossen ist.
Abstract
Intrathoracic malignant tumors potentially interfere acutely with cardiac and pulmonary functions. Bleeding, pleural and pericardial effusion and pneumothorax prevail, while superior vena cava syndrome and embolization from tumors with extension into the cardiac cavities are rare. Immediate diagnosis, correct interpretation and the corresponding intervention are mandatory. It is essential to be familiar with tracheo-bronchoscopy and techniques concerning introduction of pleural and pericardial tubes or catheters. Surgical intervention has to be discussed as far as it seems reasonable taking the individual tumor-related prognosis into consideration. All operations should be performed by an experienced general thoracic surgeon as in some patients there is chance of an operation with curative intent.
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Dienemann, H., Schneider, T. Intrathorakale onkologische Notfälle. Onkologe 16, 383–389 (2010). https://doi.org/10.1007/s00761-010-1803-0
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DOI: https://doi.org/10.1007/s00761-010-1803-0