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Operative Therapie der abdominellen und retroperitonealen Sarkome

Operative therapy of abdominal and retroperitoneal sarcoma

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An Erratum to this article was published on 09 August 2014

Zusammenfassung

Retroperitoneale Weichgewebssarkome neigen in hohem Maße zum Lokalrezidiv. Die komplette chirurgische Tumorresektion stellt die einzige potenziell kurative Therapieoption dar. Bei der systematischen abdominellen Kompartmentresektion wird der Tumor en bloc mit einem Saum von nicht infiltriertem Gewebe und Organen entfernt. Hierzu gehören häufig eine Niere, ein Hemikolon, linksseitig der Pankreasschwanz sowie Anteile des Zwerchfells und des Musculus psoas. Weitere Organe und Gefäße werden je nach Infiltration mitentfernt. Durch dieses aggressive Vorgehen können im Vergleich zu weniger radikalen Operationsverfahren häufiger histologisch tumorfreie Resektionsränder und letztlich eine geringere Lokalrezidivrate erreicht werden. Der Artikel beschreibt detailliert das chirurgische Vorgehen und die perioperative Behandlung der Patienten sowie die Ergebnisse der operativen Therapie. Ausführlich werden die Einbindung in ein immer notwendiges onkologisches Therapiekonzept und die Bedeutung spezialisierter Zentren diskutiert.

Abstract

Retroperitoneal soft tissue sarcomas are characterized by a high rate of local recurrence. Complete tumor resection is the only potentially curative therapeutic option. The concept of a systematic compartmental resection is to remove the tumor en bloc with a margin of uninvolved tissue and organs. This is frequently only achieved by multivisceral resection which often includes kidney, colon, pancreas and parts of the diaphragm or the psoas muscle. The adoption of such a policy of multivisceral organ resection improves the proportion of curative resections and, ultimately, results in lower local recurrence rates. The present article comprehensively describes the operative procedures, perioperative treatment and the oncological results of surgery for retroperitoneal sarcomas. The role of surgery in oncological treatment plans and the importance of specialized centres are outlined in detail.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Albertsmeier, J. Werner, L.H. Lindner, C. Belka, R.D. Issels und M.K. Angele geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Allgemeine, Viszeral-, Transplantations-, Gefäß- und Thoraxchirurgie, Klinikum der Universität München – Standort Großhadern, Marchioninistr. 15, 81377, München, Deutschland

    M. Albertsmeier, J. Werner &  M.K. Angele

  2. Medizinische Klinik und Poliklinik III, Klinikum der Universität München – Standort Großhadern, München, Deutschland

    L.H. Lindner & R.D. Issels

  3. Klinik und Poliklinik für Strahlentherapie, Klinikum der Universität München – Standort Großhadern, München, Deutschland

    C. Belka

Authors
  1. M. Albertsmeier
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  2. J. Werner
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  3. L.H. Lindner
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  4. C. Belka
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  5. R.D. Issels
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  6. M.K. Angele
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Correspondence to M.K. Angele.

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Albertsmeier, M., Werner, J., Lindner, L. et al. Operative Therapie der abdominellen und retroperitonealen Sarkome. Chirurg 85, 391–397 (2014). https://doi.org/10.1007/s00104-013-2688-4

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  • DOI: https://doi.org/10.1007/s00104-013-2688-4

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