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CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2022; 82(12): 1368-1377
DOI: 10.1055/a-1787-9144
DOI: 10.1055/a-1787-9144
GebFra Science
Review
Laparoskopische Chirurgie bei ovariellen Neoplasien – was ist möglich, was ist sinnvoll?
Article in several languages: English | deutsch
Zusammenfassung
Durch den technischen Fortschritt und die zunehmende chirurgische Expertise gewinnt der Einsatz minimalinvasiver Operationstechniken auch in der gynäkologischen Onkologie zunehmend an Stellenwert. Neben dem Einsatzgebiet der Laparoskopie bei der Behandlung benigner Neoplasien haben sich minimalinvasive Operationsmethoden auch in einigen Bereichen der Behandlung gynäkologischer Malignome etabliert. Bei Tumorentitäten wie dem Endometrium- und Zervixkarzinom liegen bereits aussagekräftige Studien zum Stellenwert der Laparoskopie in der operativen Therapie vor. Im Gegensatz dazu kann bei der operativen Therapie des Ovarialkarzinoms aufgrund fehlender prospektiver Daten mit Überlebenszeitanalysen keine eindeutige Aussage zum Stellenwert des laparoskopischen Zugangswegs getroffen werden. Einige kleinere und größtenteils retrospektive Fallkontroll- und Kohortenstudien lassen jedoch die Diskussion zu, dass laparoskopische Operationsverfahren, vor allem beim frühen Ovarialkarzinom, einerseits technisch durchführbar sowie qualitativ gleichwertig und andererseits mit einer geringeren perioperativen Morbidität im Vergleich zur klassischen offen-chirurgischen Längslaparotomie assoziiert sein könnten.
In dem vorliegenden Artikel werden auf der Basis der aktuellen Literatur die wichtigsten Gesichtspunkte in Bezug auf den Einsatz minimalinvasiver Operationstechniken beim Ovarialkarzinom diskutiert. Dabei wird insbesondere auf den Stellenwert der Laparoskopie als primären Zugangsweg für das operative Staging beim frühen Ovarialkarzinom eingegangen und die Rolle der diagnostischen Laparoskopie zur Operabilitätseinschätzung beim fortgeschrittenen Ovarialkarzinom bewertet.
Publication History
Received: 27 June 2022
Accepted after revision: 21 October 2022
Article published online:
01 December 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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