Peritoneal metastasiertes kolorektales Karzinom: zytoreduktive Chirurgie und hypertherme intraperitoneale Chemotherapie

Zusammenfassung

Die Peritonealkarzinose eines kolorektalen Karzinoms gilt nach wie vor als terminales Tumorstadium. Durch ein multimodales Therapiekonzept bestehend aus einer maximalen Zytoreduktion, gefolgt von einer hyperthermen intraperitonealen Chemotherapie (HIPEC), kann bei ausgewählten Patienten potenziell ein Langzeitüberleben erreicht werden. Eine ausschließlich palliative systemische Therapie bei isolierter Peritonealkarzinose entspricht somit nicht mehr modernen Gesichtspunkten. In diesem Artikel werden Aspekte der Erkrankung, die Rationale für eine Peritonektomie mit HIPEC und das chirurgische Vorgehen der Peritonealkarzinose beleuchtet.

Abstract

Peritoneal carcinomatosis caused by colorectal carcinoma is still considered as the end-stage of disease. A multi-modal therapeutic concept including maximal cytoreduction followed by intraperitoneal hyperthermic chemotherapy (HIPEC) has the potential to cure selected patients. In case of peritoneal carcinomatosis palliative systemic treatment is no longer the state of the art. This article addresses aspects of the disease, the rationale behind peritonectomy with HIPEC, and the surgical management of peritoneal carcinomatosis.

Peritonealkarzinose - kolorektales Karzinom - Peritonektomie - hypertherme intraperitoneale Chemotherapie (HIPEC)

peritoneal carcinomatosis - colorectal carcinoma - peritonectomy - hyperthermic intraperitoneal chemotherapy (HIPEC)

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