Evidence-based Chirurgie des Rektumkarzinoms

Evidence-based surgery of rectal cancer

Summary

The surgery of rectal cancer has seen significant development in recent years. When there is a multitude of therapeutic options available, it is essential to identify what can be considered a proven standard or, at least, what has to be included in planning a surgical treatment. Therefore, at this point of time a distal resection margin of 2 cm, total mesorectal excision, en-bloc resection of adherent structures, colonic pouch reconstruction after very deep resections and limitation of local excision to T1/G1 tumors have to be regarded as standards of the surgical strategy.

Zusammenfassung

Die Chirurgie des Rektumkarzinoms hat sich in den letzten Jahren stark weiterentwickelt. Bei einer Vielzahl von verfügbaren Therapieoptionen gilt es herauszufiltern, was derzeit als gesicherter Standard zu fordern oder zumindest in die therapeutischen Überlegungen zum Einzelfall mit in Betracht zu ziehen ist. Als Eckpfeiler des chirurgischen Vorgehens beim Rektumkarzinom sind ein distaler Sicherheitsabstand von 2 cm, die totale Mesorektumexzision, die en-bloc-Resektion bei Adhärenzen zu Nachbarstrukturen, die Kolon-Pouch-Rekonstruktion nach sehr tiefen Resektionen und die Begrenzung von lokalchirurgischen Maßnahmen auf T1/G1-Malignome anzusehen.

Key words

Rectal cancer - surgery - standards - evidence-based medicine

Schlüsselwörter

Rektumkarzinom - Chirurgie - Standards - Evidence-based medicine

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