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Der Klinikarzt 2008; 37(9): 422-425
DOI: 10.1055/s-0028-1103009
In diesem Monat

© Georg Thieme Verlag Stuttgart · New York

Endoskopische Resektion von Frühtumoren im oberen Gastrointestinaltrakt – Diagnose und Therapie früher Neoplasien

Endoscopic resection of early tumours in the upper gastro–intestinal tract – Diagnosis and therapy of early neoplasiasLiebwin Goßner1
  • 11. Medizinische Klinik – Gastroenterologie / Diabetologie, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg(Direktor: Prof. Dr. L. Goßner)
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Publication History

Publication Date:
30 October 2008 (online)

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Die endoskopische Mukosaresektion und – als ihre Erweiterung – die endoskopische Submukosadissektion haben sich in den letzten Jahren weltweit zunehmend in der Therapie gastrointestinaler Präkanzerosen und Frühkarzinome etabliert. Ist das Frühkarzinom des Barrett–/Ösophagus auf die Mukosa oder im Magen auf das obere Drittel der Submukosa begrenzt und finden sich keine mikrolymphangischen (L +/–) und mikrovenösen (V +/–) Tumorinfiltrationen, ist die endoskopische Resektion als Therapieverfahren der Wahl anzusehen. Sollte sich nach einer endoskopischen Resektion ein höheres Tumorstadium im Sinne einer tieferen Submukosainfiltration diagnostizieren lassen, besteht unverändert die Möglichkeit der chirurgischen Nachresektion, falls der Patient operabel ist.

Endoscopic resection of the mucosa – and its elaborationž endoscopic dissection of the submucosa – have become more and more established on a world–wide scale during the past few years in the treatment of gastro–intestinal precanceroses and early carcinomas. If the early carcinoma of Barrett's esophagus (Barrett's syndrome) is restricted to the mucosa or in the stomach to the upper third of the submucosa and if there are no microlymphangial (L +/–) and microvenous (V +/–) tumourous infiltrations, endoscopic resection must be considered to be the therapy of choice. In case a progressed stage of tumour is diagnosed after an endoscopic resection – the tumour signifying a deeper infiltration of the submucosa – there is always the possibility of subsequent surgical resection, provided the patient's condition permits surgery.

Key words

endoscopic resection of the mucosa - endoscopic resection of the submucosa - gastro–intestinal precanceroses - gastro–intestinal early carcinomas - Barrett's syndrome

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Korrespondenz

Prof. Dr. Liebwin Goßner

Medizinische Klinik, SKK Städtisches Klinikum Karlsruhe Akademisches Lehrkrankenhaus der Universität Freiburg

Moltkestraße 90

76133 Karlsruhe

Email: liebwin.gossner@klinikum-karlsruhe.de