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DOI: 10.1055/s-0038-1630032
Neurochirurgische Onkologie
Radikalität versus FunktionserhaltSurgical neurooncologyRadicalism versus functional integrityPublikationsverlauf
Publikationsdatum:
30. Januar 2018 (online)
Zusammenfassung
In der neurochirurgischen Onkologie gilt heute mehr denn je das Primat des Funktionserhaltes bei gleichzeitigem Streben nach größtmöglicher Radikalität. Eine Vielzahl von Techniken ermöglicht uns heute, Tumore vollständiger zu entfernen als früher. „Radikalität“ um jeden Preis ist jedoch nicht mehr zeitgemäß und wird von Patienten und ihren behandelnden Ärzten auch nicht mehr akzeptiert. Die Kombination operativer Möglichkeiten in der Neurochirurgie mit dem Wissen um die Biologie der jeweiligen Geschwülste und ihrem natürlichen Krankheitsverlauf ermöglicht es uns heute, für jeden Patienten differenzierte Behandlungskonzepte zu entwickeln, die im Vorfeld mit dem Patienten und den zuweisenden Kollegen besprochen werden müssen. Am Beispiel der Gliome, der Hirnmetastasen und von häufigen Schädelbasistumoren (Meningeome und Neurinome) werden Strategien zur Verbesserung der Radikalität bei gleichzeitiger Schonung der neurologischen Funktion vorgestellt.
Summary
In neurosurgical oncology, today more then ever, the principle of function preservation while striving for the highest possible surgical radicalism is evident. A number of techniques make it possible to remove tumours more completely than was previously the case. “Radicalism” at any cost, however, is no longer appropriate or accepted by patients or by treating physicians. The combination of neurosurgical possibilities and knowledge about the biology of the different tumours as well as the natural disease progression, allows us today to develop differentiated treatment concepts for individual patients, which are discussed beforehand with the patient and the referring colleague. Based on the example of gliomas, brain metastases, and frequent skull-base tumours (meningiomas and neurinomas), strategies to improve the radicalism of tumour resection and to simultaneously preserve the neurological function are described.
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