Chirurgische Methoden in der Behandlung des Aderhautmelanoms

Zusammenfassung

In der Behandlung von Aderhautmelanomen wurden in den letzten Jahrzehnten signifikante Fortschritte erzielt. Die lokale Tumorkontrolle kann mit Strahlentherapie je nach Methodik in bis zu 98% der Fälle erreicht werden. Chirurgische Techniken werden zur Behandlung von Strahlenkomplikationen, wie dem sogenannten toxischen Tumorsyndrom, oder zur primären Therapie des Tumors in Kombination mit oder ohne Strahlentherapie angewendet. Hierzu werden endo- und transsklerale Resektionstechniken für Melanome der Aderhaut und des Ziliarkörpers oder Iridotrabekulozyklektomie für Melanome der Iris und des Ziliarkörpers verwendet. Darüber hinaus spielt die Tumorbiopsie eine zunehmend wichtigere Rolle bei der Diagnose, Behandlung und Nachbehandlung von choroidalen Melanomen. Diese Übersichtsarbeit erläutert die therapeutischen Indikationen und chirurgischen Techniken sowie die Ergebnisse und Komplikationen im Rahmen der Exzision und Biopsie von Aderhautmelanomen.

Abstract

Significant advancements have been made in the last decades in the treatment of uveal melanoma. Radiation therapy can achieve, depending on the method, local tumour control in up to 98% of cases. Surgical modalities have been implemented in the ocular therapy for uveal melanoma either to treat/prevent radiation complications, such as so-called toxic tumour syndrome, or to primarily treat the tumour with or without adjunctive radiotherapy. These include endoresection and transscleral resection for melanomas of the choroid/ciliary body or irido-trabeculo-cyclectomy for melanomas of the iris-ciliary body. Furthermore, tumour biopsy is playing a progressively more important role in the diagnosis, treatment and follow-up planning of melanoma cases. This paper focuses on the background, the surgical technique as well as the results and complications of tumour excisional and biopsy surgery.

Schlüsselwörter

transsklerale Resektion - Iridotrabekulozyklektomie - Biopsie - Endoresektion - Melanom

Key words

melanoma - endoresection - transscleral resection - biopsy - irido-trabeculo-cyclectomy

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