Bericht über den Workshop „Workflow Rektumkarzinom II” am 10. / 11.11.2006 in Burghausen

Zusammenfassung

Die Arbeitsgruppe „Workflow Rektumkarzinom II” definierte Operationstechniken beim tiefen Karzinom, speziell die totale mesorektale Exzision sowie eine verbesserte Operationstechnik der abdomino-perinealen Rektumexstirpation. Neue Gesichtspunkte zur Therapie des primär fernmetastasierten Rektumkarzinoms werden dargestellt. Aufgrund dieser Publikationen wird ein Konzept eines multimodalen bidirektionalen Vorgehens mit Chirurgie und Radiochemotherapie vorgeschlagen, wobei die Chirurgie nicht zwangsläufig an erster Stelle steht. Bei Anastomosen unterhalb von 6 cm ab Anokutankanal wird wegen besserer funktioneller Ergebnisse grundsätzlich die Reservoirbildung empfohlen. Hierbei ist der Kolon-J-Pouch mit maximaler Schlingenlänge von 6 cm bisher am besten untersucht, zu den anderen Verfahren sind weitere Untersuchungen abzuwarten.

Abstract

The task force “workflow rectal cancer II” defined operative techniques in lower rectal cancer, especially the total mesorectal excision and an improved technique of abdominalperineal resection. New aspects for treatment of rectal cancer with primary distant metastases are described. Due to newer publications a concept of bidirectional procedure with surgery and radiochemotherapy is recommended, where the operation must not be inevitably the first step. In anastomoses below 6 cm of the anocutaneous verge a reservoir should be performed on principle due to better functional results. The colon-j-pouch with a maximal loop length of 6 cm is best investigated under these conditions, the other procedures should be further evaluated.

Schlüsselwörter

Rektumkarzinom - Ablaufpfad - abdominoperineale Rektumexstirpation - Fernmetastasen

Key words

rectal cancer - workflow - abdominoperineal - rectum resection - distant metastasis

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