Resektionsmethodik und funktionelle Wiederherstellung bei Weichgewebesarkomen der Extremitäten

Steinau, Hans-Ulrich; Homann, H.-H.; Drücke, D.; Torres, A.; Soimaru, D.; Vogt, Peter M.

doi:10.1007/s001040051339

Cited by 56 publications

(35 citation statements)

References 15 publications

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“…Bei adäquat onkologischer Resektion bzw. Nachresektion entsteht kein prognostischer Nachteil [22,23,30,31]. Bei Tumorwachstum im Bereich der tiefen Faszie bzw.…”

Section: Klinik Und Diagnostikunclassified

“…Die Inzisionsbiopsie gilt bei uns wie auch schon von anderen Gruppen beschrieben als Standard der Diagnosesicherung [30,31,32,36]. Entscheidend ist, möglichst gesundes Gewebe nicht zu tangieren und mit Tumorzellen zu kontaminieren.…”

Section: Klinik Und Diagnostikunclassified

“…B. Lappenplastiken oder Muskelersatzplastiken sowie Maßnahmen wie die Ausleitung der Drainage und wundwinkelsuffiziente Blutstillung bedacht werden. Eine Exzisionsbiopsie erfolgt in der Regel bei Tumoren <3 cm [23,30,31,32].…”

Section: Klinik Und Diagnostikunclassified

“…Nach wie vor ist die Resektion im Gesunden (R0-Resektion) die wichtigste Maß-nahme im multimodalen Therapiekonzept [7,17,19,22,30,31,32]. Keine andere neoadjuvante oder postoperative Therapieoption kann die onkologisch adäquate Resektion ersetzen [5,20,21,28,29].…”

Section: Therapieunclassified

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Weichgewebesarkome an Unterarm und Hand

Müller

Bickert

Germann

et al. 2008

Chirurg

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Radical tumor resection (R0) is the main therapeutic goal in the treatment of sarcomas of the forearm and hand. Plastic reconstructive procedures play a key role in limb salvage by coverage of complex defects. Sophisticated reconstructive techniques are required with the forearm and hand. Twenty patients with soft-tissue sarcomas of the hand and forearm were treated in our department between January 1995 and January 2005. Eleven were male and nine were female. The average age was 48 years. The most common tumor was myxoid fibrous histiocytoma, followed by synovial cell sarcoma. Six patients received free microvascular transplantations to cover their defects. Mesh graft or primary closure was possible in three cases; one patient received a local flap and one a pedicled flap. In nine cases preserving the limb was not possible. Ten patients received radiation and four got chemotherapy (two with neoadjuvant chemotherapy). In 18 cases histologic R0 resection was possible, in two cases R1 resection. Two patients suffered from tumor recurrence after R0 resection. The average follow-up-time was 42 months. These results show the necessity of plastic surgical reconstruction of the forearm and hand as an integral component of modern sarcoma therapy. Multidisciplinary cooperation is mandatory for adequate treatment.

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“…Bei adäquat onkologischer Resektion bzw. Nachresektion entsteht kein prognostischer Nachteil [22,23,30,31]. Bei Tumorwachstum im Bereich der tiefen Faszie bzw.…”

Section: Klinik Und Diagnostikunclassified

Section: Therapieunclassified

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Weichgewebesarkome an Unterarm und Hand

Müller

Bickert

Germann

et al. 2008

Chirurg

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“…Hier spielt meist die Durchblutung der Peripherie eine untergeordnete Rolle, es sei denn, diese ist durch Begleiterkrankungen kompromittiert. Die Größe des zu entfernenden Gewebeblocks orientiert sich allein an onkologischen Kriterien [16].Je …”

Section: Amputationen Bei Tumorresektionen Und Posttraumaunclassified

Stumpferhalt und Stumpfverlängerung an der unteren Extremität

Homann

Lehnhardt

Langer

et al. 2007

Chirurg

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Despite new techniques and better health programs in western industrialized nations, the numbers of amputations on the lower extremity remain constant. Approximately 100,000 amputations are performed annually in the U.S. and about 10,000 in Germany, more than 90% for gangrene resulting from ischemia and/or infection. Micro- and macroangiopathic changes in diabetes are the major cause of ischemia in the leg. The preservation of limb length and construction of an end bearing stump are important criteria for the functional outcome after amputation. Especially in trauma and tumor patients with "planned" amputations, all effort should be made to achieve an end bearing stump with sufficient length respectively an amputation level that is suitable for orthosis instead of prosthetic supplementation. After amputation, an interdisciplinary approach is mandatory to achieve sufficient soft tissue coverage or stump distalization. In case of insufficient bearing ability of the stump, various reconstructive possibilities must be considered to assure optimal outcome.

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The value of expert second opinion in diagnosis of soft tissue sarcomas

Lehnhardt

Daigeler

Hauser

et al. 2007

Journal of Surgical Oncology

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Introduction: Soft tissue sarcomas represent a heterogenous group of tumours with a wide range of clinical behaviour. Exact determination of diagnosis and prognosis is critical in order to guide surgical decisions and provide systemic therapy or radiation for patients. The value of consultative second opinions has been proven for general surgical pathology; some studies suggest an even higher value for the soft tissue tumour specimens in particular. Methods: We reviewed 603 patients who were operated on at our institution with the diagnosis of soft tissue sarcoma and aggressive fibromatosis; we focused on mismatches in primary and definite tumour-entity and -grading with respect to the diagnosing institution and the primary surgical procedure. Results: We found concordant primary diagnosis in 28.3% for pathologists in private clinics, 29.6% for hospital pathologists, 36.8% for academic medical centres (university hospitals) and 70.5% for the Department of Pathology at our institution. An improvement in diagnosis or confirmation of the correct primary diagnosis by the second opinion was seen in 73.1% of the patients; in 2.5%, the second opinion was false. Discussion: For accurate determination of prognosis and to provide optimal therapeutic decisions we consider expert second opinion essential for optimal treatment of soft tissue sarcomas.

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Resektionsmethodik und funktionelle Wiederherstellung bei Weichgewebesarkomen der Extremitäten

Cited by 56 publications

References 15 publications

Weichgewebesarkome an Unterarm und Hand

Weichgewebesarkome an Unterarm und Hand

Stumpferhalt und Stumpfverlängerung an der unteren Extremität

The value of expert second opinion in diagnosis of soft tissue sarcomas

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