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Technik der Thymuschirurgie

Techniques in thymic surgery

  • Operative Techniken
  • Published:
Zeitschrift für Herz-,Thorax- und Gefäßchirurgie Aims and scope

Zusammenfassung

Die Gruppe der Thymustumoren umfasst Thymome, Thymuskarzinome und neuroendokrine Thymustumoren (NETT). Es handelt sich um seltene Tumorentitäten, die den Großteil der Tumoren im vorderen Mediastinum beim Erwachsenen darstellen. Sie zeichnen sich durch ein langsames infiltratives Wachstum mit lokoregionärer Tumorausbreitung aus. Die chirurgisch vollständige Resektion ist das Fundament der Behandlung von Thymustumoren. Für Tumoren in Frühstadien stehen minimalinvasive Operationsverfahren zur Verfügung. Bei 30 % der Patienten sind aufgrund der Infiltration von Mediastinalorganen, der Lungen oder der Brustwand erweiterte Resektionen erforderlich. Im vorliegenden Beitrag werden die dem Thoraxchirurgen zur Verfügung stehenden Operationsverfahren zusammengefasst. Das Wissen über die Operationstechnik von Thymustumoren ist auf die Chirurgie anderer Mediastinaltumoren übertragbar.

Abstract

The group of thymic tumors includes thymomas, thymic carcinomas and neuroendocrine thymic tumors (NETT). They are rare tumor entities but represent the majority of malignant tumors of the anterior mediastinum in adult patients. The biological behavior is characterized by slow tissue infiltration and locoregional tumor spread. Complete surgical resection is the foundation of the treatment of thymic tumors. Early tumor stages can be addressed by minimally invasive surgical procedures. In 30 % of patients the tumors already infiltrate additional mediastinal structures, the lungs or the chest wall warranting extended surgical approaches. This review article summarizes the operative approaches available for thoracic surgeons. Knowledge of the available surgical techniques in thymic surgery can be transferred to other mediastinal tumors.

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Abbreviations

AChR:

Acetylcholinrezeptor

AK:

Antikörper

CT:

Computertomographie

DFS:

„disease free survival“ (krankheitsfreies Intervall)

HLM:

Herz-Lungen-Maschine

IASLC:

International Association for the Study of Lung Cancer

ICR:

Interkostalraum

ITMIG:

International Thymic Malignancy Interest Group

MG:

Myasthenia gravis

NETT:

neuroendokrine Thymustumoren

PET/CT:

Positronen-Emissions-Tomographie mit Computertomographie

RATS:

„robotic-assisted thoracoscopic surgery“

UICC:

Union for International Cancer Control

VATET:

„video-assisted thoracoscopic extended thymectomy“

VATS:

„video-assisted thoracoscopic surgery“

VCS:

Vena cava superior

WHO:

World Health Organization

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Correspondence to T. Walles FETCS.

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G. Somuncuoglu, T. Hoppert und T. Walles geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Somuncuoglu, G., Hoppert, T. & Walles, T. Technik der Thymuschirurgie. Z Herz- Thorax- Gefäßchir 30, 225–232 (2016). https://doi.org/10.1007/s00398-016-0083-4

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  • DOI: https://doi.org/10.1007/s00398-016-0083-4

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