[Oncological pelvic surgery from a gynecological perspective].

Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
Michael Höckel

Abstract

The established gynecological cancer operations are based on functional anatomy derived from the mature organism and on a model of radial progressive tumor permeation. Surgical treatment aims to resect the tumor with a metrically defined radial margin of tissue microscopically free of neoplastic or dysplastic disease. However, despite adequate surgical performance local tumor relapses still occur. In the presence of histopathological risk factors adjuvant radiation is therefore recommended which increases treatment-related morbidity. The Leipzig School of Radical Pelvic Surgery has developed new gynecological cancer operations from a different perspective on anatomy and local tumor spread. Tissue mapping is deduced by following the organism's development from the stage of tissue deposition to maturity (ontogenetic anatomy) to define permissive compartments for cancer permeation. The variants of mesometrial resection (TMMR, PMMR) and vulva field resection (VFR) achieve very high (>95%) local control rates in stages I and II cancer of the lower and middle female genital tract without adjuvant radiation. Laterally extended endopelvic resection (LEER) provides sustained tumor control even in locally advanced and recurrent disease a...Continue Reading

References

Jul 1, 1972·British Journal of Plastic Surgery·G D Lister, T Gibson
Jan 1, 1997·Gynecologic Oncology·J F MagrinaA L Weaver
May 16, 2000·Plastic and Reconstructive Surgery·F Moschella, A Cordova
Mar 1, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Robert E BristowF J Montz
May 25, 2002·Journal of the American College of Surgeons·Robert C G MartinMartin Karpeh
Jul 5, 2003·Lancet·Steven E Waggoner
Mar 2, 2006·Obstetrics and Gynecology·Frederick B Stehman, Katherine Y Look
Oct 3, 2006·The Lancet Oncology·Michael Höckel, Nadja Dornhöfer
Sep 5, 2007·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·P DursunE Kuscu
Mar 1, 1988·Der Schmerz
May 31, 2008·The Lancet Oncology·Michael Höckel, Nadja Dornhöfer
Nov 20, 2008·Techniques in Coloproctology·G L WilliamsP M Sagar
Mar 20, 2010·Gynecologic Oncology·Michael HöckelLars-Christian Horn

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Citations

Mar 4, 2015·Der Urologe. Ausg. A·R SteinJ W Thüroff

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