[Minimally invasive surgery and tumor surgery--palliative laparoscopic techniques].
The oncological principles of radical tumor surgery are not proven to be successfully applied with today's laparoscopic techniques. The value of minimal invasive surgery has to be critically evaluated for the radical (R0) resection of malignant tumors. On the other hand, there is an indication for laparoscopic palliation in order to minimize the surgical trauma. Many publications have demonstrated the technical feasibility with acceptable morbidity and mortality and a decreased hospital stay. For different reasons (previous operations, assessment of resectability, use of interventional techniques etc.) laparoscopic palliation obviously is realized only in a small number of patients. The most frequently reported operation concerns the implantation of feeding catheters into the stomach or jejunum. If noncurability is proven preoperatively, the rate of laparoscopic palliations probably could be increased, if minimal access surgery could take a more definite place in the wide spectrum of therapeutical options. The operative techniques usually can be easily performed by the laparoscopically experienced surgeon today. However, benefit for the patients after palliative laparoscopic tumor resection has not yet been proven. The best condition for laparoscopic palliation is the discovery of the incurable situation during diagnostic laparoscopy. Laparoscopic palliation should follow directly within the same session.
Saeger
H D
HD
Klinik und Poliklinik für Viszeral, Thorax- und Gefässchirurgie, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden.
Wehrmann
U
U
D004750:Enteral Nutrition / Q000295:instrumentation; D005770:Gastrointestinal Neoplasms / Q000601:surgery*; D006801:Humans; D020706:Laparoscopes; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D009367:Neoplasm Staging; D010166:Palliative Care; D013525:Surgical Instruments