Abstract:
:Neuroendocrine tumours (NET) differ appreciably with regard to their biological behaviour from tumours of epithelial origin. In general this leads to a better 5-year survival rate. Liver metastases per se and also in cases of NET result in a significantly poorer survival in comparison to tumours without metastases. In contrast to those with epithelial tumours, about (2/3) of the NET patients already have liver metastases at the time of diagnosis. Thus, in spite of the rarity of these tumours, the surgeon is frequently confronted with this tumour entity. Among other factors the prognosis depends on the primary localisation of the NET (pancreatic NET poorer than non-pancreatic NET) as well as the staging and grading (proliferation index Ki-67) of the tumours. In this article, we characterise the surgical and ablative therapies for liver metastases from NET of the gastrointestinal tract from both curative and palliative points of view on the basis of the recently published guidelines of the ENETS (European Neuroendocrine Tumour Society). Furthermore, the various options for conservative therapy are discussed and assessed for their relative values. For localised tumour disease, also of both liver lobes, the resection of liver metastases (single or multi-stage operation, if necessary in combination with RFA) remains the standard therapy. Liver resections as debulking operations (target: resection of > 90 % tumour volume) with good preoperative planning can also be carried out under palliative criteria. For diffuse liver metastases with more than 50 % tumour volume in the liver, orthotopic liver transplantation, if necessary even as a multivisceral transplantation, may be considered in individual cases. For inoperable metastases, depending on the tumour load in the liver, the tumour localisation (intrahepatic versus intra- and extrahepatic), the tumour grading (proliferation index Ki-67), the dynamics of tumour growth, and the primary localisation of the tumour, differentiated biotherapy with somatostatin analogues, peptide-mediated radioreceptor therapy (PRRT), transarterial chemoembolisation (TACE) and selective intraarterial radiotherapy (SIRT), chemotherapy and new molecular target-directed therapy options can be employed. The utilities of these treatment options are presented and discussed.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Auernhammer CJ,Jauch KW,Hoffmann JNdoi
10.1055/s-0029-1224607subject
Has Abstractpub_date
2009-09-01 00:00:00pages
410-7issue
5eissn
0044-409Xissn
1438-9592journal_volume
134pub_type
杂志文章,评审abstract::There are several reasons for the possible development of a short bowel syndrome, which, however, occurs only rarely. The main causes consist of extended intestinal resections in cases of congenital anomalies (e.g., gastroschisis, intestinal atresia or dysplasia) or ischaemic lesions due to a volvulus. In addition, an...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0032-1315200
更新日期:2013-08-01 00:00:00
abstract::Infection is a generally feared complication of liquor drainage. Shunt sepsis is reported in this paper with reference to 284 patients with liquor drainage. The rate of infection amounted to 9.1 percent. Therapeutic action included application of antibiotics, surgical valve removal, and delayed restitution. The mortal...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract:INTRODUCTION:Over the last decade endovascular stenting of aortic aneurysm (EVAR) has been developed from single centre experiences to a standard procedure. With increasing clinical expertise and medical technology advances treatment of even complex aneurysms are feasible by endovascular methods. One integral part for ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0035-1546261
更新日期:2015-10-01 00:00:00
abstract::In a prospective study, the results following PTA of 30 short stenoses > 70% in 17 infrainguinal arterial bypass grafts were examined. The stenoses were detected after a mean follow-up of 7.2 months by Duplex-ultrasound. The initial success rate after PTA was 100%. After an average time of 4.6 months recurrent graft s...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:Beside non-operative treatment the therapeutic options for proximal fractures of the humerus range from closed reduction and transcutaneous K-wiring to total joint replacement. While the first is regarded as minimally invasive the latter is a rather complex intervention. Plating has been disregarded as combi...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2003-37368
更新日期:2003-01-01 00:00:00
abstract:INTRODUCTION:Recent innovations in laser scanning technology provide a potentially useful tool for three-dimensional surface registration for image-guided surgery. The purpose of this study is to evaluate the clinical reliability of this technique in oral and maxillofacial surgical procedures using image-guided navigat...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2003-40811
更新日期:2003-07-01 00:00:00
abstract::Two questions are discussed: 1. our relation to death. Contrary to the saying "shadows of the death" and to it's modern concealment this contribution states: death gives light: it enables to be conscious of one's self and to bow to the inevitable, it shows the valuables of earthly and mortal beings, and even allows us...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1999-01-01 00:00:00
abstract::During a period of 29 years (1960-1989), 19 patients with benign (15 cases) or malignant (4 cases) phylloides tumours were seen at the Surgical Clinic of Fundeni Hospital. Fourteen patients were followed up for a period of 2 to 21 years (mean 9.3 years). Two patients with benign tumours developed malignant recurrences...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:In the management of gastrointestinal tumour lesions, palliative treatment has attained an increasing role. As also in curative treatment, an interdisciplinary cooperation between gastroenterologists and surgeons has to be aimed for. AIM:The aim of this study is to illustrate the diagnostic and therapeutic ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0030-1262702
更新日期:2010-12-01 00:00:00
abstract::By the mean of a prospective multicenter observational study (East German Gastric Cancer Study - EGGCS), 1 139 consecutive patients with gastric cancer were enrolled in 80 East German surgical departments from January 1 to December 31, 2002. Out of them, 1,031 (90.5%) underwent surgical intervention. The resection rat...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,多中心研究
doi:10.1055/s-2005-836491
更新日期:2005-04-01 00:00:00
abstract::Report on 40 patients suffering from a therapy resistant gastroesophageal reflux disease. Conventional ligamentum-teres-plastic was performed on 18 patients, while 22 patients were treated laparoscopically as minimal invasive procedure. Both techniques are described and the advantages of the laparoscopy versus the con...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract::The authors discuss indications for using different temporary skin substitutes in local burn therapy. The clinical philosophy is based on an experience of 15 years. The advantages of those biological materials containing epidermis are stressed. Experimental results obtained in laboratory pigs show the importance of lo...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1981-01-01 00:00:00
abstract::Aneurysms of the hepatic artery are second (20%) to the splenic artery the most common site of splanchnic artery aneurysms. The frequency of location in the branches of the hepatic artery is as follows: common hepatic 63%, right hepatic 28, left hepatic 5%, both left and right hepatic artery 4%. Today atherosclerosis ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::Intraabdominal abscesses are life-threatening complications of inflammatory processes or major surgery. Ultrasonography, computed tomography, magnetic resonance, and scintigraphy are the diagnostic methods of choice. The sole diagnosis intraabdominal abcess" is insufficient to recommend a specific therapeutic strategy...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1993-01-01 00:00:00
abstract::The normalisation of head circumference and ventricular dilatation are aims of the therapy of hydrocephalus. Sonographic follow-up after ventriculo-peritoneal shunt demonstrates a changed ventricular morphology and inform about clinical relevant questions in regard of effectivity and complications of the shunt. The di...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::At the University Hospital of Cologne-Lindenthal 260 patients underwent carotid endarterectomy during a period of 10 years. 9 patients died, representing an operative mortality rate of 2.9%. 80% of our patients with an acute stroke died. We see no indication for surgery in acute stroke. Postoperatively, 20 patients ha...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::The implementation of robot-assisted surgery requires a multi disciplinary approach with appropriate training and cooperation of surgical, anesthetic and technical staff. Besides acquiring the technical skills and getting used to complex technique, patient selection and an appropriate frequency of procedures are requi...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0042-104068
更新日期:2016-04-01 00:00:00
abstract::For the first time the surgical technique of right and left adrenalectomy by a posterior percutaneous retroperitoneoscopic access is described. The adrenal gland is mobilized after creation of a pneumoretroperitoneum and insertion of 3-4 trocars beneath the 12th rip. Indications for this new method are small, benign a...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract::A statewide report card system for cholecystectomy as a surgical tracer has been established in Westfalia-Lippe as part of a program of external quality assurance. 74,400 data between 1993 and 1997 were analyzed. Pathologic findings in preoperative diagnostics (sonography, elevated bilirubin) do not lead to therapeuti...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract:INTRODUCTION:Etiology of osteochondral lesions of the talus remains uncertain, a myriad of treatment options exists. The purpose of this study is to evaluate the clinical and radiological results of fixation of osteochondral lesions of the talus using K-wires. An unstable osteochondral fragment or osteosclerotic change...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-2004-832393
更新日期:2004-12-01 00:00:00
abstract::Since the first publication by Tartter in 1982 [3] multiple studies were performed concerning the association between blood transfusion and outcome in surgical oncology. The hypothesis was that blood transfusion-associated immunosuppression influences postoperative infection rates and long-term prognosis. Due to the f...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-2000-10045
更新日期:2000-01-01 00:00:00
abstract::The electrico-acoustical auscultation of intestinal sounds permits a continuous recording, documentation and evaluation of the intestinal motility to be made. Temporal course and duration of the sounds as well as their amplitude as a measure of their intensity are criteria for the diagnosis. The frequency-analysis of ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract::In patients with occlusive arterial disease of the lower extremity below knee amputation is successful in 75 to 85%. Below knee amputation enables a better and more rapid prosthetic rehabilitation than above knee amputation, even in very old patients. Indication, amputation technique, and postoperative stump managemen...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1981-01-01 00:00:00
abstract::The development of anaesthesiology has brought about a great variety of problems e.g. unforeseen capacities, money, vacancies and equipment. The patients welfare, of course necessitates the establishment of anaesthesiological departments wherever operations are being performed. We believe that in hospitals without ana...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::The importance of psychosocial indicators for the course and the evaluation of organ transplantation is being more and more recognized. The following paper tries to point out what should be, at the present, the "state of the art" in psychosocial evaluation and quality of life measurement in organ transplantation. ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:
更新日期:1999-01-01 00:00:00
abstract::Today we know the pathobiochemical mechanism of gallstone formation. Cholecystectomy is the therapy of choice with a mortality-rate 0,5% in uncomplicated cases. The mortality-rate increases in patients with recurrent stones in the biliary tract system after cholecystectomy. In addition the liver produces a lithogenic ...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract::Background An enterothorax with herniation of bowel segments through a diaphragmatic defect is a rare postoperative complication, which can occur in the early postoperative period as well as several months or even years after the primary procedure. In virtually all cases, this diagnosis requires surgical treatment wit...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0042-119304
更新日期:2017-02-01 00:00:00
abstract::After edovascular repair of infrarenal aortic aneurysms (EVAR) endoleaks may occur necessitating further therapy. Therefore a reliable method for follow-up imaging after EVAR for detection and control of endoleaks is of high importance. Contrast-enhanced sonography (CEUS) does not require the application of nephrotoxi...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1546147
更新日期:2015-10-01 00:00:00
abstract::Background At more than 50%, appendicitis is the leading cause of acute intra-abdominal disease requiring surgery. In the course of various other operations, prophylactic appendectomy (PA) is frequently performed. Objectives This study examines to what extent PA is justified. Patients and Methods A prospective study w...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:10.1055/s-0043-118126
更新日期:2017-12-01 00:00:00
abstract::While classical inguinal hernia repair has recently been brought up for discussions among surgeons, at present various modified techniques are being reintroduced in general surgery. Surgical hernia repair techniques which partly are known since several decades are being carried out laparoscopically since 1989. Between...
journal_title:Zentralblatt fur Chirurgie
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00