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Erweiterte Diagnostische Laparoskopie (EDL)

Extended diagnostic laparoscopy (EDL)

  • Themenschwerpunkt: Diagnostische Laparoskopie Und Thorakoskopie
  • Published:
Acta Chirurgica Austriaca Aims and scope Submit manuscript

Zusammenfassung

Grundlagen: Die sogenannte erweiterte diagnostische Laparoskopie (EDL) ist ein minimal-invasiver chirurgischer Eingriff, der die Exploration des gesamten Bauchraumes ermöglicht und somit das prätherapeutische Staging bei malignen Erkrankungen erheblich verbessern kann.

Methodik: Die EDL umfaßt die visuelle Inspektion mit gezielter Präparation aller relevanten Areale, die laparoskopische Ultraschalldiagnostik und die Gewinnung von Zytologie-Biopsiematerial.

Ergebnisse: Beim Magenkarzinom konnten in einer eigenen Studie durch die EDL in 40,5 % der Fälle therapierelevante Zusatzinformationen gewonnen werden. Eine ähnliche Bedeutung könnte die EDL auch für die Diagnostik des Adenokarzinoms der Speiseröhre gewinnen, möglicherweise auch bei Malignomen von Leber und Pankreas.

Schlußfolgerungen: Das Komplikationsrisiko der EDL ist gering; die Gefahr einer Tumorzellverschleppung durch den diagnostischen Eingriff ist jedoch nicht ganz auszuschließen, so daß die Indikation nur unter der Voraussetzung einer therapeutischen Konsequenz gestellt werden sollte.

Summary

Background: The so-called extended diagnostic laparoscopy (EDL) facilitates the comprehensive exploration of the abdominal cavity, thus improving the precision of the pretherapeutic tumor staging in gastrointestinal malignancies.

Methods: EDL comprehends the visual inspection with a surgical dissection of all relevant sites, laparoscopic sonography and retrieval of samples for biopsy and cytology.

Results: Additional relevant therapeutic information was obtained through EDL in 40,5 % of gastric cancer patients. The EDL could be of similar importance for diagnosing of the esophageal, hepatobiliary and and pancreatic malignancies.

Conclusions: The overall complication rate of EDL is low. However, the potential of tumor cell dissemination cannot entirely be excluded. Accordingly, EDL should only be performed in cases in which therapeutic consequences may result.

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  1. Chirurgische Klinik, Klinikum rechts der Isar, Technische Universität München, Ismaningerstraße 22, D-81675, München, Deutschland

    H. Feussner, M. Baumgartner & J. R. Siewert

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Feussner, H., Baumgartner, M. & Siewert, J.R. Erweiterte Diagnostische Laparoskopie (EDL). Acta Chir. Austriaca 32, 212–220 (2000). https://doi.org/10.1007/BF02949361

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