Standardtechnik der onkologischen Kolorektalchirurgie
Identifieur interne :
000513 ( PascalFrancis/Corpus );
précédent :
000512;
suivant :
000514
Standardtechnik der onkologischen Kolorektalchirurgie
Auteurs : P. BuchmanSource :
-
Swiss surgery [ 1023-9332 ] ; 2003.
RBID : Pascal:03-0387212
Descripteurs français
English descriptors
Abstract
Who ever is writing about standards should put himself the question: What is a standard? How is it produced? Who is defining it? How compulsory is it? A standard should only be understood as guiding principles or as following guidelines and never as a dogma, while otherwise every operative technical or therapeutical progress is prohibited. On the basis of the onco-surgical guidelines for the colo-rectal carcinoma is shown how standards can begin to sway. The Turnbull «no-touch isolation technique» does not stand up to the criteria of the evidence based medicine. The usefulness of the high ligation of tine veins and the intestinal occlusion has not been proven by any studies. The central ligature of the Arteria mesenterica inferior in left resection is wrong according more recent anatomical knowledge. Ligation near to the aorta leads obligatory to lesions of the plexus hypogastricus. Animal experiments are controversial concerning the dissemination of tumour cells during crushing of the cancer. And a prospective controlled study does not show any advantage of respecting the Turnbull criteria. Independent prognostic factors are the surgeon, the frequency of performing the procedure in the hospital concerned, the pT and N stage, the R-0 resection and according to American pathologists the pre-operative CEA titre. Also are mentioned the infiltration of veins and lymph vessels, micro metastases in lymph nodes and the grading. The resection should if possible be performed in anatomical layers, specially considering the meso-rec tum. What should be done in the distal 8 cm till the pelvic floor has not yet been clarified. On the contrary, the laparoscopic surgery has definitively also found its acceptance in oncological surgery. The discussions about port-metastases and tumour-cell-dissemination by the pneumoperitoneum-gas have silenced. Already, partially better long-term results are mentioned. In the beginning of 2003, the pillars of the standard technique of oncological colo-rectal surgery are besides the orthograde intestinal flushing, the pre-operative low molecular Heparin and the antibiotic prophylaxis, the opera or laparoscopic R-0 en bloc resection, the minimal safety distance in the low rectum of 1 cm, the ligature of the Arteria mesenterica inferior 2-3 cm distally to its origin from the aorta in case of left resection, respectively the Arteria ilio-colica at its origin from the Arteria mesen terica superior in case of right resection, the cytotoxic intestinal flushing in case of left resection and the flushing of the abdominal cavity as well as the port-site with Taurolin 0.5 %. In case of rectum-car cinoma uT3 or uN+, a neo-adjuvant radio-chemotherapy is administered and adjuvant chemotherapy is given by positive nodal colon-carcinoma.
Notice en format standard (ISO 2709)
Pour connaître la documentation sur le format Inist Standard.
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A08 | 01 | 1 | GER | @1 Standardtechnik der onkologischen Kolorektalchirurgie |
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A09 | 01 | 1 | GER | @1 14. Berner Symposium «Veni - vidi - sui - Rund um die Anastomose», 1. November 2002 |
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A11 | 01 | 1 | | @1 BUCHMAN (P.) |
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A12 | 01 | 1 | | @1 SEILER (Ch. A.) @9 ed. |
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A12 | 02 | 1 | | @1 CANDINAS (D.) @9 ed. |
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A14 | 01 | | | @1 Chirurgische Klinik, Stadtspital Waid Zürich @2 Zürich @3 CHE @Z 1 aut. |
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A20 | | | | @1 140-144 |
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A21 | | | | @1 2003 |
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A23 | 01 | | | @0 GER |
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A24 | 01 | | | @0 eng |
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A43 | 01 | | | @1 INIST @2 7515 @5 354000118187140080 |
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A44 | | | | @0 0000 @1 © 2003 INIST-CNRS. All rights reserved. |
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A45 | | | | @0 23 ref. |
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A47 | 01 | 1 | | @0 03-0387212 |
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A60 | | | | @1 P @2 C |
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A61 | | | | @0 A |
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A64 | 01 | 1 | | @0 Swiss surgery |
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A66 | 01 | | | @0 CHE |
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A68 | 01 | 1 | ENG | @1 Standard procedure in colorectal cancer surgery |
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A69 | 01 | 1 | ENG | @1 «Veni - vidi - sui - Around the Anastomosis», 14th Bernese Symposium, November 1st, 2002 |
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C01 | 01 | | ENG | @0 Who ever is writing about standards should put himself the question: What is a standard? How is it produced? Who is defining it? How compulsory is it? A standard should only be understood as guiding principles or as following guidelines and never as a dogma, while otherwise every operative technical or therapeutical progress is prohibited. On the basis of the onco-surgical guidelines for the colo-rectal carcinoma is shown how standards can begin to sway. The Turnbull «no-touch isolation technique» does not stand up to the criteria of the evidence based medicine. The usefulness of the high ligation of tine veins and the intestinal occlusion has not been proven by any studies. The central ligature of the Arteria mesenterica inferior in left resection is wrong according more recent anatomical knowledge. Ligation near to the aorta leads obligatory to lesions of the plexus hypogastricus. Animal experiments are controversial concerning the dissemination of tumour cells during crushing of the cancer. And a prospective controlled study does not show any advantage of respecting the Turnbull criteria. Independent prognostic factors are the surgeon, the frequency of performing the procedure in the hospital concerned, the pT and N stage, the R-0 resection and according to American pathologists the pre-operative CEA titre. Also are mentioned the infiltration of veins and lymph vessels, micro metastases in lymph nodes and the grading. The resection should if possible be performed in anatomical layers, specially considering the meso-rec tum. What should be done in the distal 8 cm till the pelvic floor has not yet been clarified. On the contrary, the laparoscopic surgery has definitively also found its acceptance in oncological surgery. The discussions about port-metastases and tumour-cell-dissemination by the pneumoperitoneum-gas have silenced. Already, partially better long-term results are mentioned. In the beginning of 2003, the pillars of the standard technique of oncological colo-rectal surgery are besides the orthograde intestinal flushing, the pre-operative low molecular Heparin and the antibiotic prophylaxis, the opera or laparoscopic R-0 en bloc resection, the minimal safety distance in the low rectum of 1 cm, the ligature of the Arteria mesenterica inferior 2-3 cm distally to its origin from the aorta in case of left resection, respectively the Arteria ilio-colica at its origin from the Arteria mesen terica superior in case of right resection, the cytotoxic intestinal flushing in case of left resection and the flushing of the abdominal cavity as well as the port-site with Taurolin 0.5 %. In case of rectum-car cinoma uT3 or uN+, a neo-adjuvant radio-chemotherapy is administered and adjuvant chemotherapy is given by positive nodal colon-carcinoma. |
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C02 | 01 | X | | @0 002B25G02 |
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C03 | 01 | X | FRE | @0 Tumeur maligne @5 01 |
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C03 | 01 | X | ENG | @0 Malignant tumor @5 01 |
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C03 | 01 | X | SPA | @0 Tumor maligno @5 01 |
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C03 | 02 | X | FRE | @0 Côlon @5 02 |
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C03 | 02 | X | ENG | @0 Colon @5 02 |
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C03 | 02 | X | SPA | @0 Colón @5 02 |
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C03 | 03 | X | FRE | @0 Rectum @5 03 |
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C03 | 03 | X | ENG | @0 Rectum @5 03 |
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C03 | 03 | X | SPA | @0 Recto @5 03 |
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C03 | 04 | X | FRE | @0 Chirurgie @5 04 |
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C03 | 04 | X | ENG | @0 Surgery @5 04 |
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C03 | 04 | X | SPA | @0 Cirugía @5 04 |
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C03 | 05 | X | FRE | @0 Traitement @5 05 |
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C03 | 05 | X | ENG | @0 Treatment @5 05 |
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C03 | 05 | X | SPA | @0 Tratamiento @5 05 |
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C03 | 06 | X | FRE | @0 Technique @5 17 |
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C03 | 06 | X | ENG | @0 Technique @5 17 |
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C03 | 06 | X | SPA | @0 Técnica @5 17 |
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C03 | 07 | X | FRE | @0 Homme @5 20 |
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C03 | 07 | X | ENG | @0 Human @5 20 |
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C03 | 07 | X | SPA | @0 Hombre @5 20 |
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C07 | 01 | X | FRE | @0 Appareil digestif pathologie @5 37 |
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C07 | 01 | X | ENG | @0 Digestive diseases @5 37 |
---|
C07 | 01 | X | SPA | @0 Aparato digestivo patología @5 37 |
---|
C07 | 02 | X | FRE | @0 Intestin pathologie @5 38 |
---|
C07 | 02 | X | ENG | @0 Intestinal disease @5 38 |
---|
C07 | 02 | X | SPA | @0 Intestino patología @5 38 |
---|
C07 | 03 | X | FRE | @0 Côlon pathologie @5 39 |
---|
C07 | 03 | X | ENG | @0 Colonic disease @5 39 |
---|
C07 | 03 | X | SPA | @0 Colón patología @5 39 |
---|
C07 | 04 | X | FRE | @0 Rectum pathologie @5 40 |
---|
C07 | 04 | X | ENG | @0 Rectal disease @5 40 |
---|
C07 | 04 | X | SPA | @0 Recto patología @5 40 |
---|
N21 | | | | @1 272 |
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N82 | | | | @1 PSI |
---|
|
pR |
A30 | 01 | 1 | GER | @1 Berner Symposium @2 14 @3 Bern CHE @4 2002-11-01 |
---|
|
Format Inist (serveur)
NO : | PASCAL 03-0387212 INIST |
ET : | (Standard procedure in colorectal cancer surgery) |
GT : | Standardtechnik der onkologischen Kolorektalchirurgie |
AU : | BUCHMAN (P.); SEILER (Ch. A.); CANDINAS (D.) |
AF : | Chirurgische Klinik, Stadtspital Waid Zürich/Zürich/Suisse (1 aut.) |
DT : | Publication en série; Congrès; Niveau analytique |
SO : | Swiss surgery; ISSN 1023-9332; Suisse; Da. 2003; No. 3; Pp. 140-144; Abs. anglais; Bibl. 23 ref. |
LA : | Allemand |
EA : | Who ever is writing about standards should put himself the question: What is a standard? How is it produced? Who is defining it? How compulsory is it? A standard should only be understood as guiding principles or as following guidelines and never as a dogma, while otherwise every operative technical or therapeutical progress is prohibited. On the basis of the onco-surgical guidelines for the colo-rectal carcinoma is shown how standards can begin to sway. The Turnbull «no-touch isolation technique» does not stand up to the criteria of the evidence based medicine. The usefulness of the high ligation of tine veins and the intestinal occlusion has not been proven by any studies. The central ligature of the Arteria mesenterica inferior in left resection is wrong according more recent anatomical knowledge. Ligation near to the aorta leads obligatory to lesions of the plexus hypogastricus. Animal experiments are controversial concerning the dissemination of tumour cells during crushing of the cancer. And a prospective controlled study does not show any advantage of respecting the Turnbull criteria. Independent prognostic factors are the surgeon, the frequency of performing the procedure in the hospital concerned, the pT and N stage, the R-0 resection and according to American pathologists the pre-operative CEA titre. Also are mentioned the infiltration of veins and lymph vessels, micro metastases in lymph nodes and the grading. The resection should if possible be performed in anatomical layers, specially considering the meso-rec tum. What should be done in the distal 8 cm till the pelvic floor has not yet been clarified. On the contrary, the laparoscopic surgery has definitively also found its acceptance in oncological surgery. The discussions about port-metastases and tumour-cell-dissemination by the pneumoperitoneum-gas have silenced. Already, partially better long-term results are mentioned. In the beginning of 2003, the pillars of the standard technique of oncological colo-rectal surgery are besides the orthograde intestinal flushing, the pre-operative low molecular Heparin and the antibiotic prophylaxis, the opera or laparoscopic R-0 en bloc resection, the minimal safety distance in the low rectum of 1 cm, the ligature of the Arteria mesenterica inferior 2-3 cm distally to its origin from the aorta in case of left resection, respectively the Arteria ilio-colica at its origin from the Arteria mesen terica superior in case of right resection, the cytotoxic intestinal flushing in case of left resection and the flushing of the abdominal cavity as well as the port-site with Taurolin 0.5 %. In case of rectum-car cinoma uT3 or uN+, a neo-adjuvant radio-chemotherapy is administered and adjuvant chemotherapy is given by positive nodal colon-carcinoma. |
CC : | 002B25G02 |
FD : | Tumeur maligne; Côlon; Rectum; Chirurgie; Traitement; Technique; Homme |
FG : | Appareil digestif pathologie; Intestin pathologie; Côlon pathologie; Rectum pathologie |
ED : | Malignant tumor; Colon; Rectum; Surgery; Treatment; Technique; Human |
EG : | Digestive diseases; Intestinal disease; Colonic disease; Rectal disease |
SD : | Tumor maligno; Colón; Recto; Cirugía; Tratamiento; Técnica; Hombre |
LO : | INIST-7515.354000118187140080 |
ID : | 03-0387212 |
Links to Exploration step
Pascal:03-0387212
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<front><div type="abstract" xml:lang="en">Who ever is writing about standards should put himself the question: What is a standard? How is it produced? Who is defining it? How compulsory is it? A standard should only be understood as guiding principles or as following guidelines and never as a dogma, while otherwise every operative technical or therapeutical progress is prohibited. On the basis of the onco-surgical guidelines for the colo-rectal carcinoma is shown how standards can begin to sway. The Turnbull «no-touch isolation technique» does not stand up to the criteria of the evidence based medicine. The usefulness of the high ligation of tine veins and the intestinal occlusion has not been proven by any studies. The central ligature of the Arteria mesenterica inferior in left resection is wrong according more recent anatomical knowledge. Ligation near to the aorta leads obligatory to lesions of the plexus hypogastricus. Animal experiments are controversial concerning the dissemination of tumour cells during crushing of the cancer. And a prospective controlled study does not show any advantage of respecting the Turnbull criteria. Independent prognostic factors are the surgeon, the frequency of performing the procedure in the hospital concerned, the pT and N stage, the R-0 resection and according to American pathologists the pre-operative CEA titre. Also are mentioned the infiltration of veins and lymph vessels, micro metastases in lymph nodes and the grading. The resection should if possible be performed in anatomical layers, specially considering the meso-rec tum. What should be done in the distal 8 cm till the pelvic floor has not yet been clarified. On the contrary, the laparoscopic surgery has definitively also found its acceptance in oncological surgery. The discussions about port-metastases and tumour-cell-dissemination by the pneumoperitoneum-gas have silenced. Already, partially better long-term results are mentioned. In the beginning of 2003, the pillars of the standard technique of oncological colo-rectal surgery are besides the orthograde intestinal flushing, the pre-operative low molecular Heparin and the antibiotic prophylaxis, the opera or laparoscopic R-0 en bloc resection, the minimal safety distance in the low rectum of 1 cm, the ligature of the Arteria mesenterica inferior 2-3 cm distally to its origin from the aorta in case of left resection, respectively the Arteria ilio-colica at its origin from the Arteria mesen terica superior in case of right resection, the cytotoxic intestinal flushing in case of left resection and the flushing of the abdominal cavity as well as the port-site with Taurolin 0.5 %. In case of rectum-car cinoma uT3 or uN+, a neo-adjuvant radio-chemotherapy is administered and adjuvant chemotherapy is given by positive nodal colon-carcinoma.</div>
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<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Colón patología</s0>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Rectum pathologie</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Rectal disease</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA"><s0>Recto patología</s0>
<s5>40</s5>
</fC07>
<fN21><s1>272</s1>
</fN21>
<fN82><s1>PSI</s1>
</fN82>
</pA>
<pR><fA30 i1="01" i2="1" l="GER"><s1>Berner Symposium</s1>
<s2>14</s2>
<s3>Bern CHE</s3>
<s4>2002-11-01</s4>
</fA30>
</pR>
</standard>
<server><NO>PASCAL 03-0387212 INIST</NO>
<ET>(Standard procedure in colorectal cancer surgery)</ET>
<GT>Standardtechnik der onkologischen Kolorektalchirurgie</GT>
<AU>BUCHMAN (P.); SEILER (Ch. A.); CANDINAS (D.)</AU>
<AF>Chirurgische Klinik, Stadtspital Waid Zürich/Zürich/Suisse (1 aut.)</AF>
<DT>Publication en série; Congrès; Niveau analytique</DT>
<SO>Swiss surgery; ISSN 1023-9332; Suisse; Da. 2003; No. 3; Pp. 140-144; Abs. anglais; Bibl. 23 ref.</SO>
<LA>Allemand</LA>
<EA>Who ever is writing about standards should put himself the question: What is a standard? How is it produced? Who is defining it? How compulsory is it? A standard should only be understood as guiding principles or as following guidelines and never as a dogma, while otherwise every operative technical or therapeutical progress is prohibited. On the basis of the onco-surgical guidelines for the colo-rectal carcinoma is shown how standards can begin to sway. The Turnbull «no-touch isolation technique» does not stand up to the criteria of the evidence based medicine. The usefulness of the high ligation of tine veins and the intestinal occlusion has not been proven by any studies. The central ligature of the Arteria mesenterica inferior in left resection is wrong according more recent anatomical knowledge. Ligation near to the aorta leads obligatory to lesions of the plexus hypogastricus. Animal experiments are controversial concerning the dissemination of tumour cells during crushing of the cancer. And a prospective controlled study does not show any advantage of respecting the Turnbull criteria. Independent prognostic factors are the surgeon, the frequency of performing the procedure in the hospital concerned, the pT and N stage, the R-0 resection and according to American pathologists the pre-operative CEA titre. Also are mentioned the infiltration of veins and lymph vessels, micro metastases in lymph nodes and the grading. The resection should if possible be performed in anatomical layers, specially considering the meso-rec tum. What should be done in the distal 8 cm till the pelvic floor has not yet been clarified. On the contrary, the laparoscopic surgery has definitively also found its acceptance in oncological surgery. The discussions about port-metastases and tumour-cell-dissemination by the pneumoperitoneum-gas have silenced. Already, partially better long-term results are mentioned. In the beginning of 2003, the pillars of the standard technique of oncological colo-rectal surgery are besides the orthograde intestinal flushing, the pre-operative low molecular Heparin and the antibiotic prophylaxis, the opera or laparoscopic R-0 en bloc resection, the minimal safety distance in the low rectum of 1 cm, the ligature of the Arteria mesenterica inferior 2-3 cm distally to its origin from the aorta in case of left resection, respectively the Arteria ilio-colica at its origin from the Arteria mesen terica superior in case of right resection, the cytotoxic intestinal flushing in case of left resection and the flushing of the abdominal cavity as well as the port-site with Taurolin 0.5 %. In case of rectum-car cinoma uT3 or uN+, a neo-adjuvant radio-chemotherapy is administered and adjuvant chemotherapy is given by positive nodal colon-carcinoma.</EA>
<CC>002B25G02</CC>
<FD>Tumeur maligne; Côlon; Rectum; Chirurgie; Traitement; Technique; Homme</FD>
<FG>Appareil digestif pathologie; Intestin pathologie; Côlon pathologie; Rectum pathologie</FG>
<ED>Malignant tumor; Colon; Rectum; Surgery; Treatment; Technique; Human</ED>
<EG>Digestive diseases; Intestinal disease; Colonic disease; Rectal disease</EG>
<SD>Tumor maligno; Colón; Recto; Cirugía; Tratamiento; Técnica; Hombre</SD>
<LO>INIST-7515.354000118187140080</LO>
<ID>03-0387212</ID>
</server>
</inist>
</record>
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