Zusammenfassung
Die radikale Zystektomie in Kombination mit einer pelvinen Lymphadenektomie ist der therapeutische Goldstandard zur chirurgischen Therapie des muskelinvasiven Urothelkarzinoms der Harnblase. Sie vereinigt die ablative radikale Tumorchirurgie mit einer rekonstruktiven Operation zur Harnableitung. Die radikale Zystektomie führt zur bestmöglichen lokoregionalen Kontrolle des Urothelkarzinoms und kann in Verbindung mit einer neoadjuvanten oder adjuvanten Cisplatin-basierten Chemotherapie durchgeführt werden. Moderne Operationstechniken und eine verbesserte perioperative Versorgung der Patienten haben dazu geführt, dass die eingriffsspezifische Morbidität gesenkt werden konnte und trotz der Radikalität des Eingriffes langfristig ein Erhalt der harnableitenden und sexuellen Funktion möglich ist. Minimalinvasive Operationsverfahren wurden innerhalb der letzten beiden Jahrzehnte entwickelt und in die Klinik eingeführt. Sie bieten die Vorteile der geringeren Invasivität, ihre funktionellen und onkologischen Langzeitergebnisse sind jedoch noch nicht bekannt.
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Bolenz, C. (2016). Urothelkarzinom der Harnblase: Chirurgische Therapie. In: Michel, M., Thüroff, J., Janetschek, G., Wirth, M. (eds) Die Urologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-39940-4_102
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