{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T16:40:08Z","timestamp":1730824808073,"version":"3.28.0"},"reference-count":61,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Rund ein Drittel aller kolorektalen Karzinome (KRK) sind im Rektum lokalisiert. Im Rahmen\n          eines multimodalen Therapiekonzeptes wird durch eine neoadjuvante Therapie in 50\u201360% der\n          F\u00e4lle ein Downstaging des Tumors und in 10\u201330% der F\u00e4lle eine sog. Complete Clinical\n          Response (cCR), definiert als klinisch (und radiologisch) nicht mehr detektierbarer\n          Residualtumor nach Abschluss der neoadjuvanten Therapie, erzielt.<\/jats:p><jats:p>Vor dem Hintergrund perioperativer Morbidit\u00e4t und Mortalit\u00e4t einer radikalen\n          Rektumresektion, mit u.\u00a0a. Auftreten des Symptomkomplexes des sog. Low Anterior Resection\n          Syndrome (LARS) sowie der zumindest passager gegebenen Notwendigkeit zur Deviation, wird\n          die Frage nach einer Nutzen-Risiko-Abw\u00e4gung einer Organresektion bei Vorliegen eines cCR\n          aufgeworfen. In diesem Zusammenhang trat das therapeutische Konzept eines\n          \u201eWatch-and-Wait\u201c-Vorgehens mit Unterlassung einer unmittelbaren Organresektion und\n          Einschluss in ein strukturiertes Surveillance-Regime in den Vordergrund.<\/jats:p><jats:p>Zur sicheren, onkologischen Durchf\u00fchrung dieser Option ist es notwendig, Standards in der\n          Definition einer geeigneten Patientenklientel sowie der Umsetzung des Konzepts zu\n          erarbeiten. Dabei ist das inh\u00e4rente Ziel neben der zun\u00e4chst korrekten Selektion der\n          Patientengruppe, die sich f\u00fcr ein prim\u00e4r nicht chirurgisches Vorgehen eignet, die\n          fr\u00fchzeitige und suffiziente Detektion eines Tumorwiederauftretens (sog. Local Regrowth)\n          w\u00e4hrend der Phase des \u201eWatch-and-Wait\u201c (Surveillance).<\/jats:p><jats:p>In diesem Zusammenhang adressieren wir in dieser Arbeit die Fragen: 1. nach dem optimalen\n          Zeitpunkt des initiales Re-Stagings, 2. nach den Kriterien zur Beurteilung des klinischen\n          Ansprechens und der Selektion der geeigneten Patientenklientel, 3. nach Rhythmus und\n          Ausgestaltung des Surveillance-Protokolls.<\/jats:p>","DOI":"10.1055\/a-2241-0334","type":"journal-article","created":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T00:12:46Z","timestamp":1709683966000},"page":"75-82","source":"Crossref","is-referenced-by-count":0,"title":["Surveillance bei Watch-and-Wait nach neoadjuvanter Therapie beim\n          Rektumkarzinom"],"prefix":"10.1055","volume":"149","author":[{"given":"Carolin","family":"Kastner","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Allgemein-, Viszeral-,\n          Transplantations-, Gef\u00e4\u00df- und Kinderchirurgie, Universit\u00e4tsklinikum W\u00fcrzburg, W\u00fcrzburg,\n          Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Meir","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Allgemein-, Viszeral-,\n          Transplantations-, Gef\u00e4\u00df- und Kinderchirurgie, Universit\u00e4tsklinikum W\u00fcrzburg, W\u00fcrzburg,\n          Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sven","family":"Flemming","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Allgemein-, Viszeral-,\n          Transplantations-, Gef\u00e4\u00df- und Kinderchirurgie, Universit\u00e4tsklinikum W\u00fcrzburg, W\u00fcrzburg,\n          Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim","family":"Reibetanz","sequence":"additional","affiliation":[{"name":"Klinik & Poliklinik f\u00fcr Allgemein- und Viszeralchirurgie, Gef\u00e4\u00df- und\n          Kinderchirurgie, Uniklinikum W\u00fcrzburg, W\u00fcrzburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph Thomas","family":"Germer","sequence":"additional","affiliation":[{"name":"Klinik & Poliklinik f\u00fcr Allgemein- und Viszeralchirurgie, Gef\u00e4\u00df- und\n          Kinderchirurgie, Uniklinikum W\u00fcrzburg, W\u00fcrzburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armin","family":"Wiegering","sequence":"additional","affiliation":[{"name":"Klinik & Poliklinik f\u00fcr Allgemein- und Viszeralchirurgie, Gef\u00e4\u00df- und\n          Kinderchirurgie, Uniklinikum W\u00fcrzburg, W\u00fcrzburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,3,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer 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