{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T14:33:51Z","timestamp":1774103631404,"version":"3.50.1"},"reference-count":52,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T00:00:00Z","timestamp":1709596800000},"content-version":"vor","delay-in-days":33,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"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>Die Endoskopie spielt heute nicht nur in der Erkennung von kolorektalen Adenomen und\n      Karzinomen eine entscheidende Rolle, sondern auch in der Behandlung von insbesondere fl\u00e4chigen\n      Adenomen und fr\u00fchen Karzinomen. In den letzten Jahren hat neben der klassischen Polypektomie\n      und Mukosaresektion flach-erhabener L\u00e4sionen mit der Schlinge (EMR), die endoskopische\n      Submukosadissektion (ESD) einen zunehmenden Stellenwert erlangt. Hierbei erfolgt nach\n      Markierung, Unterspritzung und Inzision der Mukosa um die L\u00e4sion, die Untertunnelung und das\n      \u201eEn-bloc\u201c-Ausl\u00f6sen durch eine transparente Aufsatzkappe und ein feines Diathermiemesser.\n      Gerade bei fl\u00e4chigen Ver\u00e4nderungen mit hohem Rezidivrisiko einer Piecemeal-Resektion durch EMR\n      sowie bei Risikol\u00e4sionen erm\u00f6glicht die ESD, nahezu gr\u00f6\u00dfenunabh\u00e4ngig in der Hand des\n      Erfahrenen, einen sicheren Abtrag mit einer histologischen R0-Resektionsrate an Zentren von\n      weit \u00fcber 90%. Die ESD erm\u00f6glicht eine optimale histopathologische Ausbeute und weist ein\n      niedriges Rezidivrisiko von 1\u20133% auf. Eine weitere Bereicherung des Armamentariums stellt die\n      endoskopische Vollwandresektion mit einem speziellen Applikationssystem dar (FTRD-System).\n      Dieses eignet sich f\u00fcr umschriebene submuk\u00f6se, suspekte oder narbige Ver\u00e4nderungen bis 2\u00a0cm\n      Gr\u00f6\u00dfe im mittleren und oberen Rektum. Die endoskopische intermuskul\u00e4re Dissektion (EID)\n      erm\u00f6glicht durch Mitnahme der zirkul\u00e4ren inneren Muskelschicht bei der Resektion die\n      histopathologische Analyse der kompletten Submukosa \u00fcber Mukosa und obere Submukosaschicht\n      hinaus. Sie bietet bei T1-Karzinomen ein geringeres Risiko der basalen R1-Situation und eine\n      neue Perspektive durch die kurative, organerhaltende endoskopische Therapie bei alleiniger\n      tiefer Submukosainfiltration ohne weitere Risikofaktoren f\u00fcr eine Metastasierung.\n      Indikationen, Technik und Stellenwert der verschiedenen Techniken bei pr\u00e4maligen und\n      fr\u00fchmaligen L\u00e4sionen im Rektum werden dargestellt.<\/jats:p>","DOI":"10.1055\/a-2256-6724","type":"journal-article","created":{"date-parts":[[2024,3,6]],"date-time":"2024-03-06T00:12:46Z","timestamp":1709683966000},"page":"46-55","source":"Crossref","is-referenced-by-count":5,"title":["Endoskopische Resektionsverfahren von fl\u00e4chigen Pr\u00e4kanzerosen und Fr\u00fchkarzinomen im Rektum"],"prefix":"10.1055","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5522-1271","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Hochberger","sequence":"additional","affiliation":[{"name":"Klinikum Friedrichshain, Abteilung f\u00fcr Gastroenterologie, Interdisziplin\u00e4res Darmkrebszentrum, Vivantes Netzwerk f\u00fcr Gesundheit GmbH, Berlin, Deutschland"},{"name":"Lehrkrankenhaus Vivantes Friedrichshain, Gastroenterologie, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Deutschland"},{"name":"Med. Klinik I - Gastroenterologie, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg, Erlangen, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Loss","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Allgemein- und Viszeralchirurgie, Interdisziplin\u00e4res Darmkrebszentrum, Vivantes Klinikum im Friedrichshain, Berlin, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Kruse","sequence":"additional","affiliation":[{"name":"Westklinikum Hamburg Suurheid, Abteilung f\u00fcr Gastroenterologie und Hepatologie, Asklepios Kliniken Hamburg GmbH, Hamburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,3,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1038\/s41575-023-00847-3","article-title":"Reduction in colorectal cancer incidence by screening 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