{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T04:29:56Z","timestamp":1744172996880,"version":"3.40.3"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Ziel der pr\u00e4operativen Diagnostik beim Rektumkarzinom ist die Erfassung des Ausma\u00dfes\n\t\t\tder lokalen und systemischen Tumorausbreitung. Das lokale Staging umfasst die\n\t\t\tRektoskopie mit exakter H\u00f6henlokalisation, die histologische Sicherung, die MRT des\n\t\t\tBeckens und \u2013 insbesondere bei lokal begrenzten Tumoren \u2013 die Endosonografie. Die\n\t\t\tBefundung der MRT sollte neben der H\u00f6he des Tumors und der m\u00f6glichen Infiltration von\n\t\t\tNachbarorganen den minimalen Abstand des Tumors zur mesorektalen Faszie enthalten.\n\t\t\tWichtig ist zudem die Angabe MR-morphologischer Kriterien extramuraler Gef\u00e4\u00dfinvasion.\n\t\t\tBei tiefen Karzinomen ist der Bezug zu den einzelnen Komponenten des Schlie\u00dfmuskels eine\n\t\t\twichtige Frage an die MRT zur Planung der operativen Strategie, bei hohen Karzinomen\n\t\t\tsollte auf eine m\u00f6gliche Infiltration der peritonealen Umschlagfalte geachtet werden.\n\t\t\tZum Nachweis oder Ausschluss von Fernmetastasen stellt ein R\u00f6ntgenthorax und eine\n\t\t\tSonografie des Abdomens die durch die Leitlinie geforderte Basisdiagnostik dar. Entweder\n\t\t\tprim\u00e4r, in jedem Fall aber bei unklaren Befunden, sollten diese durch ein Thorax- und\n\t\t\tAbdomen-CT erg\u00e4nzt werden. Neben der Bestimmung des karzinoembryonalen Antigens (CEA),\n\t\t\tdas vorrangig zur Verlaufskontrolle dient, sollte eine vollst\u00e4ndige Koloskopie zum\n\t\t\tAusschluss eines Zweitmalignoms im Kolon erfolgen. Ist diese aufgrund eines nicht\n\t\t\tpassierbaren Tumors nicht m\u00f6glich, dann sollte diese 3 Monate postoperativ erfolgen.\n\t\t\tErg\u00e4nzend kann eine pr\u00e4operative CT- oder MR-Kolonoskopie erfolgen, mit der gr\u00f6\u00dfere\n\t\t\tPolypen und Karzinome nachgewiesen werden k\u00f6nnen.<\/jats:p>","DOI":"10.1055\/a-2557-4857","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T23:15:41Z","timestamp":1744154141000},"page":"151-157","source":"Crossref","is-referenced-by-count":0,"title":["Optimale pr\u00e4operative Diagnostik beim Rektumkarzinom"],"prefix":"10.1055","volume":"150","author":[{"given":"Katharina","family":"Beyer","sequence":"additional","affiliation":[{"name":"Chirurgie, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes C.","family":"Lauscher","sequence":"additional","affiliation":[{"name":"Chirurgie, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,4,8]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/978-3-662-58159-9_8","volume-title":"Magnetresonanztomographie (MRT)-basierte Chirurgie des\n\t\t\t\t\tRektumkarzinoms","author":"ME Kreis","year":"2020"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1055\/s-0034-1368480","article-title":"[Colorectal Carcinoma with Suspected Lynch Syndrome: A Multidisciplinary\n\t\t\t\t\tAlgorithm]","volume":"140","author":"R Schneider","year":"2015","journal-title":"Zentralbl Chir"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2044","DOI":"10.1053\/j.gastro.2010.01.054","article-title":"Hereditary and familial colon cancer","volume":"138","author":"KW Jasperson","year":"2010","journal-title":"Gastroenterology"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"900","DOI":"10.1097\/SLA.0b013e31826bff79","article-title":"High risk of rectal cancer and of metachronous colorectal cancer in\n\t\t\t\t\tprobands of families fulfilling the Amsterdam criteria","volume":"257","author":"L Cirillo","year":"2013","journal-title":"Ann Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1055\/s-0043-1770730","article-title":"Management of Rectal Cancer in Lynch Syndrome: Balancing Risk Reduction\n\t\t\t\t\tand Quality of Life","volume":"37","author":"BA Krasnick","year":"2023","journal-title":"Clin Colon Rectal Surg"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"4285","DOI":"10.1200\/JCO.2005.03.7333","article-title":"Genotype-phenotype comparison of German MLH1 and MSH2 mutation carriers\n\t\t\t\t\tclinically affected with lynch syndrome: A report by the German HNPCC\n\t\t\t\t\tconsortium","volume":"24","author":"T Goecke","year":"2006","journal-title":"J Clin Oncol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1829","DOI":"10.1245\/s10434-012-2858-5","article-title":"Risk of metachronous colon cancer following surgery for rectal cancer in\n\t\t\t\t\tmismatch repair gene mutation carriers","volume":"20","author":"AK Win","year":"2013","journal-title":"Ann Surg Oncol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"3039","DOI":"10.1200\/JCO.2016.66.6826","article-title":"DNA Mismatch Repair Deficiency in Rectal Cancer: Benchmarking Its Impact\n\t\t\t\t\ton Prognosis, Neoadjuvant Response Prediction, and Clinical Cancer\n\t\t\t\t\tGenetics","volume":"34","author":"N de Rosa","year":"2016","journal-title":"J Clin Oncol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2363","DOI":"10.1056\/NEJMoa2201445","article-title":"PD-1 Blockade in Mismatch Repair-Deficient, Locally Advanced Rectal\n\t\t\t\t\tCancer","volume":"386","author":"A Cercek","year":"2022","journal-title":"N Engl J Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"iv22","DOI":"10.1093\/annonc\/mdx224","article-title":"Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment\n\t\t\t\t\tand follow-up","volume":"28","author":"R Glynne-Jones","year":"2017","journal-title":"Ann Oncol"},{"key":"ref13","first-page":"71","volume-title":"Pr\u00e4operatives Staging des Rektumkarzinoms","author":"K Beyer","year":"2020"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1245\/s10434-008-0231-5","article-title":"How good is endoscopic ultrasound in differentiating various T stages of\n\t\t\t\t\trectal cancer? 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