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Zentralbl Chir 2001; 126(11): 901-907
DOI: 10.1055/s-2001-19147
Evidenz-basierte Therapie des Pankreaskarzinoms

© Georg Thieme Verlag Stuttgart · New York

Qualitätsmanagement in der Chirurgie: Behandlungsmöglichkeiten des Pankreaskarzinoms

Was ist Evidenz-basiert?Quality Management in Surgery: Treatment of Pancreatic Carcinoma - What is Evidence-Based?W. Hohenberger, S. Schoolmann, S. Kastl
  • 1Chirurgische Universitätsklinik Erlangen
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Publication History

Publication Date:
19 December 2001 (online)

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Zusammenfassung

Der Ausdruck „Evidence-Based Medicine” (EMB) hat Schlagwortcharakter und ist ein in der modernen Medizin häufig verwendeter Anglizismus, dessen tatsächliche Bedeutung jedoch nicht immer allen, die ihn benützen, geläufig ist. Ganz allgemein sei darunter zu verstehen, daß Diagnostik- und Therapieentscheidungen anhand von zugrundeliegenden Daten aus randomisierten, wenn möglich doppelblinden und kontrollierten Studien mit hinreichend großen Fallzahlen getroffen werden. Dies ist aber nicht immer automatisch gleichzusetzen mit einer Entscheidungsfindung auf dem höchsten Niveau an wissenschaftlichen Erkenntnissen unter Berücksichtigung der aktuellsten Ergebnisse. Im Folgenden sollen unter Berücksichtigung der aktuellen Literatur vier Fragenkomplexe die chirurgische Therapie des Pankreaskarzinoms betreffend analysiert werden: das Ausmaß der Lymphknotendissektion, die Relevanz multimodaler Therapiekonzepte, der Wert der pyloruserhaltenden partiellen Duodenopankreatektomie und die Relevanz der Pfortaderresektion.

Summary

The term “evidence-based medicine” (EBM) - an Anglicism in common use in modern medicine - has of the nature of a catchword, the actual meaning of which is not always clear to all who use it. Generally speaking it is taken to mean that decision-making in the areas of diagnosis and treatment is based on data obtained from randomized, preferably double-blind and controlled, studies involving sufficient numbers of cases. This, however, is not always automatically equatable with arriving at a decision at the highest level of confirmed scientific knowledge, including the most recently acquired facts. Taking account of the current literature, the present article attempts an analysis of the following four aspects of surgical treatment of pancreatic carcinoma: the required extent of lymph node dissection, the relevance of multimodal treatment concepts, the significance of pylorus-preserving partial duodenopancreatectomy and the relevance of portal vein resection.

Schlüsselwörter

Qualitätsmanagement - Pankreaskarzinom - Evidenz-basierte Therapie

Key words

Quality management - Pancreatic cancer - Evidence-based medicine - Multimodal therapy concepts - Pylorus-preserving partial duodenopancreatectomy

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