Kirurgisk behandling av tykktarmskreft uten metastaser
Kirurgisk behandling av tykktarmskreft uten metastaser
Sist oppdatert: 20.05.2022
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Utgiver: Helsedirektoratet
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Kunnskapen om behandling av tykktarmskreft er i hovedsak basert på kohortstudier av varierende kvalitet og det er gjennomført få prospektive randomiserte studier. I tillegg har kirurgisk praksis og kunnskap om tykktarmens kar- og lymfeanatomi ledet fram til den behandlingsteknikk og de anbefalinger vi har i dag (Vogel et al., 2022). Høyre kolons krøs har større variasjoner i karanatomi, og den mesokoliske disseksjon er derfor mer krevende enn ved venstresidig tykktarmskreft. Det er også holdepunkt for at høyre- og venstresidige svulster i tykktarmen har ulik tumorbiologi.
Dersom preoperativ utredning indikerer kurativt siktemål, må det tilstrebes en onkologisk adekvat kirurgisk prosedyre. Dette innebærer reseksjon av tumorbærende tarmsegment med adekvate marginer og reseksjon av intakt mesokolon med regionale lymfeknuter.
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