Friedberg V
Universitäts-Frauenklinik Mainz.
Geburtshilfe Frauenheilkd. 1989 May;49(5):423-7. doi: 10.1055/s-2008-1036395.
We can now say that in our opinion exenteration is not an operation that is dangerous to life, if the conditions that will be described below are observed and if the indication is interpreted sufficiently narrowly, although during the first few years results had been moderate indeed. Exenteration has since developed so positively that it is now increasingly possible to consider the aspect of preserving the function of the adjacent organs, so that the disadvantages resulting for the patient's own body image and her self-concept and self-appraisal are now relatively acceptable compared to what had been possible previously. Indication for exenteration results from the situation, the ideas and the motivation of the patient, mainly, however, against the background of the characteristic features of the operation described here. Today we can say that even these extensive operations are firmly established in gynaecological oncology if there are extended carcinomas and recurring carcinomas. Hence, I believe it is advisable--at least in central recurring carcinomas--to refer such patients to competent surgical oncological centres before attempting to irradiate (or to irradiate again) the recurring tumour.
我们现在可以说,在我们看来,如果遵循以下将要描述的条件,并且适应症的把握足够严格,那么盆腔脏器清除术并非一种危及生命的手术,尽管在最初几年其效果确实一般。从那以后,盆腔脏器清除术有了积极的发展,现在越来越有可能考虑保留相邻器官功能的问题,因此与以前相比,对患者自身身体形象、自我概念和自我评价所造成的不利影响现在相对可以接受。盆腔脏器清除术的适应症取决于病情、患者的想法和动机,但主要还是基于此处所描述的手术的特点。如今我们可以说,即使是这些大型手术,在妇科肿瘤学中对于广泛性癌和复发性癌来说也已牢固确立。因此,我认为明智的做法是——至少对于中央型复发性癌——在试图对复发性肿瘤进行放疗(或再次放疗)之前,将此类患者转诊至有能力的外科肿瘤中心。