Haller U
Departement für Frauenheilkunde, Universitätsspital, Zürich, Schweiz.
Gynakol Geburtshilfliche Rundsch. 1993;33(4):222-30. doi: 10.1159/000272113.
It is shown how in gynaecologic oncology, proceeding from former standardized techniques, an individualized multimodal therapeutic concept has been developed. New aspects are introduced concerning diagnosis and treatment in the field of operative urogynaecology. The world-wide problem of performing poorly indicated hysterectomies is also addressed. Dynamic developments in the field of out-patient surgery will become an increasing challenge in the near future, influencing obstetrics and gynaecology to an extent that cannot be present be foreseen for the middle and long range. The forced evolution of conventional and laser-assisted laparoscopic surgery resulted in a nowadays broad spectrum of laparoscopically practicable surgical interventions, which made, even if still questioned by some experts, the vaginally assisted laparoscopic hysterectomy possible.
文中展示了在妇科肿瘤学领域，如何从以前的标准化技术出发，形成了个体化的多模式治疗理念。文中还介绍了泌尿妇科手术领域诊断和治疗方面的新情况。文中也探讨了全球范围内实施指征不当的子宫切除术这一问题。门诊手术领域的动态发展在不久的将来将成为越来越大的挑战，其对妇产科的影响在中长期内是无法预见的。传统腹腔镜手术和激光辅助腹腔镜手术的不断发展，导致如今有广泛的腹腔镜可行手术干预方式，这使得阴道辅助腹腔镜子宫切除术成为可能，尽管仍有一些专家对此表示质疑。
