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2012, Número 3

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Rev Mex Cir Endoscop 2012; 13 (3)


Calidad de la resección oncológica en cáncer de recto. Estudio comparativo entre cirugía abierta y laparoscópica

Ramírez MF, Valadez CD, Enríquez GJA, Vega JM, Cruz SCA, Ramírez MR, Decanini TCÓ

Idioma: Español
Referencias bibliográficas: 33
Paginas: 127-132
Archivo PDF: 106.69 Kb.


RESUMEN

Introducción: El cáncer de recto es la tercera forma más común de cáncer a nivel mundial. Actualmente se tiene consenso de la factibilidad de la cirugía laparoscópica para su tratamiento; sin embargo, continúa la controversia en la radicalidad de la resección oncológica. Material y métodos: Estudio retrospectivo, transversal y observacional. Pacientes sometidos a resección oncológica por cáncer de recto del 1° de enero de 2004 al 1° de septiembre del 2011. Variables: Características sociodemográfícas, perioperatorias y radicalidad del procedimiento. Análisis: Porcentaje como medida de variable cualitativa. Prueba t de Student para valores no pareados. χ2 para variables expresadas en proporciones. p ‹ 0.05 estadísticamente significativo. Resultados: 89 pacientes, cirugía laparoscópica = 39, cirugía abierta = 50, estancia promedio 7.92 versus 10.18 (p = 0.039). Resección anterior baja: 38 (98%) versus 32 (64%). Resección anterior P:1 (2%) versus 18 (36%) (p = 0.0001). Estomas protectores: 3 (7.69%) versus 29 (58%) (p = 0.043). Sangrado transoperatorio: 259 versus 525 mL (p = 0.001). Bordes quirúrgicos libres: 100 versus 96% (p = 0.006). Ganglios linfáticos resecados: 11.5 versus 13.5 (p = 0.139). Dehiscencia de anastomosis: 3 (7.6%) versus 2 (4%) (p = 0.126). Reintervenciones: 3. versus 4. (p = 1.631). Conclusiones: Los resultados del tratamiento del cáncer de recto por cirugía laparoscópica son equivalentes en términos de resección oncológica a los ya observados por cirugía abierta, con beneficios potenciales como menor dolor, tiempo de estancia y sangrado transoperatorio.


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