Publication: Cáncer de recto: valoración de recidivas locorregionales tras resección anterior versus amputación abdóminoperineal
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2018-01-09
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Universidad Complutense de Madrid
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Abstract
El cáncer colorrectal es uno de los tumores más prevalentes en la población mundial. En nuestro país supone el tercero más frecuente en ambos sexos, después de los de mama y próstata, diagnosticándose unos 26500 casos nuevos al año, según datos del Ministerio de Sanidad y Consumo. El cáncer de recto representa un tercio de ellos Desde la introducción de la amputación abdóminoperineal (AAP) por Miles en 1908 y la resección anterior (RA) descrita por Balfour a principios del siglo XIX, junto con el manejo global de cáncer de recto, estas técnicas han ido sufriendo modificaciones con el objeto de mejorar las cifras de recidiva local (RL) y los resultados de estos pacientes a largo plazo. A principios de la década de los 80 las tasas de recidivas locales oscilaban entre cifras tan dispares como un 4 y un 50%. En 1982 Heald introdujo la escisión total del mesorrecto, cuya incorporación dentro de una técnica quirúrgica estandarizada significó un descenso de las cifras de RL en todas las Unidades de Coloproctología que la adoptaron, convirtiéndose en el gold standard de la cirugía del cáncer de recto...
Colorectal cancer is one of the most prevalent tumors in world population. In our country it means the third more frequent in both gender, behind breast and prostate cancer. In Spain 26500 new cases are diagnosed each year according to the Health and Consumption Ministry. Rectal cancer represents one-third of them. Since introduction of abdominoperineal excision by Miles in 1908, and the anterior resection described by Balfour in the early nineteenth century, together with the global management of rectal cancer, these techniques have been modified in order to improve the number of local recurrences and these patients long-term results. At the beginning of the 80s decade, the local recurrence rates ranged from such disparate figures as 4 and 50%. In 1982 Heald introduced the total mesorrectal excision, whose incorporation into a standardized surgical technique represented a decrease of the local recurrence rates in all the coloproctology units who adopted it, becoming the gold standard of rectal cancer surgery. Shortly after, in 1986, Quirke demonstrated that an affected positive circumferential resection margin increased the local recurrence rates of rectal cancer and decreased the overall survival of these patients...
Colorectal cancer is one of the most prevalent tumors in world population. In our country it means the third more frequent in both gender, behind breast and prostate cancer. In Spain 26500 new cases are diagnosed each year according to the Health and Consumption Ministry. Rectal cancer represents one-third of them. Since introduction of abdominoperineal excision by Miles in 1908, and the anterior resection described by Balfour in the early nineteenth century, together with the global management of rectal cancer, these techniques have been modified in order to improve the number of local recurrences and these patients long-term results. At the beginning of the 80s decade, the local recurrence rates ranged from such disparate figures as 4 and 50%. In 1982 Heald introduced the total mesorrectal excision, whose incorporation into a standardized surgical technique represented a decrease of the local recurrence rates in all the coloproctology units who adopted it, becoming the gold standard of rectal cancer surgery. Shortly after, in 1986, Quirke demonstrated that an affected positive circumferential resection margin increased the local recurrence rates of rectal cancer and decreased the overall survival of these patients...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 22-01-2016