Medicina basada en la evidencia y la cirugía del cáncer de recto
- Labalde Martínez, M 1
- García Borda, J 1
- Peláez Torres, P 1
- Nevado García, C 1
- Alcalde Escribano, J 1
- Ferrero Herrero, E 1
- 1 Servicio de Cirugía General, Aparato Digestivo y Trasplante de Órganos Abdominales. Hospital Universitario 12 de Octubre. Madrid. España.
ISSN: 1139-8264
Any de publicació: 2018
Volum: 21
Número: 1
Pàgines: 25-31
Tipus: Article
Altres publicacions en: Revista española de investigaciones quirúrgicas
Resum
Introduction. Colorectal cancer is the fourth most common malignant in the world. The improvement in the 5-year survival for rectal cancer is probably related to multidimensional management included in clinical practice guidelines based on the scientific evidence. This systematic review was to evaluate the recommendations about surgery for rectal cancer. Materials and Methods. The relevant studies were identified by a search of MEDLINE, EMBASE and Cochrane Oral Health Group Specialized Register using terms rectal cancer AND surgical treatment AND evidence based medicine. Results. Management of rectal cancer requires a coordinated multidisciplinary team that applies the recommendations included in clinical practice guidelines. Surgical resection for rectal cancer follow the main oncologic principles as resection on bloc for locally advanced rectal tumors, adequate distal and circumferential margins and complete mesorectal excision. Intraluminal rectal washout and anastomotic leak testing were recommended. Laparoscopic approach by expert surgeons improves immediate postoperative outcomes and is as safe as the open approach in terms of oncological results. Conclusion. Adherence to evidence-based medicine included in surgical guidelines and personalization improves outcomes in rectal cancer surgery.