Cirugía laparoscópica a través de incisión única. Análisis del registro nacional

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habi&#233;ndose recomendado de forma expl&#237;cita su realizaci&#243;n en el caso de la cirug&#237;a a trav&#233;s de incisi&#243;n &#250;nica<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46; Adem&#225;s&#44; aunque los ensayos prospectivos y aleatorizados aportan la mayor calidad metodol&#243;gica a un estudio&#44; durante la introducci&#243;n de una nueva t&#233;cnica quir&#250;rgica es recomendable la realizaci&#243;n de otro tipo de an&#225;lisis&#44; que eval&#250;e su factibilidad y eficacia&#44; hasta que sus indicaciones se encuentren bien establecidas y la t&#233;cnica est&#233; completamente estandarizada<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">En Espa&#241;a&#44; el inter&#233;s suscitado por las t&#233;cnicas quir&#250;rgicas laparosc&#243;picas realizadas a trav&#233;s de un &#250;nico puerto motiv&#243; que desde la Secci&#243;n de Cirug&#237;a Endosc&#243;pica de la Asociaci&#243;n Espa&#241;ola de Cirujanos &#40;AEC&#41; se pusiera en marcha un Registro Nacional de Cirug&#237;a a trav&#233;s de Incisi&#243;n &#218;nica &#40;RNCIU&#41; con el fin de estudiar el nivel de implantaci&#243;n de estas t&#233;cnicas as&#237; como los principales aspectos cl&#237;nicos&#44; tecnol&#243;gicos y t&#233;cnicos relacionados con su uso&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El objetivo de este estudio fue recoger los principales datos cl&#237;nicos&#44; t&#233;cnicos y las posibles complicaciones de la cirug&#237;a laparosc&#243;pica a trav&#233;s de incisi&#243;n &#250;nica en nuestro pa&#237;s&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall">Durante el primer trimestre de 2010 se puso en marcha el proyecto para el desarrollo del RNCIU&#46; Valorada su idoneidad&#44; se consensu&#243; su estructura y formulario de recogida de datos que inclu&#237;a aspectos cl&#237;nicos&#44; t&#233;cnicos y tecnol&#243;gicos &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Anexo 1</a>&#41;&#46; En junio de 2010 se inici&#243; la recogida de datos a trav&#233;s de un formulario disponible en la p&#225;gina web de la AEC &#40;<a href="http://www.aecirujanos.es/registros/reg_cir_lap_incision_unica.php">http&#58;&#47;&#47;www&#46;aecirujanos&#46;es&#47;registros&#47;reg&#95;cir&#95;lap&#95;incision&#95;unica&#46;php</a>&#41;&#46; El Registro fue publicitado a trav&#233;s de los medios electr&#243;nicos de la AEC y en reuniones cient&#237;ficas de &#225;mbito nacional&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Los formularios recogidos en este trabajo se corresponden con los recibidos entre junio de 2010 y junio de 2011&#46; Todos los registros fueron revisados por el coordinador del Registro y por el responsable de la base de datos&#44; excluyendo para el an&#225;lisis datos extremos de estancia postoperatoria por considerarlos poco coherentes &#40;cirug&#237;a de &#243;rgano s&#243;lido con estancia menor a 6<span class="elsevierStyleHsp" style=""></span>h&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Los datos obtenidos a trav&#233;s de los formularios fueron almacenados en una base de datos Microsoft<span class="elsevierStyleSup">&#174;</span> Access<span class="elsevierStyleSup">&#174;</span> 2010 dise&#241;ada espec&#237;ficamente para el Registro y explotada mediante el programa SPSS<span class="elsevierStyleSup">&#174;</span>&#46; Se realiz&#243; un an&#225;lisis descriptivo de los datos y un contraste de las frecuencias mediante pruebas de Chi cuadrado&#46; Para los datos tecnol&#243;gicos se estim&#243; si la frecuencia de cada dispositivo&#44; sistema de visi&#243;n o instrumental en cada procedimiento se situaba por encima o debajo de lo esperado mediante le an&#225;lisis de los residuos tipificados&#46; Se utiliz&#243; como nivel de significaci&#243;n una p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">El estudio no recibi&#243; soporte econ&#243;mico p&#250;blico ni privado y la decisi&#243;n final de publicaci&#243;n de estos resultados fue responsabilidad del coordinador del RNCIU y de la Junta de la Secci&#243;n de Cirug&#237;a Endosc&#243;pica de la AEC&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><p id="par0045" class="elsevierStylePara elsevierViewall">Durante el per&#237;odo de estudio han participado en el registro 35 centros &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; El modelo de gesti&#243;n de las instituciones participantes fue p&#250;blico en el 90&#37; de los casos y privado en el resto&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Con respecto a la actividad&#44; el 96&#37; de la actividad se realiz&#243; en 18 centros y 4 de ellos acumularon el 51&#37; de los casos&#46; Desde 22 centros se enviaron menos de 5 casos&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Se han recogido 1&#46;198 formularios correspondientes a 749 &#40;62&#44;6&#37;&#41; mujeres y 449 &#40;37&#44;4&#37;&#41; varones&#44; con una edad media de 46&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#44;3 &#40;13-91&#41; a&#241;os&#46; Para el an&#225;lisis&#44; se desech&#243; la estancia postoperatoria de 8 registros&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Los grupos de enfermedad t tratados&#44; procedimientos y sus principales caracter&#237;sticas se detallan en las <a class="elsevierStyleCrossRefs" href="#tbl0010">tablas 2 y 3</a>&#46; El 62&#44;2&#37; de los casos corresponden a colecistectom&#237;as&#44; el 22 a apendicectom&#237;as y el 7&#44;8&#37; a colectom&#237;as&#46; Adem&#225;s&#44; se registraron procedimientos sobre &#243;rganos s&#243;lidos &#40;3&#44;4&#37;&#41;&#44; cirug&#237;a bari&#225;trica &#40;2&#44;7&#37;&#41; y distintas reparaciones herniarias &#40;1&#44;9&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Analizada la cronolog&#237;a de la implantaci&#243;n de las t&#233;cnicas en los grupos que registraron mayor actividad&#44; en todos los casos se inici&#243; la actividad con la apendicectom&#237;a y&#47;o colecistectom&#237;a&#44; incorporando progresivamente procedimientos de mayor complejidad&#44; con un claro predominio de la colectom&#237;a derecha dentro de la cirug&#237;a del colon y de la gastrectom&#237;a vertical en el caso de la cirug&#237;a bari&#225;trica &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">La distribuci&#243;n de la edad no fue homog&#233;nea entre los grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#44; con una media de edad significativamente mayor en el grupo de pacientes con cirug&#237;a del colon&#46; Con respecto al &#237;ndice de masa corporal &#40;IMC&#41;&#44; el IMC medio de todo el grupo fue 27&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;3 &#40;16-66&#41; kg&#47;m<span class="elsevierStyleSup">2</span>&#44; siendo de 44&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;2 &#40;37-66&#41; kg&#47;m<span class="elsevierStyleSup">2</span> en el grupo de pacientes sometidos a cirug&#237;a bari&#225;trica y de 26&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44;1 &#40;16-50&#41; kg&#47;m<span class="elsevierStyleSup">2</span> en el resto &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">El riesgo anest&#233;sico de los pacientes fue ASA I-II en el 89&#44;6&#37; de los casos&#46; Sin embargo&#44; en el grupo de pacientes sometidos a cirug&#237;a de colon o bari&#225;trica la mayor parte de los pacientes presentaron un ASA II-III&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">La duraci&#243;n de la cirug&#237;a y la estancia media postoperatoria fueron sensiblemente mayores en los grupos de mayor complejidad t&#233;cnica &#40;colon&#44; bari&#225;trica y &#243;rgano s&#243;lido&#41;&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Aspectos tecnol&#243;gicos</span><p id="par0085" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a> se muestran los dispositivos de entrada&#44; sistemas de visi&#243;n e instrumental utilizados&#46; El sistema de puerto &#250;nico SILS<span class="elsevierStyleSup">&#174;</span> &#40;Covidien&#44; Autosuture&#44; Hamilton&#44; Bermuda&#41; fue el dispositivo de entrada utilizado en la mayor parte de los procedimientos &#40;60&#44;5&#37;&#41;&#46; Sin embargo&#44; en el grupo de cirug&#237;a del colon se utiliz&#243; el dispositivo GelPoint<span class="elsevierStyleSup">&#174;</span> &#40;Applied Medical&#44; Rancho Santa Margarita&#44; CA&#44; EE&#46; UU&#46;&#41; en el 27&#37; de los casos &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; y en cirug&#237;a bari&#225;trica el 56&#44;5&#37; de los procedimientos &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; se realizaron con TriPort<span class="elsevierStyleSup">&#174;</span> o QuadPort<span class="elsevierStyleSup">&#174;</span> &#40;Olympus&#44; Center Valley&#44; PA&#44; EE&#46; UU&#46;&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">Con respecto a los sistemas de visi&#243;n&#44; en el 74&#44;4&#37; de los casos se utiliz&#243; un laparoscopio de 5<span class="elsevierStyleHsp" style=""></span>mm&#44; siendo de visi&#243;n angulada en el 52&#44;8&#37;&#46; Esta tendencia fue homog&#233;nea en todos los grupos de enfermedad&#44; excepto en la cirug&#237;a del colon y bari&#225;trica&#44; donde la tendencia a utilizar laparoscopios de 10<span class="elsevierStyleHsp" style=""></span>mm fue significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Finalmente&#44; el instrumental m&#225;s utilizado fue articulado &#40;55&#44;4&#37;&#41; y convencional &#40;32&#44;9&#37;&#41;&#46; En el caso de las colecistectom&#237;as&#44; existi&#243; una tendencia significativa hacia la utilizaci&#243;n de instrumental con posibilidades de angulaci&#243;n &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Sin embargo&#44; la utilizaci&#243;n de material convencional fue significativamente mayor que la media &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; en las apendicectom&#237;as y colectom&#237;as realizadas&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Aspectos t&#233;cnicos</span><p id="par0100" class="elsevierStylePara elsevierViewall">Los aspectos t&#233;cnicos m&#225;s significativos se resumen en la <a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#46; La v&#237;a de acceso m&#225;s utilizada fue la incisi&#243;n de localizaci&#243;n umbilical &#40;93&#44;4&#37;&#41;&#44; predominando la v&#237;a transumbilical &#40;73&#44;7&#37;&#41;&#46; En la mayor parte de las cirug&#237;as no se utiliz&#243; ning&#250;n sistema de asistencia &#40;63&#44;6&#37;&#41;&#44; siendo las sutura transparietal la t&#233;cnica de asistencia m&#225;s utilizada &#40;25&#44;2&#37;&#41;&#46; En el 3&#44;6&#37; de los casos se utiliz&#243; un mini- o microinstrumento &#40;&#8804;<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>mm&#41; como sistema de ayuda para finalizar el procedimiento&#44; no consider&#225;ndose este tipo de asistencia como conversi&#243;n a cirug&#237;a laparosc&#243;pica convencional&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">Respecto a la t&#233;cnica de cierre&#44; en el 95&#37; de los casos se realiz&#243; un cierre fascial simple&#44; utiliz&#225;ndose alg&#250;n tipo de pr&#243;tesis en el resto&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conversi&#243;n y morbimortalidad</span><p id="par0110" class="elsevierStylePara elsevierViewall">La tasa de conversi&#243;n fue del 12&#44;5&#37;&#44; con un 11&#44;3&#37; de conversiones a cirug&#237;a laparosc&#243;pica y 1&#44;2&#37; a laparotom&#237;a&#44; con una tasa por encima de la media en el grupo de cirug&#237;a bari&#225;trica &#40;43&#44;5&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; La dificultad para la manipulaci&#243;n de los instrumentos &#40;54&#44;6&#37;&#41; y la visi&#243;n sub&#243;ptima &#40;16&#37;&#41; fueron las principales causas de conversi&#243;n &#40;<a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">Con respecto a la morbilidad &#40;<a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a>&#41;&#44; la incidencia global de complicaciones fue del 0&#44;8&#37;&#44; con un predominio claro de las complicaciones de la herida quir&#250;rgica&#46; La distribuci&#243;n de estas complicaciones en los distintos grupos de enfermedad fue muy homog&#233;nea aunque los pacientes intervenidos de una enfermedad de la pared abdominal presentaron una incidencia muy significativa de seroma de la herida quir&#250;rgica &#40;14&#44;3&#37;&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Con respecto a las complicaciones generales&#44; destacaron las tasas de infecci&#243;n urinaria y respiratoria de los pacientes sometidos a cirug&#237;a bari&#225;trica&#44; ambas por encima de la media &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">La mortalidad de la serie fue de 0&#44;1&#37; y corresponde a un caso de f&#237;stula anastom&#243;tica en una colectom&#237;a izquierda&#44; lo que supone una mortalidad en ese grupo de intervenciones del 1&#44;4&#37;&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discusi&#243;n</span><p id="par0125" class="elsevierStylePara elsevierViewall">La cirug&#237;a a trav&#233;s de incisi&#243;n &#250;nica tiene un importante potencial de innovaci&#243;n en el campo de la cirug&#237;a m&#237;nimamente invasiva&#44; siendo imprescindible hacer todo el esfuerzo posible para conseguir un uso responsable&#44; siguiendo los m&#225;s altos est&#225;ndares de eficacia y seguridad&#46; En caso contario&#44; corremos el riesgo de desacreditar la t&#233;cnica&#44; perdiendo la oportunidad de verla madurar como tal y malogrando otros avances surgidos a trav&#233;s del desarrollo tecnol&#243;gico desencadenado&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">La utilidad de los registros cl&#237;nicos multic&#233;ntricos ha sido previamente destacada<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3&#44;5</span></a>&#46; Estas herramientas de investigaci&#243;n permiten recoger datos sobre la eficacia y seguridad de un procedimiento&#46; Adem&#225;s&#44; aportan algunas ventajas sobre otras t&#233;cnicas de recogida de datos&#44; como es la posibilidad de intercambiar informaci&#243;n entre las instituciones participantes<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#46; Teniendo en cuenta todas estas consideraciones&#44; la Secci&#243;n de Cirug&#237;a Endosc&#243;pica de la AEC decidi&#243; poner en marcha el RNCIU&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Los datos obtenidos en el RNCIU permiten orientar el nivel de implantaci&#243;n de estas t&#233;cnicas en nuestro pa&#237;s aunque con una limitaci&#243;n importante&#46; La participaci&#243;n en el RNCIU es voluntaria y como tal&#44; si bien muestra una tendencia&#44; no recoge toda la realidad del pa&#237;s&#46; Este hecho es f&#225;cilmente constatable al comprobar&#44; a trav&#233;s de los programas de las reuniones cient&#237;ficas y de la literatura m&#233;dica&#44; que existe una actividad significativa en esta &#225;rea que no se ha aportado al RNCIU&#46; No obstante&#44; tal y como se ha se&#241;alado por otros autores<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#44; el registro ha sido un importante instrumento que nos ha permitido dibujar un mapa de desarrollo de las distintas t&#233;cnicas y aportar informaci&#243;n en un campo en el que la evidencia cient&#237;fica es escasa&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Nuestros resultados demuestran la factibilidad de un buen n&#250;mero de procedimientos en distintas &#225;reas de la cirug&#237;a&#44; con un nivel de desarrollo y con una cronolog&#237;a similares a las que se presentan en la literatura<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7</span></a>&#46; Es destacable que el inter&#233;s inicial mostrado por los grupos participantes no se ha consolidado en todos los casos ya que m&#225;s del 95&#37; de la actividad registrada se realiz&#243; en solo la mitad de los centros participantes&#46; Estos datos muestran el alto grado de motivaci&#243;n necesario tanto para el desarrollo de estas t&#233;cnicas como para la participaci&#243;n en un proyecto como el RNCIU&#46; Adem&#225;s&#44; la dificultad t&#233;cnica de este tipo de cirug&#237;a&#44; su curva de aprendizaje as&#237; como aspectos econ&#243;micos&#44; organizativos y de dificultad de acceso a la tecnolog&#237;a necesaria explicar&#237;an los problemas para su consolidaci&#243;n en otros centros&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Los procedimientos realizados con m&#225;s frecuencia &#40;colecistectom&#237;a&#44; apendicectom&#237;a&#41;&#44; traducen que la v&#237;a utilizada para la inmersi&#243;n en esta cirug&#237;a son las enfermedades de alta prevalencia&#44; complejidad baja y con est&#225;ndares muy reconocidos&#46; Adem&#225;s&#44; existi&#243; una tendencia homog&#233;nea a ir incorporando procedimientos m&#225;s complejos a medida que se acumula experiencia &#40;colectom&#237;a&#41; y al desarrollo de procedimientos muy espec&#237;ficos &#40;cirug&#237;a bari&#225;trica y de &#243;rgano s&#243;lido&#41; en el seno de grupos con experiencia muy reconocida en estas &#225;reas<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;9</span></a>&#46; Dentro de los procedimientos avanzados predominaron la colectom&#237;a derecha y la gastrectom&#237;a vertical&#44; lo cual estar&#237;a en relaci&#243;n con la menor dificultad t&#233;cnica de estos procedimientos dentro de la cirug&#237;a del colon y bari&#225;trica respectivamente&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">A la vista de estos datos y en ausencia de est&#225;ndares de formaci&#243;n reconocidos&#44; la implantaci&#243;n de programas de cirug&#237;a laparosc&#243;pica a trav&#233;s de incisi&#243;n &#250;nica deber&#237;a hacerse en el seno de grupos con altos niveles de capacitaci&#243;n en cirug&#237;a laparosc&#243;pica o contando con su apoyo&#46; Adem&#225;s&#44; aunque algunos autores<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> han demostrado que la curva de aprendizaje en procedimientos como la colecistectom&#237;a es corta&#44; antes de iniciarse en este campo ser&#237;a recomendable la realizaci&#243;n de pr&#225;cticas en simuladores y modelos experimentales&#44; la realizaci&#243;n de cursos espec&#237;ficos y&#44; finalmente&#44; un uso cl&#237;nico razonable apoy&#225;ndose en t&#233;cnicas de asistencia que garanticen la seguridad de los procedimientos&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Desde el punto de vista tecnol&#243;gico&#44; existen ejemplos de utilizaci&#243;n de casi todos los recursos disponibles en el mercado&#44; aunque es posible detectar tendencias en el uso&#46; Respecto a los dispositivos de entrada&#44; la mayor parte de los procedimientos se realizaron con el dispositivo SILS<span class="elsevierStyleSup">&#174;</span>&#46; Si bien esta tendencia podr&#237;a explicarse por las caracter&#237;sticas del dispositivo&#44; tambi&#233;n podr&#237;a justificarse por su f&#225;cil disponibilidad y accesibilidad en el mercado&#46; Con respecto a los sistemas de imagen&#44; existe un predominio en la utilizaci&#243;n de laparoscopios de 5<span class="elsevierStyleHsp" style=""></span>mm y visi&#243;n angulada&#44; los cuales permiten mejorar las posibilidades de visi&#243;n&#46; Sin embargo&#44; en los casos de cirug&#237;a de &#243;rgano s&#243;lido y bari&#225;trica&#44; existi&#243; una tendencia hacia el uso de laparoscopios de 10<span class="elsevierStyleHsp" style=""></span>mm y 30&#176;&#46; Este hecho podr&#237;a explicarse por las necesidades de visi&#243;n en campos m&#225;s amplios&#44; en los que el laparoscopio de 5<span class="elsevierStyleHsp" style=""></span>mm trasmite menor cantidad de luz y permite una menor calidad de imagen&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Con respecto al instrumental&#44; es habitual en todos los grupos la utilizaci&#243;n de una combinaci&#243;n de pinzas articuladas e instrumental convencional&#44; combinaci&#243;n que ofrece un nivel de triangulaci&#243;n aceptable con poco conflicto de espacio en el &#225;rea de trabajo&#46; En este sentido&#44; es destacable el predominio en la utilizaci&#243;n de instrumental con posibilidades de angulaci&#243;n para la realizaci&#243;n de colecistectom&#237;as&#44; lo cual puede explicarse por las escasas posibilidades de triangulaci&#243;n que ofrece el instrumental convencional en este campo&#46; Por el contrario&#44; esta tendencia se invirti&#243; en los grupos de apendicectom&#237;a y cirug&#237;a del colon&#44; donde los campos son m&#225;s amplios y las posibilidades de obtener una buena triangulaci&#243;n con el instrumental convencional son mayores&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">En cualquier caso&#44; a pesar del esfuerzo realizado por la industria&#44; las herramientas tecnol&#243;gicas disponibles no son &#243;ptimas y&#44; generalmente&#44; son adaptaciones o reediciones de productos ya existentes para laparoscopia convencional&#46; La ausencia de est&#225;ndares t&#233;cnicos y las necesidades de amortizaci&#243;n de las inversiones empresariales dificultan el avance en este campo&#44; siendo necesario hacer un esfuerzo conjunto en investigaci&#243;n y desarrollo&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Con respecto a las t&#233;cnicas quir&#250;rgicas&#44; aunque no existen est&#225;ndares reconocidos&#44; es posible vislumbrar un camino com&#250;n&#44; en el que predomina la utilizaci&#243;n de incisiones transumbilicales&#44; escasas maniobras de asistencia y cierres aponeur&#243;ticos simples&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Es dif&#237;cil obtener conclusiones sobre la tasa de conversi&#243;n ya que los procedimientos incluidos en el RNCIU son muy heterog&#233;neos&#46; En cualquier caso&#44; la incidencia global registrada se encuentra en consonancia con la experiencia acumulada en la literatura &#40;0-24&#37;&#41;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;7&#44;10&#44;11</span></a>&#46; Sin embargo&#44; es posible destacar que la tasa de conversi&#243;n de los procedimientos bari&#225;tricos del registro super&#243; significativamente la media&#44; poniendo de manifiesto la dificultad de estas t&#233;cnicas y&#44; probablemente&#44; alertando sobre la existencia de una curva de aprendizaje m&#225;s patente o la necesidad de considerar estos procedimientos como h&#237;bridos&#44; ayud&#225;ndose siempre de sistemas de asistencia&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">La morbilidad registrada en todo el Registro es aceptable&#44; teniendo en cuenta la heterogeneidad de los pacientes y procedimientos realizados&#46; Uno de los aspectos que m&#225;s preocupan al evaluar los resultados de la cirug&#237;a a trav&#233;s de incisi&#243;n &#250;nica son las complicaciones de la herida&#46; Al tratarse de una incisi&#243;n mayor que la de un trocar convencional&#44; podr&#237;a esperarse un aumento en la incidencia de hernias incisionales&#46; En la actualidad&#44; aunque no existen estudios con potencia estad&#237;stica que eval&#250;en esta complicaci&#243;n&#44; la incidencia se encuentra en torno al 2&#44;5&#37;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#44; cifra similar a la comunicada para trocares convencionales &#40;0&#44;1-2&#44;8&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&#46; En los pacientes del RNCIU&#44; la incidencia de hernia incisional fue de 0&#44;8&#37; para todo el grupo y 1&#44;1&#37; para el grupo m&#225;s numeroso de pacientes &#40;colecistectom&#237;a&#41;&#46; Sin embargo&#44; el dise&#241;o del Registro hace pensar que este dato se encuentra infravalorado y que ser&#237;a necesario auditar esta complicaci&#243;n tras un per&#237;odo de seguimiento prolongado&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Aunque la mortalidad siempre reviste significaci&#243;n al evaluar una innovaci&#243;n en cirug&#237;a&#44; la tasa registrada es baja &#40;0&#44;8&#37;&#41; teniendo en cuenta que existen pacientes con edades avanzadas y comorbilidades&#46; Contextualizando la mortalidad en el grupo donde existi&#243; &#40;cirug&#237;a del colon&#41;&#44; la mortalidad fue del 1&#44;4&#37;&#44; cifra que se encuentra en el rango de mortalidad registrado &#40;1-4&#37;&#41; en grandes estudios que eval&#250;an los resultados de la cirug&#237;a laparosc&#243;pica colorrectal<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#8211;15</span></a> y su mortalidad &#40;6&#44;8&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&#46; Adem&#225;s&#44; se encuentra por debajo del 3&#37; de mortalidad registrada durante la realizaci&#243;n de un programa de formaci&#243;n en cirug&#237;a colorrectal<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclusiones</span><p id="par0190" class="elsevierStylePara elsevierViewall">La cirug&#237;a laparosc&#243;pica a trav&#233;s de incisi&#243;n &#250;nica es un concepto novedoso del que se han hecho eco cirujanos de todo el mundo y al que no es ajena la comunidad cient&#237;fica de nuestro pa&#237;s&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Los resultados del RNCIU demuestran la factibilidad de numerosos procedimientos en un contexto de eficacia y seguridad&#44; con una cronolog&#237;a y progresi&#243;n similares a las del resto del mundo&#46; Desde el punto de vista tecnol&#243;gico&#44; aunque todav&#237;a es pronto para poder hablar de est&#225;ndares&#44; existen tendencias claras hacia la utilizaci&#243;n de determinados dispositivos&#44; instrumental y equipos&#44; que pueden servir como punto de partida para futuros desarrollos&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Por &#250;ltimo&#44; el RNCIU es una importante fuente de datos que permitir&#225; el estudio pormenorizado de subgrupos de enfermedades&#44; con el fin de avanzar en el conocimiento de estas t&#233;cnicas y generar evidencia cient&#237;fica&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicto de intereses</span><p id="par0205" class="elsevierStylePara elsevierViewall">Los autores declaran que no tienen ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La cirug&#237;a laparosc&#243;pica a trav&#233;s de incisi&#243;n &#250;nica es un concepto innovador cuya implantaci&#243;n y desarrollo es un reto para los cirujanos&#46;En Espa&#241;a&#44; el inter&#233;s suscitado por estas t&#233;cnicas motiv&#243; que la Secci&#243;n de Cirug&#237;a Endosc&#243;pica de la AEC pusiera en marcha un Registro Nacional de Cirug&#237;a a trav&#233;s de Incisi&#243;n &#218;nica &#40;RNCIU&#41;&#46;El objetivo de este estudio fue recoger los principales datos cl&#237;nicos&#44; t&#233;cnicos y las posibles complicaciones de estas t&#233;cnicas en nuestro pa&#237;s&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0985" class="elsevierStyleSimplePara elsevierViewall">La recogida de datos se realiz&#243; a trav&#233;s de un formulario disponible en la p&#225;gina web de la AEC&#46; Los formularios incluidos en este trabajo se corresponden con los recibidos entre junio de 2010 y junio de 2011&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0990" class="elsevierStyleSimplePara elsevierViewall">Durante el per&#237;odo de estudio han participado 35 centros&#44; recogi&#233;ndose 1198 formularios&#46; El 62&#44;2&#37; corresponden a colecistectom&#237;as&#44; el 22&#37; a apendicectom&#237;as y el 7&#44;8&#37; a colectom&#237;as&#46; Adem&#225;s&#44; se registraron procedimientos sobre &#243;rganos s&#243;lidos &#40;3&#44;4&#37;&#41;&#44; cirug&#237;a bari&#225;trica &#40;2&#44;7&#37;&#41; y distintas reparaciones herniarias &#40;1&#44;9&#37;&#41;&#46;La incidencia global de complicaciones fue de 0&#44;8&#37;&#46; La mortalidad de la serie fue de 0&#44;1&#37;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0995" class="elsevierStyleSimplePara elsevierViewall">La cirug&#237;a laparosc&#243;pica a trav&#233;s de incisi&#243;n &#250;nica es un concepto novedoso al que no es ajena nuestra comunidad cient&#237;fica&#46; Los resultados del registro demuestran la factibilidad de numerosos procedimientos en un contexto de eficacia y seguridad&#46; Por &#250;ltimo&#44; el RNCIU es una importante fuente de datos que permitir&#225; el estudio pormenorizado de subgrupos de patolog&#237;as&#44; con el fin de avanzar en el conocimiento de estas t&#233;cnicas y generar evidencia cient&#237;fica&#46;</p>"
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      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Laparoscopic surgery through a single incision is an innovative concept which is a challenge for surgeons to implement and develop&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The interest aroused by these techniques in Spain led to the Endoscopy Section of the Spanish Association of Surgeons &#40;AEC&#41; to start a National Register for Single-Incision Surgery &#40;RNCIU&#41;&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to collect the primary clinical data&#44; techniques&#44; and the possible complications of these techniques in Spain&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Data were gathered using a form available on the AEC website&#46; The forms included in this study correspond to those received between June 2010 and June 2011&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A total of 35 centers had taken part during the study period&#44; with1&#44;198 forms being collected&#46; The surgeries performed included 62&#46;2&#37; cholecystectomies&#44; 22&#37; appendectomies&#44; and 7&#46;8&#37; colectomies&#46; Procedures on solid organs &#40;3&#46;4&#37;&#41;&#44; bariatric surgery &#40;2&#46;7&#37;&#41;&#44; and various hernia repairs &#40;1&#46;9&#37;&#41;&#44; were also registered&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The overall incidence of complications was 0&#46;8&#37;&#46; The mortality rate in the series was 0&#46;1&#37;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Single incision laparoscopic surgery is a novel concept that is not beyond our scientific community&#46; The results of the Register demonstrate the feasibility of numerous effective and safe procedures&#46; Finally&#44; the RNCIU is an important data source to be able to study sub-groups of diseases in detail&#44; with the aim of advancing the knowledge of these techniques and generating scientific evidence&#46;</p>"
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                "apendice" => "<p id="par0210" class="elsevierStylePara elsevierViewall">Juan Carlos de Agust&#237;n Asensio&#44; Iv&#225;n J&#46; Arteaga Gonz&#225;lez&#44; Carmen Balague&#44; Mar&#237;a D&#46; Balsalobre Salmer&#243;n&#44; Juan Barri Trunas&#44; Juan Bellido Luque&#44; Marcos Bruna Esteban&#44; Teresa Calder&#243;n Duque&#44; Idelfonso Campano Cruz&#44; Ram&#243;n Claver&#237;a Puig&#44; Carlos Dur&#225;n Escribano&#44; Jordi Escoll Rufino&#44; Eloy Esp&#237;n Basany&#44; Oscar Estrada Ferrer&#44; Xavier Feliu Pal&#224;&#44; Jos&#233; Mar&#237;a Fern&#225;ndez Cebri&#225;n&#44; Manuel Garc&#237;a Caballero&#44; C&#233;sar Garc&#237;a Llorente&#44; Eva Garc&#237;a Torralbo&#44; Jes&#250;s Garijo &#193;lvarez&#44; Mart&#237;n Gasc&#243;n Hove&#44; Pablo Gil Yuste&#44; C&#233;sar Ginesta Mart&#237;&#44; Luis G&#243;mez Quiles&#44; Jos&#233; Manuel Guti&#233;rrez Cabezas&#44; M&#46; Luz Herrero Bogajo&#44; Santos Jim&#233;nez de los Galanes&#44; David Lacasa Mart&#237;n&#44; Santiago L&#243;pez Ben&#44; Francisco L&#243;pez Bernal&#44; Marc Mart&#237; Gallostra&#44; David Mart&#237;nez Cecilia&#44; Sagrario Mart&#237;nez Cortijo&#44; David Mart&#237;nez Ramos&#44; Manuel Miras Estacio&#44; Salvador Morales Conde&#44; Antonio Morandeira Rivas&#44; Carlos Moreno Sanz&#44; Jos&#233; Noguera Aguilar&#44; Federico Ochando Cerd&#225;n&#44; Jose Luis Pallares&#44; Emilio Prendes Sillero&#44; Jorge Juan Jos&#233; Olsina Kissler&#44; Joaqu&#237;n Resa Bienzobas&#44; Rodolfo Rodr&#237;guez Carrillo&#44; Rafael Rosado Cobi&#225;n&#44; Mar&#237;a Rufas Ac&#237;n&#44; Rafael Ruiz Orellana&#44; Antonio Torres Garc&#237;a&#44; Alex S&#225;enz Coromina&#44; Juan Jos&#233; S&#225;nchez Cano&#44; Jos&#233; Manuel S&#225;nchez Hidalgo&#44; Eduard Targarona Soler&#44; Oscar Vidal P&#233;rez&#44; Ram&#243;n Vilallonga Puy&#44; Rafael Villalobos Mori&#46;</p>"
                "titulo" => "A&#46;2&#46; Participantes en el Registro Nacional de Cirug&#237;a a trav&#233;s de Incisi&#243;n &#218;nica"
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          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Cirug&#237;a laparosc&#243;pica a trav&#233;s de incisi&#243;n &#250;nica&#46;</p>"
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                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cl&#237;nica USP Marbella&#44; Marbella&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Departamento de Cirug&#237;a Universidad de M&#225;laga&#44; M&#225;laga&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hospital Fundaci&#243;n Alcorc&#243;n&#44; Alcorc&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hospital Arnau de Vilanova&#44; L&#233;rida&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hospital El Bierzo&#44; Ponferrada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hospital Cl&#237;nic&#44; Barcelona&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Hospital Cl&#237;nica Sagrada Familia&#44; Barcelona&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hospital General de Castell&#243;n&#44; Castell&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hospital de Hospitalet&#44; Barcelona&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hospital de Igualada&#44; Igualada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hospital Infanta Sof&#237;a&#44; Madrid&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hospital la Inmaculada&#44; Hu&#233;rcal Overa&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hospital Mateu Orfila&#44; Menorca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Militar de Zaragoza&#44; Zaragoza&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Nuestra Se&#241;ora del Prado&#44; Talavera de La Reina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital de Riotinto&#44; Riotinto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Royo Villanova&#44; Zaragoza&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Sant Joan de Reus&#44; Reus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Sant Pau&#44; Barcelona&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Sierrallana&#44; Torrelavega&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Son Ll&#225;tzer&#44; Palma de Mallorca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital General de Valencia&#44; Valencia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario de Canarias&#44; Tenerife&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Universitario Reina Sof&#237;a&#44; C&#243;rdoba&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospitales Universitarios Virgen del Roc&#237;o&#44; Sevilla&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Vall d¿Hebr&#243;n&#44; Barcelona&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Virgen de la Paloma&#44; Madrid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Virgen del Rosell&#44; Cartagena&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hospital Virgen de la Salud&#44; Toledo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Apendicectom&#237;a&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sigmoidectom&#237;a&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Resecci&#243;n anterior baja&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Resecci&#243;n ileocecal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Colectom&#237;a subtotal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Reconstrucci&#243;n del tr&#225;nsito&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">&#211;rgano s&#243;lido</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">41&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Adrenalectom&#237;a&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Esplenectom&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Quiste hep&#225;tico simple&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nefrectom&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cirug&#237;a bari&#225;trica</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Gastrectom&#237;a vertical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">By pass</span> g&#225;strico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Banda g&#225;strica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cirug&#237;a de pared</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hernioplastia TEP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hernioplastia TAP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Eventroplastia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;198&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Ves&#237;cula &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>745&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Ap&#233;ndice &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>264&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&#211;&#46; s&#243;lido &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>41&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Bari&#225;trica &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>32&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t">46&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>17&#44;3 &#40;13-91&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#44;4 &#40;16-61&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#44;4 &#40;13-75&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44;2 &#40;27-86&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>18&#44;7 &#40;13-82&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;2 &#40;20-63&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#44;3 &#40;27-79&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#44;4&#37; &#9794;&#47;62&#44;6&#37; &#9792;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;4&#37; &#9794;&#47;70&#44;6&#37; &#9792;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#44;4&#37; &#9794;&#47;49&#44;6&#37; &#9792;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&#44;8&#37; &#9794;&#47;39&#44;2&#37; &#9792;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41&#37; &#9794;&#47;59&#37; &#9792;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;7&#37; &#9794;&#47;73&#44;9&#37; &#9792;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#37; &#9794;&#47;19&#37; &#9792;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">IMC &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  """
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Convencional&nbsp;\t\t\t\t\t\t\n
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                  """
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Suprap&#250;bica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">14&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Supraumbilical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">6&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Subcostal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pararrectal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Transrectal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Asistencia</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">63&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">49&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">99&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">69&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Suturas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Veress&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Miniinstrumento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">3&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">2&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Combinaci&#243;n<span class="elsevierStyleSup">&#42;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Im&#225;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Endograb<span class="elsevierStyleSup">&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Microinstrumento&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>IFS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cierre incisi&#243;n</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Simple&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pr&#243;tesis absorbible&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;0&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pr&#243;tesis irreabsorbible&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pr&#243;tesis compuesta&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">2&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">13&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab198480.png"
              ]
            ]
          ]
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        "descripcion" => array:1 [
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      6 => array:7 [
        "identificador" => "tbl0030"
        "etiqueta" => "Tabla 6"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
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                  \t\t\t\t" style="border-bottom: 2px solid black">Total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;198&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Ves&#237;cula &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>745&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Ap&#233;ndice &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>264&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Colon &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>93&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">&#211;&#46; s&#243;lido &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>41&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Bari&#225;trica &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>32&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t" style="border-bottom: 2px solid black">Pared &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>23&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Manipulaci&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">54&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t">80&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">83&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Visi&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hemorragia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Adherencias&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">16&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">12&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Varias causas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>N&#47;A&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">44&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Morbilidad</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">78&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Infecci&#243;n de herida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Seroma herida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hematoma herida&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Eventraci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Infecci&#243;n de orina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Respiratoria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cardiaca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hemorragia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#205;leo&nbsp;\t\t\t\t\t\t\n
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