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Inicio Cirugía Española Cirugía endoscópica y medicina basada en la evidencia
Información de la revista
Vol. 70. Núm. 4.
Páginas 209-214 (octubre 2001)
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Vol. 70. Núm. 4.
Páginas 209-214 (octubre 2001)
Acceso a texto completo
Cirugía endoscópica y medicina basada en la evidencia
Endoscopic surgery and evidence-based medicine
Visitas
6562
E.M. Targarona
,1
Autor para correspondencia
etargarona@hsp.santpau.es

Correspondencia: Dr. E.M. Targarona. Servicio de Cirugía. Hospital de Sant Pau. P. Claret, 167. 08025 Barcelona.
, E.M. Neugebauer**, M. García-Caballero***, M. Trias*
* Servicio de Cirugía General y del Aparato Digestivo. Hospital de la Santa Cruz y San Pablo. Universidad Autónoma de Barcelona. Barcelona.
** Biochemische und Experimentelle Abteilung. II. Chirurgischer Lehrstuhl. Universidad de Colonia. Colonia. Alemania.
*** Departamento de Cirugía. Universidad de Málaga. Málaga.
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Resumen
Bibliografía
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Resumen
Introducción

La cirugía endoscópica (CE) ha sido considerada la revolución incontrolada más importante en cirugía en los últimos años. Sin embargo, existe la impresión de que pocos de estos nuevos procedimientos han sido evaluados mediante estudios controlados randomizados (ECR).

Objetivo

Analizar el grado de evaluación de la CE en la base de datos PubMed, Agencias de evaluación tecnológica y Cochrane Library.

Resultados

De un total de 18.814 documentos encontrados, únicamente el 4,2% (788) corresponden a ECR y, de ellos, 143 comparaban procedimientos laparoscópicos con cirugía abierta. Únicamente 7 procedimientos endoscópicos de los 33 más aceptados han sido analizados de forma aleatoria. Tampoco se encontraron estudios en las agencias con interés en medicina basada en la evidencia (MBE).

Conclusión

Los ECR no se han utilizado ampliamente en el análisis de la CE. Las razones son múltiples y se relacionan con una falta de cultura de MBE entre los cirujanos y dificultades técnicas para efectuar este tipo de estudios tanto por parte de los cirujanos como de los pacientes. La implantación de la MBE requiere el impulso individual y la concienciación de sus ventajas a medio y largo plazo, tanto de las asociaciones profesionales como de las autoridades sanitarias.

Palabras clave:
Cirugía endoscópica
Medicina basada en la evidencia
Estudios controlados
Introduction

Endoscopic surgery is considered the most significant surgical revolution to have taken place in the last few years. However, few of these new techniques have been evaluated through randomized controlled trials.

Objective

To analyze the extent to which endoscopic surgery has been evaluated through randomized controlled trials and the factors impeding its diffusion.

Material and methods

Publications on endoscopic surgery were retrieved from PubMed, Health Technology Assessment Agencies and the Cochrane Library. Results. Of 18,814 documents retrieved, only 4.2% (788) were randomized controlled trials; of these, 143 compared laparoscopic procedures with open surgery. Only 7 of the 33 most widely accepted endoscopic procedures were the subject of randomized analysis. No studies were found in agencies interested in evidence-based medicine.

Conclusions

Randomized controlled trials are not widely used in the evaluation of endoscopic surgery. The reasons for this are multiple and are related to the lack of evidence-based culture among surgeons and the technical difficulties, for both surgeons and patients, of carrying out this type of study. The implantation of evidence-based medicine requires individual effort and greater awareness of its mediumand long-term advantages among professional associations and health authorities.

Key words:
Evidence-Based Medicine
Endoscopic surgery
Controled trials
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Copyright © 2001. Asociación Española de Cirujanos
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