Niveles de calidad exigibles en cuanto a tecnología y procedimientos en la cirugía del cáncer de esófago
Technology and procedures in the surgery of esophageal cancer. What standards of quality should be expected?
Manuel Pera1
Autor para correspondencia
mpera@clinic.ub.es
Correspondencia: Dr. Manuel Pera. Servicio de Cirugía Gastrointestinal. Institut de Malalties Digestives. Hospital Clínic. Villarroel, 170. 08036 Barcelona. España.
Correspondencia: Dr. Manuel Pera. Servicio de Cirugía Gastrointestinal. Institut de Malalties Digestives. Hospital Clínic. Villarroel, 170. 08036 Barcelona. España.
Unidad de Cáncer Esófago-gástrico. Sección de Cirugía Gastrointestinal. Institut de Malalties Digestives. Hospital Clínic. Barcelona. España.
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Sección de Cirugía Gastrointestinal. Institut de Malalties Digestives. Hospital Clínic. Barcelona. España." ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia: Dr. Manuel Pera. Servicio de Cirugía Gastrointestinal. Institut de Malalties Digestives. Hospital Clínic. Villarroel, 170. 08036 Barcelona. España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Technology and procedures in the surgery of esophageal cancer. What standards of quality should be expected?" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-07-23" "fechaAceptado" => "2003-07-23" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec198716" "palabras" => array:3 [ 0 => "Calidad asistencial" 1 => "Cáncer de esófago" 2 => "Esofaguectomía" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec198717" "palabras" => array:3 [ 0 => "Quality of care" 1 => "Esophageal cancer" 2 => "Esophagectomy" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La cirugía del cáncer de esófago constituye una de las áreas más complejas de la cirugía digestiva, asociada, además, con una elevada morbimortalidad, estancias hospitalarias largas y elevados costes sanitarios. La calidad del proceso que conduce al diagnóstico y al tratamiento quirúrgico del cáncer de esófago depende de que los “sistemas de asistencia clínica” se encuentren bien integrados y coordinados. El cirujano con una especial dedicación y formación en la cirugía esofagogástrica debe ser competente a la hora de evaluar el estudio de extensión de la enfermedad para posteriormente decidir, dentro de un planteamiento multidisciplinario, la opción terapéutica más apropiada. Los resultados clínicos y la mortalidad tras la esofaguectomía se relacionan directamente con el número de estos procedimientos que se realizan en un determinado hospital. La selección adecuada de los pacientes candidatos a la resección esofágica, especialmente si han recibido tratamiento neoadyuvante, y la utilización de un “protocolo” sistematizado para la esofaguectomía y para el control postoperatorio influyen positivamente en los resultados clínicos.</p>" ] "en" => array:1 [ "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The surgery of esophageal cancer is one of the most complex areas of digestive surgery. Moreover, it is associated with elevated morbidity, prolonged length of hospital stay and high costs. The quality of the process leading to the diagnosis and surgical treatment of esophageal cancer depends on the integration and coordination of “clinical care systems”. Surgeons with special dedication and training in esophageal-gastric surgery should be competent in evaluating tumoral extension studies to subsequently choose the most appropriate therapeutic option within a multidisciplinary approach. Clinical outcome and mortality after esophagectomy are directly related to the number of these procedures performed in a particular hospital. Appropriate selection of candidates for esophageal resection, especially if they have received neoadjuvant therapy, and the use of a systematic “protocol” for esophagectomy and postoperative management positively influence the clinical outcomes.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:43 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Complications and costs after high-risk surgery: Where should we focus quality improvements initiatives?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.B. Dimick" 1 => "P.J. Pronovost" 2 => "J.A. Cowan" 3 => "P.A. 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Lundell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1365-2168.2002.02207.x" "Revista" => array:6 [ "tituloSerie" => "Br J Surg" "fecha" => "2002" "volumen" => "89" "paginaInicial" => "1228" "paginaFinal" => "1234" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12296888" "web" => "Medline" ] ] ] ] ] ] ] ] 42 => array:3 [ "identificador" => "bib0215" "etiqueta" => "43." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A prospective longitudinal study examining the quality of life of patients with esophageal cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.M. Blazeby" 1 => "J.R. Farndon" 2 => "J. Donovan" 3 => "D. Alderson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "2000" "volumen" => "88" "paginaInicial" => "1781" "paginaFinal" => "1787" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10760752" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/0009739X/0000007400000005/v1_201307101349/S0009739X03722374/v1_201307101349/es/main.assets" "Apartado" => array:4 [ "identificador" => "5764" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Artículo especial" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/0009739X/0000007400000005/v1_201307101349/S0009739X03722374/v1_201307101349/es/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0009739X03722374?idApp=UINPBA00004N" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Octubre | 6 | 3 | 9 |
| 2024 Septiembre | 9 | 6 | 15 |
| 2024 Agosto | 16 | 5 | 21 |
| 2024 Julio | 11 | 10 | 21 |
| 2024 Junio | 14 | 17 | 31 |
| 2024 Mayo | 11 | 5 | 16 |
| 2024 Abril | 17 | 10 | 27 |
| 2024 Marzo | 29 | 19 | 48 |
| 2024 Febrero | 20 | 6 | 26 |
| 2024 Enero | 17 | 13 | 30 |
| 2023 Diciembre | 23 | 21 | 44 |
| 2023 Noviembre | 28 | 32 | 60 |
| 2023 Octubre | 37 | 11 | 48 |
| 2023 Septiembre | 11 | 1 | 12 |
| 2023 Agosto | 8 | 6 | 14 |
| 2023 Julio | 11 | 46 | 57 |
| 2023 Junio | 13 | 5 | 18 |
| 2023 Mayo | 18 | 8 | 26 |
| 2023 Abril | 9 | 1 | 10 |
| 2023 Febrero | 5 | 1 | 6 |
| 2023 Enero | 7 | 12 | 19 |
| 2022 Diciembre | 9 | 7 | 16 |
| 2022 Noviembre | 23 | 32 | 55 |
| 2022 Octubre | 30 | 26 | 56 |
| 2022 Septiembre | 15 | 26 | 41 |
| 2022 Agosto | 31 | 27 | 58 |
| 2022 Julio | 13 | 8 | 21 |
| 2022 Junio | 14 | 17 | 31 |
| 2022 Mayo | 12 | 14 | 26 |
| 2022 Abril | 33 | 24 | 57 |
| 2022 Marzo | 16 | 5 | 21 |
| 2022 Febrero | 21 | 6 | 27 |
| 2022 Enero | 40 | 9 | 49 |
| 2021 Diciembre | 32 | 12 | 44 |
| 2021 Noviembre | 11 | 14 | 25 |
| 2021 Octubre | 19 | 10 | 29 |
| 2021 Septiembre | 6 | 5 | 11 |
| 2021 Agosto | 16 | 6 | 22 |
| 2021 Julio | 11 | 14 | 25 |
| 2021 Junio | 14 | 12 | 26 |
| 2021 Mayo | 13 | 5 | 18 |
| 2021 Abril | 19 | 10 | 29 |
| 2021 Marzo | 13 | 14 | 27 |
| 2021 Febrero | 25 | 11 | 36 |
| 2021 Enero | 12 | 11 | 23 |
| 2020 Diciembre | 18 | 17 | 35 |
| 2020 Noviembre | 10 | 11 | 21 |
| 2020 Octubre | 27 | 14 | 41 |
| 2020 Septiembre | 14 | 15 | 29 |
| 2020 Agosto | 11 | 18 | 29 |
| 2020 Julio | 14 | 14 | 28 |
| 2020 Junio | 7 | 14 | 21 |
| 2020 Mayo | 8 | 9 | 17 |
| 2020 Abril | 11 | 16 | 27 |
| 2020 Marzo | 13 | 15 | 28 |
| 2020 Febrero | 14 | 13 | 27 |
| 2020 Enero | 13 | 24 | 37 |
| 2019 Diciembre | 20 | 24 | 44 |
| 2019 Noviembre | 5 | 5 | 10 |
| 2019 Octubre | 6 | 3 | 9 |
| 2019 Septiembre | 6 | 10 | 16 |
| 2019 Agosto | 6 | 25 | 31 |
| 2019 Julio | 8 | 18 | 26 |
| 2019 Junio | 27 | 43 | 70 |
| 2019 Mayo | 77 | 137 | 214 |
| 2019 Abril | 10 | 36 | 46 |
| 2019 Marzo | 6 | 5 | 11 |
| 2019 Febrero | 3 | 14 | 17 |
| 2019 Enero | 3 | 6 | 9 |
| 2018 Diciembre | 1 | 12 | 13 |
| 2018 Noviembre | 10 | 19 | 29 |
| 2018 Octubre | 8 | 13 | 21 |
| 2018 Septiembre | 1 | 5 | 6 |
| 2018 Agosto | 4 | 2 | 6 |
| 2018 Julio | 0 | 5 | 5 |
| 2018 Junio | 0 | 5 | 5 |
| 2018 Mayo | 0 | 13 | 13 |
| 2018 Abril | 2 | 2 | 4 |
| 2018 Febrero | 1 | 2 | 3 |
| 2018 Enero | 0 | 7 | 7 |
| 2017 Diciembre | 2 | 2 | 4 |
| 2017 Noviembre | 9 | 1 | 10 |
| 2017 Octubre | 6 | 3 | 9 |
| 2017 Septiembre | 5 | 5 | 10 |
| 2017 Agosto | 2 | 4 | 6 |
| 2017 Julio | 13 | 0 | 13 |
| 2017 Junio | 16 | 3 | 19 |
| 2017 Mayo | 10 | 10 | 20 |
| 2017 Abril | 5 | 0 | 5 |
| 2017 Marzo | 9 | 29 | 38 |
| 2017 Febrero | 10 | 3 | 13 |
| 2017 Enero | 9 | 3 | 12 |
| 2016 Diciembre | 27 | 7 | 34 |
| 2016 Noviembre | 25 | 5 | 30 |
| 2016 Octubre | 18 | 8 | 26 |
| 2016 Septiembre | 16 | 12 | 28 |
| 2016 Agosto | 12 | 2 | 14 |
| 2016 Julio | 13 | 6 | 19 |
| 2016 Junio | 21 | 6 | 27 |
| 2016 Mayo | 23 | 2 | 25 |
| 2016 Abril | 16 | 7 | 23 |
| 2016 Marzo | 25 | 3 | 28 |
| 2016 Febrero | 6 | 5 | 11 |
| 2016 Enero | 9 | 11 | 20 |
| 2015 Diciembre | 18 | 7 | 25 |
| 2015 Noviembre | 25 | 3 | 28 |
| 2015 Octubre | 19 | 6 | 25 |
| 2015 Septiembre | 21 | 5 | 26 |
| 2015 Agosto | 19 | 5 | 24 |
| 2015 Julio | 10 | 1 | 11 |
| 2015 Junio | 6 | 0 | 6 |
| 2015 Mayo | 15 | 2 | 17 |
| 2015 Abril | 11 | 5 | 16 |
| 2015 Marzo | 11 | 4 | 15 |
| 2015 Febrero | 13 | 0 | 13 |
| 2015 Enero | 24 | 2 | 26 |
| 2014 Diciembre | 38 | 6 | 44 |
| 2014 Noviembre | 31 | 1 | 32 |
| 2014 Octubre | 28 | 2 | 30 |
| 2014 Septiembre | 31 | 1 | 32 |
| 2014 Agosto | 21 | 1 | 22 |
| 2014 Julio | 43 | 3 | 46 |
| 2014 Junio | 34 | 2 | 36 |
| 2014 Mayo | 22 | 4 | 26 |
| 2014 Abril | 15 | 1 | 16 |
| 2014 Marzo | 22 | 3 | 25 |
| 2014 Febrero | 22 | 4 | 26 |
| 2014 Enero | 22 | 2 | 24 |
| 2013 Diciembre | 13 | 2 | 15 |
| 2013 Noviembre | 20 | 4 | 24 |
| 2013 Octubre | 13 | 2 | 15 |
| 2013 Septiembre | 13 | 5 | 18 |
| 2013 Agosto | 18 | 4 | 22 |
| 2013 Julio | 9 | 1 | 10 |
| 2003 Noviembre | 1801 | 0 | 1801 |
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