Estadísticas

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      "titulo" => "Técnicas reconstructivas tras amputación abdominoperineal extraelevadora del recto o exenteración pélvica: mallas, plastias y colgajos"
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      "titulo" => "Amputación abdominoperineal extraelevadora en posición prono"
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    "titulo" => "Resección extendida y exenteración pélvica en el cáncer de recto del tercio inferior"
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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Las resecciones extendidas en el c&#225;ncer de recto inferior pueden ser necesarias en aproximadamente un 10&#37; de los casos&#46; La indicaci&#243;n se establece a partir de una estricta estadificaci&#243;n local y sist&#233;mica&#46; La resonancia magn&#233;tica de alta resoluci&#243;n es la base de una adecuada planificaci&#243;n acorde con el riesgo quir&#250;rgico en el seno del grupo multidisciplinar&#46; El margen de resecci&#243;n circunferencial es el factor pron&#243;stico oncol&#243;gico m&#225;s importante&#44; especialmente en el desarrollo de RL y&#44; por ello&#44; deberemos planificar la resecci&#243;n extendida en torno a este par&#225;metro&#46; Se necesita un cirujano colorrectal experto que&#44; en algunos casos&#44; coordine otros especialistas del grupo como el ur&#243;logo&#44; el cirujano pl&#225;stico&#44; el vascular e incluso el traumat&#243;logo si fuera necesaria la resecci&#243;n sacra&#46; La resecci&#243;n extendida m&#225;s frecuente en la mujer es la vaginectom&#237;a parcial&#46; La infiltraci&#243;n prost&#225;tica puede tratarse con prostatectom&#237;a parcial extendida en la resecci&#243;n anterior o amputaci&#243;n abdominoperineal&#59; con prostatectom&#237;a radical preservando la vejiga&#44; o bien con exenteraci&#243;n p&#233;lvica&#44; posterior o total&#44; en casos de afectaci&#243;n vesical&#46; La invasi&#243;n de la pared lateral y del sacro es menos frecuente y su resecci&#243;n obliga a cirug&#237;a m&#225;s agresiva de exenteraci&#243;n p&#233;lvica total con potencial resecci&#243;n de los vasos hipog&#225;stricos o extendida al sacro&#46;</p>"
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        "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Approximately 10&#37; of all low rectal cancer needs surgical resection extended to other pelvic structures&#46; Indication for extended resection should be given according to a precise systemic and local preoperative staging&#46; Magnetic Resonance Imaging is the most important instrument utilized by the Multidisciplinary Team to decide therapeutic strategy according to the surgical risk&#46; The status of the pathological circumferential resection margin is the most important prognostic factor determining local recurrence risk and oncological outcome and for this reason it should be considered pivotal in the decision of the strategy of treatment&#46; When extended resection is performed&#44; the presence of an expert colorectal surgeon is mandatory&#44; often coordinating a group of specialists including urologist&#44; plastic surgeon&#44; vascular surgeon and orthopaedist when sacrectomy is necessary&#46; The most frequent extended resection in women with low rectal cancer is the partial resection of vagina&#46; In men&#44; the infiltration of the prostate could be treated with partial prostatectomy&#44; total prostatectomy with bladder preservation or pelvic exenteration&#44; total or posterior&#44; when the bladder is infiltrated&#46; Rectal cancer infiltration of the pelvic sidewalls or of the sacrum is less frequent and obliges to perform a total pelvic exenteration including sometimes the hypogastric vessel or extended to the sacrum&#46;</p>"
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