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2015 FI

1.000
© Thomson Reuters, Journal Citation Reports, 2015

Indexed in:

SCIE/JCR, Index Medicus/Medline, IBECS, IME

Metrics

  • Impact Factor: 1,000(2015)
  • 5-years Impact Factor: 0,876
  • SCImago Journal Rank (SJR):0,24
  • Source Normalized Impact per Paper (SNIP):0,438
doi: 10.1016/S0009-739X(03)72085-5
Tratamiento quirúrgico y resultados del cáncer de colon
Surgical treatment and results of colon cancer
José Vicente Roig1,a, , Amparo Solanab, Rafael Alósb
a Doctor en Medicina. Board Europeo en Coloproctología (EBSQC). Jefe de Servicio. Vocal de la Asociación Española de Coloproctología.
b Doctor en Medicina. Board Europeo en Coloproctología (EBSQC). FEA. Servicio de Cirugía General y Digestiva. Hospital de Sagunto. Sagunto. Valencia. España.
Resumen

El tratamiento quirúrgico del cáncer de colon no se ha modificado en las últimas décadas y sigue siendo la base de la terapéutica de esta enfermedad. Se han demostrado pronósticos el estadio anatomopatológico, seguido de la variable cirujano, cuya especialización determina los resultados de la resección primaria, y éstos, el pronóstico del paciente. Cuando la intervención tiene carácter curativo, el margen distal deberá ser al menos de 5 cm, y el proximal dependerá de la resección vasculolinfática, que determinará la extensión de la colectomía. Si el tumor se encuentra adherido a otras vísceras, se practicará la resección en bloque. No se ha demostrado que la técnica de no tocar el tumor aporte beneficio. En este artículo se revisan las diferentes técnicas quirúrgicas clásicas, actualizando aspectos concretos de cada una. La cirugía laparoscópica del cáncer de colon se está demostrando como una técnica segura y cada vez más empleada en pacientes seleccionados. La búsqueda continua de la calidad obliga a plantear estándares de referencia y análisis de resultados en estos pacientes. Finalmente se tratan problemas especiales, que no resultan infrecuentes en la práctica diaria, como son el pólipo degenerado, el cáncer asociado a enfermedad inflamatoria intestinal y el cáncer en el seno de síndromes genéticos.

Abstract

The surgical treatment of colon cancer remains without changes along the last decades, and nowadays resection of a colonic cancer is the only advisable primary treatment. Demonstrated prognostic variables are pathologic stage followed by the surgeon fact. The specialization of the surgeon brings about results of the first resection, as well as the final prognosis. In radical excision of a colonic tumour the distal margin must measure at least 5cm, and the proximal one depends on lymphovascular resection. If the tumour involves adjacent organs, “in block” excision must be performed. “No-touch technique” has shown no survival advantage. In this article classical surgical techniques are reviewed, and specific aspects are brought up to date. Laparoscopic surgery for colorectal cancer has been demonstrated as a safe technique, and its use is increasing in selected patients. To search for quality, we must use reference standards and analysis of results in these disease. Finally special problems as malignant polyp, cancer in inflammatory bowel disease and surgical treatment in the presence of familiar risk are treated.

Palabras clave
Cáncer de colon, Tratamiento quirúrgico
key words
Colon cancer, Surgical treatment
This article is only available in PDF
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Copyright © 2003. Asociación Española de Cirujanos