RESUMO
Introducción: La cirugía en directo se ha convertido en una excelente herramienta para la formación médica. Pese a ello, existe controversia sobre la seguridad de los pacientes que participan.ObjetivoAnalizar los resultados de las cirugías en directo realizadas en 17 cursos consecutivos de retroperitoneoscopia organizados en nuestro centro, en los cuales se intervinieron nefrectomías parciales (NP), nefrectomías radicales (NR) y nefroureterectomías (NU).Material y métodosRevisión realizada desde enero del 2010 a octubre del 2017 de todas las cirugías en directo ejecutadas por un equipo quirúrgico experto en los cursos de retroperitoneoscopia, comparadas con un grupo control de cirugías llevadas a cabo de forma ordinaria y que fue emparejado en relación con la edad, el índice de masa corporal y las comorbilidades (1:1 por cada NR y 1:2 por cada NP y NU).ResultadosSe analizaron 21 cirugías en directo (ocho NP, siete NR y seis NU) con una mediana de seguimiento global de 38 meses. No se observaron diferencias significativas entre las cirugías de los cursos y los controles en cuanto a las variables perioperatorias (tiempo quirúrgico, sangrado operatorio y complicaciones intraoperatorias) ni en las complicaciones postoperatorias y los días de ingreso. Tampoco encontramos diferencias en la tasa de recidiva en los tres grupos (NP: 0% vs. 6,3%, p = 0,47, NU: 33,3% vs. 66,7%, p = 0,180, NR: 0% vs. 28,6%, p = 0,127).ConclusiónLa cirugía en directo realizada, por cirujanos expertos, en un ambiente adecuado y con pacientes idóneos no representa un riesgo añadido de complicaciones para estos y permite mantener los mismos resultados oncológicos. (AU)
Introduction: Live surgery has become an excellent tool for medical training. Despite this, there is controversy about the safety of the patients involved.ObjectiveTo analyze the results of live surgeries performed in 17 consecutive retroperitoneoscopy courses organized in our center. Procedures performed were partial nephrectomy (PN), radical nephrectomy (RN) and nephroureterectomy (NU).Material and methodsReview from January 2010 to October 2017 of all live surgeries carried out by an expert surgical team in the retroperitoneoscopy courses, compared with a control group of surgeries performed in standard conditions. A matching (1:1 for each RN and 1:2 for each PN and NU) according to age, body mass index and comorbidities was performed.ResultsTwenty-one live surgeries were analyzed (eight PN, seven RN and six NU) with a global median follow-up of 38 months. No significant differences were observed between both groups in terms of perioperative variables (operative time, operative bleeding and intraoperative complications) or of postoperative complications and length of hospital stay. Likewise, there were no differences between recurrence rates (PN: 0% vs. 6.3%, p = 0.47, NU: 33.3% vs. 66.7%, p = 0.180, RN: 0% vs. 28.6%, p = 0,127).ConclusionsLive surgery in the hands of expert surgeons in a suitable environment and with well-selected patients does not increase the risk of complications and allows maintaining the same oncological outcomes. (AU)
Assuntos
Humanos , Neoplasias Renais/cirurgia , Nefrectomia/efeitos adversos , Segurança , Resultado do TratamentoRESUMO
INTRODUCTION: Live surgery has become an excellent tool for medical training. Despite this, there is controversy about the safety of the patients involved. OBJECTIVE: To analyze the results of live surgeries performed in 17 consecutive retroperitoneoscopy courses organized in our center. Procedures performed were partial nephrectomy (PN), radical nephrectomy (RN) and nephroureterectomy (NU). MATERIAL AND METHODS: Review from January 2010 to October 2017 of all live surgeries carried out by an expert surgical team in the retroperitoneoscopy courses, compared with a control group of surgeries performed in standard conditions. A matching (1:1 for each RN and 1:2 for each PN and NU) according to age, body mass index and comorbidities was performed. RESULTS: Twenty-one live surgeries were analyzed (eight PN, seven RN and six NU) with a global median follow-up of 38 months. No significant differences were observed between both groups in terms of perioperative variables (operative time, operative bleeding and intraoperative complications) or of postoperative complications and length of hospital stay. Likewise, there were no differences between recurrence rates (PN: 0% vs. 6.3%, p = 0.47, NU: 33.3% vs. 66.7%, p = 0.180, RN: 0% vs. 28.6%, p = 0,127). CONCLUSIONS: Live surgery in the hands of expert surgeons in a suitable environment and with well-selected patients does not increase the risk of complications and allows maintaining the same oncological outcomes.
