Resumen
Objetivo: Investigar las evidencias científicas disponibles sobre estrategias quirúrgicas conservadoras para órganos digestivos, especialmente en el hígado y el páncreas, en el contexto del tratamiento oncológico y sus resultados. Métodos: Esta revisión integradora utilizó la estrategia PVO para buscar artículos en la base de datos de PubMed. La búsqueda se limitó a artículos originales en inglés publicados en los últimos 5 años e incluyó ensayos clínicos, revisiones sistemáticas y/o metaanálisis. Después de aplicar los criterios de inclusión, se seleccionaron 50 artículos y se consideraron relevantes 17. Resultados: Los estudios indicaron que la cirugía conservadora de los órganos digestivos es un enfoque prometedor para el tratamiento de tumores hepáticos y pancreáticos en etapas tempranas. Este enfoque mostró un menor riesgo de complicaciones postoperatorias en comparación con las resecciones completas, mejorando la calidad de vida de los pacientes con antecedentes oncológicos. Consideraciones finales: La hepatectomía y la pancreatectomía parcial, especialmente cuando se realizan laparoscópicamente, demostraron resultados positivos en el tratamiento de pacientes oncológicos, minimizando las complicaciones postoperatorias y eliminando la necesidad de donantes de órganos.
Referencias
CHEN S, et al. Liver resection versus transarterial chemoembolization for the treatment of intermediate-stage hepatocellular carcinoma. Cancer Med, 2019; 8(4): 1530-1539.
CHOI J, et al. Endoscopic ultrasound-guided radiofrequency ablation for management of benign solid pancreatic tumors. Thiene, 2018; 50: 1099-1104.
DAI XM, et al. Oncological outcomes of anatomic versus non-anatomic resections for small hepatocellular carcinoma: systematic review and meta-analysis of propensity-score matched studies. World J Surg Oncol, 2022; 20(1): 299.
FELLI E, et al. Laparoscopic anatomical liver resection for malignancies using positive or negative staining technique with intraoperative indocyanine green-fluorescence imaging. HPB (Oxford), 2021; 23(11): 1647-1655.
GONG WF, et al. Evaluation of liver regeneration and post-hepatectomy liver failure after hemihepatectomy in patients with hepatocellular carcinoma. Biosci Rep, 2019; 39(8): BSR20190088.
KABIR T, et al. Laparoscopic versus open resection of hepatocellular carcinoma in patients with cirrhosis: meta-analysis. Br J Surg, 2021; 109(1): 21-29.
KHOURY T, et al. Endoscopic ultrasound-guided radiofrequency ablation for pancreatic tumors: A critical review focusing on safety, efficacy and controversies. World J Gastroenterol, 2023; 29(1): 157-170.
LAKHTAKIA S, SEO DW. Endoscopic ultrasonography-guided tumor ablation. Dig Endosc, 2017; 29: 486-94.
LESMANA CRA, et al. Impact of endoscopic ultrasound-guided radiofrequency ablation in managing pancreatic malignancy. World J Gastrointest Surg, 2023; 15(2): 163-168.
LIANG Y, et al. Perioperative outcomes comparing laparoscopic with open repeat liver resection for post-hepatectomy recurrent liver cancer: A systematic review and meta-analysis. International Journal of Surgery, 2020; 79: 17-28.
LIU J, et al. Impact of clinically significant portal hypertension on outcomes after partial hepatectomy for hepatocellular carcinoma: a systematic review and meta-analysis. HPB, 2019; 21: 1–13.
LIU Y, et al. A meta-analysis of the three-dimensional reconstruction visualization technology for hepatectomy. Asian Journal of Surgery, 2023; 46: 669e676.
MANZINI G, et al. Resection or radiofrequency ablation for hepatocellular carcinoma? Assessment of validity of current studies, meta-analyses and their influence on guidelines. HPB: the official journal of the International Hepato Pancreato Biliary Association, 2020; 22(8): 1206-1215.
MEIJERINK MR, et al. Radiofrequency and Microwave Ablation Compared to Systemic Chemotherapy and to Partial Hepatectomy in the Treatment of Colorectal Liver Metastases: A Systematic Review and Meta-Analysis. Cardiovasc Intervent Radiol, 2018; 41: 1189–1204.
PARK DH, et al. Endoscopic ultrasonography-guided ethanol ablation for small pancreatic neuroendocrine tumors: Results of a pilot study. Clin Endosc, 2015; 48: 158-64.
PENG, Long et al. Systematic review and meta-analysis of laparoscopic versus open repeat hepatectomy for recurrent liver cancer. Surgical Oncology, 2019; 28: 19-30.
TUSTUMI F, et al. Preoperative strategies to improve resectability for hepatocellular carcinoma: a systematic review and meta-analysis. HPB, 2018; 20: 1109–1118.
VAN ROSMALEN BV, et al. Impact of open and minimally invasive resection of symptomatic solid benign liver tumours on symptoms and quality of life: a systematic review. HPB (Oxford), 2019; 21(9): 1119-1130.
WANG ZY, et al. Laparoscopic open major liver resection for hepatocellular carcinoma: systematic review and meta-analysis of comparative cohort studies. BMC Cancer, 2019; 19(1): 1047.
XIA Y, et al. Long-term Effects of Repeat Hepatectomy vs Percutaneous Radiofrequency Ablation Among Patients With Recurrent Hepatocellular Carcinoma: A Randomized Clinical Trial. JAMA Oncology, 2020; 6(2): 255–263.
YANG G, et al. The efficacy of microwave ablation versus liver resection in the treatment of hepatocellular carcinoma and liver metastases: A systematic review and meta-analysis. Int J Surg, 2020; 77: 85-93.
