RESUMO
Las unidades encargadas de los sarcomas en España están poco estudiadas. El objetivo es conocer el manejo de esta patología para identificar áreas de mejora mediante un estudio multicéntrico basado en una encuesta voluntaria.La encuesta fue completada por 74 cirujanos de centros diferentes. El 32,4% se dedican exclusivamente a los sarcomas. Solo el 24,3% han recibido formación específica. El hospital más frecuente fue el tercer nivel (56,8%), donde el 38,1% de los cirujanos pertenecen a sociedades/grupos de trabajo específicos vs. 9,4% en segundo-primer nivel. El número de cirujanos con formación teórica específica y artículos publicados en este campo es mayor en los de tercer nivel. El 55,4% pertenecen a una unidad multidisciplinar. Los equipos multidisciplinares están disponibles en el 57% de los hospitales terciarios vs. el 28% en los demás.La mayoría de los servicios que atienden esta patología presentan escasa especialización, baja carga de trabajo y carecen de equipos multidisciplinares (AU)
Surgical units attending sarcomas in Spain are poor studied. The aim is to know the management of this pathology to identify areas of improvement through multicenter study based on a voluntary survey.The survey was completed by 74 surgeons of different hospitals, which 32.4% is exclusively dedicated to sarcomas. Only 24.3% declared to receive specific training in sarcomas. The most frequent type of hospital was the third level (56.8%), where 38.1% of the surgeons belong to societies or working-groups in sarcoma fields vs. 9.4% in first-second levels. The number of surgeons with specific theoretical training and papers published in this field are higher in third level hospitals. 55.4% belonged to a multidisciplinary unit. A multidisciplinary team was available in 57% of third level hospital vs. 28% in others.Most services in charge of these patients are characterized by deficient specialization, low workload and the absence of a multidisciplinary team (AU)
Assuntos
Humanos , Sarcoma/cirurgia , Neoplasias de Tecidos Moles/cirurgia , Pesquisas sobre Atenção à Saúde , Estudos Transversais , EspanhaRESUMO
Surgical units attending sarcomas in Spain are poor studied. The aim is to know the management of this pathology to identify areas of improvement through multicenter study based on a voluntary survey. The survey was completed by 74 surgeons of different hospitals, which 32.4% is exclusively dedicated to sarcomas. Only 24.3% declared to receive specific training in sarcomas. The most frequent type of hospital was the third level (56.8%), where 38.1% of the surgeons belong to societies or working-groups in sarcoma fields vs. 9.4% in first-second levels. The number of surgeons with specific theoretical training and papers published in this field are higher in third level hospitals. 55.4% belonged to a multidisciplinary unit. A multidisciplinary team was available in 57% of third level hospital vs. 28% in others. Most services in charge of these patients are characterized by deficient specialization, low workload and the absence of a multidisciplinary team.
RESUMO
BACKGROUND: Hepatobiliary resections are challenging due to the complex liver anatomy. Three-dimensional printing (3DP) has gained popularity due to its ability to produce anatomical models based on the characteristics of each patient. METHODS: A multicenter study was conducted on complex hepatobiliary tumours. The endpoint was to validate 3DP model accuracy from original image sources for application in the teaching, patient-communication, and planning of hepatobiliary surgery. RESULTS: Thirty-five patients from eight centers were included. Process testing between 3DP and CT/MRI presented a considerable degree of similarity in vascular calibers (0.22 ± 1.8 mm), and distances between the tumour and vessel (0.31 ± 0.24 mm). The Dice Similarity Coefficient was 0.92, with a variation of 2%. Bland-Altman plots also demonstrated an agreement between 3DP and the surgical specimen with the distance of the resection margin (1.15 ± 1.52 mm). Professionals considered 3DP at a positive rate of 0.89 (95%CI; 0.73-0.95). According to student's distribution a higher success rate was reached with 3DP (median:0.9, IQR: 0.8-1) compared with CT/MRI or 3D digital imaging (P = 0.01). CONCLUSION: 3DP hepatic models present a good correlation compared with CT/MRI and surgical pathology and they are useful for education, understanding, and surgical planning, but does not necessarily affect the surgical outcome.
Assuntos
Modelos Anatômicos , Impressão Tridimensional , Humanos , Imageamento Tridimensional , Fígado/diagnóstico por imagem , Fígado/cirurgia , Imageamento por Ressonância MagnéticaRESUMO
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