{"id":12079,"date":"2025-09-25T10:24:15","date_gmt":"2025-09-25T14:24:15","guid":{"rendered":"https:\/\/www.rigicon.com\/glossary-term\/salvage-surgery\/"},"modified":"2026-10-06T18:04:24","modified_gmt":"2026-10-06T22:04:24","slug":"cirugia-de-rescate","status":"publish","type":"glossary-term","link":"https:\/\/www.rigicon.com\/es\/glossary-term\/cirugia-de-rescate\/","title":{"rendered":"Cirug\u00eda de Rescate"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"template":"","glossary-category":[112],"glossary-product":[],"class_list":["post-12079","glossary-term","type-glossary-term","status-publish","hentry","glossary-category-surgical-procedures"],"acf":{"gt-definition":"<p>La cirug\u00eda de rescate se refiere a los procedimientos quir\u00fargicos que se realizan tras el fracaso de tratamientos previos, en particular en el contexto de la recidiva de un c\u00e1ncer.<sup>1<\/sup> En la pr\u00e1ctica urol\u00f3gica, la cirug\u00eda de rescate consiste con mayor frecuencia en la extirpaci\u00f3n quir\u00fargica de la pr\u00f3stata (prostatectom\u00eda radical de rescate) o de la vejiga (cistoprostatectom\u00eda de rescate) tras el fracaso de la radioterapia u otros tratamientos primarios no quir\u00fargicos.<sup>2<\/sup> La cirug\u00eda de rescate representa una opci\u00f3n terap\u00e9utica fundamental para los pacientes con recidiva localizada de la enfermedad, ya que ofrece la posibilidad de curaci\u00f3n cuando los tratamientos iniciales han fracasado.<sup>3<\/sup> El procedimiento tiene como objetivo extirpar por completo el tejido tumoral residual minimizando el da\u00f1o a las estructuras circundantes, aunque es t\u00e9cnicamente m\u00e1s complejo que la cirug\u00eda primaria debido a los cambios tisulares y la fibrosis inducidos por la radiaci\u00f3n.<sup>4<\/sup><\/p>","gt-synonyms":"Prostatectom\u00eda radical de rescate (PRS), Prostatectom\u00eda radical rob\u00f3tica de rescate (sRRP), Cistoprostatectom\u00eda de rescate, Linfadenectom\u00eda de rescate, Cirug\u00eda de rescate, Intervenci\u00f3n quir\u00fargica secundaria","gt-citation":"[1] Ward JF, Sebo TJ, Blute ML, Zincke H. Salvage surgery for radiorecurrent prostate cancer: contemporary outcomes. J Urol. 2005 Apr;173(4):1156-60. DOI: 10.1097\/01.ju.0000155534.54711.60\n\n[2] Bochner BH, Figueroa AJ, Skinner EC, Lieskovsky G, Petrovich Z, Boyd SD, Skinner DG. Salvage radical cystoprostatectomy and orthotopic urinary diversion following radiation failure. J Urol. 1998 Jul;160(1):29-33. PMID: 9628599\n\n[3] Kaffenberger SD, Smith JA. Salvage robotic radical prostatectomy. Indian J Urol. 2014 Oct-Dec;30(4):429-433. DOI: 10.4103\/0970-1591.142074","gt-clinical-context":"<p>La cirug\u00eda de rescate est\u00e1 cl\u00ednicamente indicada cuando existen indicios de recidiva o persistencia del c\u00e1ncer tras un tratamiento primario no quir\u00fargico, en particular la radioterapia.<sup>1<\/sup> La selecci\u00f3n de pacientes es crucial para obtener resultados \u00f3ptimos; los candidatos ideales tienen una esperanza de vida de al menos 10-15 a\u00f1os, enfermedad en estadio cl\u00ednico \u2264T3, recidiva localizada confirmada por biopsia y ausencia de met\u00e1stasis en las pruebas de imagen preoperatorias.<sup>3<\/sup><\/p>\n    \n    <p>La decisi\u00f3n de realizar una cirug\u00eda de rescate exige valorar con detenimiento varios factores, como las cifras de PSA preoperatorias, la puntuaci\u00f3n de Gleason de la biopsia, el tiempo de duplicaci\u00f3n del PSA y el intervalo entre el tratamiento primario y la recidiva, ya que se ha demostrado que estos par\u00e1metros predicen la recidiva bioqu\u00edmica y la aparici\u00f3n de enfermedad metast\u00e1sica tras los procedimientos de rescate.<sup>1,3<\/sup><\/p>\n    \n    <p>Los abordajes quir\u00fargicos incluyen la prostatectom\u00eda radical de rescate abierta, la prostatectom\u00eda radical de rescate asistida por robot y la cistoprostatectom\u00eda de rescate con derivaci\u00f3n urinaria.<sup>2<\/sup> La plataforma rob\u00f3tica ha ganado popularidad en los \u00faltimos a\u00f1os por sus posibles ventajas, como una menor p\u00e9rdida de sangre, estancias hospitalarias m\u00e1s cortas y una mejor visualizaci\u00f3n del campo quir\u00fargico, algo especialmente valioso dada la complejidad de los procedimientos de rescate.<sup>3<\/sup><\/p>\n    \n    <p>Hist\u00f3ricamente, la cirug\u00eda de rescate se ha asociado a complicaciones importantes, con tasas de lesi\u00f3n rectal cercanas al 15% y tasas de estenosis de la anastomosis de hasta el 32% en las primeras series.<sup>3<\/sup> Sin embargo, las t\u00e9cnicas quir\u00fargicas modernas y la mayor experiencia han mejorado sustancialmente los perfiles de seguridad, y las tasas actuales de lesi\u00f3n rectal han descendido al 2-5%.<sup>1,3<\/sup> Los resultados funcionales siguen siendo un motivo de preocupaci\u00f3n importante: la continencia urinaria (definida como no necesitar compresas) se consigue en el 43-56% de los pacientes, y un 20% adicional necesita una compresa o menos al d\u00eda.<sup>1<\/sup> La disfunci\u00f3n sexual es frecuente tras los procedimientos de rescate debido a la dificultad de preservar los haces neurovasculares tras la radioterapia.<sup>4<\/sup><\/p>\n    \n    <p>Los resultados oncol\u00f3gicos a largo plazo son alentadores, con tasas globales de supervivencia c\u00e1ncer-espec\u00edfica a 10 a\u00f1os de aproximadamente el 65%, e incluso mejores (77% de supervivencia c\u00e1ncer-espec\u00edfica a 10 a\u00f1os) en los pacientes sometidos a prostatectom\u00eda radical de rescate frente a los que requieren procedimientos m\u00e1s extensos.<sup>1<\/sup> Se han identificado varias caracter\u00edsticas anatomopatol\u00f3gicas de la pr\u00f3stata extirpada, como la ploid\u00eda tumoral, el porcentaje de enfermedad de grado de Gleason 4\/5 y el estadio patol\u00f3gico, como factores predictivos s\u00f3lidos de la supervivencia tras la cirug\u00eda de rescate.<sup>1<\/sup><\/p>","gt-related-evidence":null,"gt-featured":true,"gt-ai-referenced":false,"gt-view-count":113},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.7 (Yoast SEO v28.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Cirug\u00eda de Rescate<\/title>\n<meta name=\"description\" content=\"La cirug\u00eda de rescate en urolog\u00eda comprende procedimientos quir\u00fargicos secundarios para corregir complicaciones o fallos tras una intervenci\u00f3n previa.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" 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