Base de dados : LILACS
Pesquisa : C06.405.469.158 [Categoria DeCS]
Referências encontradas : 377 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 38 ir para página                         

  1 / 377 LILACS  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
Id: biblio-1291265
Autor: Giraldo Pinto, Manuel Alejandro; Capre Pereira, Jessica; González Quitian, Jairo; Kestenberg, Abraham; Bejarano, Mónica.
Título: Sangrado gastrointestinal secundario a síndrome de Klippel-Trenaunay / Gastrointestinal bleeding secondary to Klippel-Trenaunay syndrome
Fonte: Rev. colomb. cir;36(4):709-711, 25082021. fig.
Idioma: es.
Descritores: Síndrome de Klippel-Trenaunay-Weber
Hemorragia Gastrointestinal
-Malformações Arteriovenosas
Doenças do Colo
Doenças Raras
Limites: Humanos
Tipo de Publ: Relatos de Casos
Responsável: CO113


  2 / 377 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo SciELO Brasil
Malafaia, Osvaldo
Czeczko, Nicolau Gregori
Texto completo
Id: biblio-1152630
Autor: Wendler, Eduardo; Malafaia, Osvaldo; Ariede, Bruno Luiz; Ribas-Filho, Jurandir Marcondes; Czeczko, Nicolau Gregori; Nassif, Paulo Afonso Nunes.
Título: Could the intestinal epithelial alterations promoted by roux-en-y gastric bypass explain higher tendency for colonic diseases in bariatric patients? / As alterações epiteliais intestinais promovidas pelo bypass em y-de-roux podem explicar maior tendência a doenças colônicas em pacientes bariátricos?
Fonte: ABCD arq. bras. cir. dig;33(4):e1570, 2020. tab, graf.
Idioma: en.
Projeto: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior.
Resumo: ABSTRACT Background: Intestinal diversions have revolutionized the treatment of morbid obesity due to its viability and sustained response. However, experimental studies suggest, after these derivations, a higher risk of colon cancer. Aim: To analyze the histological and immunohistological changes that the jejunojejunal shunt can produce in the jejunum, ileum and ascending colon. Method: Twenty-four male Wistar rats were randomly divided into two groups, control (n=12) and experiment (n=12) and subdivided into groups of four. Nine weeks after the jejunojejunal shunt, segmental resection of the excluded jejunum, terminal ileum and ascending colon was performed. Histological analysis focused on the thickness of the mucosa, height of the villi, depth of the crypts and immunohistochemistry in the expression of Ki-67 and p53. Results: Significant differences were found between the experiment and control groups in relation to the thickness of the mucosa in the jejunum (p=0.011), in the ileum (p<0.001) and in the colon (p=0.027). There was also a significant difference in relation to the height of the villus in the ileum (p<0.001) and the depth of the crypts in the jejunum (p0.001). The results indicated that there is a significant difference between the groups regarding the expression of Ki-67 in the colon (p<0.001). No significant differences were found between the groups regarding the expression of Ki-67 in the jejunum and ileum. In the P53 evaluation, negative nuclear staining was found in all cases. Conclusion: The jejunojejunal deviation performed in the Roux-in-Y gastrojejunal bypass, predispose epithelial proliferative effects, causing an increase in the thickness of the mucosa, height of the villi and depth of the crypts of the jejunum, ileum and ascending colon.

RESUMO Racional: As derivações intestinais revolucionaram o tratamento da obesidade mórbida pela sua viabilidade e resposta sustentada. Porém, estudos experimentais sugerem, após estas derivações, risco maior de câncer de cólon. Objetivo: Analisar as alterações histológicas e imunoistológicas que a derivação jejunojejunal possa produzir no jejuno, íleo e cólon ascendente. Método: Foram utilizados 24 ratos Wistar machos randomicamente divididos em dois grupos, controle (n=12) e experimento (n=12) e subdivididos em grupos de quatro. Nove semanas após a derivação jejunojejunal procedeu-se a ressecção segmentar do jejuno excluso, íleo terminal e cólon ascendente. Análise histológica focou na espessura da mucosa, altura dos vilos, profundidade das criptas e a imunoistoquímica na expressão do Ki-67 e p53. Resultados: Foram encontradas diferenças significativas entre os grupos experimento e controle em relação à espessura da mucosa no jejuno (p=0,011), no íleo (p<0,001) e no cólon (p=0,027). Também houve diferença significativa em relação à altura dos vilos no íleo (p<0,001) e profundidade das criptas no jejuno (p<0,001). Os resultados indicaram que existe diferença significativa entre os grupos em relação à expressão do Ki-67 no cólon (p<0,001). Não foram encontradas diferenças significativas entre os grupos em relação à expressão do Ki-67 no jejuno e no íleo. Na avaliação do P53, foi encontrada coloração nuclear negativa em todos os casos. Conclusão: O desvio realizado na derivação gastrojejunal em Y-de-Roux, predispõem efeitos proliferativos epiteliais, causando aumento da espessura da mucosa, altura dos vilos e profundidade das criptas do jejuno, íleo e cólon ascendente.
Descritores: Derivação Gástrica/efeitos adversos
Doenças do Colo/etiologia
-Ratos Wistar
Antígeno Ki-67/metabolismo
Íleo
Mucosa Intestinal
Intestino Delgado
Intestinos
Jejuno/cirurgia
Limites: Humanos
Animais
Masculino
Ratos
Responsável: BR1.1 - BIREME


  3 / 377 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo SciELO Brasil
Texto completo
Id: lil-785722
Autor: Kaddumi, Ezidin G.
Título: The influence of distal colon irritation on the changes of cystometry parameters to esophagus and colon distentions
Fonte: Int. braz. j. urol;42(3):594-602tab, graf.
Idioma: en.
Resumo: ABSTRACT The co-occurrence of multiple pathologies in the pelvic viscera in the same patient, such as, irritable bowel syndrome and interstitial cystitis, indicates the complexity of viscero-visceral interactions and the necessity to study these interactions under multiple pathological conditions. In the present study, the effect of distal colon irritation (DCI) on the urinary bladder interaction with distal esophagus distention (DED), distal colon distention (DCD), and electrical stimulation of the abdominal branches of vagus nerve (abd-vagus) were investigated using cystometry parameters. The DCI significantly decreased the intercontraction time (ICT) by decreasing the storage time (ST); nonetheless, DED and Abd-vagus were still able to significantly decrease the ICT and ST following DCI. However, DCD had no effect on ICT following the DCI. The DCI, also, significantly decreased the Intravesical pressure amplitude (P-amplitude) by increasing the resting pressure (RP). Although DED has no effect on the P-amplitude, both in the intact and the irritated animals, the abd-vagus significantly increased the P-amplitude following DCI by increasing the maximum pressure (MP). In the contrary, 3mL DCD significantly increased the P-amplitude by increasing the MP and lost that effect following the DCI. Concerning the pressure threshold (PT), none of the stimuli had any significant changes in the intact animals. However, DCI significantly decreased the PT, also, the abd-vagus and 3mL DCD significantly decreased the PT. The results of this study indicate that chemical irritation of colon complicates the effects of mechanical irritation of esophagus and colon on urinary bladder function.
Descritores: Bexiga Urinária/fisiopatologia
Doenças do Colo/fisiopatologia
Síndrome do Intestino Irritável/fisiopatologia
Doenças do Esôfago/fisiopatologia
-Pressão
Valores de Referência
Fatores de Tempo
Nervo Vago/fisiopatologia
Doenças da Bexiga Urinária/etiologia
Doenças da Bexiga Urinária/fisiopatologia
Vísceras/fisiopatologia
Vísceras/inervação
Ratos Wistar
Colo/fisiopatologia
Colo/inervação
Doenças do Colo/etiologia
Síndrome do Intestino Irritável/complicações
Estimulação Elétrica
Doenças do Esôfago/etiologia
Esôfago/fisiopatologia
Esôfago/inervação
Limites: Animais
Masculino
Feminino
Responsável: BR1.1 - BIREME


  4 / 377 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo SciELO Brasil
Texto completo
Id: biblio-892978
Autor: Ma, Liang; Yu, Yanlan; Ge, Guangju; Li, Gonghui.
Título: Laparoscopic nephrectomy outside gerota fascia and en bloc ligation of the renal hilum for management of inflammatory renal diseases
Fonte: Int. braz. j. urol;44(2):280-287, Mar.-Apr. 2018. tab, graf.
Idioma: en.
Projeto: Department of Education of Zhejiang Province.
Resumo: ABSTRACT Objectives This study aims to improve laparoscopic nephrectomy techniques for inflammatory renal diseases (IRD) and to reduce complications. Materials and Methods Thirty-three patients underwent laparoscopic nephrectomy for IRD, with a method of outside Gerota fascia dissection and en-bloc ligation and division of the renal pedicle. Operative time, blood loss, complications, analgesia requirement, post-operative recovery of intestinal function and hospital stay were recorded. The degrees of perinephric adhesion were classified based on the observation during operation and post-operative dissection of the specimen, and the association of different types of adhesion with the difficulty of the procedures was examined. Results Among 33 cases, three were converted to hand-assisted laparoscopy, and one was converted to open surgery. Mean operative time was 99.6±29.2min, and blood loss was 75.2±83.5 mL. Postoperative recovery time of intestinal function was 1.6±0.7 days and average hospital stay was 4.8±1.4 days. By classification and comparison of the perinephric adhesions, whether inflammation extending beyond Gerota fascia or involving renal hilum was found to be not only an important factor influencing the operative time and blood loss, but also the main reason for conversion to hand-assisted laparoscopy or open surgery. Conclusions In laparoscopic nephrectomy, outside Gerota fascia dissection of the kidney and en-bloc ligation of the renal pedicle using EndoGIA could reduce the difficulty of procedure and operative time, with satisfactory safety and reliability. Inflammation and adhesion extending beyond Gerota fascia or involving renal hilum is an important predictor of the difficulty related to laparoscopic nephrectomy for IRD.
Descritores: Pielonefrite/cirurgia
Tuberculose Renal/cirurgia
Pionefrose/cirurgia
Laparoscopia Assistida com a Mão/efeitos adversos
Nefropatias/cirurgia
Nefrectomia/métodos
Nefrite/cirurgia
-Pielonefrite Xantogranulomatosa/cirurgia
Reprodutibilidade dos Testes
Perda Sanguínea Cirúrgica
Fístula Intestinal/cirurgia
Doenças do Colo/cirurgia
Duração da Cirurgia
Fístula/cirurgia
Tempo de Internação
Pessoa de Meia-Idade
Nefrectomia/efeitos adversos
Limites: Humanos
Masculino
Feminino
Adulto
Idoso
Tipo de Publ: Research Support, Non-U.S. Gov't
Responsável: BR1.1 - BIREME


  5 / 377 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
Id: biblio-1026189
Autor: Raña-Garibay, R; Salgado-Nesme, N; Carmona-Sánchez, R; Remes-Troche, M. J; Aguilera-Carrera, J; Alonso-Sánchez, L; Arnaud-Carreño, C; Charúa-Guindic, L; Coss-Adame, E; Torre-Bravo, A. de la; Espinosa-Medina, D; Esquivel-Ayanegui, F; Roesch-Dietlen, F; López-Colombo, A; Muñoz-Torres, J. I; Noble-Lugo, A; Rojas-Mendoza, F; Suazo-Barahona, J; Stoopen-Rometti, M; Torres-Flores, E; Vallejo-Sotos, M; Vergara-Fernández, O.
Título: Consenso mexicano sobre el diagnóstico y tratamiento de la enfermedad diverticular del colon / The Mexican consensus on the diagnosis and treatment of diverticular disease of the colon
Fonte: Rev. Gastroenterol. Mex;84(2):220-240, April-June 2019.
Idioma: es.
Resumo: Desde la publicación en 2008 de las guías de diagnóstico y tratamiento de la enfermedad diverticular del colon de la Asociación Mexicana de Gastroenterología ha habido avances significativos en el conocimiento de esta enfermedad. Se realizó una revisión sistemática de la literatura en PubMed de enero de 2008 a julio de 2018 con el fin de revisar y actualizar las guías 2008 y proporcionar nuevas recomendaciones basadas en la evidencia. Se incluyeron todas las publicaciones en español e inglés, de alta calidad. Se redactaron los enunciados, que fueron votados utilizando el método Delphi. Se estableció la calidad de la evidencia y la fuerza de las recomendaciones según el sistema GRADE para cada enunciado. Cuarenta y tres enunciados fueron finalmente votados y calificados. Se informan nuevos datos sobre definición, clasificación, epidemiología, fisiopatología y factores de riesgo. Se revisó con especial énfasis la utilidad de la tomografía computarizada y de la colonoscopia, así como los métodos endoscópicos para el control de la hemorragia. Se discutió sobre el tratamiento ambulatorio de la diverticulitis no complicada, el papel de la rifaximina y la mesalazina, en el manejo de la diverticulitis aguda complicada tanto en sus alternativas mínimamente invasivas hasta las opciones quirúrgicas con énfasis en sus indicaciones, limitaciones y contraindicaciones. Los nuevos enunciados proporcionan directrices basadas en la evidencia actualizada. Se presentan la discusión, el grado y la fuerza de la recomendación de cada uno de ellos.
Descritores: Doenças do Colo/diagnóstico
Doenças do Colo/prevenção & controle
Diverticulite/complicações
Doença Diverticular do Colo/diagnóstico
-Divertículo do Colo/terapia
México
Limites: Humanos
Responsável: BR1.1 - BIREME


  6 / 377 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo SciELO Brasil
Texto completo
Id: biblio-1055877
Autor: Sobrado Junior, Carlos Walter; Guzela, Vivian Regina; Sobrado, Lucas Faraco; Nahas, Sérgio Carlos; Cecconello, Ivan.
Título: Local treatment of colostomy prolapse with the MESH STRIP technique: A novel and highly efficient day hospital technique
Fonte: Clinics;75:e1353, 2020. tab, graf.
Idioma: en.
Resumo: OBJECTIVE: Stoma prolapse is an intussusception of the bowel through a mature stoma. It can be caused by increased intra-abdominal pressure, excessively mobile bowel mesentery and/or a large opening in the abdominal wall at the time of stoma formation. It occurs predominantly in loop stomas, and correction methods include conservative modalities, such as local reduction to the prolapsed bowel, or surgical treatment. The purpose of this study was to describe our experience with the treatment of colostomy prolapse using a novel mesh strip technique. METHODS: Between February 2009 and March 2018, ten consecutive male patients underwent correction of colostomy prolapse under local anesthesia by peristomal placement of a polypropylene mesh strip. Operation time, short- and long-term complications, and recurrence rates were recorded and analyzed. RESULTS: No postoperative complications, morbidity or mortality were observed. The median length of the prolapse ranged from 6-20 cm, and the median operative time was 30 minutes. The median duration of follow-up was 25 months (range, 12-89 months). No relapse, mesh strip extrusion, local infection or granuloma formation were found. CONCLUSION: A simple, fast, and low-cost operation under local anesthesia using a mesh strip is a valuable option to treat colostomy prolapse.
Descritores: Complicações Pós-Operatórias/cirurgia
Telas Cirúrgicas
Colostomia/reabilitação
Doenças do Colo/cirurgia
Estomas Cirúrgicos/efeitos adversos
-Prolapso
Resultado do Tratamento
Parede Abdominal
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME


  7 / 377 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo SciELO Brasil
Texto completo
Id: biblio-897020
Autor: Zekavat, Omid Reza; Abdolkarimi, Babak; Pouladfar, Gholamreza; Fathpour, Gholamreza; Mokhtari, Maral; Shakibazad, Nader.
Título: Colonic basidiobolomycosis with liver involvement masquerading as gastrointestinal lymphoma: a case report and literature review
Fonte: Rev. Soc. Bras. Med. Trop;50(5):712-714, Sept.-Oct. 2017. tab, graf.
Idioma: en.
Resumo: Abstract Basidiobolomycosis is an unusual fungal skin infection that rarely involves the gastrointestinal tract. This study reported a 5-year-old boy with gastrointestinal basidiobolomycosis that had been misdiagnosed as gastrointestinal lymphoma. He was treated by surgical resection and a combination of posaconazole and amphotericin B deoxycholate with an acceptable response and no recurrence.
Descritores: Doenças do Colo/microbiologia
Zigomicose/patologia
Zigomicose/tratamento farmacológico
Zigomicose/diagnóstico por imagem
Neoplasias Gastrointestinais/diagnóstico
Hepatopatias/microbiologia
Linfoma/diagnóstico
-Triazóis/uso terapêutico
Tomografia Computadorizada por Raios X
Anfotericina B/uso terapêutico
Resultado do Tratamento
Doenças do Colo/patologia
Doenças do Colo/diagnóstico por imagem
Ácido Desoxicólico/uso terapêutico
Diagnóstico Diferencial
Combinação de Medicamentos
Neoplasias Gastrointestinais/patologia
Hepatopatias/patologia
Hepatopatias/diagnóstico por imagem
Linfoma/patologia
Antifúngicos/uso terapêutico
Limites: Humanos
Masculino
Pré-Escolar
Tipo de Publ: Relatos de Casos
Revisão
Responsável: BR1.1 - BIREME


  8 / 377 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo SciELO Brasil
Texto completo
Id: biblio-1134970
Autor: Al-Khalidy, Huda Saleem H.
Título: Obesity and helicobacter pylori infection in adults with non specific colitis / Obesidade e infecção por Helicobacter pylori em adultos com colite inespecífica
Fonte: J. coloproctol. (Rio J., Impr.);40(2):168-171, Apr.-Jun. 2020. tab.
Idioma: en.
Resumo: ABSTRACT Background Non specific colitis is defined as inflammatory condition of the colon that when examined microscopically lacks any characteristic features of any specific form of colitis and is commonly seen in reports of colonoscopy biopsies. There are many factors that cause it like obesity and H pylori. Aim of the study To determine the association of obesity and H pylori as contributory factors to this disease. Patients and methods This is a case-controlled study was carried out in Al-Kindy College of Medicine from January 2017 to June 2018. Sixty individuals were included; forty of them had non specific colitis. The rest were healthy control group. Demographic information's were taken like age and sex. Anthropometric measurement like weight in kilograms (kg), height in meters (m), waist circumference in centimeters (cm), and body mass index was done. H pylori IgG was done to both groups. Results Study results indicated that this disease was more common with increasing age, there is a significant difference (p = 0.002) between patients (48.12 ± 1.50) and control group (41.00 ± 1.10) regarding age. BMI of the patients is significantly higher in patients group (29.21 ± 0.41; p = 0.000) than the control (22.23 ± 0.41). Patients with non specific colitis showed significant (p = 0.000) increased in H pylori infection 33 (82.5%) compared with control group 2 (10%). Conclusions Obesity and infection withH pylori may predispose to non specific colitis.

RESUMO Introdução Colite inespecífica é uma condição inflamatória do cólon que microscopicamente não apresenta características de qualquer forma específica de colite; é comumente observada em relatórios patológicos de biópsias de colonoscopia. Vários fatores podem causar colite inespecífica, dentre os quais obesidade e infecção por H. pylori. Objetivo do estudo Determinar o possível papel da obesidade e H. pylori como fatores contribuintes para esta doença. Pacientes e Métodos Este foi um estudo caso-controle, realizado na Al-Kindy College of Medicine entre janeiro de 2017 e junho de 2018. Um total de 60 indivíduos foram incluídos, 40 dos quais apresentavam colite inespecífica. Os demais foram incluídos no grupo de controles saudáveis. Foram coletadas informações demográficas, como idade e sexo. Medidas antropométricas, como peso (kg), altura (m), circunferência da cintura (cm) e índice de massa corporal, também foram coletadas. Nos dois grupos, foi feita serologia para H. pylori (IgG) Resultados Os presentes resultados indicaram que esta doença era mais comum entre pacientes de idade mais avançada; observou-se uma diferença significativa p = 0,002 entre os pacientes 48,12 ± 1,50 e o grupo controle 41,00 ± 1,10 quanto à idade. O IMC foi significativamente maior no grupo de pacientes 29,21 ± 0,41; p = 0,000 do que no grupo controle 22,23 ± 0,41. A infecção por H. pylori foi significamente mais frequentemente observada no grupo de pacientes (33; 82,5%) em comparação ao grupo controle (2; 10%; p = 0,000. Conclusões A obesidade e a infecção por H. pylori podem predispor à colite inespecífica.
Descritores: Helicobacter pylori
Colite/patologia
Obesidade
-Fatores de Risco
Doenças do Colo
Limites: Humanos
Masculino
Feminino
Responsável: BR545.3 - Biblioteca ICBS


  9 / 377 LILACS  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Id: biblio-1157427
Autor: Augusto Barros Roberto; Monteverde María José; Federico Barros Roberto; De Elizalde Santiago; Barros Augusto Sebastian.
Título: Seguridad de la resección con asa fría de lesiones colorrectales no polipoideas (0-IIa y 0-IIb) de hasta 20 mm / [Safety and efficacy of cold snare resection of non-polypoid colorectal lesions (0-IIa and 0-IIb)].
Fonte: Acta gastroenterol. latinoam;44(1):27-32, 2014 Mar.
Idioma: es.
Resumo: BACKGROUND: Cold polypectomy is a widely used technique for removing small polyps. Little evidence is available regarding its use for removing non-polypoid colorectal lesions (NPCRL). OBJECTIVE: The main aim of this study was to assess the safety of cold snare resection of NPCRL up to 20 mm. METHODS: This was a prospective cohort study carried out from January 2009 to January 2012. Consecutive patients scheduled for colonoscopy who had at least one NPCRL were recruited. Patients undergoing antiaggregation or anticoagulation treatment were excluded. NPCRL of up to 20 mm were removed by means of a cold snare, with or without piecemeal technique. To evaluate the safety of the procedure, the measured outcomes were bleeding and perforation rates. Statistical measures as percentages with their respective confidence intervals of 95

were estimated and the level of significance was set at alpha = 0.03. The calculated interval was unilateral, because the experimental rate was 0

, and was built based on the binomial distribution. Statistix (SX9.0) was used. RESULTS: A total of 171 NPCRL were removed from 124 patients. The mean size of the lesions was 9.22 +/- 4.7 mm (range: 4 to 20 mm). The mean age of patients was 55 +/- 11 years (range: 25 to 81 years) and 56

of them were women. No immediate or delayed complications were recorded. CONCLUSIONS: Cold snare resection could be used to remove LNPCR (0-IIa and 0-IIb) measuring up to 20 mm, without immediate or delayed complications.
Descritores: Colonoscopia/métodos
Doenças Retais/cirurgia
Doenças do Colo/cirurgia
Lesões Pré-Cancerosas/cirurgia
-Adulto
Estudos Prospectivos
Feminino
Humanos
Idoso
IDOSO DE ACETABULARIA ANOS OU MAIS
Masculino
Pessoa de Meia-Idade
Resultado do Tratamento
Tipo de Publ: Resumo em Inglês
Artigo de Revista
Responsável: AR5.1 - Centro de Gestión del Conocimiento y las Comunicaciónes


  10 / 377 LILACS  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
Texto completo
Id: biblio-1147904
Autor: Mendivelso, Fredy Orlando; Barrios Parra, Arnold José; Zárate López, Eduardo; Navas Camacho, Ángela María; Álvarez, Adrián Osvaldo; Mc Loughlin, Santiago; Mendoza, Gabriela Renee; Enciso Pérez, Daniel; Rodríguez Barajas, Rubén; Jiménez Chávez, María Sofía; Ramírez, José; Faber, Florencia; Solla, Gonzalo; Viola Malet, Marcelo; Rodríguez Bedoya, Milena.
Título: Asociación entre desenlaces clínicos y cumplimiento del protocolo de recuperación mejorada después de la cirugía (ERAS) en procedimientos colorrectales: estudio multicéntrico / Association between clinical outcomes and compliance with the Enhanced Recovery After Surgery (ERAS) protocol in colorectal procedures: A multicenter study
Fonte: Rev. colomb. cir;35(4):601-613, 2020. fig, tab.
Idioma: es.
Resumo: Introducción. Los protocolos de recuperación mejorada después de cirugía se han diseñado como una innovación en salud tras demostrarse que la mejora en los dispositivos médicos y la depuración de técnicas alcanzaron la meseta en disminución de complicaciones. Con estas estrategias de la medicina perioperatoria, en cirugía colorrectal se reducen la morbilidad y estancia hospitalaria. El objetivo del estudio fue evaluar si la tasa de adherencia al programa de recuperación mejorada después de la cirugía (ERAS) está asociada con los resultados quirúrgicos. Métodos. Estudio multicéntrico, observacional, retrospectivo de cohorte (2015-2019), en cinco hospitales latinoamericanos certificados por la sociedad ERAS. Se calculó la incidencia de complicaciones quirúrgicas durante el posquirúrgico inmediato (30 días) y la duración de la estancia hospitalaria. Se utilizaron análisis bivariado y regresión logística multivariada para evaluar los factores asociados con la tasa de complicaciones. Resultados. Fueron incluidos en el estudio 648 pacientes en cinco hospitales ERAS, con edad promedio de 61 años y mayor porcentaje de hombres (51 %). El cumplimiento global al protocolo ERAS fue de 75 % y la estancia promedio de 6,2 días (mediana: 4 días). Se tuvo un cumplimiento óptimo del protocolo ERAS (igual o mayor al 80 %) en 23,6 % de los pacientes. Se documentó fuga de la anastomosis en 4 %, complicaciones infecciosas en 8,4 %, íleo en 5,7 %, reingreso en 10,2 % y mortalidad de 1,1 %. El análisis multivariado mostró que los niveles de adherencia óptima al protocolo ERAS reducen significativamente la aparición de complicaciones como fuga de la anastomosis (OR 0,08; IC95% 0,01-0,48; p=0,005) y complicaciones infecciosas (OR 0,17; IC95%0,03-0,76; p=0,046).Discusión. Los resultados sugieren que un cumplimiento del programa ERAS mayor al 80 % se asocia a menor frecuencia de complicaciones en pacientes con cirugía electiva colorrectal

Introduction. Enhanced Recovery After Surgery (ERAS) protocol has been designed as an innovation in health after demonstrating that the improvement in medical devices and the refinement of techniques reached the plateau in reducing complications. With these strategies of perioperative medicine, in colorectal surgery morbidity and hospital stay are reduced. The aim of the study was to evaluate whether the rate of adherence to the ERAS protocol is associated with surgical outcomes.Methods. Multicenter, observational, retrospective cohort study (2015-2019), in five Latin American hospitals certified by the ERAS Society. The incidence of surgical complications during the immediate postoperative period (30 days) and length of hospital stay were calculated. Bivariate analyzes and multivariate logistic regression were used to assess factors associated with complication rates.Results. 648 patients were included in the study in five ERAS hospitals, with an average age of 61 years and a higher percentage of men (51%). Overall compliance with the ERAS protocol was 75% and the average stay was 6.2 days (median: 4 days). There was optimal compliance with the ERAS protocol (equal to or greater than 80%) in 23.6% of the patients. Anastomotic leak was documented in 4%, infectious complications in 8.4%, ileus in 5.7%, readmission in 10.2%, and mortality in 1.1%. Multivariate analysis showed that optimal adherence levels to the ERAS protocol significantly reduce the appearance of complications such as anastomotic leakage (OR 0.08; 95%CI 0.01-0.48; p=0.005) and infectious complications (OR 0.17; 95%CI 0.03-0.76; p=0.046).Discussion. The results suggest that compliance with the ERAS program greater than 80% is associated with a lower frequency of complications in patients with elective colorectal surgery
Descritores: Recuperação Pós-Cirúrgica Melhorada
-Doenças do Colo
Medidas de Associação, Exposição, Risco ou Desfecho
Cooperação e Adesão ao Tratamento
Limites: Humanos
Responsável: CO113



página 1 de 38 ir para página                         
   


Refinar a pesquisa
  Base de dados : Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde