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2007, Número 6

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Cir Cir 2007; 75 (6)


Síndrome de vaciamiento rápido en pacientes sometidos a resección gástrica

Rivera I, Ochoa-Martínez CI, Hermosillo-Sandoval JM, Morales-Amezcua JM, Fuentes-Orozco C, González-Ojeda A

Idioma: Español
Referencias bibliográficas: 44
Paginas: 429-433
Archivo PDF: 61.62 Kb.


RESUMEN

Objetivo: Establecer la incidencia de síndrome de vaciamiento rápido después de resección gástrica parcial o total y su asociación con el estado nutricional preoperatorio, así como el comportamiento clínico con manipulación dietética durante un periodo corto de seguimiento.
Material y métodos: Estudio prospectivo durante un periodo de 24 meses, de pacientes consecutivos mayores de 30 años de edad sometidos a gastrectomía por cáncer gástrico o enfermedad ulceropéptica complicada, en un hospital de alta especialidad.
Resultados: Fueron evaluados 42 pacientes, con ligero predominio del sexo femenino (n = 22). Veintinueve casos (69 %) tuvieron gastrectomía subtotal y 13 (31 %) total, con media de edad de 54.4 ± 7.6 y 66 ± 14 años, respectivamente (p = 0.034). Las técnicas de reconstrucción fueron la gastroyeyunostomía en Y de Roux en 69 % y esofagoyeyunostomía en Y de Roux en 28.5 %. Encontramos síndrome de vaciamiento rápido en 45 %, asociado con desnutrición aguda y crónica (p = 0.003); 53 % de los pacientes con vaciamiento rápido mejoraron con una adecuada manipulación dietética durante un periodo de seguimiento de 211 días.
Conclusiones: No obstante que la mayoría de las reconstrucciones fueron hechas con segmentos de intestino delgado desfuncionalizado, la incidencia de síndrome vaciamiento rápido fue de 45 %. El estado nutricional preoperatorio influyó en la presencia de manifestaciones clínicas. La manipulación dietética redujo 53 % los síntomas de vaciamiento rápido en un corto periodo de seguimiento.


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