Roesch-Dietlen F, Pérez-Morales AG, Romero-Sierra G, Remes-Troche JM, Jiménez-García VA

Idioma: Español
Referencias bibliográficas: 77
Paginas: 143-149
Archivo PDF: 95.94 Kb.

RESUMEN

Objetivo: Analizar y comparar los resultados obtenidos con las diferentes técnicas quirúrgicas que existen y el manejo conservador de la apendicitis.
Sede: Instituto de Investigaciones Médico-Biológicas y Facultad de Medicina de la Universidad Veracruzana.
Diseño: Revisión de la literatura.
Material y métodos: Se procedió a la revisión bibliográfica de los principales artículos científicos publicados en los últimos 6 años, así como las bases de datos en las fuentes electrónicas de las bibliotecas EBSCOhost, Cochrane y UpToDate. Se analiza y presenta toda la literatura crítica sobre el tratamiento de la apendicitis complicada y no complicada por medio de cirugía convencional, cirugía laparoscópica, NOTES®, cirugía a través de un solo puerto, manejo médico y/o manejo conservador, publicadas entre los años 1996 y 2012.
Resultados: La apendicetomía convencional ha sido durante muchos años el estándar de oro para su manejo. En 1982, se introdujo el abordaje laparoscópico que ha demostrado ser tan seguro y eficiente como la cirugía convencional; posteriormente, en 2004, se introdujo la cirugía endoscópica a través de orificios naturales (NOTES®), y en 2007, la cirugía a través de un solo puerto. Recientemente, han aparecido publicaciones sobre su manejo conservador con cirugía de intervalo, lo cual evita un gran número de intervenciones innecesarias con morbimortalidad, comparables a los pacientes sometidos a cirugía en forma urgente.
Conclusiones: La apendicetomía continúa siendo el estándar de oro del manejo de la apendicitis aguda; sin embargo, han surgido alternativas de manejo diferentes al criterio quirúrgico tradicional, las cuales han demostrado ser útiles y permiten disminuir la cirugía innecesaria, sin incremento de la morbimortalidad.

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