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2018, Número 4

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Cir Gen 2018; 40 (4)


Análisis retrospectivo de 120 apendicectomías laparoscópicas: utilidad del uso de escalas clínicas y factores predictores de apéndice blanca

Escobedo BL, Hernández LAH, Muñoz HJD, Méndez HM, Valdés CA, Gómez-Palacio VM, Olguín GA, Hernández LAS

Idioma: Español
Referencias bibliográficas: 30
Paginas: 243-249
Archivo PDF: 202.97 Kb.


RESUMEN

Introducción: La apendicitis aguda es el diagnóstico presuntivo más común en pacientes con dolor abdominal en el servicio de urgencias. El uso de la imagenología ha disminuido el porcentaje de apendicetomías blancas. Objetivos: Integrar el manejo de escalas clínicas diagnósticas rutinarias en busca de factores predictores de apéndice blanca. Material y métodos: Se realizó un estudio retrospectivo, observacional, descriptivo y longitudinal para buscar factores que contribuyen en el desenlace de una apendicectomía blanca en una institución privada de servicios de salud durante 2011 y 2015. Se analizaron estudios de laboratorio, gabinete y sintomatología, con frecuencia presentados en los cuadros apendiculares y su relación con respecto a resultados por patología de la pieza quirúrgica. Resultados: Se reportó 35% de apendicectomías blancas, con predominio en mujeres 73.81 vs. 26.19% en hombres. Las variables más significativas fueron: género, (OR 5.955, IC 95% 1.494-23.735) p = 0.01, migración de dolor (OR 36.20, IC 95% 6.78-193.32) p = 0.0001, leucocitosis (OR 14.102, IC 95% 3.45-57.61) p = 0.0001. Conclusiones: La ausencia de migración de dolor y leucocitosis son factores predisponentes del desenlace de apéndice blanca. El sexo femenino fue predominante, por lo que su abordaje diagnóstico previo debe ser más riguroso.


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