Vergara-Fernández O, Trejo-Avila M, Salgado-Nesme N

Idioma: Ingles.
Referencias bibliográficas: 26
Paginas: 337-346
Archivo PDF: 190.77 Kb.

RESUMEN

Antecedentes: A pesar de las ventajas de la ileostomía en asa de derivación, múltiples complicaciones se han asociado a su uso. Objetivo: Determinar los factores de riesgo para presentar complicaciones tras el cierre de una ileostomía en asa. Método: Se realizó un análisis retrospectivo de los pacientes sometidos a cierre de ileostomía en asa de enero de 2010 a marzo de 2018. Se determinaron los factores de riesgo utilizando regresión multivariable. Resultados: Se incluyeron 136 pacientes. Las indicaciones para cirugía fueron cáncer colorrectal (39.7%), diverticulitis (25.7%), colitis ulcerosa crónica idiopática (CUCI) (8.1%), poliposis adenomatosa familiar (PAF) (7.4%) y otras (19.1%). Se identificaron los siguientes factores de riesgo: incisión en línea media (OR: 6.5) para infección de herida; tratamiento inmunomodulador (OR: 12.5) para fuga de anastomosis; antecedente de PAF (OR: 9.8) para oclusión intestinal; tratamiento inmunomodulador (OR: 10) e incisión en línea media (OR: 18.9) para reintervención; y edad ≥ 65 años (OR: 3.5) para complicaciones médicas. La frecuencia de hernia incisional fue del 11%: ‹ 3 meses para el cierre (OR: 6.4) y hernia parastomal (OR: 13.2). Conclusiones: Numerosos factores relacionados con el paciente y con la técnica quirúrgica deben de ser considerados al momento del cierre de la ileostomía en asa para reducir la morbilidad posoperatoria.

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