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2006, Número 3

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Rev Med Hosp Gen Mex 2006; 69 (3)


Cirugía laparoscópica y anestesia en pacientes de alto riesgo

López-Herranz GP

Idioma: Español
Referencias bibliográficas: 32
Paginas: 164-170
Archivo PDF: 121.24 Kb.


RESUMEN

En las últimas décadas, la cirugía laparoscópica se practica no sólo en adultos sin antecedentes de enfermedades, sino que también son candidatos pacientes de alto riesgo, con patología preexistente significativa. En estos sujetos es esencial el entendimiento de las consecuencias fisiológicas de los cambios hemodinámicos que se producen por el capnoperitoneo. Las alteraciones son más aparentes en pacientes clasificados como ASA III–IV, de edad avanzada, con reserva cardiopulmonar limitada, en obesos, cirróticos y en el embarazo, por lo que el riesgo anestésico se incrementa. El procedimiento perioperatorio integral, con monitoreo invasivo, permite realizar cirugía laparoscópica con seguridad y proporciona una alternativa al tratamiento convencional en pacientes de alto riesgo.


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