Nazario DAM, Falcón VGC, Romero GLI, Oliu LH, de la Cruz CNA

Language: Spanish
References: 0
Page: 1-9
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ABSTRACT

Introduction: acute mediastinitis is a serious complication of esophageal perforation. There are no classifications or general guidelines for its treatment. Objective: to develop an evolutionary classification and a surgical treatment algorithm. Methods: aresearch was carried out at Saturnino Lora Provincial Hospital in Santiago de Cuba, from 1990 to 2014. The chi-square homogeneity test was used for the validation of the results, as well as the percentage as a summary measure and the calculation of incidence rates and mortality. The study included two methodological designs: the first, technological development, for the elaboration of the classification and the treatment algorithm, and a quasi-experiment for the application of the algorithm. Results: in the more severe states of acute mediastinitis, mortality was identified as higher. The mortality load for the first group of patients was 77.7 % and decreased to 22.3 % in the group treated with the algorithm (risk reduction of 64.8 %). Conclusions: the evolutionary classification guides the implementation of the surgical treatment algorithm of the disease. The application of the surgical treatment algorithm of acute mediastinitis through esophageal perforation allows reducing the burden of morbidity. Consequently, the risk of dying from this disease decreases significantly.