Comparación de los resultados de la nefrectomía simple abierta secundaria a litiasis en pacientes con y sin nefrostomía

Published on Jul 1, 2017in Cirugia Y Cirujanos0.264
· DOI :10.1016/J.CIRCIR.2017.05.001
Luis Daniel Carrillo-Córdova1
Estimated H-index: 1
(HGM: Hospital General de México),
Jean Manuel Jiménez-Villavicencio (HGM: Hospital General de México)+ 10 AuthorsMateo Leopoldo Garduño-Arteaga1
Estimated H-index: 1
(HGM: Hospital General de México)
Resumen Antecedentes La nefrectomia es el procedimiento de eleccion en el tratamiento de rinones excluidos. La nefrostomia percutanea es una herramienta que permite desobstruir la via urinaria, asociada a una mayor fibrosis e inflamacion perirrenal; el objetivo de este estudio fue describir y comparar los resultados quirurgicos en nefrectomias retroperitoneales simples abiertas en pacientes con nefrostomia y sin nefrostomia. Metodologia Se analizaron 58 pacientes. Los parametros demograficos de los pacientes con nefrostomia fueron comparados con los pacientes sin nefrostomia (edad, genero, peso, localizacion del lito, variables transoperatorias [tiempo quirurgico, sangrado transoperatorio]) y variables posquirurgicas (necesidad de terapia intensiva, necesidad de transfusion, infeccion de herida quirurgica y dias de estancia hospitalaria) Resultados Se encontraron diferencias estadisticamente significativas para las variables de sangrado transoperatorio (p = 0.0442), tiempo quirurgico (p = 0.0093), dias de estancia hospitalaria (p = 0.0040) y necesidad de transfusion (p = 0.0170). No existieron diferencias para necesidad de terapia intensiva (p = 0.6314), complicaciones transoperatorias (p = 0.7414) e infeccion de la herida quirurgica (p = 0.2762). Conclusiones La presencia de un cateter de nefrostomia en pacientes sometidos a nefrectomia simple abierta lleva a un mayor riesgo de morbilidad, con un mayor sangrado, tiempo quirurgico, necesidad de transfusion y dias de estancia hospitalaria.
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