Complicaciones según manejo quirúrgico en pacientes con vólvulo de sigmoides en los Hospitales del Ministerio de Salud del Cusco 2015 - 2019

Abstract

ANTECEDENTES: El vólvulo de sigmoides representa más del 50% de las obstrucciones intestinales, en el Perú la incidencia llega al 75%, es una emergencia frecuente y requiere un diagnóstico precoz y manejo oportuno, el estudio tiene como objetivo determinar si existe asociación entre el manejo quirúrgico y las complicaciones post operatorias en pacientes con vólvulo de sigmoides en los Hospitales del Ministerio de Salud Cusco en el periodo 2015 – 2019. METODO: El presente trabajo es de tipo cualitativo de corte transversal, retrospectivo y analítico. El diseño es observacional. Se revisaron 350 historias clínicas de pacientes atendidos en los hospitales del Ministerio de Salud del Cusco en el periodo del 2015 – 2019. Para el análisis estadístico se utilizó SPSS 21.0 y Microsoft Office Excel 2016. RESULTADOS: El vólvulo de sigmoides afecta más al género masculino (77.4%) con edades entre 60 y 69 años de procedencia rural (67.7%). Las complicaciones fueron más frecuentes en pacientes masculinos (26.2%) > 80 años (36%) de procedencia urbana (26.5%). El manejo quirúrgico más usado fue anastomosis primaria (76.8%) seguida por colostomía tipo Hartmann (22.6%). Las complicaciones se presentaron en el 41.8% (33/79) de colostomía Hartmann y 19.3% (52/269) de anastomosis primaria. Del total el 24.9% presentó complicaciones, las más frecuentes fueron: dehiscencia de anastomosis (11.6%) seguida de evisceración e infección de sitio operatorio (10.1%) cada una, el 46.5% son catalogadas como “otras”. La relación entre los parámetros pre, intra y postoperatorios frente a las complicaciones fueron significativos. La mortalidad fue del 6.6.%. CONCLUSIONES: Existe relación estadísticamente significativa entre el manejo quirúrgico y las complicaciones post operatorias en pacientes con vólvulo de sigmoides.

BACKGROUND: Sigmoid volvulus accounts for more than 50% of intestinal obstructions, in Peru the incidence reaches 75%, it is a frequent emergency and requires early diagnosis and prompt management. The study aims to determine whether there is an association between surgical management and post-operative complications in patients with sigmoid volvulus in the Hospitals of the Ministry of Health in Cusco in the period 2015-2019. METHOD: This work is qualitative, cross-sectional, retrospective and analytical. The design is observational. 350 medical records of patients operated on for sigmoid volvulus who met the inclusion and exclusion criteria in the hospitals of the Ministry of Health of Cusco in the period of 2015-2019 were reviewed. For the statistical analysis, SPSS 21.0 and Microsoft Office Excel 2016. RESULTS: Sigmoid volvulus affects more males (77.4%) with ages between 60 and 69 years of rural origin (67.7%). Complications were more frequent in male patients (26.2%)> 80 years (36%) of urban origin (26.5%). The most widely used surgical management was primary anastomosis (76.8%) followed by a Hartmann-type colostomy (22.6%). Complications occurred in 41.8% (33/79) of Hartmann colostomy and 19.3% (52/269) of primary anastomosis. Of the total, 24.9% presented complications, the most frequent were: anastomosis dehiscence (11.6%) followed by evisceration and infection of the operative site (10.1%) each, 46.5% are classified as “other“. The relationship between the pre, intra, and postoperative parameters versus complications were significant. Mortality was 6.6.% BACKGROUND: Sigmoid volvulus accounts for more than 50% of intestinal obstructions, in Peru the incidence reaches 75%, it is a frequent emergency and requires early diagnosis and prompt management. The study aims to determine whether there is an association between surgical management and post-operative complications in patients with sigmoid volvulus in the Hospitals of the Ministry of Health in Cusco in the period 2015-2019. METHOD: This work is qualitative, cross-sectional, retrospective and analytical. The design is observational. 350 medical records of patients operated on for sigmoid volvulus who met the inclusion and exclusion criteria in the hospitals of the Ministry of Health of Cusco in the period of 2015-2019 were reviewed. For the statistical analysis, SPSS 21.0 and Microsoft Office Excel 2016. RESULTS: Sigmoid volvulus affects more males (77.4%) with ages between 60 and 69 years of rural origin (67.7%). Complications were more frequent in male patients (26.2%)> 80 years (36%) of urban origin (26.5%). The most widely used surgical management was primary anastomosis (76.8%) followed by a Hartmann-type colostomy (22.6%). Complications occurred in 41.8% (33/79) of Hartmann colostomy and 19.3% (52/269) of primary anastomosis. Of the total, 24.9% presented complications, the most frequent were: anastomosis dehiscence (11.6%) followed by evisceration and infection of the operative site (10.1%) each, 46.5% are classified as “other“. The relationship between the pre, intra, and postoperative parameters versus complications were significant. Mortality was 6.6.% BACKGROUND: Sigmoid volvulus accounts for more than 50% of intestinal obstructions, in Peru the incidence reaches 75%, it is a frequent emergency and requires early diagnosis and prompt management. The study aims to determine whether there is an association between surgical management and post-operative complications in patients with sigmoid volvulus in the Hospitals of the Ministry of Health in Cusco in the period 2015-2019. METHOD: This work is qualitative, cross-sectional, retrospective and analytical. The design is observational. 350 medical records of patients operated on for sigmoid volvulus who met the inclusion and exclusion criteria in the hospitals of the Ministry of Health of Cusco in the period of 2015-2019 were reviewed. For the statistical analysis, SPSS 21.0 and Microsoft Office Excel 2016. RESULTS: Sigmoid volvulus affects more males (77.4%) with ages between 60 and 69 years of rural origin (67.7%). Complications were more frequent in male patients (26.2%)> 80 years (36%) of urban origin (26.5%). The most widely used surgical management was primary anastomosis (76.8%) followed by a Hartmann-type colostomy (22.6%). Complications occurred in 41.8% (33/79) of Hartmann colostomy and 19.3% (52/269) of primary anastomosis. Of the total, 24.9% presented complications, the most frequent were: anastomosis dehiscence (11.6%) followed by evisceration and infection of the operative site (10.1%) each, 46.5% are classified as “other“. The relationship between the pre, intra, and postoperative parameters versus complications were significant. Mortality was 6.6.% CONCLUSIONS: There is a statistically significant relationship between surgical management and postoperative complications in patients with sigmoid volvulus.