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1.
Int J Legal Med ; 136(1): 343-356, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34223994

RESUMO

This experimental study provides a further understanding of the post-burning nature of sharp force trauma. The main objective is to analyse the distortion that fire may inflict on the length, width, roughness, and floor shape morphology of toolmarks induced by four different implements. To this end, four fresh juvenile pig long bones were cut with a bread knife, a serrated knife, a butcher machete, and a saw. A total of 120 toolmarks were induced and the bone samples were thus burnt in a chamber furnace. The lesions were analysed with a 3D optical surface roughness metre before and after the burning process. Afterwards, descriptive statistics and correlation tests (Student's t-test and analysis of variance) were performed. The results show that fire exposure can distort the signatures of sharp force trauma, but they remain recognisable and identifiable. The length decreased in size and the roughness increased in a consistent manner. The width did not vary for the saw, serrated knife, or machete toolmarks, while the bread knife lesions slightly shrunk. The floor shape morphology varied after burning, and this change became more noticeable for the three knives. It was also observed that the metrics of the serrated knife and machete cut marks showed no significant variations. Our results demonstrate that there is a variation in the toolmark characteristics after burning. This distortion is dependent on multiple factors that influence their dimensional and morphological changes, and the preservation of class features is directly reliant upon the weapon employed, the trauma caused, and the burning process conditions.


Assuntos
Queimaduras , Incêndios , Animais , Osso e Ossos/patologia , Queimaduras/patologia , Temperatura Alta , Humanos , Suínos , Armas
2.
Updates Surg ; 73(6): 2103-2111, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34018141

RESUMO

Procalcitonin (PCT) and C-Reactive Protein (CRP) are acute-phase reactants that indicate the presence and severity of an infection. The aim of this study was to verify the utility of CRP and PCT as tools for early diagnosis of anastomotic leakage (AL) in patients undergoing elective colorectal surgery. A prospective observational study including 95 patients undergoing elective colorectal surgery with anastomosis, where patients were divided into two groups according to whether or not AL happened. Different variables were compared using a uni- and multivariate analyses to identify the risk factors for AL. Receiver Operating Characteristic (ROC) curves were added to establish a cut-off point for CRP and PCT. The inflammatory marker levels were analysed in other complications different from AL. AL was detected in 11 patients (14%), 7 required an emergency reoperation. The overall morbidity rate was 42.1% and the mortality was 3.2%. In the univariate study, increased CRP on days 3 and 5, male sex and intraoperative complications were significantly associated with AL. In the multivariate study, CRP on day 5 was the only factor related to AL. AUC at ROC curves showed that CRP results ≥ 15.3 mg/dL on day 3 and 9.1 mg/dL on day 5 were predictors of AL. Normal CRP and PCT values had a high negative predictive value. CRP on postoperative day 5 is a reliable marker for early detection of anastomotic leakage in colorectal surgery. Both CRP and PCT on days 3 and 5 have a high negative predictive value.Trial registration: The study has been registered at ClinicalTrials.gov. Code: NCT04632446.


Assuntos
Fístula Anastomótica , Cirurgia Colorretal , Fístula Anastomótica/diagnóstico , Biomarcadores , Cirurgia Colorretal/efeitos adversos , Diagnóstico Precoce , Humanos , Masculino , Valor Preditivo dos Testes , Pró-Calcitonina
3.
Med. clín (Ed. impr.) ; 156(6): 277-280, marzo 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-208471

RESUMO

Objetivo: Caracterizar los episodios adversos relacionados con la asistencia sanitaria en pacientes infectados por SARS-CoV-2 fallecidos en un hospital de tercer nivel.MétodosEstudio observacional retrospectivo en el que se incluyeron los pacientes fallecidos en el centro entre el 16 de marzo y el 10 de abril de 2020. La información fue extraída desde la historia clínica electrónica.ResultadosLa mediana de edad de los 164 pacientes analizados fue de 77,5 años. Más de 9 de cada 10 pacientes fallecidos presentaban al menos una comorbilidad. El 40,2% de los pacientes presentó al menos un episodio adverso (EA) asociado a la atención sanitaria. Un 23,8% de los pacientes presentó alguna reacción adversa a medicamentos, constituyendo la primera causa de EA entre los pacientes fallecidos. Entre los pacientes que fallecieron en unidades de cuidados intensivos, los problemas relacionados con la ventilación mecánica han aparecido con una frecuencia del 8,8%.ConclusionesA pesar de que la letalidad asociada a los EA detectados fue muy reducida, es fundamental establecer una vigilancia estrecha de los posibles EA asociados a la asistencia sanitaria, especialmente los farmacológicos, dado que se trata de una enfermedad con un tratamiento terapéutico incierto. (AU)


Objective: To characterize health care-related adverse events in patients with SARS-CoV-2 infection who died in a tertiary hospital.MethodsThis is a retrospective, observational study, that included patients who died at HUGTiP hospital between 16 March and 10 April 2020. Data was extracted from the electronic medical record.ResultsThe median age of the 164 SARS-CoV-2 infected patients who died in the center in the study period was 77.5 years and> 90% of patients had ≥ 1 comorbidity. Forty point two percent of patients had at least ≥ 1 health care-related adverse event. Twenty three point eight of patients had an adverse drug reaction, the leading cause of adverse events in patients who died. Of patients who died in intensive care units, the frequency of problems related to mechanical ventilation was 8.8%.ConclusionsAlthough the case fatality rate associated with the adverse events detected was very low, close monitoring of potential health care-related adverse events, especially drug reactions, as the therapeutic management of the disease remains unclear. (AU)


Assuntos
Humanos , Antivirais/efeitos adversos , Antivirais/uso terapêutico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/terapia , Respiração Artificial/efeitos adversos , Respiração Artificial/mortalidade , Centros de Atenção Terciária , Estudos Retrospectivos , Espanha/epidemiologia
4.
Med Clin (Engl Ed) ; 156(6): 277-280, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33589877

RESUMO

OBJECTIVE: To characterize health care-related adverse events in patients with SARS-CoV-2 infection who died in a tertiary hospital. METHODS: This is a retrospective, observational study, that included patients who died at HUGTiP hospital between 16 March and 10 April 2020. Data was extracted from the electronic medical record. RESULTS: The median age of the 164 SARS-CoV-2 infected patients who died in the center in the study period was 77.5 years and >90% of patients had ≥1 comorbidity. Forty point two percent of patients had at least ≥1 health care-related adverse event. Twenty three point eight of patients had an adverse drug reaction, the leading cause of adverse events in patients who died. Of patients who died in intensive care units, the frequency of problems related to mechanical ventilation was 8.8%. CONCLUSIONS: Although the case fatality rate associated with the adverse events detected was very low, close monitoring of potential health care-related adverse events, especially drug reactions, as the therapeutic management of the disease remains unclear.


OBJETIVO: Caracterizar los eventos adversos relacionados con la asistencia sanitaria en pacientes infectados por SARS-CoV-2 fallecidos en un hospital de tercer nivel. MÉTODOS: Estudio observacional retrospectivo en el que se incluyeron los pacientes fallecidos en el centro entre el 16 de marzo y el 10 de abril de 2020. La información fue extraída desde la historia clínica electrónica. RESULTADOS: La mediana de edad de los 164 pacientes analizados fue de 77,5 años. Más de 9 de cada 10 pacientes fallecidos presentaban al menos una comorbilidad. El 40,2% de los pacientes presentó al menos un evento adverso (EA) asociado a la atención sanitaria. Un 23,8% de los pacientes presentó alguna reacción adversa a medicamentos, constituyendo la primera causa de EA entre los pacientes fallecidos. Entre los pacientes que fallecieron en unidades de cuidados intensivos, los problemas relacionados con la ventilación mecánica han aparecido con una frecuencia del 8,8%. CONCLUSIONES: A pesar de que la letalidad asociada a los EA detectados fue muy reducida, es fundamental establecer una vigilancia estrecha de los posibles EA asociados a la asistencia sanitaria, especialmente los farmacológicos, dado que se trata de una enfermedad con un manejo terapéutico incierto.

5.
Med Clin (Barc) ; 156(6): 277-280, 2021 03 26.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33358536

RESUMO

OBJECTIVE: To characterize health care-related adverse events in patients with SARS-CoV-2 infection who died in a tertiary hospital. METHODS: This is a retrospective, observational study, that included patients who died at HUGTiP hospital between 16 March and 10 April 2020. Data was extracted from the electronic medical record. RESULTS: The median age of the 164 SARS-CoV-2 infected patients who died in the center in the study period was 77.5 years and> 90% of patients had ≥ 1 comorbidity. Forty point two percent of patients had at least ≥ 1 health care-related adverse event. Twenty three point eight of patients had an adverse drug reaction, the leading cause of adverse events in patients who died. Of patients who died in intensive care units, the frequency of problems related to mechanical ventilation was 8.8%. CONCLUSIONS: Although the case fatality rate associated with the adverse events detected was very low, close monitoring of potential health care-related adverse events, especially drug reactions, as the therapeutic management of the disease remains unclear.


Assuntos
Antivirais/efeitos adversos , COVID-19/mortalidade , COVID-19/terapia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Respiração Artificial/efeitos adversos , Centros de Atenção Terciária , Adulto , Idoso , Idoso de 80 Anos ou mais , Antivirais/uso terapêutico , COVID-19/diagnóstico , Terapia Combinada , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Respiração Artificial/mortalidade , Estudos Retrospectivos , Espanha/epidemiologia
8.
Int J Colorectal Dis ; 33(1): 23-28, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29138933

RESUMO

INTRODUCTION: Diagnosis of colorectal cancer (CRC) based on clinical symptoms is usually established in its advanced stages. One strategy for reducing mortality is the early detection and removal of preneoplastic and initial neoplastic lesions, even before the first symptoms appear, by means of population-based screening campaigns. The aim of the present study is to determine whether CRC diagnosed via a screening campaign has more favourable histopathological prognostic factors than when diagnosed in the symptomatic phase. MATERIAL AND METHODS: The prospective study of all the patients undergoing programmed CRC surgery at the JM Morales Meseguer Hospital (Spain) is between 2004 and 2010. The patients were divided into two groups: one diagnosed from clinical symptoms and one through a screening campaign. The following factors were compared: tumour size; degree of tumour invasion of the wall; lymph node, perineural and lymphovascular involvement; tumour stage; and grade of differentiation. RESULTS: Compared to the symptomatic group, the screen-detected patients had smaller-sized tumours (lesions of less than 5 cm in 84 vs 69.55%, p < 0.001), a lower degree of colorectal wall invasion (T0-1 in 36 vs 9.02%, p < 0.001), less lymph node involvement (N0 in 72 vs 58.76%, p > 0.05), less vascular invasion (7.20 vs 15.22%, p = 0.79) and less perineural invasion (6.4 vs 20.70%, p < 0.001). The TNM staging in the screening group was lower than in the symptomatic group (stage 0-1 in 50.40 vs 18.58%, p < 0.001). CONCLUSIONS: CRC diagnosed through a population-based screening programme presents more favourable histopathological characteristics than that diagnosed from the appearance of symptoms.


Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer , Programas de Rastreamento , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/patologia , Feminino , Humanos , Consentimento Livre e Esclarecido , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico
9.
Med. clín (Ed. impr.) ; 149(4): 170-175, ago. 2017. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-165588

RESUMO

Debemos reconocer el error diagnóstico como un episodio adverso posible e inherente al acto clínico, e incorporarlo con normalidad al resto de los indicadores de calidad asistencial. Por diferentes fuentes de información podemos conocer su frecuencia, aunque probablemente todavía está subestimada. En contra de lo que se podría suponer, en la mayoría de los casos no acontece en enfermedades infrecuentes. Sus causas suelen ser complejas y multifactoriales, con aspectos tanto cognitivos individuales como del sistema. Estos errores pueden tener un gran impacto clínico y socioeconómico. Es necesario aprender de los errores diagnósticos para desarrollar un sistema seguro, propio de una cultura de calidad (AU)


Diagnostic errors have to be recognised as a possible adverse event inherent to clinical activity and incorporate them as another quality indicator. Different sources of information report their frequency, although they may still be underestimated. Contrary to what one could expect, in most cases, it does not occur in infrequent diseases. Causes can be complex and multifactorial, with individual cognitive aspects, as well as the health system. These errors can have an important clinical and socioeconomic impact. It is necessary to learn from diagnostic errors in order to develop an accurate and reliable system with a high standard of quality (AU)


Assuntos
Humanos , Erros de Diagnóstico/estatística & dados numéricos , Tratamento de Emergência/estatística & dados numéricos , Gestão da Segurança/tendências , Serviço Hospitalar de Emergência/estatística & dados numéricos , Fatores de Risco
10.
Med Clin (Barc) ; 149(4): 170-175, 2017 Aug 22.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28571967

RESUMO

Diagnostic errors have to be recognised as a possible adverse event inherent to clinical activity and incorporate them as another quality indicator. Different sources of information report their frequency, although they may still be underestimated. Contrary to what one could expect, in most cases, it does not occur in infrequent diseases. Causes can be complex and multifactorial, with individual cognitive aspects, as well as the health system. These errors can have an important clinical and socioeconomic impact. It is necessary to learn from diagnostic errors in order to develop an accurate and reliable system with a high standard of quality.


Assuntos
Erros de Diagnóstico , Serviço Hospitalar de Emergência , Erros de Diagnóstico/efeitos adversos , Erros de Diagnóstico/prevenção & controle , Erros de Diagnóstico/psicologia , Erros de Diagnóstico/estatística & dados numéricos , Humanos , Melhoria de Qualidade , Indicadores de Qualidade em Assistência à Saúde
11.
Cancer Epidemiol ; 43: 70-5, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27399311

RESUMO

INTRODUCTION: Population-based screening programmes for colorectal cancer (CRC) allow an early diagnosis, even before the onset of symptoms, but there are few studies and none in Spain on the influence they have on patient survival. The aim of the present study is to show that patients receiving surgery for CRC following diagnosis via a screening programme have a higher survival and disease-free survival rate than those diagnosed in the symptomatic stage. MATERIAL AND METHODS: Prospective study of all the patients undergoing programmed surgery for CRC at the JM Morales Meseguer Hospital in Murcia (Spain) between 2004 and 2010. The patients were divided into two groups: (a) those diagnosed through screening (125 cases); and (b) those diagnosed in the symptomatic stage (565 cases). Survival and disease-free survival were analysed and compared for both groups using the Mantel method. RESULTS: The screen-detected CRC patients show a higher rate of survival (86.3% versus 72.1% at 5 years, p<0.05) and a lower rate of tumour recurrence (73.4% versus 88.3% at 5 years, p<0.05). CONCLUSIONS: Population-based screening for CRC is an effective strategic measure for reducing mortality specific to this neoplasia.


Assuntos
Neoplasias Colorretais/diagnóstico , Programas de Rastreamento/métodos , Idoso , Neoplasias Colorretais/mortalidade , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estudos Prospectivos
12.
Rev Esp Enferm Dig ; 107(12): 761-3, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26671590

RESUMO

BACKGROUND: Endometriosis is a relatively common disease among women with child-bearing potential, and rare before puberty or following menopause. It consists of the presence of hormone-responsive endometrium outside the endometrial cavity. CASE REPORT: We report the case of a patient with a rectal lesion, initially approached as a primary rectal malignancy, where histopathology eventually revealed an adenocarcinoma arising from endometrial tissue in the colonic wall. DISCUSSION: Endometriosis has an estimated rated of 10-20%. Sites may be split up into two larger categories - gonadal and extragonadal. The frequency of extragonadal endometriosis in the bowel is estimated to involve 3%-37% of women with pelvic endometriosis, and most lesions are found in the sigmoid colon and rectum. The malignant transformation of endometriotic lesions is estimated between 0.3% and 1% of cases. The gold standard in the diagnosis of intestinal endometriosis is exploratory laparotomy and the pathological study of specimens. Adjuvant radiotherapy and chemotherapy, although used for some patients, have not proven effective.


Assuntos
Adenocarcinoma/patologia , Transformação Celular Neoplásica , Doenças do Colo/patologia , Endometriose/patologia , Lesões Pré-Cancerosas/patologia , Neoplasias Retais/patologia , Feminino , Humanos , Pessoa de Meia-Idade
13.
Rev. esp. enferm. dig ; 107(12): 761-764, dic. 2015. ilus
Artigo em Espanhol | IBECS | ID: ibc-146745

RESUMO

INTRODUCCIÓN: la endometriosis es una patología relativamente frecuente en mujeres en edad fértil y poco prevalerte en mujeres prepúberes o postmenopáusicas. CASO CLÍNICO: presentamos el caso clínico de una mujer de 57 años, con antecedentes de histerectomía y doble anexectomía por endometriosis ovárica, diagnosticada de neoplasia de recto T3N1. Se realizó neoadyuvancia preoperatoria y resección anterior baja, sin complicaciones. La anatomía patológica describía infiltración de la pared rectal por adenocarcinoma pobremente diferenciado de origen ginecológico. DISCUSIÓN: la endometriosis tiene una prevalencia estimada del 10-20% y su lugar de aparición puede ser variado, tanto gonadal como extragonadal. La frecuencia de endometriosis extragonadal de localización intestinal se estima en un 3-37% de mujeres con endometriosis pélvica, y de estas la mayoría se localizan en colon sigmoide y recto. La transformación maligna de un foco de endometriosis se estima entre el 0,3 y el 1%. El gold estándar para el diagnóstico es la resección y estudio histológico. La radioterapia y quimioterapia adyuvante todavía no ha demostrado su clara utilidad


BACKGROUND: Endometriosis is a relatively common disease among women with child-bearing potential, and rare before puberty or following menopause. It consists of the presence of hormone-responsive endometrium outside the endometrial cavity. CASE REPORT: We report the case of a patient with a rectal lesion, initially approached as a primary rectal malignancy, where histopathology eventually revealed an adenocarcinoma arising from endometrial tissue in the colonic wall. DISCUSSION: Endometriosis has an estimated rated of 10-20%. Sites may be split up into two larger categories - gonadal and extragonadal. The frequency of extragonadal endometriosis in the bowel is estimated to involve 3%-37% of women with pelvic endometriosis, and most lesions are found in the sigmoid colon and rectum. The malignant transformation of endometriotic lesions is estimated between 0.3% and 1% of cases. The gold standard in the diagnosis of intestinal endometriosis is exploratory laparotomy and the pathological study of specimens. Adjuvant radiotherapy and chemotherapy, although used for some patients, have not proven effective


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Endometriose/patologia , Neoplasias Retais/patologia , Complicações Pós-Operatórias/diagnóstico , Quimioterapia Adjuvante , Neoplasias Retais/cirurgia
16.
Cir Cir ; 82(5): 567-72, 2014.
Artigo em Espanhol | MEDLINE | ID: mdl-25259438

RESUMO

BACKGROUND: Retrorectal or presacral space is occupied during embryological stem cell development and therefore may contain a heterogeneous group of tumors. CLINICAL CASE: We report the case of a 22-year-old male with a pilonidal cyst operated due to recurrent pilonidal sinus cyst. Final diagnosis after pelvic computed tomography is large retrorectal cystic tumor and magnetic resonance diagnosis of a presacral cystic compatible wtih germ cell tumor. The tumor was removed surgically through the abdomen and diagnosis of cystic teratoma was established. CONCLUSION: Retrorectal tumors are rare lesions whose presence must be ruled out in case of recurrent sinus.


Antecedentes: durante el desarrollo embriológico, el espacio retrorrectal o presacro está ocupado por células pluripotenciales y, por tanto, puede contener un grupo heterogéneo de tumores. Caso clínico: se comunica el caso de un paciente masculino de 22 años de edad, intervenido de sinus pilonidal recidivado. Con estudios de tomografía computada de pelvis y resonancia magnética nuclear se sospechó la existencia de un tumor quístico presacro compatible con tumor germinal; la lesión se extirpó quirúrgicamente por vía abdominal y se estableció el diagnóstico definitivo de teratoma quístico. Conclusiones: los tumores retrorrectales son lesiones poco habituales que es necesario descartar en caso de sinus recidivantes.


Assuntos
Neoplasias Pélvicas/diagnóstico , Seio Pilonidal/etiologia , Teratoma/diagnóstico , Diagnóstico Diferencial , Cisto Epidérmico/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias Pélvicas/complicações , Neoplasias Pélvicas/epidemiologia , Neoplasias Pélvicas/patologia , Neoplasias Pélvicas/cirurgia , Seio Pilonidal/cirurgia , Recidiva , Infecção da Ferida Cirúrgica/etiologia , Teratoma/complicações , Teratoma/epidemiologia , Teratoma/patologia , Teratoma/cirurgia , Tomografia Computadorizada por Raios X , Carga Tumoral , Adulto Jovem
17.
Surg Laparosc Endosc Percutan Tech ; 24(4): e143-5, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24710231

RESUMO

INTRODUCTION: Transanal endoscopic microsurgery is a widely used and valid technique with established indications. However, the cost of surgical anoscopes is not available in all centers. Many authors have described transanal resection of rectal tumors through a single laparoscopy port such as the SILS system. MATERIALS AND METHODS: We analyzed 5 cases of patients undergoing transanal resection with an SILS device. The clinical, surgical, and oncological data were assessed. RESULTS: The median distance to the anal margin was 7.2 cm (range, 5 to 10 cm) and median tumor size was 3 cm (range, 1 to 6 cm). Median operating time was 75 minutes (range, 60 to 120 min). A postsurgical rectorrhagia occurred in 1 of the case. Two cases were adenocarcinoma, 2 were adenomas, and the other was a mucosa without any tumor remnants. The margins were negative in all cases. CONCLUSIONS: Transanal resection of rectal tumors using the SILS technique is a feasible procedure. Longer series and prospective studies are necessary.


Assuntos
Adenocarcinoma/cirurgia , Adenoma Viloso/cirurgia , Colectomia/métodos , Endoscópios , Microcirurgia/métodos , Cirurgia Endoscópica por Orifício Natural/instrumentação , Neoplasias Retais/cirurgia , Adenocarcinoma/diagnóstico , Adenoma Viloso/diagnóstico , Idoso , Canal Anal , Biópsia , Colonoscopia , Endossonografia , Desenho de Equipamento , Humanos , Masculino , Pessoa de Meia-Idade , Ressonância Magnética Nuclear Biomolecular , Neoplasias Retais/diagnóstico , Resultado do Tratamento
18.
Cir. Esp. (Ed. impr.) ; 92(4): 254-260, abr. 2014. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-120693

RESUMO

INTRODUCCIÓN: Las abdominoplastias se han convertido en un proceso quirúrgico frecuente en pacientes con pérdida masiva de peso tras cirugía bariátrica. Este tipo de procedimientos no están exentos de complicaciones que afectan a la calidad de vida y satisfacción del paciente. El objetivo de este estudio es encontrar los factores de riesgo para desarrollar dichas complicaciones y evaluar la satisfacción de nuestros pacientes. MATERIAL Y MÉTODOS: A un total de 72 pacientes, de los 175 intervenidos de cirugía bariátrica, se les realizó una abdominoplastia entre 2003 y 2008. Fueron revisados, retrospectivamente: datos demográficos, estado pre- y poscirugía, comorbilidades, tasa de complicaciones y reintervención. El nivel de satisfacción fue medido mediante una encuesta expresada en una escala tipo Likert. Se realizó un análisis comparativo de las distintas variables entre pacientes con y sin complicaciones. RESULTADOS: a) Complicaciones: tasa global del 45,5%. La más frecuente fue el seroma (23,6%); infección (13,9%), sangrado (11,1%), hematoma (6,9%) (requiriendo transfusión [6,9%]), necrosis de piel (6,9%) y necrosis umbilical (4,2%). Se reintervino a 8 pacientes (11,1%). b) Satisfacción: 1) muy satisfecho: 51,4%; 2) satisfecho: 31,9%; 3) insatisfecho: 8,3%; 4) muy insatisfecho: 8,3%.c) Se encuentra una relación estadísticamente significativa entre complicaciones, reintervención, estancia media y satisfacción (p < 0,001). CONCLUSIÓN: Las complicaciones son relativamente frecuentes en este tipo de pacientes, alargando la estancia media y posteriores controles ambulatorios. No hemos identificado factores de riesgo que ayuden a prevenir este tipo de complicaciones. El grado de insatisfacción está en relación con las complicaciones postoperatorias del procedimiento quirúrgico y no con el resultado estético


BACKGROUND: Body contouring surgery is in high demand following the increase in bariatric surgery. But these types of procedures are associated with high complication rates that cause long hospital stays and have a negative effect on patient satisfaction. The purpose of this study is to identify predictors of complications in order to optimize outcomes in these patients and find a relationship between complication rate and satisfaction. MATERIAL AND METHODS: Out of a group of 175 post-bariatric patients, 72 patients underwent body contouring surgery following massive weight loss from 2003-2008. They were reviewed retrospectively for demographic data, pre- and postoperative weight status, co-morbidities and complications and reoperation rate. Patient satisfaction was evaluated. RESULTS: a) Complications: The overall complication rate was 45.8%. The most frequent were seromas (23.6%); infection (13.9%), bleeding (11.1%), hematoma (6.9%) (needing transfusions [6.9%]), skin necrosis (6.9%) and umbilical necrosis (4.2%). A total of 8 patients required reoperation (11.1%).b) Satisfaction rating: 1) very satisfied: 51.4%, 2) satisfied: 31.9%, 3) dissatisfied: 8.3%, 4) very dissatisfied: 8.3%.c) The presence of complications was significantly associated with patients' satisfaction, reoperation rate and longer hospital stays (P<.001). CONCLUSIONS: Post operative complications were frequent. No predictors could be found to prevent these complications and optimize patient selection and appropriate timing of surgery. Patients with complications had a significantly higher reoperation rate, longer hospital stay and more dissatisfaction. The patients' satisfaction was negatively influenced by complication occurrence and not by the aesthetic results


Assuntos
Humanos , Lipectomia/métodos , Cirurgia Bariátrica/métodos , Obesidade/cirurgia , Abdominoplastia/métodos , Satisfação do Paciente , Complicações Pós-Operatórias
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