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1.
Updates Surg ; 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38489129

RESUMO

INTRODUCTION: During the surge of the SARS-CoV-2 pandemic, studies revealed high complication and morbidity rates following surgical procedures in COVID-19 positive patients. Anesthetic and surgical societies swiftly developed strategies to mitigate these risks, including a recommended postponement of elective surgeries for a minimum of 7 weeks post-COVID infection. Nowadays, with a predominantly vaccinated population, it has become crucial to discern the influencing factors on post-COVID morbidity and mortality and a reevaluation of the existing recommendations pertaining to elective surgery. METHODS: A single-center case-control study was conducted, including patients who underwent surgery between November 2021 and March 2022 and met the inclusion criteria. Eighty COVID-19 positive patients were matched 1:1 with 80 controls, each undergoing an identical intervention within a 2-week time frame. The primary outcome was 30-day postoperative mortality and secondary outcome postoperative complications (respiratory and thromboembolic). RESULTS: At the time of surgery, 88.8% of patients in the case group and 92.5% in the control group had received at least one vaccine dose. Mortality and morbidity did not show a significant difference when comparing the case and control groups (7.5% vs 6.2%, p = 0.755; 11.3% vs 8.9%, p = 0.541 respectively). In the COVID-positive group, mortality was significantly associated with age over 70 years, ASA score over III, RCRI over 1, emergency procedures, and absence of thromboembolic prophylaxis. CONCLUSIONS: In contrast to previously reported findings, we did not observe an increased morbi-mortality in patients with perioperative COVID-19 infection. It may not be necessary to delay elective interventions, except in cases with a high-risk.

2.
Rev. esp. investig. quir ; 24(4): 137-140, 2021. ilus
Artigo em Espanhol | IBECS | ID: ibc-219952

RESUMO

Introducción. La melanosis coli es una patología intestinal benigna y reversible que se caracteriza por el depósito de lipofuscina en la lamina propia de la mucosa del colon, adquiriendo una coloración oscura. Su aspecto macroscópico puede confundirse con una colitis isquémica avanzada como en el caso presentado a continuación. Caso clínico. Mujer de 86 años con estreñimiento crónico y consumo habitual de laxantes antraquinónicos que es sometida a cirugía de urgencia. Presenta perforación diastásica por oclusión de colon sigmoide. Se confecciona colostomía terminal apreciando desde el postoperatorio inmediato colostomía oscura aunque aparentemente bien vascularizada que presentó diagnostico diferencial entre isquemia y melanosis coli. Discusión. La melanosis presenta una incidencia en torno al 1% siendo más frecuente en mujeres mayores con estreñimiento crónico. Aunque su etiología no esta clara, se relaciona directamente con el consumo de laxantes antraquinónicos. La mayoría de los pacientes son asintomáticos y se trata de un hallazgo casual en estudios endoscópicos o anatomo-patológicos tras resecciones quirúrgicas. No tiene tratamiento especifico, pero parece que la interrupción de la toma de laxantes durante más de un año puede revertir el cuadro clínico. (AU)


Introduction. Melanosis coli is a benign and a reversible intestinal condition. MC is associated with the deposition of lipofuscin in the lamina propria of the colonic mucosa, causing the darkly pigmentation. Dark pigmentation can be considered a ischemic colitis, for example the next case. Clinical case. A 86 years old woman with a chronic constipation and a long-term using anthraquinone laxatives was undergoing emergency surgery. She had colonic perforation due to sigma occlusion. It was made terminal colostomy with dark pigmentation but adequate vascularization from immediate postoperative. The differential diagnosis between ischemic colitis and melanosis was necessary. Discussion. Melanosis has an incidence of around 1%, being more frequent in older women with chronic constipation. Although its etiology is not clear, it is directly related to the consumption of anthraquinone laxatives. Most of the patients are asymptomatic and it is an accidental finding in endoscopic or anatomopathological studies after surgicalresections. There is no specific treatment, but it seems that stopping the use of laxatives for more than a year can reverse the clinical symptoms. (AU)


Assuntos
Humanos , Feminino , Idoso de 80 Anos ou mais , Melanose/diagnóstico por imagem , Melanose/diagnóstico , Melanose/terapia , Colostomia , Constipação Intestinal , Laxantes , Antraquinonas
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