Preparación intestinal selectiva en un programa de rehabilitación multimodal. Influencia en el confort preoperatorio y resultados tras cirugía colorrectal / Selective intestinal preparation in a multimodal rehabilitation program. Influence on preoperative comfort and the results after colorectal surgery
Cir. Esp. (Ed. impr.)
; 89(3): 167-174, mar. 2011. ilus, tab
Article
em Es
| IBECS
| ID: ibc-92634
Biblioteca responsável:
ES1.1
Localização: BNCS
RESUMEN
Introducción:
Pese a no haberse evidenciado ventajas de su empleo, la preparación mecánica anterograda (PMA) sigue siendo usual en cirugía colorrectal. Nuestro objetivo es analizar el impacto de su empleo selectivo respecto a confort y resultados en pacientes de un programa de rehabilitación multimodal perioperatoria (RHMM) o con cuidados convencionales (CC). Material ymétodos:
Estudio prospectivo de 108 pacientes propuestos para cirugía electiva, asignados consecutivamente 21 a un protocolo de RHMM que incluyo emplear solamente PMA en cirugía rectal con anastomosis baja o a CC en los que se empleo PMA, salvo en cirugía del colon derecho. Además se estudiaron dos grupos (A y B) en función de si se uso o no PMA. Se analizaron su tolerabilidad, sus resultados y las variables de recuperación postoperatoria.Resultados:
Se incluyo a 39 pacientes en el grupo A y a 69 en el B; 69 siguieron el protocolo de RHMM. Los pacientes del grupo A presentaron más dolor abdominal, malestar anal, nauseas y sed, pero no hubo diferencias en lo que respecta a la tasa de muertes, complicaciones globales o su tipo, mientras que sý tuvieron menos complicaciones, fallos de sutura y muertes los pacientes del grupo RHMM (p < 0,05). Tampoco hubo ventajas del empleo de PMA respecto al inicio del tránsito intestinal, tolerancia a la dieta o estancias, pero estos parametros fueron favorables al grupo de RHMM.Conclusiones:
La restricción de la PMA a casos seleccionados es segura, y asociada a un programa de RHMM contribuye a una recuperación mas rápida y cómoda sin incrementarlas complicaciones (AU)ABSTRACT
Introduction:
Despite there being no evidence of the advantages of its use, mechanical bowel preparation (MBP) continues to be routine in colorectal surgery. Our objective is to analyse the impact of its selective use, as regards patient comfort and results, comparing a perioperative multimodal rehabilitation program (MMRH) with conventional care (CC). Material andmethods:
A prospective study of 108 patients proposed for elective surgery, assigned consecutively 21 to an MMRH protocol which only included MBP in rectal surgery with low anastomosis, or to CC in whom MBP was used except in right colon surgery. We also studied two Groups (A and B) with and without the use of MBP. Their tolerance, results and postoperative recovery variables were analysed.Results:
Thirty-nine patients were included in Group A, and 69 in Group B. A MMRH protocol was used in another 69 patients. The Group A patients had more abdominal pain, anal discomfort, nausea and thirst, but there were no differences as regards, death, overall or local complications, whilst there was less complications, suture failures and death in the MMRH when compared with CC Group (P < .05). There were no advantages observed in the use of MBP as regards the start of bowel movements, tolerance to diet or hospital stay, but these parameters were favourable to the MMRH when compared with CC Group.Conclusions:
The restriction of MBP is safe, and associated with an MMRH program, contributes to a faster and more comfortable recovery, without increasing complications (AU)
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Coleções:
06-national
/
ES
Base de dados:
IBECS
Assunto principal:
Neoplasias Colorretais
/
Cirurgia Colorretal
/
Enema
Tipo de estudo:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
Idioma:
Es
Revista:
Cir. Esp. (Ed. impr.)
Ano de publicação:
2011
Tipo de documento:
Article