Evaluación de la ausencia de recidiva de la hernia incisional abdominal con malla de polipropileno
Fecha
2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Antecedentes: El uso de malla quirúrgica sintética se ha convertido en el estándar de reparación de la hernia, pero hasta ahora la aplicación de mallas no parece haber reducido el riesgo de recurrencia mientras que se cree que solo la retrasaría. Actualmente existen mallas de diferentes materiales y es posible que esto determine resultados diferentes. Objetivo: Determinar la eficacia a largo plazo (5 años) de la hernioplastia con malla de polipropileno en pacientes con hernia incisional intervenidos en el Hospital “Abel Gillbert Pontón” Metodología: Se realizó un estudio cuantitativo, observacional longitudinal, retrospectivo, no experimental en el que se incluyeron pacientes consecutivos con hernia incisional en quienes se realizó hernioplastia con malla de polipropileno, 45 casos sin recidiva y 17 con recidiva, atendidos en el hospital Abel Gilbert en Guayaquil – Ecuador, entre 2005 y 2015. El análisis estadístico se efectuó con tablas actuariales y de mortalidad. Resultados: el primer año, la tasa de no recidiva es del 100%, al tercer año es de 98% y el quinto año se es del 65%. La tasa acumulada a 5 años es del 40% a los 5 años. Las complicaciones se produjeron con mayor frecuencia en pacientes que recidivaron (23.5% vs 2,2%; P 0,06). La presencia de factores de riesgo se asoció significativamente con la presencia de recidiva (70,6% vs. 37,8%; P 0.021) Conclusiones: El porcentaje de no recidiva a 5 años en pacientes con hernia incisional sometidos a hernioplastia con malla de polipropileno es baja.
Background: The use of synthetic surgical mesh has become the standard of the hernia repair, but so far the implementation of mesh does not seem to have reduced the risk of recurrence while it is believed that it would only delay it. Currently there are meshes of different materials and it is possible to let it determine different results. Objective: determine the efficiency to long term (5 years) of the hernioplasty with polypropylene mesh in patients with incisional hernia intervened in the "Abel Gilbert Pontón" Hospital. Methodology: is carried out a study quantitative, observational longitudinal, retrospective, not experimental in which is included consecutive patients with incisional hernia in who was made hernioplasty with polypropylene mesh: 45 cases without recurrence and 17 with recurrence, treated in Abel Gilbert hospital from Guayaquil - Ecuador, between 2005 and 2015. The analysis statistical is carried out with tables actuarial and of mortality. Results: the first year, the rate of no recurrence is of the 100%, to the third year is of 98% and the fifth year is of the 65%. The cumulative 5-year rate is 40% at 5 years. The complications are produced with greater frequency in patients that recurred (23,5% vs. 2,2%; P 0,06). The presence of factors of risk are associated significantly with the presence of recurrence (70,6% vs. 37,8%;) (P 0,021) Conclusions: the rate of no recurrence at 5 years in patients with incisional hernia and hernioplasty with polypropylene mesh, is low
Background: The use of synthetic surgical mesh has become the standard of the hernia repair, but so far the implementation of mesh does not seem to have reduced the risk of recurrence while it is believed that it would only delay it. Currently there are meshes of different materials and it is possible to let it determine different results. Objective: determine the efficiency to long term (5 years) of the hernioplasty with polypropylene mesh in patients with incisional hernia intervened in the "Abel Gilbert Pontón" Hospital. Methodology: is carried out a study quantitative, observational longitudinal, retrospective, not experimental in which is included consecutive patients with incisional hernia in who was made hernioplasty with polypropylene mesh: 45 cases without recurrence and 17 with recurrence, treated in Abel Gilbert hospital from Guayaquil - Ecuador, between 2005 and 2015. The analysis statistical is carried out with tables actuarial and of mortality. Results: the first year, the rate of no recurrence is of the 100%, to the third year is of 98% and the fifth year is of the 65%. The cumulative 5-year rate is 40% at 5 years. The complications are produced with greater frequency in patients that recurred (23,5% vs. 2,2%; P 0,06). The presence of factors of risk are associated significantly with the presence of recurrence (70,6% vs. 37,8%;) (P 0,021) Conclusions: the rate of no recurrence at 5 years in patients with incisional hernia and hernioplasty with polypropylene mesh, is low
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Hernia ventral, Hernia incisional, Malla de polipropileno, Estudios retrospectivos, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador