Factores de riesgo en la formación de abscesos intraabdominales postapendicectomía
Fecha
2021
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Introducción: El absceso intraabdominal posoperatorio es la complicación más común de la apendicitis aguda y sigue siendo un problema importante. Actualmente no se cuenta con una herramienta que permita identificar los factores de riesgo para la formación de abscesos intraabdominales en pacientes pediátricos. Objetivo: determinar los factores de riesgo para la formación de abscesos intraabdominales postapendicectomía en pacientes pediátricos. Materiales y métodos: Estudio no experimental de tipo transversal, analítico; se analizaron las historias clínicas de pacientes que cumplieron con los criterios de inclusión y exclusión, durante enero 2018 a diciembre 2020 en el hospital de Niños “Dr. Roberto Gilbert Elizalde”. Resultados: De los pacientes que se realizaron apendicectomía el 9,07% presentaron formación de abscesos abdominales; siendo la edad promedio de 10,5 años; el grupo etario de mayor frecuencia fue de 10 a 14 años con 41,8%, seguido de 5 a 9 años el 32,9%; el 64,6% fueron de sexo masculino; el 51,9% tuvieron sobrepeso; el 16,5% presentaron hiponatremia, el 83,5% fue cirugía abierta, el tipo de apéndice fue el 17,7% necrosada y 82,3% perforada, el 72,1% tuvo un tiempo quirúrgico mayor a 90 minutos, el 89,9% realizaron lavado de la cavidad, el 86,1% uso dren y el 98,7% tuvo una estancia hospitalaria mayor a 6 días. Se obtuvo un valor p menor al nivel de significancia 0,05, indicando que las diferencias encontradas entre sobrepeso, grupo etario, hiponatremia, uso de dren, tipo de cirugía, tipo de apéndice, tiempo quirúrgico, estancia hospitalaria y el absceso intraabdominal fueron estadísticamente significativas. Conclusion: de los pacientes con formación de abscesos intraabdominales, fueron más en niños de 10 a 14 años de edad, en apéndices perforadas; cuyos los factores de riesgo fueron la edad, sexo, sobrepeso, hiponatremia, uso de dren, tipo de cirugía, tipo de apéndice, tiempo quirúrgico y estancia hospitalaria.
Palabras clave: Apendicitis, absceso intraabdominal, niños, apendicectomía laparoscópica
Introduction: Postoperative intra-abdominal abscess is the most common complication of acute appendicitis and continues to be an important problem. There is currently no tool to identify risk factors for intra-abdominal abscess formation in pediatric patients. Objective: to determine the risk factors for postapendectomy intra-abdominal abscess formation in pediatric patients. Materials and methods: Non-experimental, cross-sectional, analytical study; The medical records of patients who met the inclusion and exclusion criteria were analyzed, during January 2018 to December 2020 at the Hospital de Niños “Dr. Roberto Gilbert Elizalde ”. Results: Of the patients who underwent appendectomy, 9.07% had abdominal abscess formation; the average age being 10.5 years; the age group with the highest frequency was from 10 to 14 years with 41.8%, followed by 5 to 9 years with 32.9%; 64.6% were male; 51.9% were overweight; 16.5% presented hyponatremia, 83.5% was open surgery, the type of appendix was necrotic and 82.3% perforated, 72.1% had a surgical time greater than 90 minutes, the 89.9% performed washing of the cavity, 86.1% used a drain and 98.7% had a hospital stay greater than 6 days. A p-value lower than the 0.05 level of significance was obtained, indicating that the differences found between overweight, age group, hyponatremia, drain use, type of surgery, type of appendix, surgical time, hospital stay and intra-abdominal abscess were statistically significant. Conclusion: of the patients with intra-abdominal abscess formation, there were more in children from 10 to 14 years of age, in perforated appendages; whose risk factors were age, sex, overweight, hyponatremia, drain use, type of surgery, type of appendix, surgical time and hospital stay. Key words: Appendicitis, intraabdominal abscess, children, laparoscopic appendectomy
Introduction: Postoperative intra-abdominal abscess is the most common complication of acute appendicitis and continues to be an important problem. There is currently no tool to identify risk factors for intra-abdominal abscess formation in pediatric patients. Objective: to determine the risk factors for postapendectomy intra-abdominal abscess formation in pediatric patients. Materials and methods: Non-experimental, cross-sectional, analytical study; The medical records of patients who met the inclusion and exclusion criteria were analyzed, during January 2018 to December 2020 at the Hospital de Niños “Dr. Roberto Gilbert Elizalde ”. Results: Of the patients who underwent appendectomy, 9.07% had abdominal abscess formation; the average age being 10.5 years; the age group with the highest frequency was from 10 to 14 years with 41.8%, followed by 5 to 9 years with 32.9%; 64.6% were male; 51.9% were overweight; 16.5% presented hyponatremia, 83.5% was open surgery, the type of appendix was necrotic and 82.3% perforated, 72.1% had a surgical time greater than 90 minutes, the 89.9% performed washing of the cavity, 86.1% used a drain and 98.7% had a hospital stay greater than 6 days. A p-value lower than the 0.05 level of significance was obtained, indicating that the differences found between overweight, age group, hyponatremia, drain use, type of surgery, type of appendix, surgical time, hospital stay and intra-abdominal abscess were statistically significant. Conclusion: of the patients with intra-abdominal abscess formation, there were more in children from 10 to 14 years of age, in perforated appendages; whose risk factors were age, sex, overweight, hyponatremia, drain use, type of surgery, type of appendix, surgical time and hospital stay. Key words: Appendicitis, intraabdominal abscess, children, laparoscopic appendectomy
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Absceso abdominal, Apendicitis, Período posoperatorio, Pediatría, Epidemiología analítica, Registros médicos, Hospital de Niños Dr. Roberto Gilbert Elizalde, Cantón Guayaquil, Ecuador