Complicaciones en el posquirúrgico de apendicectomía laparoscópica versus abierta en niños con apendicitis complicada
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2021
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Introducción: La apendicitis aguda, es la causa quirurgica abdominal urgente más frecuente en pediatría, aunque la complicada no presenta lineamientos e indicaciones quirurgicas claras, pero la técnica abierta es la eleccion, en los ultimos años la técnica laparoscopica es ampliamente utilizada. Objetivo: Determinar las complicaciones en el posquirúrgico de apendicectomía laparoscópica versus abierta en niños con apendicitis complicada. Materiales y métodos: Se realizará un estudio de tipo descriptiva, no experimental, analítico, transversal en el cual se incluirán a todos los pacientes con apendicitis complicada operados con técnica laparoscópica vs abierta, en el Hospital Dr. Roberto Gilbert Elizalde durante el período 2018 – 2020. Resultados: 872 casos pediátricos con apendicectomía, siendo más frecuente el grupo de 10 a 14 años con 39.91%, masculinos con 61.01% y femenino del 38.99%; estado nutricional la mayoría eran de bajo peso con 54.47%. El promedio de edad en la cirugía abierta fue 9.6 años y en laparoscópica de 10.2 años; el tiempo quirúrgico en cirugía abierta fue 91.6 minutos y Laparoscópica de 118.4 minutos; la estancia en cirugía abierta fue 8.2 días y laparoscópica de 8.4 días. Las diferencias encontradas en el tipo de cirugía según el tipo de apéndice y las complicaciones post quirúrgicas son estadísticamente significativas con p<0.05. Conclusiones: Las cirugías laparoscópicas tienen un tiempo de duración mayor que las cirugías abiertas., pero se tiene menos complicaciones posquirúrgicas y un inicio temprano de la vía oral, aunque con similar en días de estancia hospitalaria postoperatoria, pero es más efectiva que la apendicectomía abierta.
Palabras clave: apendicitis complicada, niños, laparoscopía, complicaciones posquirúrgicas
Introduction: Acute appendicitis is the most frequent urgent abdominal surgical cause in pediatrics, although the complicated one does not present clear surgical guidelines and indications, but the open technique is the choice, in recent years the laparoscopic technique is widely used. Objective: To determine the postoperative complications of laparoscopic versus open appendectomy in children with complicated appendicitis. Materials and methods: A descriptive, non-experimental, analytical, cross-sectional study will be carried out in which all patients with complicated appendicitis operated with laparoscopic vs open technique will be included, at the Dr. Roberto Gilbert Elizalde Hospital during the period 2018 - 2020. Results: 872 pediatric cases with appendectomy, the most frequent group of 10 to 14 years with 39.91%, male with 61.01% and female with 38.99%; nutritional status, the majority were underweight with 54.47%. The mean age in open surgery was 9.6 years and in laparoscopic it was 10.2 years; surgical time in open surgery was 91.6 minutes and Laparoscopic 118.4 minutes; the stay in open surgery was 8.2 days and laparoscopic 8.4 days. The differences found in the type of surgery according to the type of appendix and post-surgical complications are statistically significant with p <0.05. Conclusions: Laparoscopic surgeries have a longer duration than open surgeries, but there are fewer postoperative complications and an early start of the oral route, although with a similar number of days of postoperative hospital stay, but it is more effective than open appendectomy. Key words: complicated appendicitis, children, laparoscopy, postoperative complications
Introduction: Acute appendicitis is the most frequent urgent abdominal surgical cause in pediatrics, although the complicated one does not present clear surgical guidelines and indications, but the open technique is the choice, in recent years the laparoscopic technique is widely used. Objective: To determine the postoperative complications of laparoscopic versus open appendectomy in children with complicated appendicitis. Materials and methods: A descriptive, non-experimental, analytical, cross-sectional study will be carried out in which all patients with complicated appendicitis operated with laparoscopic vs open technique will be included, at the Dr. Roberto Gilbert Elizalde Hospital during the period 2018 - 2020. Results: 872 pediatric cases with appendectomy, the most frequent group of 10 to 14 years with 39.91%, male with 61.01% and female with 38.99%; nutritional status, the majority were underweight with 54.47%. The mean age in open surgery was 9.6 years and in laparoscopic it was 10.2 years; surgical time in open surgery was 91.6 minutes and Laparoscopic 118.4 minutes; the stay in open surgery was 8.2 days and laparoscopic 8.4 days. The differences found in the type of surgery according to the type of appendix and post-surgical complications are statistically significant with p <0.05. Conclusions: Laparoscopic surgeries have a longer duration than open surgeries, but there are fewer postoperative complications and an early start of the oral route, although with a similar number of days of postoperative hospital stay, but it is more effective than open appendectomy. Key words: complicated appendicitis, children, laparoscopy, postoperative complications
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APENDICEPTOMIA, LAPAROSCOPIA, COMPLICACIONES POSOPERATORIA, APENDICITIS, PEDIATRA, EPIDEMILOGIA DESCRIPTIVA, EPIDEMIOLOGIA ANALITICA, HOSPITAL DE NIÑO DR. ROBERTO GILBERT ELIZALDE, CANTON GUAYAQUIL, ECUADOR