Hernias paraestomales y fistulas del intestino asociados a las enterostomias
Fecha
2022
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
Las enterostomías son procedimientos quirúrgicos que si bien mejoran la condición
del paciente también tienen varias complicaciones entre la cuales nos enfocamos en
nuestro proyecto en las hernias paraestomales y fistulas del intestino. Entre los
principales factores que generan complicaciones en pacientes con estomas incluyen
obesidad, sobrepeso, cáncer, desnutrición y edad. Se deben tomar en cuanta varias
recomendaciones para evitar complicaciones entre ellas están las preoperatorias en las
que incluye: valoración, preparación psicológica, física del paciente; ubicación del
estoma evitando prominencias óseas que se realice cerca de la flexura de la ingle o en la
línea natural de la cintura o en pliegues de grasa. El sitio ideal es en la línea media entre
el ombligo y la cresta iliaca anterosuperior, escoger la técnica adecuada y el tamaño de
orificio en dimensiones correctas también reduce el riesgo de hernias paraestomales; y
cuidados postoperatorios realizando una evaluación global del paciente. Se concluyo que
a diferencia de las fistulas enterocutáneas, las hernias para estomales son las
complicaciones más frecuentes, no tienen relación con la edad, pero en nuestro estudio
hubo un predominio de edad entre 50-60 años
Enterostomies are surgical procedures that, although they improve the patient's condition, also have several complications, among which we focus in our project on parastomal hernias and intestinal fistulas. Among the main factors that generate complications in patients with stomas include obesity, overweight,cancer, malnutrition and age. Several recommendations must be taken into account to avoid complications, among them are the preoperative ones that include: assessment, psychological and physical preparation of the patient; stoma placement avoiding bony prominences that is made near the groin flexureor in the natural waist line or in fat folds. The ideal site is in the midline betweenthe umbilicus and the anterior superior iliac crest. Choosing the appropriate technique and the correct orifice size also reduces the risk of parastomal hernias; and postoperative care performing a global evaluation of the patient. It was concluded that, unlike enterocutaneous fistulas, parastomal hernias are the mostfrequent complications, they are not related to age, but in our study there was a predominance of age between 50-60 years.
Enterostomies are surgical procedures that, although they improve the patient's condition, also have several complications, among which we focus in our project on parastomal hernias and intestinal fistulas. Among the main factors that generate complications in patients with stomas include obesity, overweight,cancer, malnutrition and age. Several recommendations must be taken into account to avoid complications, among them are the preoperative ones that include: assessment, psychological and physical preparation of the patient; stoma placement avoiding bony prominences that is made near the groin flexureor in the natural waist line or in fat folds. The ideal site is in the midline betweenthe umbilicus and the anterior superior iliac crest. Choosing the appropriate technique and the correct orifice size also reduces the risk of parastomal hernias; and postoperative care performing a global evaluation of the patient. It was concluded that, unlike enterocutaneous fistulas, parastomal hernias are the mostfrequent complications, they are not related to age, but in our study there was a predominance of age between 50-60 years.
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FISTULA, HERNIA, FACTORES DE RIESGO, SOBRE PESO, OBESIDAD, HOSPITAL GENERAL DR. LIBORIO PANCHANA SOTOMAYOR, SANTA ELENA, ECUADOR