Evolución posoperatoria de atresias y estenosis intestinales en el Centro Regional de Cirugía Neonatal
DOI:
https://doi.org/10.55204/trc.v3i2.e236Palabras clave:
atresia y estenosis intestinales, evolución postoperatoria, tratamiento quirúrgico, síndrome de intestino cortoResumen
Introducción: Las atresias y estenosis intestinales, constituyen la principal etiología de obstrucción digestiva orgánica en la etapa de recién nacido. En los últimos años, la letalidad de estas afecciones ha disminuido en forma importante, de un 36,5 % en 1969 a un 10 %, según las revisiones más actuales. .
Objetivo: Describir la evolución posquirúrgica a corto plazo de las atresias y estenosis intestinales en el Centro Regional de Cirugía Neonatal de Holguín, Cuba durante el período de enero de 2010 a diciembre de 2022.
Métodos: Se realizó un estudio descriptivo, retrospectivo, de los 54 pacientes diagnosticados por estas afecciones, los que fueron relacionados con variables generales, epidemiológicas y clínicas.
Resultados: La mortalidad de la serie fue de un 11,1 %. Predominó el sitio anatómico duodenal (62,9 %) y, como técnica quirúrgica inicial, la anastomosis primaria (77,7 %). Tuvo una evolución desfavorable el 29,7 % y la comorbilidad fue en el periodo neonatal (64,8 %) y en el primer año de vida (54,9 %).
Conclusiones: Los factores pronósticos más significativos fueron la asociación a malformaciones congénitas complejas y el bajo peso al nacer. La evolución inadecuada estuvo favorecida por la presencia de condiciones anatómicas desfavorables, el desarrollo de enteropatía posoperatoria, así como tiempos prolongados de ayuno, nutrición parenteral y, por ende, de hospitalización. El seguimiento debe estar encaminado a las alteraciones del crecimiento y desarrollo, así como a la malabsorción asociada al síndrome de intestino corto. El buen funcionamiento de los protocolos actuales en uso permitirá mejorar la calidad de vida de estos pacientes.
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Derechos de autor 2023 Wilmer Quintero Nicó, Erika Yolanda Álvarez Cruz, Efrén Andrés Velecela Ardila, José Guillermo Allieri Fernández, Nelson Wladimir Campbell Burgos, Edwin Rafael Rojas Yela
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