Medicina

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Subject: search.filters.subject.ANASTOMOSIS

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    FACTORES DE RIESGO ASOCIADOS A COMPLICACIONES DE ANASTOMOSIS COLORRECTAL EN CIRUGÍA COLÓNICA
    (2025-06-16) Ricachi Guevara, Steven Alexander; Cadena Baquero, Juan Carlos; Universidad Técnica de Ambato / Facultad de Ciencias de Salud / Carrera de Medicina
    Postoperative complications in colorectal surgery can significantly impact patient health. Therefore, this study aims to identify the risk factors associated with postoperative complications in colorectal anastomosis to optimize clinical decision-making through an up-to-date literature review. Studies published between 2019 and 2024 were reviewed using databases such as PUBmed, Scopus, Google Scholar, and Cochrane Library. Out of 10,000 initial articles, 41 relevant studies were selected. The findings reveal that comorbidities such as hypertension, diabetes, chronic kidney disease, obesity, liver cirrhosis, and autoimmune disorders increase the risk of postoperative complications, including anastomotic dehiscence, severe infections, and prolonged hospital stays. In adition, factors such as smoking, alcohol consumption, anemia, and hypoalbuminemia negatively affect wound healing and postoperative recovery. The discussion highlights the influence of these factors on tissue perfusion, healing, and infection susceptibility, emphasizing the importance of a multidisciplinary approach in preoperative and postoperative management. Finally, it has been concluded that personalized preoperative strategies and the appropriate selection of surgical techniques are essential to effectively reduce morbidity and mortality in patients undergoing colorectal surgery.
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    Tratamiento quirúrgico de aneurisma aórtico por la técnica de Bentall-Bono, a propósito de un caso clínico
    (Universidad Técnica de Ambato/Facultad de Ciencias de la Salud/Carrera de Medicina, 2022-10-13) Illicachi Manzano, Pedro Israel; Andrade Albán, Noemí Rocío
    An aortic aneurysm is a protrusion or dilation that deforms the artery and leads it to exceed its own diameter by more than 50%, this dilation can be triggered due to different risk factors, which are usually dependent or independent of the patient, such as age , gender, patient size and pathological arterial segment. This excess arterial diameter results from a progressive weakening of the mural layers, mostly of the intima and media, which in the short or long term will generate the retention of a perivascular clot in the adventitia of the vessel. Aneurysms of the ascending aorta are characterized by their slow and silent growth, which does not generate florid symptoms but rather debuts with aortic coarctation that most of the time ends in the death of the patient. We present the case of a 50-year-old patient, with no significant pathological history and no obvious risk factors, who is identified on physical examination as hypotensive, afebrile, conscious, oriented in space and person, and a diastolic murmur is heard in the aortic focus. 6/6 irradiated to accessory aortic focus, external hairpin, evident Quincke's signs, Traube, Musset, Hill, celerity pulse and Corrigan's present. It is decided to perform an echocardiogram, where a quadricuspid aortic valve is identified, so it is decided to perform a chest tomography where the diagnosis of an ascending aortic aneurysm is corroborated. He was referred to a more complex hospital, where it was decided to apply the Bental-Bono technique to resolve the aneurysm.
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    “Fístula enterocutánea secundaria a adherencias intestinales + resección de segmento intestinal por laparotomía con anastomosis de termino terminal por isquemia intestinal + abdomen congelado”
    (Universidad Técnica de Ambato - Facultad de Ciencias de la Salud - Carrera de Medicina, 2018-06-01) Pacheco López, Carolina Lissette; Vélez Salgado, Jaime Efraín Dr. Esp.
    The Enterocutaneous fistulas are pathologies that represent a very large problem in surgical practice. They usually present in postoperative processes developing 90% after surgery. Despite medical advances, morbidity and mortality rates remain high. In the clinical case studied, three complications were identified: electrolyte imbalance, levels of malnutrition and sepsis. The objective of the management of the presented clinical case is the spontaneous closure and the installation of an adequate nutritional support to achieve the success of the treatment. The control of sepsis is a priority, uncontrolled sepsis must be attacked quickly because it is the main cause of death. Spontaneous closure has increased in recent years; however, it is likely that still a large part of the patients merit surgical treatment, and this must be done at the right time.