Herramientas predictoras y marcadores serológicos de fuga anastomótica en cirugía colorrectal
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Fecha
2022-09
Tipo
tesis
Autores
Díaz Hernández, Gabriel
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Resumen
La fuga anastomótica es una complicación temida después de una intervención quirúrgica colorrectal que conduce a una morbilidad y mortalidad significativa con estancia hospitalaria prolongada y costos de atención médica considerables. Aunque algunas fugas se presentan poco después de la cirugía y las personas pacientes desarrollan una sepsis abrumadora, otras pueden presentarse con un curso más insidioso y solo se hacen evidentes clínicamente hasta el día posoperatorio 8-12. En el periodo posoperatorio temprano, la sepsis puede ser difícil de diferenciar de la respuesta inflamatoria sistémica normal al estrés quirúrgico. Existen numerosos factores de riesgo reconocidos para la fuga anastomótica, sin embargo, es difícil predecir su desarrollo.
Se han descrito marcadores serológicos con alto poder predictivo negativo para el diagnóstico temprano de fuga anastomótica colorrectal. Este trabajo pretende hacer una revisión bibliográfica de estos marcadores con la evidencia científica actual más reciente.
Anastomotic leak is a feared complication following colorectal surgery leading to significant morbidity and mortality with prolonged hospital stay and substantial healthcare costs. Although some leaks present soon after surgery and patients develop overwhelming sepsis, others may present with a more insidious course and only become clinically apparent as late as postoperative day (8-12). In the early postoperative period, sepsis can be difficult to distinguish from the normal systemic inflammatory response to surgical stress. There are numerous recognized risk factors for anastomotic leak, however it remains difficult to predict its development. Serological markers with high negative predictive value have been described for the early diagnosis of colorectal anastomotic leak. This work aims to make a bibliographic review of these markers with the most recent current scientific evidence.
Anastomotic leak is a feared complication following colorectal surgery leading to significant morbidity and mortality with prolonged hospital stay and substantial healthcare costs. Although some leaks present soon after surgery and patients develop overwhelming sepsis, others may present with a more insidious course and only become clinically apparent as late as postoperative day (8-12). In the early postoperative period, sepsis can be difficult to distinguish from the normal systemic inflammatory response to surgical stress. There are numerous recognized risk factors for anastomotic leak, however it remains difficult to predict its development. Serological markers with high negative predictive value have been described for the early diagnosis of colorectal anastomotic leak. This work aims to make a bibliographic review of these markers with the most recent current scientific evidence.
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Palabras clave
CIRUGÍA, colorrectal, Fuga anastomosis, marcadores serológicos