RESUMO
Introducción. El conjunto de estrategias de recuperación mejorada después de la cirugía (ERAS, por sus siglas en inglés) constituye un enfoque de atención multimodal y multidisciplinario, cuyo propósito es reducir el estrés perioperatorio de la cirugía, disminuir la morbilidad y acortar la estancia hospitalaria. Este estudio tuvo como objetivo describir los resultados clínicos de pacientes sometidos a cirugía por cáncer colorrectal, identificando las complicaciones principales y los factores perioperatorios relacionados con el alta temprana. Métodos. Se analizaron los pacientes consecutivos sometidos a cirugía colorrectal entre los años 2020 y 2023, todos los cuales siguieron el protocolo ERAS institucional. Se evaluaron las características clínicas, los factores perioperatorios, los desenlaces postoperatorios y la tasa global de adherencia al protocolo. Resultados. Un total de 456 pacientes fueron sometidos a cirugía colorrectal, 51% de sexo masculino, con edad media de 60 años. La mayoría de las intervenciones se realizaron por laparoscopia (78 %), con una tasa de conversión del 14,5 %. Las complicaciones postoperatorias incluyeron fuga anastomótica (4,6 %), sangrado, infección intraabdominal y obstrucción intestinal. La estancia hospitalaria promedio fue de 4 días y la mortalidad del 2,8 %. La tasa global de adherencia al protocolo ERAS fue del 84,7 %. Conclusiones. El enfoque combinado de cirugía laparoscópica y protocolo ERAS es factible, seguro y se asocia con una estancia hospitalaria más corta. La implementación y adherencia al protocolo ERAS no solo mejora los resultados postoperatorios, sino que también resalta la importancia de acceder a datos sólidos, permitiendo mejorar la atención perioperatoria local.
Introduction. The Enhanced Recovery After Surgery (ERAS) protocol is a multimodal, multidisciplinary approach to care, the purpose of which is to reduce the perioperative stress of surgery, decrease morbidity, and shorten hospital stay. This study aimed to describe the clinical outcomes of patients undergoing surgery for colorectal cancer, identifying the main complications and perioperative factors related to early discharge. Methods. Consecutive patients undergoing colorectal surgery between 2020 and 2023 were analyzed, who followed the institutional ERAS protocol. Clinical characteristics, perioperative factors, postoperative outcomes, and overall protocol adherence rate were evaluated. Results. A total of 456 patients underwent colorectal surgery, 51% male, with a mean age of 60 years. Most interventions were performed laparoscopically (78%), with a conversion rate of 14.5%. Postoperative complications included anastomotic leak (4.6%), followed by bleeding, intra-abdominal infection, and intestinal obstruction. The average hospital stay was 4 days and mortality was 2.8%. The overall adherence rate to the ERAS protocol was 84.7%. Conclusions. The combined approach of laparoscopic surgery and ERAS protocol is feasible, safe, and associated with a shorter hospital stay. Implementation and adherence to the ERAS protocol not only improves postoperative outcomes, but also highlights the importance of accessing solid data, allowing for improved local perioperative care.
Assuntos
Humanos , Neoplasias Colorretais , Recuperação Pós-Cirúrgica Melhorada , Tempo de Internação , Laparoscopia , Cirurgia Colorretal , Procedimentos Cirúrgicos Minimamente InvasivosRESUMO
Objective. This study evaluated the effect of age and coasting period over oocyte quality and their posterior development under in vitro conditions from prepubertal Bos indicus crossbred donors. Material and methods. Donors females received a norgestomet implant and estradiol benzoate. Four days later a unique dosage of 150 IU of eCG was administered. Three coasting periods (24, 48, and 56 h) and four ages (3, 6, 10, and 12 months) were proved. All antral follicles were aspirated and an in vitro culture proceed was done. Results. 439 follicles were aspirated, of which 385 (87.7%) were 2-5 mm, 41 (9.33%) were 5-10 mm, and 13 (2.3%) were 10 mm. After aspiration, a total of 373 oocytes (84.9%) were recovered, finding differences (p<0.05) between averages of 6 (9.3) and 10 months old animals (32.3). 285 (76.4 %) recovered oocytes were subjected to in vitro process. Cleavage values were significantly higher (p<0.05) in 10 (27.1%) and 12 months animals (26.8%). Although the number of transferable embryos was low, there were differences between ages (p<0.05) obtaining a higher percentage in age 3 (12.6%). Conclusions. A coasting period higher than 24 h has a negative effect on oocyte quality. Some oocytes from 3 months old calves were competent for in vitro embryo development; however, higher numbers of embryos were produced from 10 and 12 months of age prepuber females, indicating they have higher competency in vitro.