Relationship between quality of life, emotional symptomology and perceived emotional intelligence in a sample of burn victims.

The main objective of this study is to analyse the association between Quality of Life (QOL), Emotional Symptomology and perceived Emotional Intelligence (EI) in burn patients. Additionally, it is intended determine the predictor models of QOL, and confirm the mediating effect of emotional symptomology between QOL and perceived EI. This is a transversal study developed in the Hospital da Prelada, Porto, Portugal, with a sample of 92 patients that were hospitalized in the Burn Unit and the Reconstructive Plastic Surgery Service. The assessment protocol consisted of a sociodemographic and clinical data sheet. To assess the perception of QOL of the burn patient it was used the Burn Specific Health Scale - Revised (BSHS-R), the emotional symptomology was measured by the Brief Symptom Inventory (BSI) and Trait Met-Mood Scale-24 (TMMS) was used to assess Emotional Intelligence (EI). The cross-sectional and correctional data were analysed through descriptive statistics, correlations, regressions and simple mediations. The results obtained suggest significant associations between QOL, perceived EI and Emotional Symptomology in burn patients. The results of the predictor models of the QOL domains encompass the Positive Symptom Distress Index (PSDI of Emotional Symptomology), where the total variance is explained mainly by the models of QOL Affect and Body Image 46% and Treatment 31%. The mediating effect of the PSDI in the relationship between QOL in the Affect and Body Image dimension and the Mood Repairs (MR) was also tested, having proved to have a total mediation (the Mood Repairs loses its contribution in the QOL model when the PSDI variable is introduced). This study underscores the importance of perceived Emotional Intelligence and its association with the burn impact in the different dimensions of QOL of the patients. The intention of this study is to alert health professionals for patient support in the search for strategies that aim for positive adaptation which promotes QOL and emotional adjustment of burn patients to their new condition.

A metabolic readout of the urine metabolome of COVID-19 patients.

Analysis of urine samples from COVID-19 patients by 1H NMR reveals important metabolic alterations due to SAR-CoV-2 infection. Previous studies have identified biomarkers in urine that reflect metabolic alterations in COVID-19 patients. We have used 1H NMR to better define these metabolic alterations since this technique allows us to obtain a broad profile of the metabolites present in urine. This technique offers the advantage that sample preparation is very simple and gives us very complete information on the metabolites present. To detect these alterations, we have compared urine samples from COVID-19 patients (n = 35) with healthy people (n = 18). We used unsupervised (Robust PCA) and supervised (PLS-LDA) multivariate analysis methods to evaluate the differences between the two groups: COVID-19 and healthy controls. The differences focus on a group of metabolites related to energy metabolism (glucose, ketone bodies, glycine, creatinine, and citrate) and other processes related to bacterial flora (TMAO and formic acid) and detoxification (hippuric acid). The alterations in the urinary metabolome shown in this work indicate that SARS-CoV-2 causes a metabolic change from a normal situation of glucose consumption towards a gluconeogenic situation and possible insulin resistance.

Validation of the Spanish Version of Fear of COVID-19 Scale: its Association with Acute Stress and Coping.

The COVID-19 is a "unique" stressor, which can produce physical and psychological trauma. Coping styles can buffer this psychological impact. Consequently, this paper aims to psychometrically adapt the Fear of COVID-19 scale (FCV-19S) to Spanish and examines the relationships between FCV-19S, stress response, and coping strategies. The sample comprised a convenience sample of 1146 participants (12-83 years), 880 from Spain (76.8%), and 266 from Dominican Republic (23.2%). Overall, the findings support a one-factor structure for FCV-19S, consisting of 7-items, and was invariant across age, sex, occupational status, and cross-national. Therefore, indicating evidences of construct validity. Evidences of reliability were also observed (Cronbach's α = .86, McDonald's ω = .86, Guttmann's λ6 = .86, greatest lower bound = .91, composite reliability = .85, and average variance extracted = .44). Moreover, as regards criterion-related validity, the mediation analysis indicated that the relationship between FCV-19S and acute stress was positive and high, with maladaptive coping styles mediating the relationship, and with a stronger mediation for men. The findings give evidences of the reliability and validity of the Spanish version of FCV-19S among Spanish-speaker participants, which provides the chance of cross-cultural studies.

Correction to: Validation of the Spanish Version of Fear of COVID-19 Scale: its Association with Acute Stress and Coping.

[This corrects the article DOI: 10.1007/s11469-021-00615-x.].

The adaptation of the Burn Specific Health Scale-Revised (BSHS-R) into the Portuguese context.

The objective of this study was the adaptation of the Burn Specific Health Scale-Revised (BSHS-R) into the Portuguese context. The authors of the original version of BSHS-R with 31 items are Blalock, Bunker and DeVellis and it was developed to evaluate the health status of burns victims. The Brazilian version of the BSHS-R was translated from Portuguese (Brazil) to Portuguese (Portugal), through a semantic adaptation process, by independent Portuguese-Brazilian specialists, followed by a verbal comprehension assessment of all items, with a heterogeneous group of people, in terms of age, education and occupation. After the survey adaptation to Portuguese (Portugal), a psychometric study of the BSHS-R has been realized with a sample of 92 patients, which had been hospitalized in the Burn, Plastic and Reconstructive Surgery units of the Prelada Hospital, Porto, Portugal. For the process of instrument validation, a factorial exploratory analysis has been conducted and the internal consistency indicators were analysed using Cronbach's alpha (reliability). The results analysis allowed to assess and identify the validity of the construct through the factorial exploratory analysis, which confirmed the same previous factorial structure identified in the original language and in the Brazilian version. The BSHS-R also presented good internal consistency indicators (global α = .921; affect and body image α = .874; heat sensitivity α = .830; simple functional abilities α = .893; treatment regimens α = .772; work α = .876; interpersonal relationships α = .804). The Portuguese (Portugal) adapted version has revealed useful, valid and reliable for the quality of life assessment related to the health of people that suffered burn injuries.

Quantitative biomolecular sensing station based on magnetoresistive patterned arrays.

The combination of magnetoresistive sensors and magnetic labeling of bioanalytes, which are selectively captured by their complementary antibody in the proximity of the sensor is a powerful method in order to attain truly quantitative immunological assays. In this paper we present a technical solution to exploit the existing spin valve technology to readout magnetic signals of bio-functionalized magnetic nanoparticles. The method is simple and reliable, and it is based on a discrete scan of lateral flow strips with a precise control of the contact force between sensor and sample. It is shown that the signal of the sensor is proportional to the local magnetization produced by the nanoparticles in a wide range of concentrations, and the sensitivity thresholds in both calibration samples and real immunorecognition assays of human chorionic gonadotropin hormone are well below the visual inspection limit (5.5 ng/ml). Furthermore the sample scanning approach and the reduced dimensions of the sensors provide unprecedented spatial resolution of the nanoparticle distribution across the supporting nitrocellulose strip, therefore enabling on-stick control references and multi-analyte capability.

Sacral nerve stimulation for the treatment of faecal incontinence following low anterior resection for rectal cancer.

AIM: The aim of this study was to assess the effectiveness of sacral nerve stimulation (SNS) in the management of faecal incontinence following neoadjuvant therapy and low anterior resection (LAR) for rectal cancer. METHOD: In a prospective single-centre study, 15 patients (12 men, median age 72 years) were enrolled between 2005 and 2008. All had severe incontinence after total mesorectal excision, and 14 had received preoperative full-course chemoradiotherapy. The patients were followed up for a median of 50 (range: 24-144) months. There was no recurrence (local or distal). Incontinence was evaluated using the Cleveland Clinic Florida Fecal Incontinence (CCF-FI) scoring system. Quality of life (QoL) was evaluated using the Fecal Incontinence Quality of Life (FIQL) questionnaire. SNS was performed in three stages. RESULTS: During percutaneous nerve evaluation (PNE), a good response was observed in seven patients, all of whom received a permanent implant. The median follow up was 12 (range: 1-44) months. The mean CCF-FI score was reduced from 19.2 [standard deviation (SD) 1.2] to 6.2 (SD 1.7) (P < 0.01). The mean number of days per week with an incontinent episode decreased from 7 (SD 0) to 0.2 (SD 0.3) (P < 0.01), and the mean number of defaecations per week decreased from 42.5 (SD 13.7) to 13.2 (SD 7.4) (P < 0.01). In the five patients with a permanent implant who were followed up for longer than 6 months, all FIQL scores improved. An increase in the mean resting and squeeze pressures was seen in four patients with a permanent implant. CONCLUSIONS: SNS is a treatment option for faecal incontinence after LAR for rectal cancer.

Control sintomático y cuidados paliativos en pacientes que fallecen en un Servicio de Medicina Interna / No disponible

Objetivo: el objetivo de este estudio es describir las características clínicas de los pacientes fallecidos en el Servicio de Medicina Interna del Hospital Cruz Roja de Madrid durante el año 2007, analizando aquellos que fallecieron tras una fase de agonía (describiendo síntomas, control sintomático, fármacos usados y cuidados paliativos no farmacológicos). Material y métodos: se diseñó un estudio observacional retrospectivo donde se examinaron las historias clínicas, excluyendo aquellas que correspondían a pacientes que fallecieron a menos de 24 horas de su ingreso hospitalario o tras maniobras de reanimación avanzada. Resultado: de 861 pacientes ingresados fallecieron 42; el 87,5% fueron catalogados como agónicos y el síntoma principal que presentaron fue la disnea (85,7%), teniendo esta, al igual que los otros síntomas recogidos un control deficitario (sólo el 7,1% falleció con la totalidad de sus síntomas controlados). No se recogió, en las historias clínicas, ningún otro tipo de abordaje paliativo no farmacológico (psicosocial, espiritual o atención tras el duelo). Conclusiones: existe un porcentaje elevado de pacientes que fallecen en agonía en una planta de hospitalización convencional. Los síntomas recogidos en estos pacientes no difieren de los recogidos en las Unidades de Cuidados Paliativos, aunque predomina la disnea y es menos frecuente el dolor no controlado. El control sintomático es dificultoso, pero mejora al emplear fármacos habituales en cuidados paliativos (morfina, midazolam y butilescopolamina). No se recoge de manera habitual o sistemática el uso de cuidados paliativos no farmacológicos en las historias clínicas (AU)

Objective: the aim of this study was to describe the clinical characteristics of patients who died in an Internal Medicine department during 2007, including those who passed over after a phase of agony (including symptoms, symptom control, drugs used, and non-pharmacological palliative care). Materials and methods: this was an observational prospective study that analyzed medical records, excluding those who died less than 24 hours after hospital admission or after advanced cardiopulmonary resuscitation. Result: of 861 admissions 42 subjects died; 87.5% were catalogued as agonizing, and their main symptom was dyspnea (85.7%); control was in adequate for dyspnea as well as for other silent symptoms (only 7.1% died with all symptoms controlled). There were no references in their medical records to any other type of palliative non-pharmacological approach (psychosocial, spiritual, or grief care). Conclusions: there is a high percentage of patients who die in agony in conventional hospitalization wards. Symptoms collected from these patients do not differ from those seen in palliative care units, although dyspnea is most usual and uncontrolled pain is less frequent. Symptom control is difficult but improves with standard palliative drugs (morphine, midazolam and butylscopolamine). There were no systematic references to non-pharmacological palliative care in medical records (AU)

Randomized clinical trial of anal fistula plug versus endorectal advancement flap for the treatment of high cryptoglandular fistula in ano.

BACKGROUND: The aim of this randomized study was to compare the results of anal fistula plug and endorectal advancement flap in the treatment of high fistula in ano of cryptoglandular origin. METHODS: Consecutive patients with high trans-sphincteric fistula in ano of cryptoglandular aetiology were randomized to treatment with either an anal fistula plug or endorectal advancement flap. Patients agreed to participate in a follow-up programme, which included scheduled visits at 2, 4, 8, 12 and 24 weeks and at 1 year after surgery. The primary endpoint was effectiveness in fistula healing. Recurrence was defined as the presence of an abscess arising in the same area, or obvious evidence of fistulation. RESULTS: A large number of recurrences in the fistula plug group led to premature closure of the trial. After 1 year, fistula recurrence was noted in 12 of 15 patients treated with an anal fistula plug compared with two of 16 treated with an endorectal advancement flap (relative risk 6.40 (95 per cent confidence interval 1.70 to 23.97); P < 0.001). CONCLUSION: Contrary to other published studies, an anal fistula plug was associated with a low rate of fistula healing, particularly in patients with a history of fistula surgery.

Tratamiento de la enfermedad de Crohn perianal / Treatment of perianal Crohn’s disease

La afectación perianal por enfermedad de Crohn comprende un amplio espectro de lesiones de diferente manejo y pronóstico. Una exploración minuciosa del paciente, si es preciso bajo anestesia, una rectoscopia para valorar la posible afectación del recto por la enfermedad, y en ocasiones la valoración mediante ecografía endoanal o resonancia magnética, son las bases para un correcto enfoque diagnóstico y terapéutico. Farmacología y cirugía han de complementarse en el tratamiento de la enfermedad de Crohn perianal y perseguir un doble objetivo: aliviar la sintomatología del paciente y prevenir posibles complicaciones. Salvo en situaciones de urgencia por sepsis perianal, el tratamiento médico es el primer escalón en el manejo de la enfermedad de Crohn perianal, y en muchas ocasiones se controlará la enfermedad haciendo innecesaria la cirugía. Cuando se precisa de ésta, al propósito de un tratamiento definitivo de la lesión perianal, ha de contraponerse el riesgo de desarrollar complicaciones, muy especialmente incontinencia

Perianal affectation due to Crohn’s disease includes a wide spectrum of lesions involving different management and prognosis. A thorough exploration of the patient, under anaesthetic if necessary, a rectoscope to evaluate the possible affectation of the rectum by the disease, and on occasions evaluation through endoanal echography or magnetic resonance, are the bases for a correct diagnostic and therapeutic focus. Pharmacology and surgery must be complementary in the treatment of perianal Crohn’s disease and must pursue a double aim: to alleviate the symptomology of the patient and prevent possible complications. Except in situations of emergency due to perianal sepsis, medical treatment is the first step in managing perianal Crohn’s disease, and on many occasions it will control the disease, making surgery unnecessary. When surgery is required, with the aim of a definitive treatment of the perianal lesion, the risk of developing complications, especially incontinence, must be contrasted

[Treatment of perianal Crohn's disease]. / Tratamiento de la enfermedad de Crohn perianal.

Perianal affectation due to Crohn's disease includes a wide spectrum of lesions involving different management and prognosis. A thorough exploration of the patient, under anaesthetic if necessary, a rectoscope to evaluate the possible affectation of the rectum by the disease, and on occasions evaluation through endoanal echography or magnetic resonance, are the bases for a correct diagnostic and therapeutic focus. Pharmacology and surgery must be complementary in the treatment of perianal Crohn's disease and must pursue a double aim: to alleviate the symptomology of the patient and prevent possible complications. Except in situations of emergency due to perianal sepsis, medical treatment is the first step in managing perianal Crohn's disease, and on many occasions it will control the disease, making surgery unnecessary. When surgery is required, with the aim of a definitive treatment of the perianal lesion, the risk of developing complications, especially incontinence, must be contrasted.

Quality of life assessment in patients with chronic anal fissure after lateral internal sphincterotomy.

BACKGROUND: The aim of this study was to compare quality of life of patients with chronic anal fissure before and after open lateral internal sphincterotomy. METHODS: A prospective study was undertaken of 108 consecutive patients with a history of chronic anal fissure who underwent lateral internal sphincterotomy. Quality of life was measured before and 6 months after operation with the Short-Form 36 (SF-36) Health Survey. RESULTS: Quality of life improved significantly in six of the eight scales of the SF-36 questionnaire: physical functioning, role physical, bodily pain, energy, social functioning and mental health. There were no significant differences between the 70 patients who had no change in continence after operation and the 38 patients with continence disturbances after sphincterotomy. However, there were significant improvements in four scales in patients without changes in continence compared with improvements in only two scales in those with continence disturbances. CONCLUSION: Patients with chronic anal fissure showed an improvement in quality of life 6 months after internal lateral sphincterotomy. Patients with postoperative continence disturbances showed improvement in fewer scales of the SF-36 questionnaire than those without changes in continence.

Randomized clinical trial of stapled haemorrhoidopexy versus conventional diathermy haemorrhoidectomy.

BACKGROUND: The aim of this study was to compare the results of stapled haemorrhoidopexy (commonly called stapled haemorrhoidectomy) with those of conventional diathermy haemorrhoidectomy. METHODS: Fifty-five patients with symptomatic third- and fourth-degree haemorrhoids were randomized to either stapled haemorrhoidopexy (n = 27) or conventional diathermy haemorrhoid ectomy (n = 28). Operating time, postoperative pain, time to return to work, postoperative complications and effectiveness of haemorrhoidal symptom control were recorded. The mean follow-up was 15.9 months in the stapled haemorrhoidopexy group and 15.2 months in the conventional haemorrhoidectomy group. RESULTS: Mean pain intensity was significantly less in the stapled group (P = 0.001). There were no significant differences in the total number of complications, the length of absence from work or control of symptoms. Seven patients in the stapled group re-presented with prolapse compared with none in the conventional haemorrhoidectomy group (P = 0.004). This difference was also observed in the subset of patients with fourth-degree haemorrhoids (P = 0.003). CONCLUSION: The stapled operation was significantly less painful than conventional haemorrhoidectomy. However, the rate of recurrent prolapse was higher after stapled haemorrhoidopexy than after conventional diathermy haemorrhoidectomy.

Accuracy of hydrogen peroxide-enhanced ultrasound in the identification of internal openings of anal fistulas.

OBJECTIVE: This prospective study was designed to assess the accuracy of hydrogen peroxide-enhanced ultrasound in the identification of internal openings of anal fistulas, with surgical findings as the golden standard. PATIENTS AND METHODS: A total of 143 consecutive patients (102 men; mean age, 45 years) with fistula-in-ano were assessed by hydrogen peroxide-enhanced ultrasound before surgery involving one radiologist. Ultrasound was performed using a B & K Diagnostic Ultrasound System trade mark with a 10-MHz rotating endoprobe. Hydrogen peroxide (3%) was infused into the fistula. All operations were perfomed by the same surgeon who was unaware of results of anal endosonography. RESULTS: In 128 (89.5%) patients, an internal opening was identified at surgery. Correct identification of an internal opening endosonographically was recorded in 80 (62.5%) patients. The internal opening was correctly identified by ultrasound in 32% (8/25) of patients with intersphincteric fistulas, in 77% (70/91) with transsphincteric fistulas, and in 17% (2/12) with suprasphincteric fistulas. CONCLUSION: The accuracy of hydrogen peroxide-enhanced anal endosonography for the identification of internal openings was still insufficient to justify pre-operative endosonography as a diagnostic method for routine use in patients with fistula-in-ano.

Valoración por parte de los pacientes con incontinencia fecal de los resultados del biofeedback / Patient evaluation of the results of biofeedback in fecal incontinence

Objetivo. Valoración subjetiva de los resultados inmediatos y a largo plazo del biofeedback para el tratamiento de la incontinencia fecal, y su correlación con los resultados objetivos logrados. Pacientes y métodos. Se incluyeron en el estudio 20 pacientes (16 mujeres y 4 varones, con una media de edad 62,05 ñ 13,84 años), con incontinencia fecal (idiopática 14, traumatismo de médula espinal 2, poscirugía de fisura anal 2, posresección anterior baja 1, colitis ulcerosa 1). Se han realizado cuatro sesiones con periodicidad quincenal. A todos se les ha valorado su continencia anal previa, al término de las sesiones y a largo plazo (media 23,1 meses; rango 12-41 meses) mediante una escala de cuatro grados: menos de una fuga al mes, más de una fuga al mes y menos de una a la semana, más de una fuga a la semana y menos de una al día, y fugas diarias. La valoración subjetiva se ha hecho con una escala analógica (0-10 puntos), y otra de sensación (empeoramiento, no empeoramiento). Resultados. Inmediatos: 10 (50 por ciento) reducen escapes; menos de una fuga al mes, 5 casos (25 por ciento); más de una fuga al mes y menos de una a la semana, 4 casos (20 por ciento); más de una fuga a la semana y menos de una al día 9 casos (45 por ciento), y fugas diarias 2 casos (10 por ciento); valoración subjetiva 6,35 ñ 2,5; 4 casos (20 por ciento) valoración de 9-10 puntos, 6 casos (30 por ciento) de 7-8 puntos, 6 casos (30 por ciento) de 5-6 puntos, y 4 (20 por ciento) inferior a 5 puntos. La valoración subjetiva se correlaciona con la frecuencia de escapes lograda: menos de un escape/semana (n = 9) 8,0 ñ 1,50, más de un escape/semana (n = 11) 5,0 ñ 2,53 (t -3,13; p < 0,006). Tardíos: 18 (90 por ciento) no han empeorado; menos de una fuga al mes 15 (75 por ciento); más de una fuga a la semana y menos de una al día 1 (5 por ciento), y fugas diarias 4 (20 por ciento); valoración subjetiva 5,05 ñ 2,8 (p < 0,01); en 2 casos (10 por ciento) la valoración fue de 9-10 puntos, en 4 casos (20 por ciento) fue de 7-8 puntos, en 5 casos (25 por ciento) fue de 5-6 puntos, y en 9 (45 por ciento) inferior a 5.La valoración subjetiva también se relaciona con la frecuencia de escapes: menos de uno/semana (n = 5) 5,86 ñ 2,5, más de un escape/semana (n = 15) 2,6 ñ 2,5 (t -2,53; p < 0,02). Diecinueve pacientes (95 por ciento) consideran no haber empeorado; 17 de los 18 que no han aumentado su frecuencia de escapes así lo han valorado. Conclusión. La valoración subjetiva de los resultados del biofeedback para el tratamiento de la incontinencia fecal, tanto inmediata como a largo plazo, coincide con los resultados objetivos logrados aunque sean moderados (AU)

Anastomosis coloanal con reservorio: ¿es una solución para el síndrome de la resección anterior? / Coloanal anastomosis with reservoir: a solution to anterior resection syndrome?

Introducción. La anastomosis coloanal con reservorio se ha propuesto como solución para mejorar la función defecatoria tras anastomosis rectales muy bajas. Objetivo. Evaluar los resultados funcionales de una serie consecutiva. Pacientes y métodos. Un total de 55 pacientes a los que se ha realizado una anastomosis coloanal con reservorio en "J". Para la evaluación funcional debe haber transcurrido por lo menos un año del cierre del estoma temporal. Resultados. Complicaciones: cuatro abscesos pélvicos/dehiscencias (7,2 por ciento), un absceso subhepático (1,8 por ciento), tres íleos (5,4 por ciento), dos disfunciones de la ileostomía (3,6 por ciento), 21 fallecimientos por embolismo pulmonar (1,8 por ciento). Funcionales: evaluados 36 pacientes. Frecuencia deposicional de 8 casos de 1,9/día; 20 problemas funcionales de forma global (56 por ciento): ocho tenesmos (22 por ciento), ocho dificultades evacuatorias (22 por ciento), cuatro urgencias (11 por ciento), 13 casos de incontinencia (36 por ciento) (gases en tres, heces en cinco y ensuciamiento en cinco). Conclusión. La anastomosis coloanal con reservorio mejora la frecuencia deposicional, pero no el resto de problemas funcionales. La evaluación de la cirugía conservadora de esfínteres deberá hacer más hincapié sobre la calidad de vida que sobre los resultados funcionales (AU)

Hemorroidectomía mediante máquina de sutura automática (técnica de Longo). ¿Son reproducibles los resultados de esta técnica? / Hemorrhoidectomy using stapled devices (Longo technique): are the results with this technique reproducible?

Introducción. Recientemente, se ha propuesto el tratamiento de la enfermedad hemorroidal mediante la exéresis y sutura del prolapso mucoso mediante una máquina de autosutura circular, técnica con la que se han descrito resultados excelentes tanto en términos de curación de la enfermedad como de alivio del dolor postoperatorio. El objetivo de este trabajo prospectivo ha sido evaluar la simplicidad del procedimiento, el dolor en el postoperatorio y las complicaciones de esta intervención. Pacientes y método. Veinticinco pacientes consecutivos, 19 con hemorroides de grado III y seis de grado IV fueron tratados con la técnica descrita por Longo, utilizándose el dispositivo PPH (ethicon endo-surgery). En todos los casos se indicó la misma pauta analgésica y fueron dados de alta 2 días después de la intervención. Para evaluar el dolor se utilizó una escala analógica visual, con un rango de 0-10 puntos. Al alta se le entregaba al paciente un diario donde debía anotar cada día la intensidad del dolor, con la misma escala empleada durante la estancia hospitalaria, y el consumo de analgésicos. El tiempo operatorio se midió mediante un cronómetro. Se recogieron las complicaciones postoperatorias. Todos los pacientes fueron visitados en la consulta a las 6 semanas de la intervención, solicitándoles una valoración de su satisfacción con la operación mediante una escala de 0 a 10 puntos. Resultados. El tiempo medio del procedimiento fue 12,4 ñ 4,20 min (rango, 6,2-25,3). Tres pacientes presentaron complicaciones después del alta. Ninguno requirió ingreso ni tratamiento quirúrgico. La intensidad del dolor postoperatorio fue de 5,2 ñ 1,9 puntos (rango, 1-10) el primer día y 3,1 ñ 1,7 (rango, 0-6) el segundo. Todos los pacientes excepto uno requirieron quetorolaco. En 3 casos fue necesario emplear meperidina. La intensidad media más alta del dolor después del alta fue 4,6 ñ 1,8 puntos (rango, 1-8). La media de días que los pacientes tomaron analgésicos en su domicilio fue 9,4 ñ 6,3. Ningún paciente requirió más de 3 dosis de quetorolaco. A las 6 semanas el 92 por ciento de los pacientes se mostró muy satisfecho con la intervención. Conclusión. En conclusión, la intervención de Longo es una técnica sencilla y rápida, con una tasa de complicaciones baja. Sin embargo, el dolor postoperatorio no ha sido tan escaso ni tan infrecuente como cabría esperar de la mayoría de las publicaciones previas (AU)

El cirujano colorrectal como factor pronóstico de resultados / The colorectal surgeon as a prognostic factor of results

No disponible