ABSTRACT
INTRODUCTION: Physiotherapy before thoraco-abdominal surgery aims to optimize the patient's cardiorespiratory fitness, in order to limit his alterations in the immediate postoperative period and to reduce postoperative morbidity. This support also aims to make eligible for surgery the patient who is not initially. This review of the literature addresses chest physiotherapy and exercise training that the patient can benefit. STATE OF ART: Scientific evidence remains relatively weak for physiotherapy before thoraco-abdominal surgery, especially for bronchial drainage and incentive spirometry techniques. However, inspiratory muscle training and prehabilitation seem interesting for increasing exercise capacity and reducing morbidity. These last two innovative modalities that can be carried out at home are particularly relevant for patients who present a high risk of complications or who cannot access conventional programs. Smoking cessation, nutritional care and educational support are areas that the physiotherapist must integrate into his practice. PERSPECTIVES: In a decisional algorithm, we suggest 4 types of programs ranging from a simple preoperative education to an intensive multimodal program. This remains to be evaluated in current practice. CONCLUSIONS: The physiotherapist must fully participate in assessing the risk of postoperative morbidity in the context of thoraco-abdominal surgery. He must also identify the most efficient modalities within the delay imposed by the date of surgery. It is also necessary that the latter learn to identify the patient at higher risk of postoperative complications in order to adapt the preoperative management according to the levels of scientific evidence.
Subject(s)
Physical Therapists , Humans , Male , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Postoperative Complications/prevention & control , Postoperative Period , Preoperative Care/methods , Preoperative ExerciseABSTRACT
La "Ascitis Quilosa o Quiloperitoneo", es una entidad clínica rara con incidencia baja y de difícil diagnóstico, poco conocida alrededor del mundo sobre todo en la comunidad quirúrgica, misma que fue descrita por primera vez en 1691. El objetivo del presente artículo es exponer un caso de Ascitis Quilosa o Quiloperitoneo, diagnosticado y tratado en el Centro de Especialidades Clínico - Quirúrgicas Jesús Obrero, en un paciente masculino de 36 años; tras la revisión de antecedentes quirúrgicos, sintomatología, semiología, estudios imagenológicos, laboratoriales, y la revisión sistemática de la literatura; se llegó al diagnóstico final. Además se enfocara no solo conocimientos históricos, etiológicos y fisiopatológicos, sino medios diagnósticos y planes terapéuticos estandarizados conservadores, que implica tomar en cuenta en esta patología una vez diagnosticada; siendo esta una manera de acumular experiencia en el adecuado manejo y a su vez aportar a la literatura médica nacional en el levantamiento epidemiológico y casuístico de esta variedad rara y poco frecuente patología abdominal.
The Chilosa Ascites or Quiloperitoneo, is a rare clinical entity with low incidence and difficult to diagnose, little known around the world especially in the surgical community, which was first described in 1691. The objective of this article is to expose a case of Chilosa Ascites or Quiloperitoneo, diagnosed and treated at the Center for Clinical Specialties - Surgical Jesus Obrero, in a male patient of 36 years; after reviewing surgical backgrounds, symptomatology, semiology, imaging, laboratorial studies, and systematic review of literature; the final diagnosis was reached. In addition, it will focus not only historical, etiological and pathophysiological knowledge, but also conservative diagnostic means and standardized therapeutic plans, which involves taking into account this pathology once diagnosed; this being a way to accumulate experience in the proper management and in turn contribute to the national medical literature in the epidemiological and casuistic uprising of this rare and rare abdominal pathology variety.
