Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 1 de 1
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
HPB (Oxford) ; 15(7): 535-40, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23458703

RESUMO

BACKGROUND: The control of sepsis is the primary goal of surgical intervention in patients with infected necrosis. Simple surgical approaches that are easy to reproduce may improve outcomes when specialists in endoscopy are not available. The aim of the present study was to describe the experience with a focused open necrosectomy (FON) in patients with infected necrosis. METHOD: A prospective pilot study conducted to compare a semi-open/closed drainage laparotomy and FON with the assistance of peri-operative ultrasound. The incidence of sepsis, dynamics of C-reactive protein (CRP), intensive care unit (ICU)/hospital stay, complication rate and mortality were compared and analysed. RESULTS: From a total of 58 patients, 36 patients underwent a conventional open necrosectomy and 22 patients underwent FON. The latter method resulted in a faster resolution of sepsis and a significant decrease in mean CRP on Day 3 after FON, P = 0.001. Post-operative bleeding was in 1 versus 7 patients and the incidence of intestinal and pancreatic fistula was 2 versus 8 patients when comparing FON to the conventional approach. The median ICU stay was 11.6 versus 23 days and the hospital stay was significantly shorter, 57 versus 72 days, P = 0.024 when comparing FON versus the conventional group. One patient died in the FON group and seven patients died in the laparotomy group, P = 0.139. DISCUSSION: FON can be an alternative method to conventional open necrosectomy in patients with infected necrosis and unresolved sepsis.


Assuntos
Drenagem/métodos , Pancreatectomia/métodos , Pancreatite Necrosante Aguda/cirurgia , Sepse/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Distribuição de Qui-Quadrado , Drenagem/efeitos adversos , Drenagem/mortalidade , Feminino , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pancreatectomia/efeitos adversos , Pancreatectomia/mortalidade , Pancreatite Necrosante Aguda/sangue , Pancreatite Necrosante Aguda/diagnóstico por imagem , Pancreatite Necrosante Aguda/microbiologia , Pancreatite Necrosante Aguda/mortalidade , Projetos Piloto , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/terapia , Estudos Prospectivos , Sepse/sangue , Sepse/diagnóstico por imagem , Sepse/microbiologia , Sepse/mortalidade , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...