Predictive factors of conversion in the videolaparoscopic appendectomy
Keywords:
acute appendicitis, appendectomy, laparoscopic surgery, conversion, conventional surgery.Abstract
Introduction: the videolaparoscopic procedure has become the election technique for the treatment of patients with acute appendicitis. Unfortunately, in occasions it is necessary to convert the procedure to conventional surgery.
Objective: to identify the predictive factors of conversion in the videolaparoscopic appendectomy.
Methods: a longitudinal, prospective, cohort study was carried out in 131 patients operated on for acute appendicitis by means of videolaparoscopic surgery in the General Surgery Service of “Saturnino Lora Torres" Teaching Clinical Surgical Provincial Hospital in Santiago de Cuba, from January, 2010 to December, 2014. The analysis of the data was based on the construction of a multivaried model to identify these factors (multivariable logistical regression).
Results: there was a prevalence of young male patients. The construction of the pattern of logistical regression was sustained by 8 possibly predictive variables of conversion, 4 of which were highly influential. Sensibility of 70.6, a specificity of 97.4 and a predictive global percentage of 93.9 of the calculated regression pattern were considered.
Conclusions: the most influencial factors for the conversion of videolaparoscopicsurgery to conventional surgery were: previous laparotomy in lower hemiabdomen, presence of adherences diagnosed by laparoscopy, retrocaecal location and perforated appendicitis.Downloads
References
2. Rodríguez Fernández Z. Consideraciones actuales sobre el diagnóstico de la apendicitis aguda. Rev Cubana Cir. 2009 [citado 22 Dic 2014];48(3). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-74932009000 300004
3. Agresta F, Mazzarolo G, Ciardo LF, Bedin N. The laparoscopic approach in abdominal emergencies: has the attitude changed? A single-center review of a 15 year experience. Surg Endosc. 2008;22(5):1255-62.
4. Hoyuela C, Camps J, Martí M, Gallostra M, Veloso E, Marco C. Tratamiento laparoscópico de la peritonitis difusa por apendicitis aguda: técnica quirúrgica, limitaciones y complicaciones. Cir Esp. 2010;80(Supl 1):1-250.
5. Korndorffer JR, Fellinger E, Reed W. SAGES guideline for laparoscopic appendectomy. Surg Endosc. 2010; 24(4):757-61.
6. Bermúdez Balado A, Rivero Ramos A, Barroetabeña Riol Y, Padierne Olivera R. Caracterización de los pacientes con abdomen agudo quirúrgico atendidos en el
Centro Médico de Diagnóstico Integral. Municipio Pampán. MEDICIEGO. 2012 [citado 22 Dic 2014];18(Supl1). Disponible en: http://bvs.sld.cu/revistas/ mciego/vol18_supl1_2012/pdf/T9.pdf
7. Rodríguez Conde N, Oller Sales B, Troya Díaz J. Apendicitis aguda. Integración del diagnóstico por la imagen y abordaje clínico. Cirugía Casos Clínicos. 2007 [citado 22 Dic 2014];2(1):2-7. Disponible en: http://www.aecirujanos.es/en/ publicaciones/revista-cirugia-casos-clinicos/121946-cirugia-casos-clinicos-volumen-2-numero-1
8. Rodríguez Fernández Z. Complicaciones de la apendicectomía por apendicitis aguda. Rev Cubana Cir. 2010 [citado 22 Dic 2014];49(2). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-74932010000200006
9. Deulofeu Betancourt B, Rodríguez Fernández Z, Cremé Lobaina E, Lesme Reyte Sola G, Pineda Chacón J. Caracterización de pacientes operados mediante apendicectomía videolaparoscópica a causa de apendicitis aguda. MEDISAN. 2014 [citado 22 Dic 2014];18(12). Disponible en: http://scielo.sld.cu/scielo.php? script=sci _arttext&pid=S1029-30192014001200005
10. Hilaire R, Rodríguez Z, Romero LI, Rodríguez LP. Apendicectomía videolaparoscópica frente a apendicectomía convencional. Rev Cubana Cir. 2014 [citado 22 Dic 2014];53(1). Disponible en: http://scielo.sld.cu/scielo.php? script=sci_arttext&pid=S0034-74932014000100004
11. Motta Ramírez GA, Méndez Colín E, Martínez Utrera MJ, Bastida Alquicira J, Aragón Flores M, Garrido Sánchez GA, et al. Apendicitis atípica en adultos. An Radiol México. 2014;13:143-65.
12. Galloso Cueto L, Lantigua Godoy A, Alfonso Moya O, Sánchez Maya AY. Cirugía laparoscópica en la apendicitis aguda. Rev Med Electrón. 2011 [citado 22 Dic 2014];33(2). Disponible en: http://scielo.sld.cu/scielo.php?script =sci_ arttex t&pid=S1684-18242011000200002
13. Gavilán Yodú RL. Morbilidad y mortalidad por apendicitis aguda en el hospital integral comunitario del municipio Monteagudo (2006–2008). MEDISAN. 2010 [citado 22 Dic 2014];14(8). Disponible en: http://bvs.sld.cu/revistas/san/vol_ 14_8_10/san10810.htm
14. Pagán Pomar A, García Sanz M, Soro Gosálvez JA. Apendicectomía laparoscópica nuestra vía de abordaje. Rev Colomb Cir. 2010;16:156-60.
15. Luzardo Silveira EM, Rodríguez Ramírez R, González Rondón PL, Puertas Álvarez JF. Ventajas de la cirugía mayor ambulatoria en situaciones de urgencia médica. MEDISAN. 2009 [citado 22 Dic 2014];13(3). Disponible en: http://bvs.sld.cu/revistas/san/vol13_3_09/san03309.htm
16. Manrique Mansilla D, Aquimo Márquez H, Garro Montoro E. Apendicectomía laparoscópica: modelo de programa ambulatorio. Rev Colombiana Cir 2008;23(2):74-84.
17. Morales CH, Uribe AL, Ramírez N, Valencia TJ ¿Apendicectomía abierta o laparoscópica? Rev Colombiana Cir. 2010;17:156-60.
18. Li X, Zhang J, Sang L, Zhang W, Chu Z, Li X, Liu Y. Laparoscopic versus conventional appendectomy-a meta-analysis of randomized controlled trials. BMC Gastroenterol. 2010;10:129.
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