| Abstract: | Acute appendicitis is the most common surgical disease in surgical services in first place of surgical acute abdomen. As minimally invasive surgery treatment is the best surgical approach. However it has ventured into less invasive and safer techniques such as single-port laparoscopic appendectomy.
Objective: compare the use of laparoscopic appendectomy single port with 3 ports in patients with acute appendicitis hospitals "Vicente Corral Moscoso" and "Jose Carrasco Arteaga".
Materials and method: an experimental study. We included 170 participants in the emergency department of hospitals “Vicente Corral Moscoso” and “Jose Carrasco Arteaga” underwent surgery for acute appendicitis; half were performed with single-port appendectomy and the other half were appendectomy performed with 3 ports.
Results: the most affected age group was 18-25 years, and the present male predominance in both groups. The operating time of 61-120 min was 61.2% in group 1, group 2 of 55.3%. The mild postoperative pain was presented in group 1 and 63.5% in group 2 was 41.2% mild , moderate 38.8%, with a hospital stay of 13-24 hours in the group 1 of 62 , 4% of group 2 unlike a prevalence of 25 to 36 hours 47.1%. Analyzing the behavior of the single port for less surgical time we found a RR of 0.71 (95% CI 0.4-1.2 ) , RRR 0.29 , NNT 15 RAR 0.07 , for pain intensity ( mild) RR of 1.54 (95% CI 1.1-2 ) , RRR -0.54 , -0.22 and NND RAR 5 and for shorter hospital stay ( less than 12 hours) 3.5 0.71 (CI 95% from 0.75 to 12.3 ) , -2.5 RRR , NNH 17 RAR 0.06.
Discussion: performing single-port laparoscopic appendectomies similar presents international research results, with regard to postoperative pain and hospital stay and is beneficial compared to 3 access ports.
Conclusion: the realization of single-port laparoscopic appendectomy showed higher benefits in terms of postoperative pain and hospital stay.
Keywords: APPENDICITIS / THERAPY, APPENDICITIS / SURGERY, LAPAROSCOPY APPENDECTOMY / CLASSIFICATION, APPENDECTOMY / METHODS, POSTOPERATIVE PAIN / SURGERY, POSTOPERATIVE PAIN / CLASSIFICATION, REGIONAL “HOSPITAL VICENTE CORRAL MOSCOSO”, “JOSE CARRASCO ARTEAGA HOSPITAL” OF SOCIAL SECURITY INSTITUTE OF ECUADOR, CUENCA-ECUADOR.
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| Description: | La apendicitis aguda es la enfermedad quirúrgica más frecuente en los servicios de cirugía ocupando el primer lugar de las intervenciones quirúrgicas de abdomen agudo.
Objetivo general: comparar el uso de la apendicectomía laparoscópica de puerto único con la de 3 puertos en pacientes con apendicitis aguda de los hospitales “Vicente Corral Moscoso” y “José Carrasco Arteaga” durante el 2013.
Materiales y método: estudio experimental. Con 170 participantes, en emergencias de hospitales “Vicente Corral Moscoso” y “José Carrasco Arteaga”, intervenidos por apendicitis aguda, a la mitad se les realizó apendicectomía con puerto único y a la otra mitad se les realizó apendicectomía con 3 puertos.
Resultados: Tiempo quirúrgico 61 a 120 min fue 61,2%, grupo 1, grupo 2, 55,3%. Dolor posoperatorio leve grupo 1 63,5%, grupo 2, 41,2%, moderado, 38,8%, Estancia hospitalaria 13 a 24 horas grupo 1, 62,4%, grupo 2, 25 a 36 horas, 47,1%. En puerto único menor tiempo quirúrgico con RR, 0,71 (IC 95% 0,4-1,2), RRR 0,29, RAR 0,07 y NNT 15; intensidad del dolor (leve) RR de 1,54 (IC 95% 1,1-2), RRR -0,54, RAR -0,22 y NND 5 y menor estancia hospitalaria (menor a 12 horas) 3,5 de 0,71 (IC 95% 0,75-12,3), RRR -2,5, RAR 0,06 y NND 17.
Discusión: Las apendicectomías laparoscópicas con puerto único presentan similares resultados con investigaciones internacionales, en lo referente al dolor posoperatorio y estancia hospitalaria y resulta beneficiosa en comparación con el acceso de 3 puertos.
Conclusión: Las apendicectomías laparoscópicas con puerto único presentaron mayores beneficios posoperatorios en lo referente al dolor y estancia hospitalaria.
DeCS: APENDICITIS/TERAPIA., APENDICITIS/CIRUGIA, APENDICECTOMÍA LAPAROSCÓPIA/CLASIFICACIÓN, APENDICECTOMÍA/MÉTODOS., DOLOR POSTOPERATORIO/CIRUGÍA, DOLOR POSTOPERATORIO/CLASIFICACIÓN, “HOSPITAL REGIONAL VICENTE CORRAL MOSCOSO”, “HOSPITAL JOSE CARRASCO ARTEAGA” DEL INSTITUTO ECUATORIANO DE SEGURIDAD SOCIAL, CUENCA-ECUADOR. |
