Browsing by Author "Fernández de Córdova Rubio, Germán Lenin"

Now showing 1 - 4 of 4

Colecistitis aguda severa según criterios de Tokio y factores asociados en pacientes del Hospital Vicente Corral Moscoso, Cuenca 2017
(2019) Sánchez León, José Adrián; Fernández de Córdova Rubio, Germán Lenin; Álvarez Serrano, Marlene Elizabeth
BACKGROUND: Acute cholecystitis is also a global problem, both in terms of morbidity and social, economic and quality of life impact. OBJECTIVE: To determine the prevalence of acute cholecystitis according to the Tokyo criteria and associated factors in patients of the Hospital Vicente Corral Moscoso, Cuenca 2017 METHODOLOGY: A cross-sectional, analytical study was conducted in the trauma and emergency department of the Vicente Corral Moscoso Hospital, in patients with acute cholecystitis during 2017, the sample was 150 patients, who met the inclusion criteria, the prevalence of severe acute cholecystitis according to the Tokyo criteria and the association with risk factors such as age over 65, male sex, obesity, overweight, hypertension, diabetes, vesicular plastron, pyocolecyst, vesicular hydrops, vesicular necrosis, and vesicular necrosis. O was obtained with confidence index, frequencies and percentages. RESULTS: A prevalence of severe acute cholecystitis of 24.7% was found; It is a statistically significant relationship with age, HBP, vesicular plastron, pyocolecisto, vesicular necrosis; there is a risk that patients have diabetes, male sex, obesity or vesicular perforation; However, it was not significant. There is no significant statistical difference in patients who are overweight or who present with vesicular hydrops. There was a mortality of 3%. CONCLUSIONS: Severe cholecystitis has a high prevalence and is associated with several factors such as age over 65 years, hypertension, the presence of pyocolecisto, vesicular necrosis and plastron.
Complicaciones trans y postquirúrgicas inmediatas derivadas de la colecistectomía laparoscópica en pacientes con colecistitis aguda en el Hospital Vicente Corral Moscoso, Cuenca 2014
(2016) Pérez Guartambel, Julio Milton; Fernández de Córdova Rubio, Germán Lenin; Arévalo Peláez, Carlos Eduardo
Introduction: laparoscopic cholecystectomy is the gold standard in the treatment of symptomatic cholelithiasis. This surgical technique in addition to reducing costs also reduces the hospital stay. Material and methods: We conducted a cross-sectional observational study of 172 patients undergoing laparoscopic cholecystectomy in the Hospital Vicente Corral Moscoso during the year 2014. A form was utilized to collect data Results: The majority of patients undergoing laparoscopic cholecystectomy are 73.8 % women and young adults 55.8 %. The main symptoms by those who consult patients were pain in the right hypochondrium 50.6 % and pain plus nausea and vomiting 31.4 %.In the 76.2 % observed leukocytosis. In the 98.3 % were diagnose nonlithiasic cholecystitis, showing thickening of the wall in the 73.8 %. The findings of the main surgical edema was vesicular at 69,8%, piocolecisto in 12.8 %, hidrocolecisto at 5.8 % and to a lesser frequency gangrene, plastron and pancreatitis. Average surgical time was 75.52 minutes DS ± 20.2. In the majority 40.1 % surgical time was 70-89 minutes. The average number of days of hospitalization was 1.67 days. There were a 3% of complications: vascular lesion 1.8 %,biliary injury 0.6 %, and visceral injury 0.6 %. The main inconvenience was postoperative nausea and vomiting 4.7 % and the pain; mainly moderate pain in 58.6 %. There was a prevalence of mortality of 0 %. Conclusions: The frequency of complications was 3% and the mortality rate is 0 %
Omalgia postcolecistectomìa laparoscópica en pacientes aleatorizados de los hospitales Vicente Corral Moscoso y José Carrasco Arteaga. 2013
(2014) Abad Tapia, Marcelo Alfonso; Fernández de Córdova Rubio, Germán Lenin; Tenezaca Tacuri, Ángel Hipólito
Objective: to determine the intensity of shoulder pain associated with laparoscopic cholecystectomy with pneumoperitoneum pressure of 12 mmHg in the Vicente Corral Moscoso and José Carrasco Arteaga hospital. Methodology: study controlled clinical trial. It was considered a universe to patients who were admitted for elective laparoscopic cholecystectomy in the Vicente Corral Moscoso and José Carrasco Arteaga hospitals. Sample: it is calculated with IC of 95%. Statistics power 80%, shoulder pain postlaparoscopic cholecystectomy of 35% of the control group and 20% in the intervention group. Ratio 1:1. Plus 10% for losses. By applying the formula of sample for two proportions in Epi Info 7 version 2011. n:110 patients for each group, total 220 patients. In Group 1, control: laparoscopic cholecystectomy with pneumoperitoneum with 12 mmHg of CO2. In Group 2, intervention: laparoscopic cholecystectomy with pneumoperitoneum with 15 mmHg of CO2. Results: The average age in the group with 12 mmHg or less of CO2 pressure was 44,81 years with a DE of 17,55 years; while in the other group was 45,97 years old with a DE 17,55 years; the prevalence of shoulder pain in the group of patients with 12 mmHg of CO2 pressure (Group 1) was 28.2%, while in the group that received a pressure of 15 mmHg with CO2 (Group 2) the prevalence of omalgia was 46.4; (CO2 pressure was associated with the presentation of pain at 2,6,12,18 and 24 hours (Chi-square and significant p-value); low pressure (12 mmHg) is beneficial for the presentation of moderate or severe pain with a RR at 2 hours of 0.21 (0, 1-0, 4) at 6 hours 0.43 (0, 2-0, 7); at 12 hours 0.61 (0, 4-0, 9); at 18 hours 0.26 (0, 1-0, 5) and at 24 hours 0.41 (0, 1-1, 1). Conclusions: A pneumoperitoneum with low pressure (12 mmHg) is beneficial than high-pressure (15 mmHg) in the appearance of shoulder pain and tin he intensity of it. Keywords: LAPAROSCOPIC CHOLECYSTECTOMY, SHOULDER PAIN, PNEUMOPERITONEUM
Validez de la guía de Tokio para colecistitis aguda litiásica en el departamento de emergencia de cirugía del Hospital Vicente Corral Moscoso de Cuenca 2014
(2016) Cabrera Ordóñez, Catherine Mercedes; Fernández de Córdova Rubio, Germán Lenin; Jaramillo Oyervide, Julio Alfredo
OBJECTIVE: the objective was to determine the validity of Tokyo guidelines 2013 for the diagnosis of acute cholecystitis in the emergency department of "Vicente Corral Moscoso" Hospital in Cuenca 2014. METHODS: a validation study was performed in a diagnostic test from January to December 2014, data of 171 patients were collected with the following variables: age, sex, residence, information of the clinical, laboratory and ultrasound parameters of the Tokyo guidelines as well as the pathology report. The data were tabulated and analyzed using SPSS version 15.00. Quantitative variables were expressed using mean and standard deviation for qualitative variables frequencies and percentages plus the chi-square or Fisher exact test was used. For the diagnostic test for acute cholecystitis was performed using Bayesian analysis guide Tokyo and histopathology analyzing Gold standard: sensitivity, specificity, positive predictive value, negative and positive rate, negative likelihood. RESULTS: Of 171 patients, acute cholecystitis showed more females 119 (70%) with a mean age of 38 ± 14 and 102 residents in urban areas (60%). Tokyo guide had a sensitivity and specificity of 93.3% and 97.9% respectively. A 97.22% positive predictive value and negative predictive of 94.95%. CONCLUSIONS: acute biliary disease occurs more often in women and is prevalent in the young adult population. In our study we observed that the Tokyo guide had a high sensitivity and specificity