{"id":115241,"date":"2014-12-02T00:00:00","date_gmt":"2014-12-02T00:00:00","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/estimulacion-del-asa-eferente-previa-al-cierre-de-la-ileostoma%c2%ada-de-proteccion-estudio-prospectivo-randomizado\/"},"modified":"2014-12-02T00:00:00","modified_gmt":"2014-12-02T00:00:00","slug":"estimulacion-del-asa-eferente-previa-al-cierre-de-la-ileostoma%c2%ada-de-proteccion-estudio-prospectivo-randomizado","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/cirugia\/estimulacion-del-asa-eferente-previa-al-cierre-de-la-ileostoma%c2%ada-de-proteccion-estudio-prospectivo-randomizado\/","title":{"rendered":"Estimulaci\u00f3n del asa eferente previa al cierre de la ileostom\u00edade protecci\u00f3n, estudio prospectivo randomizado"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Israel Abellan Morcillo <\/strong><\/h2>\n<p>Objetivo pretendemos evaluar la utilidad de una nueva t\u00e9cnica en la disminuci\u00f3n del \u00edleo postoperatorio tras el cierre de ileostom\u00eda de protecci\u00f3n. introducci\u00f3n el \u00edleo paral\u00edtico postoperatorio representa la complicaci\u00f3n m\u00e1s frecuente tras el cierre de ileostom\u00eda con un aumento de la morbilidad, estancia hospitalaria y gasto sanitario. pacientes y m\u00e9todo este estudio prospectivo randomizado incluye a 70 pacientes intervenidos de cierre de ileostom\u00eda.  En 35 pacientes se realiz\u00f3 previamente a la cirug\u00eda, una estimulaci\u00f3n diaria los 15 d\u00edas previos a la intervenci\u00f3n, del segmento intestinal excluido, a trav\u00e9s del asa eferente de la ileostom\u00eda con una soluci\u00f3n de consistencia espesa. En los otros 35 pacientes no se realiz\u00f3 estimulaci\u00f3n previa a la cirug\u00eda. El estudio fue aprobado por el comit\u00e9 \u00e9tico del hospital y  registrado en  clinicaltrials.Gov con el n\u00famero de inscripci\u00f3n nct01881594. resultados ambos grupos de pacientes fueron homog\u00e9neos respecto a los datos demogr\u00e1ficos, caracter\u00edsticas de la primera intervenci\u00f3n del c\u00e1ncer de recto y  periodo intercirugias. tras el cierre de la ileostom\u00eda el grupo de pacientes estimulados presentaba un inicio m\u00e1s precoz de la tolerancia oral: 1,06 vs 2,57 d\u00edas (p=0,007) y de la emisi\u00f3n de gases y\/o heces: 1,14 vs 2,8 d\u00edas (p&lt;0,001) respecto al grupo de pacientes no estimulados. La incidencia de \u00edleo postoperatorio: 2,8% vs 20 % (p=0,024) y  la estancia hospitalaria: 2,4 vs 5,09 d\u00edas (p=0,01) tambi\u00e9n fue menor en los pacientes estimulados. No hubo diferencias respecto al resto de complicaciones. conclusiones la estimulaci\u00f3n  del asa eferente de la ileostom\u00eda previa a su cierre es una t\u00e9cnica segura y reproducible que en nuestra experiencia, disminuye el \u00edleo postoperatorio y favorece un tr\u00e1nsito intestinal y una tolerancia oral precoces con una menor estancia hospitalaria postoperatoria.  objective the aim of this study is to assess the utility of a new technique for reducing postoperative ileus after protective ileostomy closure.  background postoperative ileus is the most common complication after ileostomy closure with an increase in morbidity, hospital stay and healthcare costs. methods this prospective randomised study included 70 patients undergoing surgery for ileostomy closure. In 35 patients, over the 2 weeks prior to surgery, daily stimulation of the defunctionalised stomal segment was performed using a thick solution. In the other 35 patients stimulation was not performed prior to surgery. The study was approved by the hospital ethics committee and registered on clinicaltrials.Gov with inscription number nct01881594.  results both groups of patients were homogenous for demographic data, characteristics of the first rectal cancer operation and intersurgery periods. after ileostomy closure, the stimulated group of patients had an earlier return to oral tolerance (1.06 vs 2.57 days; p=0.007) and passage of flatus or stool (1.14 vs 2.8 days; p&lt;0.001) than the non-stimulated group of patients. The incidence of postoperative ileus (2.8% vs 20 %; p=0.024) and hospital stay (2.4 vs 5.09 days; p=0.01) was also lower in the stimulated patients. There were no differences in terms of the other complications. conclusions stimulation of the efferent limb of the ileostomy prior to closure is a safe and reproducible technique that reduces postoperative ileus and fosters early intestinal transit and oral tolerance with a shorter postoperative hospital stay.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Estimulaci\u00f3n del asa eferente previa al cierre de la ileostom\u00edade protecci\u00f3n, estudio prospectivo randomizado<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Estimulaci\u00f3n del asa eferente previa al cierre de la ileostom\u00edade protecci\u00f3n, estudio prospectivo randomizado <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Israel Abellan Morcillo <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Murcia<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 12\/02\/2014<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Pascual Parrilla Paricio<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: pablo Ram\u00edrez romero <\/li>\n<li>Jes\u00fas Cifuentes tebar (vocal)<\/li>\n<li>sebastiano Biondo agio (vocal)<\/li>\n<li>eduardo Garcia granero ximenez (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Israel Abellan Morcillo Objetivo pretendemos evaluar la utilidad de una nueva t\u00e9cnica en la disminuci\u00f3n del \u00edleo [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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