{"id":72250,"date":"2018-03-09T23:17:02","date_gmt":"2018-03-09T23:17:02","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/medicion-del-ph-intramucoso-en-las-anastomosis-colorrectales-y-su-relacion-con-el-fallo-de-sutura\/"},"modified":"2018-03-09T23:17:02","modified_gmt":"2018-03-09T23:17:02","slug":"medicion-del-ph-intramucoso-en-las-anastomosis-colorrectales-y-su-relacion-con-el-fallo-de-sutura","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/medicion-del-ph-intramucoso-en-las-anastomosis-colorrectales-y-su-relacion-con-el-fallo-de-sutura\/","title":{"rendered":"Medici\u00f3n del ph intramucoso en las anastomosis colorrectales y su relaci\u00f3n con el fallo de sutura."},"content":{"rendered":"<h2>Tesis doctoral de <strong> M\u00f3nica Mill\u00e1n Scheiding <\/strong><\/h2>\n<p>Objetivos: valorar la evoluci\u00f3n del ph intramucoso medido mediante tonometr\u00eda en el \u00e1rea anastom\u00f3tica colorrectal, y su utilidad para predecir el riesgo de fallo de sutura.  material y metodos: se estudiaron 90 pacientes intervenidos de c\u00e1ncer de recto-sigma con anastomosis primaria. En todos los casos se determin\u00f3 mediante tonometr\u00eda el ph a nivel anastom\u00f3tico y a nivel g\u00e1strico (control) en las primeras 24 y 48 horas del postoperatorio. Se estudiaron tambi\u00e9n otras variables relacionadas con el fallo anastom\u00f3tico: variables demogr\u00e1ficas, asa, possum, distancia del tumor y estad\u00edo, transfusiones, duraci\u00f3n de la intervenci\u00f3n, nivel de la anastomosis, oxigenoterapia, y uso de estoma.  resultados: la media de edad fue de 66,63 a\u00f1os; 55,6% varones. El estad\u00edo tumoral m\u00e1s frecuente fue el ii (43,3%). El 30% de las anastomosis se realizaron a        &lt; 6cm del margen anal; 35,6% entre 6-11 cm, y 34,4% a m\u00e1s de 11 cm. La tasa de fallo de sutura fue del 11,1% (4 fugas subcl\u00ednicas y 6 cl\u00ednicas). en el an\u00e1lisis univariante se encontr\u00f3 asociaci\u00f3n estad\u00edsticamente significativa entre fallo de sutura y distancia tumoral (p=0,001), distancia de la anastomosis (p=0,045), ileostom\u00eda de protecci\u00f3n (p=0,009), tiempo de intervenci\u00f3n (p=0,011), oxigenoterapia postoperatoria (p=0,038), y ph anastom\u00f3tico y g\u00e1strico a las 24 horas (p=0,0001 y p=0,027). En el an\u00e1lisis multivariante mediante regresi\u00f3n log\u00edstica s\u00f3lo se mantuvo como factor independiente el ph anastom\u00f3tico en las primeras 24 horas (p=0,001; ic95%:0,000-0,05). Utilizando como punto de corte el ph&lt;\/= 7,28 su medici\u00f3n presenta una sensibilidad del 28,1%, especificidad 98,3% con vpp 90% y vpn 71,3% (or: 22,304; ic95%:2,672-186,185).  conclusiones: durante las primeras 24 horas del postoperatorio existe una hipoxia relativa en el \u00e1rea anastom\u00f3tica colorrectal. La disminuci\u00f3n del phi anastom\u00f3tico en estas primera horas postoperatorias es un factor de riesgo i<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Medici\u00f3n del ph intramucoso en las anastomosis colorrectales y su relaci\u00f3n con el fallo de sutura.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Medici\u00f3n del ph intramucoso en las anastomosis colorrectales y su relaci\u00f3n con el fallo de sutura. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 M\u00f3nica Mill\u00e1n Scheiding <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Universitat de val\u00e9ncia (estudi general)<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 13\/01\/2005<\/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>Salvador Lledo Matoses<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: Francisco Sanchez bueno <\/li>\n<li>h\u00e9ctor Ortiz hurtado (vocal)<\/li>\n<li>alejandro Espi macias (vocal)<\/li>\n<li>Antonio Compa\u00f1 rosique (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de M\u00f3nica Mill\u00e1n Scheiding Objetivos: valorar la evoluci\u00f3n del ph intramucoso medido mediante tonometr\u00eda en el \u00e1rea anastom\u00f3tica [&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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