RESUMO
RESUMEN La diverticulosis es la presencia de divertículos en el tránsito intestinal, diverticulitis es la inflamación de los divertículos y ocurre en menos del 5% de pacientes con diverticulosis. El tratamiento quirúrgico de la diverticulitis aguda se aplica en los casos complicados. Tradicionalmente la operación de Hartmann es el procedimiento estándar en los casos de Diverticulitis aguda Hinchey III y IV, actualmente se recomienda individualizar el tratamiento quirúrgico en los casos de peritonitis purulenta no fecaloidea siendo el lavado peritoneal laparoscópico una opción factible. Objetivo : Describir los resultados del tratamiento quirúrgico de 4 pacientes con el diagnóstico de diverticulitis aguda Hinchey III sometidos al Lavado peritoneal en un centro privado. Material y métodos: Estudio descriptivo retrospectivo tipo serie de casos. Se recopiló información de historias clínicas para la descripción de los casos. Resultados: En los 4 pacientes intervenidos mediante el Lavado peritoneal laparoscópico, ninguno tuvo complicaciones postoperatorias ni mortalidad. Conclusiones: A juicio de los autores los beneficios del lavado peritoneal laparoscópico repercuten en una adecuada evolución postquirúrgica y generan calidad de vida en los pacientes intervenidos.
SUMMARY Diverticulosis is defined as the presence of diverticula in the intestine, when these diverticula become inflamed diverticulitis occurs, but this complication happens in less than 5% of these patients. Surgical treatment is indicated in complicated diverticulitis cases. Traditionally, the Hartmann procedure is carried out in patients with Hinchey III and IV acute diverticulitis. Currently, individualized surgical procedures are indicated in patients with non-fecal purulent peritonitis with laparoscopic peritoneal lavage as an optional choice. Objective: To report the results of laparoscopic peritoneal lavage in four patients with Hinchey III acute diverticulitis performed at a private clinic. Methods: Case series for which a review of patient clinical files was done. Results: No post-operative complications or mortality was found. Conclusions: based on authors judge, laparoscopic peritoneal lavage leads to an adequate post-operative evolution resulting in better quality of life.
RESUMO
Background: During the Health Emergency due to coronavirus disease 2019 (COVID-19) in Peru, elective surgeries were suspended and only emergency surgeries were allowed. Conservative management was considered as an alternative and laparoscopic surgery was indicated following safety recommendations. Surgically operated patients were at higher risk of becoming infected with COVID-19 due to hospital exposure, being more susceptible to complications. Methods: Retrospective cohort-type analytical study that includes patients who were admitted to a private center due to an emergency and who underwent laparoscopic gastrointestinal surgery during the National Health Emergency (group exposed to the COVID-19 pandemic) from March 11, 2020 to June 8, 2020 and were compared with those patients operated between March 11, 2019 and June 8, 2019 (group not exposed to the COVID-19 pandemic). Results: A total of 104 patients were identified, 59 patients operated during the COVID-19 pandemic. All were operated by laparoscopy, both groups with a similar degree of disease severity. There was no mortality or surgical reintervention. No surgeon at the institution was infected with the virus during the study period. Conclusions: The degree of severity of abdominal surgical pathologies in this time of pandemic has not increased compared with the previous year. Likewise, the laparoscopic approach to emergency surgery was safe and effective during the pandemic.