Características Clínico Quirúrgicas De Pacientes De 75 Años O Más Colostomízados en El Hospital Nacional Edgardo Rebagliati Martins

Abstract

Palabras clave: Colostomía; Características clinicoquirúrgicas (fuente: DeCS BIREME). ABSTRACTObjective: To determine the clinical and surgical characteristics of patients aged 75 and older who underwent colostomy in the department of Surgery of Colon, Rectum and Anus of "Edgardo Rebagliati Martins National Hospital" during January 2013 to December 2014. Materials and methods: Transversal study where clinical records from the Colon, Rectum and Anus Surgery Service were reviewed from January 2013 to December 2014. The study population was set up by 38 patients aged 75 or more. They were subject to colostomy according to inclusion and exclusion established criteria. Data was registered in a SPSS database for its analysis (IBM). Results: The average age was 81.37 years. 63.2% of patients had 75 to 80; 21.1%, from 81 to 90 and 15.8% over 90 years. 73.7% were female. 81.3% had high blood pressure; 18.8%, Diabetes mellitus 2; As well as chronic kidney disease. 43.8% had been previously undergone surgery in abdomen or pelvis and 62.5% had a classification of ASA III or IV. 42.11% of patients underwent colostomy because of unresectable colon, rectum or anus cancer, sole cause of intestinal obstruction in these patients; while 21.05% as part of an AP resection. 68.42% of colostomies were final and 52.63% of them were terminal. 52.63% of patients had postoperative complications: septic shock (15.79%), surgical site infection (10.53%), colostomy necrosis (5.26%), intra-abdominal abscesses (5.26%) and others (15.79%). The 52.63% of complicated cases were distributed according to age group: 26.32%, 10.53% and 15.79% for groups of 75-80, 81-90, and over 90 years, while 47.37% without complications were distributed 36.84%, 10.53% and 0%, respectively. Patients who had a classification of ASA III or IV doubled those without complications. Conclusion: The patient aged ≥ 75, who underwent colostomy, is mostly in the age group 75-80 years old, female, operated because of intestinal obstruction (colorectoanal unresectable cancer), with a clear and terminal colostomy, and has high risk for complications, probably related to high ASA classification.