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Factores asociados a complicaciones posoperatorias en pacientes con neoplasia colorrectal
Factors associated with postoperative complications in patients with colorectal neoplasia
Fatores associados a complicações pós-operatórias em pacientes com neoplasia colorretal
DOI:
https://doi.org/10.15446/av.enferm.v43n2.122430Keywords:
Neoplasia Colorrectal, Enfermería, Complicaciones Posoperatorias, Periodo Posoperatorio, Factores Predisponentes (es)Colorectal Neoplasms, Nursing, Postoperative Complications, Postoperative Period, Precipitating Factors (en)
Neoplasias Colorretais, Enfermagem, Complicações Pós-Operatórias, Período Pos-Operatório, Fatores Predisponentes (pt)
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Objetivo: identificar los factores asociados con la presencia de complicaciones en pacientes posquirúrgicos por neoplasia colorrectal.
Metodología: estudio transversal y analítico que incluyó a 102 pacientes oncológicos durante el posoperatorio por neoplasia colorrectal, quienes ingresaron a una unidad de cuidado intensivo/intermedio entre los años 2020 y 2022.
Resultados: el 45,1 % de los pacientes eran hombres y el 54,9 % mujeres; el 71,6 % residía en zona urbana. El grupo etario más representativo fue el de 67 a 75 años, con un 33,3 %. Se encontró una asociación estadísticamente significativa entre la hipopotasemia y
las transfusiones de concentrado globular. El íleo paralítico posoperatorio se asoció con el género masculino y con el tratamiento previo con radioterapia. La filtración de la anastomosis se asoció con el uso posoperatorio de vasopresores y con la transfusión de
concentrado globular. La infección del sitio operatorio se relacionó con la residencia en zona rural y con el uso posoperatorio de vasopresores; además, la infección del sitio de inserción de drenes se asoció tanto con el uso posoperatorio de vasopresores como con las transfusiones de concentrado globular.
Conclusión: la complicación posoperatoria más frecuente fue la hipopotasemia. Se evidenció la relación entre el género masculino, la residencia en zona rural, el uso posoperatorio de vasopresores, las
transfusiones sanguíneas y la radioterapia previa a la cirugía como factores de riesgo para el desarrollo de complicaciones posoperatorias en pacientes con neoplasia colorrectal.
Objective: To identify factors associated with the presence of complications in post-surgical patients with colorectal neoplasia.
Methods: Cross-sectional, analytical study that included 102 oncology patients during their postoperative period for colorectal neoplasia who were admitted to an intensive/intermediate care unit between 2020 and 2022.
Results: 45.1% of patients were male and 54.9% female; 71.6% resided in urban areas. The most represented age group was 67–75 years (33.3%). A statistically significant association was found between hypokalemia and packed red blood cell transfusions.
Postoperative paralytic ileus was associated with male gender and prior radiotherapy. Anastomotic leakage was associated with postoperative vasopressor use and packed red blood cell transfusion. Surgical site infection was associated with rural residence and postoperative vasopressor use and drain insertion site infection was associated with postoperative vasopressor use and packed red blood cell transfusions.
Conclusions: The most frequent postoperative complication was hypokalemia. A relationship was demonstrated between male gender, living in a rural area, use of vasopressors during the postoperative period, blood transfusions, and radiotherapy before surgery, as risk factors for the development of postoperative complications in patients with colorectal neoplasia.
Objetivo: Identificar os fatores associados à presença de complicações em pacientes pós-cirúrgicos com neoplasia colorretal.
Métodos:Estudo transversal e analítico, que incluiu 102 pacientes oncológicos em pós-operatório de neoplasia colorretal internados em uma unidade de terapia
intensiva/intermediária entre 2020 e 2022.
Resultados: 45,1% dos pacientes eram do sexo masculino e 54,9% do sexo feminino; 71,6% residiam em áreas urbanas. A faixa etária mais representada foi de 67 a 75 anos (33,3%). Foi encontrada uma associação estatisticamente significativa entre hipocalemia e transfusões de concentrado de hemácias. O íleo paralítico pós-operatório foi associado ao sexo masculino e à radioterapia prévia. A fístula anastomótica foi associada ao uso de vasopressores no pós-operatório e à transfusão de concentrado de hemácias. A infecção do sítio cirúrgico foi associada à residência em área rural e ao uso de vasopressores no pós-operatório, e a infecção do local de inserção do dreno foi associada ao uso de vasopressores no pós-operatório e às transfusões de
concentrado de hemácias.
Conclusões: A complicação pós-operatória mais frequente foi a hipocalemia. Demonstrou-se uma relação entre sexo masculino, residência em área rural, uso de vasopressores no período pós-operatório, transfusões sanguíneas e radioterapia prévia à cirurgia como fatores de risco para o desenvolvimento de complicações pós-operatórias em pacientes com neoplasia colorretal.
References
(1) República de Colombia. Ministerio de Salud y Protección. Cáncer. https://www.minsalud.gov.co/salud/publica/PENT/Paginas/Prevenciondelcancer.aspx
(2) World Health Organization. Internactional Agency for Research on Cancer. Cancer Today. https://gco.iarc.fr/today/online-analysispie?
v=2020&mode=population&mode_population=continents&population=900&populations=900&key=total&sex=0&cancer=39&type=1&statistic=5&prevalence=0&population_group=0&ages_group%5B%5D=0&ages_group%5B%5D=17&nb_items=7&group_cancer=1&include_nmsc=0&include_nmsc_other=1&half_pie=0&donut=0
(3) República de Colombia. Congreso de la República. Ley 1384 de 2010. Por la cual se establecen las acciones para la atención integral del Cáncer en Colombia. Resolución 4496. 19 de abril de 2012. https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=39368
(4) Kryzauskas M; Bausys A; Kuliavas J; Bickaite K; Dulskas A; Poskus E et al. Short and long-term outcomes of elderly patients undergoing
left-sided colorectal resection with primary anastomosis for cancer. BMC Geriatr. 2021;21:682. https://doi.org/10.1186/s12877-021-02648-2
(5) República de Colombia. Ministerio de Salud y Protección Social. Cuenta de alto costo. Fondo colombiano de enfermedades de alto costo.
https://cuentadealtocosto.org/enfermedades-de-alto-costo/cancer/
(6) Wang S; Tang J; Sun W; Yao H; Li Z. The natural orifice specimen extraction surgery compared with conventional laparoscopy for colorectal cancer: A meta-analysis of efficacy and long-term oncological outcomes. Int J Surg. 2022;97:106196. https://doi.org/10.1016/j.ijsu.2021.106196
(7) Merboth F; Garcia S; Renesse J; Distler M; Welsch T; Weitz J; Stange DE. Comparative analysis of postoperative complications after cytoreductive surgery and HIPEC in gastric cancer. Oncol Res Treat. 2022; 45(1-2):45-53. https://doi.org/doi:10.1159/000520330
(8) Paredes Terrones X; Pérez Agüero C; Runzer Colmenares FM; Parodi JF. Factores asociados a complicaciones quirúrgicas en pacientes adultos
mayores con neoplasias gastrointestinales del Centro Médico Naval. Horiz Med. 2020;20(1):45-53. https://dialnet.unirioja.es/servlet/articulo?codigo=7321258
(9) Oodit R; Constant DA; Maree F; Lorrimer I; Dalwai EK; Moodley J. Colorectal surgical outcomes following implementation of an enhanced recovery after surgery programme in Cape Town. S. Afr. j. surg. 2021;59(4):157-163. https://doi.org/10.17159/2078-5151/2021/v59n4a3512
(10) Laporte M; Matzner Perfumo M; Piatti J; Mattioni L; Canelas A; Bun M et al. Manejo laparoscópico de la dehiscencia anastomótica en cirugía colorrectal. Rev. Argent. Coloproctol. 2020;31(04):138-144. https://doi.org/10.46768/racp.v31i04.40
(11) Romo JA; Aguilera PA; López A; Pedraza M; Figueroa C. Experiencia en cirugía colorrectal en un hospital de cuarto nivel de complejidad en Bogotá, Colombia. Rev. Gastroenterol. Mex. 2023;88(3). 214-219. https://doi.org/10.1016/j.rgmx.2021.08.004
(12) Molina Meneses SP; Palacios Fuenmayor LJ; Castaño LLano RJ; Mejía Gallego JI; Sánchez Patiño LA. Determinación de los factores predictivos para complicaciones en cirugía electiva de pacientes con cáncer colorrectal. Experiencia del Instituto de Cancerología Las Américas Auna (Colombia, 2016-2019). Rev Colomb Cir. 2021; 36(4):637-646. https://doi.org/10.30944/20117582.863
(13) Lawler M; Johnston B; Van Schaeybroeck S; Salto-Tellez M; Wilson R; Dunlop M et al. Cáncer colorrectal. En: Abeloff. Oncología clínica. 6.a ed. España: Elsevier. 2020. https://tienda.elsevier.es/abeloff-oncologia-clinica-9788491135203.html
(14) Andrada M; Bollati NP; Signorini FJ; Maldonado PS; Moser F; Obeide LR et al. Seguridad y reproducibilidad de la cirugía colorrectal laparoscópica en dos centros académicos de tercer nivel en Sudamérica. Cir. Cir. 2021;89(2):141-149. https://doi.org/10.24875/CIRU.19001463
(15) Fuentes Díaz Z; Rodríguez Salazar O; Tarancón Serrano IA; Capote Guerrero G; Puerto Pérez T. Modelo de gestión de riesgo del programa de recuperación precoz de la cirugía colorectal electiva. Rev cuba anestesiol reanim. 2022:21(2):e837. http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1726-67182022000200012&lng=es
(16) Hara T; Kogure E; Iijima S; Fukawa Y; Kubo A; Kakuda W. Minimal clinically important difference in postoperative recovery among patients with gastrointestinal cancer. Support Care Cancer. 2022;30:2197-2205. https://doi.org/10.1007/s00520-021-06632-9
(17) Tuominen L; Leino-Kilpi H; Meretoja R. Expectations of patients with colorectal cancer towards nursing care– a thematic analysis. Eur J
Oncol Nurs. 2020;44:101699. https://doi.org/10.1016/j.ejon.2019.101699
(18) Briñez Ariza KJ. Revisión: integración teoría y práctica de enfermería en el cuidado de pacientes oncológicos. Cult. cuid. enferm. 2020;17(1):120-134. https://pesquisa.bvsalud.org/enfermeria/resource/pt/biblio-1247914
(19) República de Colombia. Ministerio de Salud y Protección Social. Resolución 8430 de 1993. 4 de octubre de 1993. https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/DE/DIJ/RESOLUCION-8430-DE-1993.PDF
(20) Marcano-Salazar LM. Bioética: del Código de Núremberg a la jurisprudencia. Kairos. 2024;7(12):9-23. https://doi.org/10.37135/kai.03.12.01
(21) Flynn DE; Mao D; Yerkovich ST; Franz R; Iswariah H; Hughes A et al. The impact of comorbidities on post-operative complications following colorectal cancer surgery. PloS One. 2020;15(12):e0243995. https://doi.org/10.1371/journal.pone.0243995
(22) McSorley ST; Tham A; Dolan RD; Steele CW; Ramsingh J; Roxburgh C et al. Perioperative blood transfusion is associated with postoperative
systemic inflammatory response and poorer outcomes following surgery for colorectal cancer. Ann Surg Oncol. 2020;27:833-843.
https://doi.org/10.1245/s10434-019-07984-7
(23) Van der Hulst HC; Van der Bol JM; Bastiaannet E; Portielje JEA; Dekker JWT. Surgical and non-surgical complications after colorectal cancer surgery in older patients; time-trends and age-specific differences. Eur J Surg Oncol. 2023;49(4):724-729. https://doi.org/10.1016/j.ejso.2022.11.095
(24) Zhang B; Liu XY; Kang B; Yuan C; Li ZW; Wei ZQ et al. Preoperative hypokalemia can increase complications after colorectal cancer surgery: A propensity score matching analysis. BMC Cancer. 2022;(22):846. https://doi.org/10.1186/s12885-022-09950-1
(25) Abdelrahman TM; Alharthi AK; Alamri SS; Alnefaie AM; Omar BA; Alzahrani MA. Predictive factors of postoperative paralytic ileus following abdominal surgery: A clinical study. World Fam. Med. J. 2022;20(11):15-22. https://doi.org/10.5742/MEWFM.2022.95251361
(26) Namba Y; Hirata Y; Mukai S; Okimoto S; Fujisaki S; Takahashi M et al. Clinical indicators for the incidence of postoperative ileus after elective surgery for colorectal cancer. BMC Surg. 2021;21:80. https://doi.org/10.1186/s12893-021-01093-7
(27) Cheong CM; Golder AM; Horgan PG; McMillan DC; Roxburgh CSD. Evaluation of clinical prognostic variables on short-term outcome for
colorectal cancer surgery: An overview and minimum dataset. Cancer Treat Res Commun. 2022;31:100544. https://doi.org/10.1016/j.ctarc.2022.100544
(28) Lin V; Tsouchnika A; Allakhverdiiev E; Rosen AW; Gögenur M; Clausen JSR et al. Training prediction models for individual risk assessment of
postoperative complications after surgery for colorectal cancer. Tech Coloproctol. 2022;26:665-675. https://doi.org/10.1007/s10151-022-02624-x
(29) Tsalikidis C; Mitsala A; Mentonis VI; Romanidis K; Pappas-Gogos G; Tsaroucha AK et al. Predictive factors for anastomotic leakage following colorectal cancer surgery: Where are we and where are we going? Curr Oncol. 2023;30(3):3111-3137. https://doi.org/10.3390/curroncol30030236
(30) Pallan A; Dedelaite M; Mirajkar N; Newman PA; Plowright J; Ashraf S. Postoperative complications of colorectal cancer. Clin Radiol. 2021;76(12):896-907. https://doi.org/10.1016/j.crad.2021.06.002
(31) Jensen KK; Oma E; Van Ramshorst GH; Nordholm-Carstensen A; Krarup PM. Abdominal wound dehiscence is dangerous: A nationwide study of 14,169 patients undergoing elective open resection for colonic cancer. Hernia. 2022;26:75-86. https://doi.org/10.1007/s10029-020-02350-z
(32) Durrani KK; Ilyas S; Shah U; Naveed; Rehman AU. Association of pre-operative risk factors with abdominal wound dehiscence. Pak Armed Forces Med J. 2025;75(2):353-358. https://doi.org/10.51253/pafmj.v75i211399
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