PURPOSE: to analyze complications, morbidity, mortality and survival rate in a group of patients with cervical cancer with central pelvic relapse after primary radiotherapy treatment. METHODS: retrospective study of a series of 16 cases of pelvic exenteration after primary radiotherapy treatment. Descriptive statistics, survival curve through Kaplan-Meier's method, and regression analysis to evaluate prognosis were performed. RESULTS: sixteen patients have undergone pelvic exenteration. Epidermoid carcinoma, IIb stage and undifferentiated grade were the most frequent conditions. Post-operatory tumor relapse occurred in half the cases. Eleven patients presented peri or post-surgical complications, the most frequent being pelvic infection, that of the surgical wound, and urinary fistulae. Global survival rate was 64.3%, with average follow-up of 11 months. Regression analysis did not detect any significant prognosis factor for the patient survival. CONCLUSIONS: the survival rate was 64.3%. No particular factor associated to poor prognosis has been found in the present series of cases.
RESUMO: Racional-A reconstrução do trânsito intestinal não está isenta de riscos cirúrgicos e apresenta taxas consideráveis de complicações pós-operatórias, sendo que a infecção continua a ser um dos maiores desafios
INTRODUÇÃOOstomia tem origem na palavra grega stoma, significando abertura de origem cirúrgica, quando há necessidade de desviar, temporária ou permanentemente, o trânsito normal da alimentação e/ou eliminações. Considerando-se os tipos de ostomia, a colostomia é a mais freqüente. Caracteriza-se pela exteriorização do cólon através da parede abdominal, com o objetivo de eliminação fecal. Já a abertura artificial entre o íleo, no intestino delgado, e a parede abdominal, denomina-se ileostomias. 1 Desde a primeira descrição da realização de colostomia pelo francês Littré 1 , a utilização de estomas e suas indicações foram modificadas conforme a evolução da medicina. Sua utilização como auxílio terapêutico das afecções colorretais é bem definido, porém a carga de morbimortalidade associada à reconstrução do trânsito intestinal é ainda motivo de preocupações. 2
DESCRITORESABSTRACT -Background -The reconstruction of the intestinal tract is not surgical complications risk-free and is associated to postoperative complications high rates; furthermore, infection remains the hardest challenge in this procedure. Aim -Epidemiological profile and mortality and morbidity in patients undergoing reconstruction of intestinal transit. Methods -Retrospectively, 86 patients with intestinal stomas were analyzed through factors that impact on the morbimortality afterwards intestinal transit reconstruction, since January 2003 to April 2009. Results -Loop colostomy (n=34) and abdominal trauma implicating 38.2% of indications to colostomy or ileostomy, were the most frequent conditions. The mean interval between stoma confection and intestinal transit reconstruction was 15.7 months. The morbidity frequency was 56.8% and incisional infection was its commonest complication (27.47%). The mean inpatient length of stay was 7.6 days. There was positive linear regression between post-operative inpatient length of stay and inpatient's age. Inpatient length of stay prolongation is associated to occurrence of complications (p<0,001). Conclusion -It can be inferred that the occurrence of postoperative complications and age were associated with prolonged hospital stay.
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