Procedimiento de Hartmann vs resección y anastomosis primaria en peritonitis diverticular de colon izquierdo por cirugía abierta: Revisión sistemática de la literatura

Abstract

Hartmann's procedure and resection with primary anastomosis in diverticular peritonitis Introduction: Colonic diverticulosis, as diverticulitis, is a frequent disease in different stages of evolution. There is uncertainty about treatment options that are used in secondary peritonitis. The aim of this study is to determine the best treatment option for patients with peritonitis secondary to diverticulitis of the left colon in terms of postoperative morbidity (POM) and mortality, comparing Hartmann's procedure (HP) and resection with primary anastomosis (RPA). Material and Methods: Systematic review. Studies in adults with peritonitis secondary to diverticulitis of the left colon treated with HP and RPA published between 1990 and 2011 were analyzed. TRIPDATABSE, IWO, MEDLINE, SciELO and LILACS databases were consulted and search strategies were applied using MeSH and free terms. Selected studies were analyzed using a score of methodological quality (MQ). The following variables were considered: mortality, POM, hospital stay, percentage of bowel transit reconstitution in patients undergoing HP and MQ of primary studies. Results: 26 primary studies were analyzed (47 series). There were no significant differences in the variable mortality (p = 0.0805), but significant difference was observed in POM (incompletely reported) (p = 0.0187). The median of MQ of the studies was 11 points for HP series and 10 for RPA series. Conclusion: The available evidence to determine the best treatment option in terms of mortality and POM in this kind of patients is insufficient. Studies with better level evidence and MQ are needed to clarify the uncertain.

Instructions for the Use of MInCir Scale to Assess Methodological Quality in Therapy Studies

“…After the publication of the first version of the instructions for use of the MInCir scale to assess MQ of therapy studies , and its use in many bibliometric studies and SR (Manterola et al, 2003(Manterola et al, , 2005a(Manterola et al, , 2005b(Manterola et al, , 2006(Manterola et al, , 2009Claros et al;Arias et al;Moraga et al, 2013Moraga et al, , 2014Aravena et al;Santander et al;Cartes-Velasquez et al), the need to update its instructions became obvious. The main reason for this update is to adjust to the real situations in which the MQ of therapy studies are evaluated, in order to facilitate the allocation of scores for each of the items and domains.…”

“…Similarly, this scale has been used for conducting systematic reviews (SR) with an alternative methodology (Arias et al, 2012;Claros et al, 2007;Manterola et al, 2005aManterola et al, , 2005bManterola et al, , 2007Moraga et al, 2014;Santander et al, 2013), allowing for the use of primary studies with different designs and evidence levels, thus overcoming the limitation of traditional methodology that only uses clinical trials (CT) as primary sources .…”

Vigencia de la operación de Hartmann en el tratamiento de la diverticulosis colónica complicada: estudio realizado en pacientes tratados durante el periodo 2009-2018, en Hospital de Clínicas de Montevideo

“…Los casos de abordaje laparoscópico con lavado y drenaje, no presentaron mortalidad y la morbilidad fue inferior, de un 20 %, pero se trató de pacientes en general seleccionados, con menor riesgo previo y cuadros menos evolucionados. De todos modos, la mortalidad global de la serie es aceptable en comparación con series similares publicadas, al igual que sucede con la morbilidad [23][24][25][26][27] . A su vez, la mayoría de las complicaciones fueron leves, vinculadas al sitio quirúrgico.…”

Efecto Terapéutico de los Exosomas en el ACV Isquémico en Animales de Experimentación

“…Diseño: Revisión bibliográfica, búsqueda sistemática de la literatura (Arias et al, 2012;Manterola et al, 2013;Santander et al, 2013) Pregunta de búsqueda: ¿Cuál es la función de los exosomas en ratas con enfermedad cerebral isquémica en términos de protección, antiinflamación y regeneración? ((((((((((((rat) Criterios de inclusión: Articulos de investigacíon de exsomas y sus funciones de protección, antiinflamación y regeneracion.…”