Estado postiroidectomía en los pacientes del Hospital San José en el periodo 2015-2016

19 p.Introducción: Existen síntomas postoperatorios de la tiroidectomía que no se tienen en cuenta y se han agrupado bajo el concepto de estado postiroidectomía, descritos como alteración en la voz, trastorno de la deglución, cambio en el estado de ánimo, siendo un motivo frecuente de consulta, con impacto en la calidad de vida de los pacientes. Objetivo: Describir el estado postiroidectomía de los pacientes que son llevados a tiroidectomía en el Hospital San José en el periodo 2015-2016. Métodos: Estudio descriptivo de cohorte longitudinal. Resultados:Se analizaron 154 pacientes con indicación de tiroidectomía total o subtotal. 137 (88,9%) eran mujeres. 77 (50%) de los pacientes referían presencia de los síntomas previo al procedimiento. Dentro de los síntomas valorados se encontró mejoría en cambio de estado de ánimo y estilo de vida. Tanto en el contexto de patología benigna o maligna se logró una adecuada supresión hormonal luego del tercer control postoperatorio requiriendo dosis promedio de 100mcg de hormona. Conclusiones: Se encontraron variaciones importantes en el estado de ánimo y estilo de vida de los síntomas valorados, se determinó que el cambio en la calidad de vida de los pacientes no se presentaba secundario a alteraciones en niveles de calcio, Tsh y dosis de levotiroxina. Se logró un control metabólico tanto en los pacientes con patología benigna como maligna. Sin embargo la subjetividad del instrumento no permite valorar adecuadamente el impacto quirúrgico en nuestros pacientes, por lo que es necesario implementar tablas de calidad de vida con mayor nivel de objetividad

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2