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Reparación de la hernia paraestomal. Estudio observacional prospectivo basado en el Registro Español de Hernia Incisional (EVEREG)
Parestomal hernia repair. Prospective observational study based on the Spanish Registry of Incisional Hernia (EVEREG)
Manuel López-Canoa,
Autor para correspondencia
mlpezcano@gmail.com

Autor para correspondencia.
, José Antonio Pereirab, Victor Rodrigues-Gonçalvesa, Mireia Verdaguer-Tremolosaa, Pilar Hernández-Granadosc, Alejandro Bravo-Salváb, miembros del registro EVEREG
a Unidad de Cirugía de la Pared Abdominal, Servicio de Cirugía General, Hospital Universitario Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, España
b Servicio de Cirugía General, Hospital Universitari del Mar, Departament de Cièncias Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, España
c Servicio de Cirugía General, Hospital Universitario Fundación Alcorcón, Madrid, España
Miembros del grupo EVEREG
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La hernia paraestomal &#40;HP&#41; es una patolog&#237;a muy frecuente&#44; pudiendo observarse en el 78-93&#37; cuando se realizan controles radiol&#243;gicos<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; En mayor o menor grado e independientemente del tipo de ostom&#237;a&#44; la HP alterar&#225; la calidad de vida del paciente pudi&#233;ndose plantear la reparaci&#243;n quir&#250;rgica electiva como una opci&#243;n de tratamiento<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a>&#46; Sin embargo&#44; esta reparaci&#243;n engloba un grupo heterog&#233;neo de abordajes &#40;abiertos y&#47;o m&#237;nimamente invasivos&#41;&#44; gravados con altas tasas de recidiva y donde las revisiones sistem&#225;ticas del tema solo pueden inferir que &#171;&#8230; no es posible sacar conclusiones acerca de cu&#225;l es la t&#233;cnica preferida&#8230;&#187;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">4</span></a> ya que &#171;&#8230; la calidad de la evidencia para las diversas t&#233;cnicas quir&#250;rgicas es baja y no permite conclusiones firmes&#187;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">4</span></a>&#46; Por otro lado&#44; la HP puede presentar complicaciones &#40;i&#46;e&#46;&#44; obstrucci&#243;n intestinal&#44; estrangulaci&#243;n&#41; y necesitar un tratamiento urgente&#46; Aqu&#237; tambi&#233;n&#44; la informaci&#243;n presente en la literatura ofrece datos muy limitados<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">5&#44;6</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Los estudios observacionales basados en registros de alguna actividad quir&#250;rgica proporcionan informaci&#243;n de la pr&#225;ctica habitual en pacientes no seleccionados&#44; pueden dar respuesta a preguntas que son m&#225;s dif&#237;ciles de contestar con otros dise&#241;os de estudio &#40;i&#46;e&#46;&#44; estudios aleatorizados&#41;&#44; proporcionan datos sobre la eficacia de intervenciones en la poblaci&#243;n general y pueden ofrecer una plataforma para la evaluaci&#243;n&#44; &#171;control&#187; y uso a largo plazo de &#171;instrumentos&#187; quir&#250;rgicos y&#47;o el an&#225;lisis de la innovaci&#243;n quir&#250;rgica<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">7&#8211;9</span></a>&#46; En el contexto previo disponemos en nuestro pa&#237;s de un registro para la hernia incisional &#40;EVEREG&#41;&#44; iniciado en Catalu&#241;a en el a&#241;o 2012 y promovido desde el a&#241;o 2013 por la Asociaci&#243;n Espa&#241;ola de Cirujanos &#40;AEC&#41; a trav&#233;s de la Secci&#243;n de Pared Abdominal<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">10</span></a>&#46; EVEREG forma parte de los escasos registros de estas caracter&#237;sticas presentes en Europa y en el mundo<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">11</span></a> y en &#233;l se anotan y se siguen tambi&#233;n las cirug&#237;as de la HP&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El objetivo del presente trabajo es analizar los datos recogidos en EVEREG desde su inicio en julio de 2012 hasta junio de 2018 para describir a los pacientes que siguen cirug&#237;a de la HP y analizar las pr&#225;cticas actuales y resultados en la reparaci&#243;n de la misma entre los cirujanos que participan en el registro EVEREG&#44; tanto en cirug&#237;a electiva como urgente&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">M&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">La base de datos EVEREG fue dise&#241;ada a partir de una plataforma de introducci&#243;n informatizada de datos denominada OpenClinica&#44; accesible a trav&#233;s de Internet &#40;<a href="http://www.evereg.es/">http&#58;&#47;&#47;www&#46;evereg&#46;es&#47;</a>&#41;&#46; En ella es posible registrar de forma an&#243;nima todos los casos de HP intervenidos en los centros participantes &#40;178 centros&#41;&#46; La base est&#225; abierta de forma permanente a todos los centros que quieran participar&#46; La pr&#225;ctica del an&#225;lisis de los datos del registro&#44; la aprobaci&#243;n por comit&#233;s y la sistem&#225;tica de recogida de datos ya han sido descritas previamente<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">10</span></a>&#46; Brevemente&#44; se trata de una base de datos <span class="elsevierStyleItalic">online</span>&#44; prospectiva y mantenida por los cirujanos responsables de cada centro&#44; en la que se recogen los par&#225;metros de los pacientes&#44; el tipo de hernia&#44; las operaciones&#44; las complicaciones&#44; y el seguimiento mediante control cl&#237;nico y llamada telef&#243;nica al mes&#44; 6 meses&#44; a&#241;o y 2 a&#241;os&#44; de cada una de las HP operadas&#46; El registro es de hernias y no de pacientes&#44; por lo que los pacientes afectos de m&#225;s de una hernia&#44; o aquellos intervenidos varias veces por recurrencias&#44; pueden estar registrados de forma repetida&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Las variables independientes analizadas en este estudio incluyeron las caracter&#237;sticas demogr&#225;ficas del paciente &#91;edad&#44; sexo&#44; &#237;ndice de masa corporal &#40;IMC&#41;&#44; diabetes mellitus &#40;DM&#41;&#44; enfermedad pulmonar obstructiva cr&#243;nica &#40;EPOC&#41;&#44; tabaquismo&#93;&#44; antecedentes de c&#225;ncer&#44; el tipo de HP &#40;colost&#243;mica&#44; ileost&#243;mica o ureteroileost&#243;mica &#91;Bricker&#93;&#41;&#44; la presencia de un ASA &#40;American Society of Anesthesiologists&#41; mayor de III y la capacidad de reducci&#243;n de la HP &#40;reductible e incarceraci&#243;n cr&#243;nica&#41;&#46; Las variables de resultado que se describen en este trabajo fueron&#58; si hab&#237;a una malla previa o no&#44; si se hizo una reparaci&#243;n con malla y si esta fue colocada en posici&#243;n prefascial <span class="elsevierStyleItalic">&#40;onlay&#41;</span>&#44; retromuscular <span class="elsevierStyleItalic">&#40;sublay&#41;</span> o intraabdominal&#44; si se cerr&#243; el defecto herniario&#44; cu&#225;l fue el tipo de abordaje quir&#250;rgico &#40;abierto o laparosc&#243;pico&#41;&#44; la presencia de complicaciones globales&#44; complicaciones del sitio quir&#250;rgico &#40;SSO&#41;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">12</span></a>&#44; infecciones del sitio quir&#250;rgico &#40;SSI&#41;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">12</span></a>&#44; complicaciones no relacionadas con el sitio quir&#250;rgico &#40;i&#46;e&#46;&#44; respiratorias&#44; cardiacas&#44; otras&#41; y las complicaciones postoperatorias de acuerdo con la clasificaci&#243;n de Clavien-Dindo<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">13</span></a>&#46; Finalmente&#44; se describe si la cirug&#237;a fue electiva o urgente&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Se analizaron los potenciales factores asociados a las complicaciones y la recurrencia del grupo completo&#46; Sin embargo&#44; y dado que la mayor&#237;a de HP correspond&#237;an al grupo de colostom&#237;a&#44; solo se utiliz&#243; este grupo para el an&#225;lisis de la SSO&#44; la SSI&#44; las complicaciones no relacionadas con el sitio quir&#250;rgico y la recurrencia&#46; El escaso n&#250;mero de pacientes incluidos para la ileostom&#237;a y ureteroileostom&#237;a &#40;Bricker&#41; no permiti&#243; un an&#225;lisis estad&#237;stico de estos grupos m&#225;s all&#225; del descriptivo&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">An&#225;lisis estad&#237;stico</span><p id="par0035" class="elsevierStylePara elsevierViewall">Las variables cuantitativas se expresan como media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>desviaci&#243;n est&#225;ndar &#40;DE&#41; y las cualitativas como proporciones con su intervalo de confianza&#46; Para analizar la asociaci&#243;n entre variables cualitativas se us&#243; el test de la Chi-cuadrado &#40;&#967;<span class="elsevierStyleSup">2</span>&#41; o el test de Fisher cuando fue necesario&#44; as&#237; como la t de Student o el test de Mann-Whitney para las variables cuantitativas&#46; La normalidad de la distribuci&#243;n de las variables cuantitativas se verific&#243; mediante la prueba de Kolmogorov-Smirnov&#46; Se estableci&#243; la significaci&#243;n estad&#237;stica en p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; La descripci&#243;n de las variables y el an&#225;lisis estad&#237;stico se realiz&#243; utilizando el programa SPSS&#174; &#40;IBM&#44; Armonk&#44; New York&#44; EE&#46;UU&#46;&#41; versi&#243;n 21&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="par0040" class="elsevierStylePara elsevierViewall">Entre julio de 2012 y junio 2018 se introdujeron en el registro 8&#46;675 intervenciones de hernia incisional de las cuales 353 &#40;4&#37;&#41; fueron HP&#46; De estas&#44; 259 &#40;73&#37;&#41; fueron HP en el contexto de una colostom&#237;a terminal&#44; 74 &#40;21&#37;&#41; en el contexto de una ileostom&#237;a terminal y 20 &#40;6&#37;&#41; en el contexto de ureteroileostom&#237;a &#40;Bricker&#41;&#46; La edad media global fue de 68&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;1 a&#241;os&#44; y en 135 &#40;38&#37;&#41; de 353 pacientes el sexo fue femenino&#46; Las caracter&#237;sticas demogr&#225;ficas generales y desglosadas por los diferentes tipos de HP se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; En la reparaci&#243;n de la HP con referencia al grupo global&#44; 55 &#40;16&#37;&#41; de 353 pacientes ten&#237;an una malla previa&#46; El abordaje abierto y la cirug&#237;a electiva fueron predominantes con 275 &#40;78&#37;&#41; y 325 &#40;92&#37;&#41; de 353 pacientes&#44; respectivamente&#44; haci&#233;ndose mayoritariamente &#40;326 &#91;99&#37;&#93; de 353 pacientes&#41; una reparaci&#243;n con una malla sint&#233;tica no absorbible y en una posici&#243;n intraperitoneal en 158 &#40;44&#44;8&#37;&#41; pacientes&#46; El n&#250;mero de complicaciones intraoperatorias fue bajo&#44; apareciendo en 13 &#40;4&#37;&#41; pacientes del grupo total&#46; Las caracter&#237;sticas de la intervenci&#243;n quir&#250;rgica del grupo total y desglosado en funci&#243;n del tipo de HP se presentan en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46; Las complicaciones postoperatorias ocurrieron en 108 &#40;30&#44;6&#37;&#41; pacientes del grupo total&#59; estas complicaciones seg&#250;n la clasificaci&#243;n Clavien-Dindo&#44; junto a la divisi&#243;n en SSO&#44; SSI y las no relacionadas con el sitio quir&#250;rgico&#44; se expresan en la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">El seguimiento no fue posible para toda la serie completa&#44; haci&#233;ndose en 149 &#40;42&#44;2&#37;&#41; de 353 pacientes durante un per&#237;odo m&#237;nimo de 6 meses&#46; Las razones para excluir los registros restantes fueron la ausencia de datos de seguimiento&#46; Para el grupo de colostom&#237;a&#44; y por la misma raz&#243;n&#44; tampoco fue completo&#44; llev&#225;ndose a cabo en 108 &#40;42&#37;&#41; de 259 pacientes&#46; El seguimiento medio fue de 9&#44;4 meses &#40;DE 39&#44;4&#41;&#44; IC95&#37; &#40;5&#44;3-13&#44;5&#41; para el grupo total y 9&#44;2 meses &#40;DE 32&#44;6&#41;&#44; IC95&#37; &#40;5&#44;2-13&#44;1&#41; para el grupo de colostom&#237;a&#46; Durante este per&#237;odo de seguimiento se registraron un total de 41 &#40;27&#44;5&#37;&#41; de 149 pacientes con recidiva de la HP&#44; de los cuales 34 &#40;31&#44;5&#37;&#41; de 108 pacientes pertenec&#237;an al grupo de colostom&#237;a&#46; La mortalidad durante el per&#237;odo de seguimiento fue de 9 &#40;6&#37;&#41; de 149 pacientes&#59; todos los fallecimientos fueron ajenos a la intervenci&#243;n por HP&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">El an&#225;lisis de los factores asociados con las complicaciones globales de la serie completa mostr&#243; que las variables demogr&#225;ficas de sexo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;045&#41;&#44; EPOC &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41; y ASA mayor de III &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;000&#41; se asociaron significativamente a una mayor incidencia de complicaciones&#46; Adem&#225;s&#44; en esta misma serie completa el abordaje quir&#250;rgico abierto y la malla en una posici&#243;n <span class="elsevierStyleItalic">sublay</span> se asociaron a m&#225;s complicaciones&#44; con una p significativa de 0&#44;038 y 0&#44;040&#44; respectivamente &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">El an&#225;lisis del grupo espec&#237;fico de colostom&#237;a mostr&#243; que las complicaciones no relacionadas con el sitio quir&#250;rgico eran m&#225;s frecuentes en los pacientes de m&#225;s de 70 a&#241;os &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;015&#41; y en los pacientes con un ASA mayor de III &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;008&#41;&#46; En este mismo grupo de colostom&#237;a las SSO aparecieron con mayor frecuencia en el sexo femenino &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;037&#41;&#44; en pacientes con EPOC &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;025&#41; y con un ASA mayor de III &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;019&#41;&#46; No se encontr&#243; ninguna variable que significativamente se asociase con una mayor incidencia de SSI&#46; Sin embargo&#44; la recidiva en los pacientes con colostom&#237;a fue significativamente mayor en los pacientes con antecedente de cirug&#237;a por c&#225;ncer &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;009&#41; y en aquellos que presentaban una HP con incarceraci&#243;n cr&#243;nica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;023&#41;&#46; El an&#225;lisis de los factores asociados a la SSO&#44; SSI y recurrencia en el grupo de colostom&#237;a se presentan en la <a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discusi&#243;n</span><p id="par0060" class="elsevierStylePara elsevierViewall">La disponibilidad de un registro como EVEREG nos ha permitido el estudio observacional prospectivo de 353 HP reparadas&#46; Hasta la fecha solo algunos estudios provenientes de los escasos registros mundiales como el Americas Hernia Society Quality Collaborative &#40;AHSQG&#41;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a> o el registro dan&#233;s de hernia<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a> ofrecen n&#250;meros similares al nuestro&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">La HP es una hernia incisional relacionada con la presencia de un estoma en la pared abdominal<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">16</span></a>&#44; sin embargo&#44; en nuestro registro solo constituye un 4&#37; de las hernias incisionales reparadas&#46; Esto podr&#237;a estar en consonancia con la creencia de que los cirujanos en general son reacios a la reparaci&#243;n de una HP debido a los resultados poco satisfactorios de dicha cirug&#237;a en lo que se refiere a morbilidad y recurrencia<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">14&#44;15</span></a>&#46; La edad media de los pacientes sometidos a reparaci&#243;n de una HP en nuestro registro fue de 68 a&#241;os&#44; lo cual se superpone con los resultados de otros registros que la sit&#250;an en los 66<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">14&#44;15</span></a>&#46; La distribuci&#243;n por sexo es variable en los registros mencionados&#59; en el nuestro se observ&#243; un predominio masculino&#46; No es sorprendente que la reparaci&#243;n de una HP secundaria a una colostom&#237;a sea la m&#225;s frecuentemente registrada &#40;73&#37;&#41;&#44; ya que este tipo de HP tambi&#233;n se describe como la m&#225;s frecuente<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">17</span></a>&#46; El abordaje quir&#250;rgico &#40;i&#46;e&#46;&#44; abierto vs&#46; laparosc&#243;pico&#41; de la HP es un tema controvertido&#59; alguna revisi&#243;n sistem&#225;tica no &#171;aclara&#187; cu&#225;l debe ser el abordaje de elecci&#243;n dado el bajo nivel de la evidencia presente en la literatura<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">4</span></a>&#46; Sin embargo&#44; otras revisiones indican que el abordaje laparosc&#243;pico &#40;i&#46;e&#46;&#44; Sugarbaker modificado&#41; puede proporcionar los mejores resultados<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">18</span></a>&#46; Nuestro estudio muestra que el abordaje quir&#250;rgico mayoritario fue el abierto con el 78&#37; del total&#44; y para explicarlo es tentador recurrir al argumento cierto de que en nuestro pa&#237;s la cirug&#237;a laparosc&#243;pica de la pared abdominal &#40;i&#46;e&#46;&#44; hernia incisional&#41; est&#225; por debajo de los est&#225;ndares internacionales<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">19</span></a>&#46; No obstante&#44; es interesante observar como registros de otros pa&#237;ses que en teor&#237;a se esperar&#237;a tuvieran porcentajes altos de cirug&#237;a laparosc&#243;pica de la HP comunican cifras de hasta el 80&#37; de cirug&#237;a abierta<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a>&#46; El 92&#37; de los pacientes de nuestro registro fueron operados de forma electiva y mayoritariamente con una malla sint&#233;tica no absorbible&#44; en la misma l&#237;nea que otros registros<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a> y de acuerdo con las recomendaciones respecto a la utilizaci&#243;n de malla de las recientes gu&#237;as de la European Hernia Society &#40;EHS&#41; sobre la prevenci&#243;n y tratamiento de la HP<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a>&#46; Adem&#225;s&#44; es interesante observar que las complicaciones intraoperatorias fueron bajas &#40;4&#37;&#41; pero las complicaciones postoperatorias de la cirug&#237;a de la HP &#40;globalmente y para el grupo de colostom&#237;a&#41; presentan porcentajes altos&#46; En nuestra opini&#243;n&#44; los datos de otros registros sobre este particular son discordantes&#59; de esta manera&#44; algunos describen entre el 9 y el 15&#37;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a> de complicaciones y otros concluyen que es una cirug&#237;a de elevada morbilidad<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a>&#46; Nuestros datos est&#225;n en l&#237;nea con los de otros registros europeos<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a> y s&#237; podemos afirmar que la cirug&#237;a de la HP considerada en todo su conjunto&#44; y espec&#237;ficamente para la hernia asociada a una colostom&#237;a&#44; es una cirug&#237;a con altas tasas de morbilidad postoperatoria&#46; El sexo masculino&#44; la EPOC y los pacientes con clase III o mayor de la clasificaci&#243;n ASA demostraron incrementar de manera significativa las complicaciones globales y espec&#237;ficamente para la colostom&#237;a&#46; Otras variables tambi&#233;n incrementaron las complicaciones globales significativamente&#44; algunas quiz&#225;s de forma l&#243;gica como la cirug&#237;a urgente y otras como el abordaje abierto quiz&#225;s por la mayor exposici&#243;n y manipulaci&#243;n del estoma&#46; Adem&#225;s&#44; es interesante observar como la t&#233;cnica <span class="elsevierStyleItalic">sublay</span> de colocaci&#243;n de la malla tambi&#233;n increment&#243; significativamente las complicaciones&#46; En cualquier caso y como se menciona m&#225;s arriba&#44; en nuestro contexto esta cirug&#237;a se asocia con un porcentaje alto de complicaciones&#44; la mayor&#237;a de las cuales pertenecen al grado I o II de Clavien-Dindo<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">13</span></a>&#46; Asimismo&#44; aunque el abordaje abierto fue el m&#225;s frecuentemente utilizado&#44; parece que la cirug&#237;a laparosc&#243;pica se asocia de forma estad&#237;sticamente significativa con menor n&#250;mero de complicaciones&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Respecto al escaso registro de casos urgentes &#40;28&#37;&#41;&#44; no nos atrevemos a generalizar la idea de que se reparan pocas HP en contexto de urgencias ya que la propia naturaleza de los registros y el contexto de la recogida de datos de estos pueden hacer que haya una tendencia a recoger mayoritariamente los casos electivos&#46; El escaso n&#250;mero de pacientes urgentes registrados no permite hacer un an&#225;lisis adecuado de este tipo de cirug&#237;a en el contexto de la HP&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">La recurrencia fue alta tanto para el grupo total &#40;27&#44;5&#37;&#41; como para el grupo de colostom&#237;a &#40;31&#44;5&#37;&#41;&#44; sobre todo teniendo en cuenta el corto per&#237;odo de seguimiento&#46; Estos altos porcentajes tambi&#233;n se observan en otros registros<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">14&#44;15</span></a> y demuestran de nuevo la dificultad del tratamiento quir&#250;rgico de la HP en t&#233;rminos de recurrencia y de resolver el &#171;acertijo&#187; de &#171;cerrar&#187; un orificio herniario sin de hecho cerrarlo&#46; En nuestro registro&#44; solo el antecedente de c&#225;ncer y la incarceraci&#243;n cr&#243;nica preoperatoria en el grupo de colostom&#237;a mostraron ser dos variables asociadas significativamente con la recurrencia&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Este trabajo tiene limitaciones fundamentalmente derivadas de un an&#225;lisis observacional no completo de todos los datos del registro&#59; desafortunadamente&#44; el registro no completo de datos como los m&#233;todos de fijaci&#243;n de la malla o el n&#250;mero de reparaciones previas no permiten establecer una visi&#243;n m&#225;s completa de la cirug&#237;a de la HP&#46; Adem&#225;s del registro incompleto&#44; otra limitaci&#243;n importante es la imposibilidad de seguir a todos los pacientes registrados&#44; aunque estas problem&#225;ticas tambi&#233;n han sido mencionadas como limitantes de otros registros<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a>&#46; Esto podr&#237;a determinar que los datos aqu&#237; mostrados&#44; sobre todo de recurrencia&#44; pudieran ser incluso potencialmente menores que los que se hubieran hallado en caso de haber seguido a todos los pacientes&#46; Adem&#225;s&#44; los datos aqu&#237; presentados no pretenden representar al conjunto de la cirug&#237;a de la HP de todo el pa&#237;s&#44; y aunque la muestra es importante solo presenta la experiencia de los centros que se incluyen en EVEREG&#44; pudiendo potencialmente producirse sesgos relacionados con el tipo de pacientes y con los centros que los tratan&#46; Por otro lado&#44; el an&#225;lisis de toda la serie y de solo el grupo de colostom&#237;a limita la generalizaci&#243;n de los datos a las HP relacionadas con los otros tipos de estomas&#46; El hecho de ser esencialmente un an&#225;lisis de HP en contexto electivo limita tambi&#233;n la extensi&#243;n de los resultados a la cirug&#237;a en contexto urgente&#46; Las fortalezas de nuestro trabajo son el elevado n&#250;mero de HP analizadas&#44; probablemente la segunda serie m&#225;s numerosa de cirug&#237;a electiva analizada hasta ahora y presente en la literatura&#46; Por otro lado&#44; los datos son multiinstitucionales y no limitados a la experiencia de un &#250;nico centro&#44; y finalmente ofrecen una visi&#243;n del &#171;mundo real&#187; propia de los datos incluidos prospectivamente en un registro&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">En resumen&#44; la reparaci&#243;n de la HP es poco frecuente si se compara con el conjunto de reparaciones de la hernia incisional&#44; y las que m&#225;s se reparan est&#225;n en relaci&#243;n con las colostom&#237;as terminales&#46; La cirug&#237;a de la HP en nuestro registro parece relacionarse con un porcentaje alto de complicaciones&#46; El abordaje abierto con malla es el m&#225;s utilizado y la cirug&#237;a laparosc&#243;pica se asocia con menos complicaciones&#46; La recidiva de la HP intervenida en contexto electivo es muy elevada&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Financiaci&#243;n</span><p id="par0090" class="elsevierStylePara elsevierViewall">Ninguna&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicto de intereses</span><p id="par0095" class="elsevierStylePara elsevierViewall">Los autores declaran no tener conflictos de inter&#233;s en relaci&#243;n con el trabajo presentado&#46;</p></span></span>"
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          "titulo" => "Financiaci&#243;n"
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          "titulo" => "Conflicto de intereses"
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    "fechaRecibido" => "2020-07-28"
    "fechaAceptado" => "2020-07-30"
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            0 => "Hernia"
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            2 => "Registry"
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    "resumen" => array:2 [
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introducci&#243;n</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Los resultados de la reparaci&#243;n de la hernia paraestomal &#40;HP&#41; basados en datos provenientes de registros son escasos&#46; El objetivo del presente trabajo es analizar los datos recogidos sobre la HP en el Registro Nacional de Hernia Incisional &#40;EVEREG&#41; y as&#237; evaluar las pr&#225;cticas actuales y resultados en la reparaci&#243;n de una HP&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se analizan los datos de la cohorte de HP registradas en el per&#237;odo desde julio de 2012 hasta junio de 2018&#46; Se analizan las complicaciones&#44; recidivas y factores asociados a ellas de la cohorte completa de HP&#44; independientemente del tipo de estoma al que se asocian&#46; Posteriormente&#44; se realiza el mismo an&#225;lisis del grupo de HP con relaci&#243;n a una colostom&#237;a &#40;grupo m&#225;s numeroso&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 353 HP&#46; De estas&#44; 259 &#40;73&#37;&#41; fueron HP en el contexto de una colostom&#237;a terminal&#44; 74 &#40;21&#37;&#41; en el de una ileostom&#237;a terminal y 20 &#40;6&#37;&#41; en el de una ureteroileostom&#237;a &#40;Bricker&#41;&#46; La edad media global fue de 68&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;1 a&#241;os y 135 &#40;38&#37;&#41; pacientes fueron del sexo femenino&#46; El abordaje abierto y la cirug&#237;a electiva fueron predominantes &#40;78&#37; y 92&#37;&#44; respectivamente&#41;&#46; El 99&#37; se repar&#243; con una malla sint&#233;tica no absorbible&#46; Las complicaciones postoperatorias globales fueron altas &#40;30&#44;6&#37;&#41;&#44; as&#237; como la recurrencia global &#40;27&#44;5&#37;&#41; tras un seguimiento medio de 9&#44;4 meses&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La reparaci&#243;n de la HP es poco frecuente comparada con el conjunto de reparaciones de la hernia incisional&#46; La cirug&#237;a de la HP parece relacionarse con un porcentaje elevado de complicaciones postoperatorias y recidiva&#46;</p></span>"
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        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The results of parastomal hernia &#40;PH&#41; repair based on data from registries are scarce&#46; The objective of this work is to analyze the data collected on PH in the National Registry of Incisional Hernia &#40;EVEREG&#41; and thus evaluate current practices and results in PH repair&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Data from the PH cohort recorded in the period from July 2012 to June 2018 are analyzed&#46; Complications&#44; recurrences and associated factors of the entire PH cohort are analyzed&#44; regardless of the type of stoma they are associated with&#46; Subsequently&#44; the same PH group analysis was performed in relation to a colostomy &#40;larger group&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">353 PH were studied&#46; Of these&#44; 259 &#40;73&#37;&#41; were HP in the context of a terminal colostomy&#44; 74 &#40;21&#37;&#41; in the context of a terminal ileostomy&#44; and 20 &#40;6&#37;&#41; in the context of a ureteroileostomy &#40;Bricker&#41;&#46; The global mean age was 68&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;1 years and 135 &#40;38&#37;&#41; patients were female&#46; The open approach and elective surgery were predominant &#40;78&#37; and 92&#37; respectively&#41;&#59; 99&#37; were repaired with a non-absorbable synthetic mesh&#46; Global postoperative complications were high &#40;30&#46;6&#37;&#41;&#46; As well as&#44; the global recurrence &#40;27&#46;5&#37;&#41; after a mean follow-up of 9&#46;4 months&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusions</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">PH repair is infrequent&#46; PH surgery seems to be associated with a high percentage of postoperative complications and recurrence&#46;</p></span>"
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            "apendice" => "<p id="par0105" class="elsevierStylePara elsevierViewall">Antonio Utrera Gonz&#225;lez&#46; Hospital Juan Ram&#243;n Jim&#233;nez&#44; Huelva&#46;</p> <p id="par0110" class="elsevierStylePara elsevierViewall">Jos&#233; M&#46; Capit&#225;n Vallvey&#46; Complejo Hospitalario de Ja&#233;n&#44; Ja&#233;n&#46;</p> <p id="par0115" class="elsevierStylePara elsevierViewall">Mat&#237;as Pradas&#46; Hospital Comarcal de Ronda&#44; Ronda&#44; M&#225;laga&#46;</p> <p id="par0120" class="elsevierStylePara elsevierViewall">Daniel P&#233;rez Gomar&#46; Hospital Universitario Puerta del Mar&#44; C&#225;diz&#46;</p> <p id="par0125" class="elsevierStylePara elsevierViewall">Manuel Bustos&#46; Hospital Virgen del Roc&#237;o&#44; Sevilla&#46;</p> <p id="par0130" class="elsevierStylePara elsevierViewall">Francisco Antonio Herrera Fern&#225;ndez&#46; Hospital Comarcal Santa Ana&#44; Motril&#46;</p> <p id="par0135" class="elsevierStylePara elsevierViewall">Juan A&#46; Blanco&#46; Hospital Civil de M&#225;laga&#46;</p> <p id="par0140" class="elsevierStylePara elsevierViewall">Joaquim Robres Puig&#46; Consorci Sanitari Integral de l&#8217;Hospitalet&#44; Barcelona&#46;</p> <p id="par0145" class="elsevierStylePara elsevierViewall">Rafael Villalobos&#46; Hospital Arnau de Vilanova&#44; Lleida&#46;</p> <p id="par0150" class="elsevierStylePara elsevierViewall">Dolors G&#252;ell Puigcerc&#243;s&#46; Hospital de Terrassa&#44; Terrassa&#46;</p> <p id="par0155" class="elsevierStylePara elsevierViewall">Jos&#233; Mar&#237;a Puigcerc&#243;s Fust&#233;&#46; Hospital Dos de Maig&#44; Barcelona&#46;</p> <p id="par0160" class="elsevierStylePara elsevierViewall">Vicente Ayuso Osuna&#46; Hospital Esp&#237;ritu Santo&#44; Santa Coloma Gramanet&#44; Barcelona&#46;</p> <p id="par0165" class="elsevierStylePara elsevierViewall">Marta Pi&#241;ol&#46; Hospital Esp&#237;ritu Santo&#44; Santa Coloma Gramanet&#44; Barcelona&#46;</p> <p id="par0170" class="elsevierStylePara elsevierViewall">Carles Olona Cases&#46; Hospital Joan XXIII&#44; Tarragona&#46;</p> <p id="par0175" class="elsevierStylePara elsevierViewall">Francisco Mart&#237;nez R&#243;denas&#46; Hospital Municipal de Badalona&#44; Badalona&#46;</p> <p id="par0180" class="elsevierStylePara elsevierViewall">Jordi Comajuncosas&#46; Hospital Parc Sanitari Sant Joan de D&#233;u&#44; Sant Boi&#46;</p> <p id="par0185" class="elsevierStylePara elsevierViewall">Enric Sebasti&#225;n Valverde&#46; Hospital Parc Sanitari Sant Joan de D&#233;u&#44; Sant Boi&#46;</p> <p id="par0190" class="elsevierStylePara elsevierViewall">Sara Amador&#46; Hospital de Granollers&#46;</p> <p id="par0195" class="elsevierStylePara elsevierViewall">Jaume Gelonch&#46; Hospital de Palam&#243;s&#46;</p> <p id="par0200" class="elsevierStylePara elsevierViewall">Helena Vallverd&#250;&#46; Hospital de Vic&#46;</p> <p id="par0205" class="elsevierStylePara elsevierViewall">Magda Abell&#243; Sala&#46; Hospital Pius&#44; Valls&#46;</p> <p id="par0210" class="elsevierStylePara elsevierViewall">Antonio Veres G&#243;mez&#46; Hospital de la Cerda&#241;a&#46;</p> <p id="par0215" class="elsevierStylePara elsevierViewall">Rosa Gam&#243;n&#46; Hospital General de Castell&#243;n&#46;</p> <p id="par0220" class="elsevierStylePara elsevierViewall">Pedro Garc&#237;a Peche&#46; Hospital General Universitario Reina Sof&#237;a&#44; Elche&#46;</p> <p id="par0225" class="elsevierStylePara elsevierViewall">Miguel Gonz&#225;lez Valverde&#46; Hospital General Universitario Reina Sof&#237;a&#44; Elche&#46;</p> <p id="par0230" class="elsevierStylePara elsevierViewall">Miguel Angel Mart&#237;n Blanco&#46; Hospital de Vinaroz&#44; Castell&#243;n&#46;</p> <p id="par0235" class="elsevierStylePara elsevierViewall">Ram&#243;n J Ferri&#46; Hospital Llu&#237;s Alcany&#237;s&#44; Valencia&#46;</p> <p id="par0240" class="elsevierStylePara elsevierViewall">Elena Mart&#237; Ci&#241;at&#46; Hospital Malvarrosa&#44; Valencia&#46;</p> <p id="par0245" class="elsevierStylePara elsevierViewall">Providencia Garc&#237;a Pastor&#46; Hospital Universitario La Fe&#44; Valencia&#46;</p> <p id="par0250" class="elsevierStylePara elsevierViewall">Carlos Montero&#46; Hospital Virgen de los Lirios&#44; Alcoy&#46;</p> <p id="par0255" class="elsevierStylePara elsevierViewall">Miguel &#193;ngel Lorenzo Li&#241;&#225;n&#46; Hospital General de Onteniente&#44; Valencia</p> <p id="par0260" class="elsevierStylePara elsevierViewall">Vicente Barbero&#46; Complejo Hospitalario Virgen de la Salud&#44; Toledo&#46;</p> <p id="par0265" class="elsevierStylePara elsevierViewall">Miguel &#193;ngel Morlan&#46; Complejo Hospitalario Virgen de la Salud&#44; Toledo&#46;</p> <p id="par0270" class="elsevierStylePara elsevierViewall">Jos&#233; Mar&#237;a Jover&#46; Hospital de Getafe&#44; Madrid&#46;</p> <p id="par0275" class="elsevierStylePara elsevierViewall">Isabel Delgado Lillo&#46; Hospital Cl&#237;nico San Carlos&#44; Madrid&#46;</p> <p id="par0280" class="elsevierStylePara elsevierViewall">Mar&#237;a Mercedes Sanz S&#225;nchez&#46; Hospital General Universitario Gregorio Mara&#241;&#243;n&#44; Madrid&#46;</p> <p id="par0285" class="elsevierStylePara elsevierViewall">Leire Zarain Obrador&#46; Hospital General Universitario Gregorio Mara&#241;&#243;n&#44; Madrid&#44;</p> <p id="par0290" class="elsevierStylePara elsevierViewall">Alejandro Lusilla&#46; Hospital General Universitario Gregorio Mara&#241;&#243;n&#44; Madrid&#46;</p> <p id="par0295" class="elsevierStylePara elsevierViewall">Juan Jes&#250;s Cabeza G&#243;mez&#46; Hospital Cl&#237;nico San Carlos&#44; Madrid&#46;</p> <p id="par0300" class="elsevierStylePara elsevierViewall">Teresa Butr&#243;n&#46; Hospital Universitario 12 de Octubre&#44; Madrid&#46;</p> <p id="par0305" class="elsevierStylePara elsevierViewall">Guillermo Supelano Eslait&#46; Hospital Universitario 12 de Octubre&#44; Madrid&#46;</p> <p id="par0310" class="elsevierStylePara elsevierViewall">Jos&#233; Luis &#193;lvarez Conde&#46; Complejo Hospitalario de Palencia&#46;</p> <p id="par0315" class="elsevierStylePara elsevierViewall">Baltasar P&#233;rez Saborido&#46; Hospital R&#237;o Ortega&#44; Valladolid&#46;</p> <p id="par0320" class="elsevierStylePara elsevierViewall">Mario Rodr&#237;guez L&#243;pez&#46; Hospital R&#237;o Ortega&#44; Valladolid&#46;</p> <p id="par0325" class="elsevierStylePara elsevierViewall">Santiago Revuelta &#193;lvarez&#46; Hospital Universitario Marqu&#233;s de Valdecilla&#44; Santander&#46;</p> <p id="par0330" class="elsevierStylePara elsevierViewall">Pedro Trillo Parejo&#46; Complexo Hospitalario Universitario&#44; Orense&#46;</p> <p id="par0335" class="elsevierStylePara elsevierViewall">Jos&#233; Luis Rodicio&#46; Hospital Universitario Central de Asturias&#44; Oviedo&#46;</p> <p id="par0340" class="elsevierStylePara elsevierViewall">Antonio Blanco&#46; Hospital Universitario Central de Asturias&#44; Oviedo&#46;</p> <p id="par0345" class="elsevierStylePara elsevierViewall">Jacobo Tr&#233;bol L&#243;pez&#46; Complejo Asistencial Universitario de Salamanca&#46;</p> <p id="par0350" class="elsevierStylePara elsevierViewall">Ram&#243;n Casta&#241;era Gonz&#225;lez&#46; Complejo Hospitalario de Palencia&#46;</p> <p id="par0355" class="elsevierStylePara elsevierViewall">Gian Pier Protti&#46; Hospital Arnau de Vilanova&#44; Lleida&#46;</p> <p id="par0360" class="elsevierStylePara elsevierViewall">Dami&#225;n Turi&#241;o Luque&#46; Hospital Civil de M&#225;laga&#46;</p> <p id="par0365" class="elsevierStylePara elsevierViewall">Juan Jos&#233; Espert&#46; Hospital Cl&#237;nic i Provincial de Barcelona&#46;</p> <p id="par0370" class="elsevierStylePara elsevierViewall">Carmen Zaragoza&#46; Hospital de Alicante&#46;</p> <p id="par0375" class="elsevierStylePara elsevierViewall">Marta Hidalgo Pujol&#46; Hospital de Bellvitge&#46;</p> <p id="par0380" class="elsevierStylePara elsevierViewall">Daniel Carmona Navarro&#46; Hospital de Igualada&#44; Barcelona&#46;</p> <p id="par0385" class="elsevierStylePara elsevierViewall">&#193;lvaro Vald&#233;s de Anca&#46; Hospital de La Princesa&#44; Madrid&#46;</p> <p id="par0390" class="elsevierStylePara elsevierViewall">Laura Fresno de Prado&#46; Hospital del Mar&#44; Barcelona&#46;</p> <p id="par0395" class="elsevierStylePara elsevierViewall">Antonio Nieto Soler&#46; Hospital de M&#233;rida-Almendralejo&#46;</p> <p id="par0400" class="elsevierStylePara elsevierViewall">Francisca Vasco Rodr&#237;guez&#46; Hospital de Palam&#243;s&#44; Girona&#46;</p> <p id="par0405" class="elsevierStylePara elsevierViewall">Roberto Lozoya Trujillo&#46; Hospital de Sagunto&#44; Valencia&#46;</p> <p id="par0410" class="elsevierStylePara elsevierViewall">M&#46; Pilar Anaya Reig&#46; Hospital General de Onteniente&#44; Valencia&#46;</p> <p id="par0415" class="elsevierStylePara elsevierViewall">M&#46; Mercedes Sanz S&#225;nchez&#46; Hospital General Universitario Gregorio Mara&#241;&#243;n&#44; Madrid&#46;</p> <p id="par0420" class="elsevierStylePara elsevierViewall">Jos&#233; Bueno Lled&#243;&#46; Hospital La Fe&#44; Valencia&#46;</p> <p id="par0425" class="elsevierStylePara elsevierViewall">Salvador Pous Serrano&#46; Hospital La Fe&#44; Valencia&#46;</p> <p id="par0430" class="elsevierStylePara elsevierViewall">Elena Mart&#237; Cu&#241;at&#46; Hospital Malvarrosa&#44; Valencia&#46;</p> <p id="par0435" class="elsevierStylePara elsevierViewall">Ernest Bombuy Gim&#233;nez&#46; Hospital Matar&#243;&#44; Barcelona&#46;</p> <p id="par0440" class="elsevierStylePara elsevierViewall">Esther Mans&#46; Hospital Matar&#243;&#44; Barcelona&#46;</p> <p id="par0445" class="elsevierStylePara elsevierViewall">Aparicio Garc&#237;a&#46; Hospital Nuestra Sra&#46; del Prado de Talavera de la Reina&#44; Toledo&#46;</p> <p id="par0450" class="elsevierStylePara elsevierViewall">Elena Ortega Ortega&#46; Hospital Nuestra Sra&#46; del Prado de Talavera de la Reina&#44; Toledo&#46;</p> <p id="par0455" class="elsevierStylePara elsevierViewall">Enric Sebasti&#225;n&#46; Hospital Parc Sanitari Sant Joan de D&#233;u&#44; Sant Boi&#44; Barcelona&#46;</p> <p id="par0460" class="elsevierStylePara elsevierViewall">Carlos Hoyuela Alonso&#46; Hospital Plat&#243;&#44; Barcelona&#46;</p> <p id="par0465" class="elsevierStylePara elsevierViewall">Raquel Grajal Marino&#46; Hospital Santos Reyes&#44; Aranda de Duero&#44; Burgos&#46;</p> <p id="par0470" class="elsevierStylePara elsevierViewall">Lofti Elmalaki Hossain&#46; Hospital Universitario de Ceuta&#46;</p> <p id="par0475" class="elsevierStylePara elsevierViewall">Raul Medina&#46; Hospital Universitario de Gran Canaria Doctor Negr&#237;n&#44; Las Palmas de Gran Canaria&#46;</p> <p id="par0480" class="elsevierStylePara elsevierViewall">Jos&#233; Daniel S&#225;nchez&#46; Hospital Universitario Infanta Sof&#237;a&#44; Madrid&#46;</p> <p id="par0485" class="elsevierStylePara elsevierViewall">Tomas Ratia Gim&#233;nez&#46; Hospital Universitario Pr&#237;ncipe de Asturias&#44; Madrid&#46;</p> <p id="par0490" class="elsevierStylePara elsevierViewall">Antonio L&#243;pez&#46; H&#46; Univ&#46; Guadalajara&#46;</p> <p id="par0495" class="elsevierStylePara elsevierViewall">Rosa Ana Garc&#237;a D&#237;az&#46; H&#46; Univ&#46; Marqu&#233;s de Valdecilla&#44; Santander&#46;</p> <p id="par0500" class="elsevierStylePara elsevierViewall">Itziar Larra&#241;aga&#46; Mutua de Terrassa&#44; Barcelona&#46;</p>"
            "etiqueta" => "Anexo"
            "titulo" => "Miembros del grupo EVEREG"
            "identificador" => "sec0040"
          ]
        ]
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        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">ASA&#58; American Society of Anesthesiologists&#59; DE&#58; desviaci&#243;n est&#225;ndar&#59; DM&#58; diabetes mellitus&#59; EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; F&#58; femenino&#59; IC95&#37;&#58; intervalo de confianza al 95&#37;&#59; IMC&#58; &#237;ndice de masa corporal&#59; M&#58; masculino&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>353 &#91;100&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Colostom&#237;a&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>259 &#91;73&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ileostom&#237;a&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>74 &#91;21&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ureteroileostom&#237;a &#40;Bricker&#41;&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20 &#91;6&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad&#44;media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68&#44;7 &#40;11&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&#44;4 &#40;10&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&#44;4 &#40;11&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#44;9 &#40;9&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sexo &#40;M&#58;F&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">218&#58;135&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">143&#58;116&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58&#58;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#58;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IMC&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#44;2 &#40;25&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;07 &#40;4&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#44;03 &#40;55&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;2 &#40;3&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DM &#91;n &#40;&#37;&#41;&#44; IC95&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">85 &#40;24&#41;&#44; &#40;0&#44;19-0&#44;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 &#40;23&#41;&#44; &#40;0&#44;18-0&#44;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;28&#41;&#44; &#40;0&#44;19-0&#44;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;20&#41;&#44; &#40;0&#44;08-0&#44;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">EPOC &#91;n &#40;&#37;&#41;&#44; IC95&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65 &#40;18&#41;&#44; &#40;0&#44;14-0&#44;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;15&#41;&#44; &#40;0&#44;11-0&#44;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;26&#41;&#44; &#40;0&#44;17-0&#44;36&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;30&#41;&#44; &#40;0&#44;14-0&#44;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tabaquismo &#91;n &#40;&#37;&#41;&#44; IC95&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63 &#40;18&#41;&#44; &#40;0&#44;14-0&#44;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;16&#41;&#44; &#40;0&#44;12-0&#44;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;20&#41;&#44; &#40;0&#44;12-0&#44;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;30&#41;&#44; &#40;0&#44;14-0&#44;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">C&#225;ncer &#91;n &#40;&#37;&#41;&#44; IC95&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">226 &#40;64&#41;&#44; &#40;0&#44;58-0&#44;68&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">166 &#40;64&#41;&#44; &#40;0&#44;58-0&#44;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;63&#41;&#44; &#40;0&#44;52-0&#44;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;65&#41;&#44; &#40;0&#44;43-0&#44;81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ASA<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>III &#91;n &#40;&#37;&#41;&#44; IC95&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">143 &#40;40&#41;&#44; &#40;0&#44;35-0&#44;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100 &#40;38&#41;&#44; &#40;0&#44;32-0&#44;44&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;46&#41;&#44; &#40;0&#44;35-0&#44;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;45&#41;&#44; &#40;0&#44;25-0&#44;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Incarceraci&#243;n cr&#243;nica &#91;n &#40;&#37;&#41;&#44; IC95&#37;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77 &#40;22&#41;&#44; &#40;0&#44;17-0&#44;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54 &#40;21&#41;&#44; &#40;0&#44;16-0&#44;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;24&#41;&#44; &#40;0&#44;15-0&#44;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;25&#41;&#44; &#40;0&#44;11-0&#44;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>353 &#91;100&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ileostom&#237;a&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>74 &#91;21&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ureteroileostom&#237;a &#40;Bricker&#41;&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20 &#91;6&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Malla previa</span><span class="elsevierStyleItalic">&#91;n &#40;&#37;&#41;&#44; IC95&#37;&#93;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55 &#40;16&#41;&#44; &#40;0&#44;12-0&#44;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46 &#40;18&#41;&#44; &#40;0&#44;13-0&#44;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;11&#41;&#44; &#40;0&#44;05-0&#44;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;5&#41;&#44; &#40;0&#44;008-0&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Reparaci&#243;n con malla</span><span class="elsevierStyleItalic">&#91;n &#40;&#37;&#41;&#44; IC95&#37;&#93;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">329 &#40;93&#41;&#44; &#40;0&#44;90-0&#44;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">250 &#40;97&#41;&#44; &#40;0&#44;93-0&#44;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69 &#40;93&#41;&#44; &#40;0&#44;85-0&#44;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;50&#41;&#44; &#40;0&#44;29-0&#44;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Tipo de malla&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sint&#233;tica no absorbible&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">326 &#40;99&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">248 &#40;99&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68 &#40;99&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Otras&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cierre del defecto herniario &#91;n &#40;&#37;&#41;&#44; IC95&#37;&#93;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">205 &#40;58&#41;&#44; &#40;0&#44;52-0&#44;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">115 &#40;44&#41;&#44; &#40;0&#44;38-0&#44;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;99&#41;&#44; &#40;0&#44;92-0&#44;99&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;85&#41;&#44; &#40;0&#44;63-0&#44;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Posici&#243;n de la malla &#91;n &#40;&#37;&#41;&#44; IC95&#37;&#93;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Onlay</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">124 &#40;35&#44;1&#41; &#40;0&#44;30-0&#44;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;18&#44;5&#41; &#40;0&#44;14-0&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;100&#41; &#40;0&#44;83-1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Sublay</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71 &#40;20&#44;1&#41; &#40;0&#44;16-0&#44;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;23&#44;5&#41; &#40;0&#44;18-0&#44;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;13&#44;5&#41; &#40;0&#44;07-0&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">150 &#40;58&#41; &#40;0&#44;51-0&#44;63&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Abordaje abierto &#91;n &#40;&#37;&#41;&#44; IC95&#37;&#93;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">68 &#40;26&#41;&#44; &#40;0&#44;21-0&#44;31&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;8&#41;&#44; &#40;0&#44;03-0&#44;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">1 &#40;5&#41;&#44; &#40;0&#44;008-0&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Cirug&#237;a electiva &#91;n &#40;&#37;&#41;&#44; IC95&#37;&#93;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5 &#40;7&#41;&#44; &#40;0&#44;02-0&#44;14&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Grado I&#44; n &#91;&#37; &#40;IC95&#37;&#41;&#93;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#91;11&#44;1 &#40;0&#44;08-0&#44;14&#41;&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Grado II&#44; n &#91;&#37; &#40;IC95&#37;&#41;&#93;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#91;17&#44;5 &#40;0&#44;10-0&#44;27&#41;&#93;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4 &#91;20 &#40;0&#44;08-0&#44;41&#41;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Grado IIIa&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Grado IIIb&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#91;1&#44;7 &#40;0&#44;007-0&#44;03&#41;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#91;15 &#40;0&#44;006-0&#44;03&#41;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1 &#91;1&#44;3 &#40;0&#44;002-0&#44;07&#41;&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;911&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tabaquismo&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;31&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">43 &#40;68&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;840&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Incarceraci&#243;n cr&#243;nica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;39&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;61&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;269&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Malla previa&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;32&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;67&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;367&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cirug&#237;a urgente&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;57&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;42&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ASA<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>III&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59 &#40;41&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84 &#40;58&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Abordaje abierto&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91 &#40;33&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">184 &#40;66&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;038&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reparaci&#243;n con malla&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100 &#40;30&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">229 &#40;69&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;390&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Malla <span class="elsevierStyleItalic">sublay</span>&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29 &#40;40&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42 &#40;59&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;040&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cierre defecto&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66 &#40;32&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">139 &#40;67&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;433&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tipo de estoma &#40;colostom&#237;a&#41;&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72 &#40;27&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">187 &#40;72&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;058&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">ASA&#58; American Society of Anesthesiologists&#59; DM&#58; diabetes mellitus&#59; EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; IMC&#58; &#237;ndice de masa corporal&#59; SSI&#58; infecciones del sitio quir&#250;rgico&#59; SSO&#58; complicaciones del sitio quir&#250;rgico&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SSO</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">SSI</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="3" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Recurrencia</th></tr><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>70&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;67&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;32&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;316&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;36&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;63&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;538&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;26&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">IMC<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>30&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">EPOC&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">C&#225;ncer&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Tabaquismo&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Incarceraci&#243;n cr&#243;nica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">17 &#40;54&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Malla previa&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Cirug&#237;a urgente&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">ASA<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>III&#44; n<span class="elsevierStyleSmallCaps">&#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Abordaje abierto&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reparaci&#243;n con malla&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;222&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">Malla <span class="elsevierStyleItalic">sublay</span>&#44;n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12 &#40;41&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">17 &#40;58&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;21&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">25 &#40;78&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;495&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Cierre defecto&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">41 &#40;62&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;906&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">21 &#40;26&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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ISSN: 0009739X
Idioma original: Español
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