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Operação de Serra Dória no tratamento do megaesôfago chagásico avançado : resultados imediatos.

Source: OAI

ABSTRACT No tratamento cirúrgico do megaesôfago está bem aceita e determinada, a operação conservadora de cardiomiotomia associada à gastrofundoplicatura para os grupos não avançados. Para o grupo avançado onde a atonia do esôfago é maior com grande dilatação do orgão, ainda não existe consenso quanto a melhor intervenção. O objetivo deste estudo foi analisar os resultados imediatos (até 30 dias) da operação de Serra Doria no tratamento do megaesôfago avançado (G IV) com ou sem sutura mecânica. Foram analisados os prontuários de 50 pacientes todos com megaesôfago avançado (G IV) no período de 1988 a 2002, 98% com sorologia positiva para doença de Chagas. Trinta e sete eram do sexo masculino e 13 feminino. Dos prontuários avaliados apenas 20 foram retrospectivos sendo os outros 30 acompanhados prospectivamente. As idades variaram de 22 a 80 anos com média de 51,6 anos. Nesta série 58% dos pacientes apresentavam algum tipo de alteração cardiológica e 24% tinham alterações pulmonares. Quanto ao risco anestésico somente 14% apresentavam ASA 1. Vinte e dois (44%) dos pacientes eram emagrecidos sendo que foram operados com o IMC inferior a 19. A média do tempo operatório foi de 246 minutos com sutura manual e 163,4 minutos com sutura mecânica. Apenas 22% necessitaram serem acompanhados em UTI após a cirurgia. A complicação mais importante no pós-operatório imediato foi hemorragia digestiva alta que ocorreu em cinco (10%) pacientes. Destes, t. Dissertação (Mestrado).

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