Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery

Detalhes bibliográficos
Autor(a) principal: Moreira Júnior,Hélio
Data de Publicação: 2013
Outros Autores: Moreira,José P. T., Isaac,Raniere R., Almeida,Arminda C. de, Moreira,Hélio, Klug,Wilmar A.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Journal of Coloproctology (Rio de Janeiro. Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2237-93632013000200062
Resumo: ORIGINAL CONTRIBUTION: understand the reasons why Duhamel surgery results in clinical improvement of constipation in patients with Chagasic colopathy. BACKGROUND: Duhamel surgery is one of the most widespread techniques for the treatment of Chagasic megacolon, with low rates of recurrence of constipation. OBJECTIVE: evaluate the anatomical and physiological changes in the pelvic diaphragm of patients with chagasic colopathy, as well as changes occurring after undergoing Duhamel surgery. DESIGN: clinical data and results of cinedefecography, electromanometry and anorectal ultrasound of the anal canal were evaluated in patients with Chagasic colopathy, before and after Duhamel surgery. LOCATION: Service of Coloproctology - Departament of Surgery, Faculdade de Medicina da Universidade Federal de Goiás. Patients: patients with positive serology for Chagas Disease, with constipation and radiological megacolon, who presented consecutively to the Chagas outpatient clinic and freely agreed to participate in this study, were prospectively included. RESULTS: a total of 20 patients were included, with a mean age of 53.2 years, of which 16 were women. The following parameters were observed in the postoperative period: change in bowel frequency, of, on average, one evacuation every ten days to daily bowel movement; 16 patients used laxatives preoperatively and only one did, intermittently, in postoperative period. Electromanometry showed, postoperatively, a decrease in anal resting pressure (60.88 to 37.2 mmHg p < 0.001) and anal squeeze pressures (244.3 mL to 161.25 p = 0.01), whereas ultrasound showed that 75% of the patients had abnormalities of the internal anal sphincter in the posterior anal canal juxtaposed to the pulled-through colon. Postoperative rectal emptying observed in cinedefecographic tests occurred more quickly and with less effort when compared with the preoperative findings. There was a change in the anorectal angle postoperatively, which became more obtuse, both during rest, straining and during evacuation. CONCLUSIONS: the anatomical and functional changes in the pelvic diaphragm are significant after Duhamel surgery and together, they result in clinical improvement of patients.
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spelling Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgeryChagas diseaseMegacolonIntestinal constipationAnal canalSurgical procedures of the digestive systemPerioperative careEvaluation ORIGINAL CONTRIBUTION: understand the reasons why Duhamel surgery results in clinical improvement of constipation in patients with Chagasic colopathy. BACKGROUND: Duhamel surgery is one of the most widespread techniques for the treatment of Chagasic megacolon, with low rates of recurrence of constipation. OBJECTIVE: evaluate the anatomical and physiological changes in the pelvic diaphragm of patients with chagasic colopathy, as well as changes occurring after undergoing Duhamel surgery. DESIGN: clinical data and results of cinedefecography, electromanometry and anorectal ultrasound of the anal canal were evaluated in patients with Chagasic colopathy, before and after Duhamel surgery. LOCATION: Service of Coloproctology - Departament of Surgery, Faculdade de Medicina da Universidade Federal de Goiás. Patients: patients with positive serology for Chagas Disease, with constipation and radiological megacolon, who presented consecutively to the Chagas outpatient clinic and freely agreed to participate in this study, were prospectively included. RESULTS: a total of 20 patients were included, with a mean age of 53.2 years, of which 16 were women. The following parameters were observed in the postoperative period: change in bowel frequency, of, on average, one evacuation every ten days to daily bowel movement; 16 patients used laxatives preoperatively and only one did, intermittently, in postoperative period. Electromanometry showed, postoperatively, a decrease in anal resting pressure (60.88 to 37.2 mmHg p < 0.001) and anal squeeze pressures (244.3 mL to 161.25 p = 0.01), whereas ultrasound showed that 75% of the patients had abnormalities of the internal anal sphincter in the posterior anal canal juxtaposed to the pulled-through colon. Postoperative rectal emptying observed in cinedefecographic tests occurred more quickly and with less effort when compared with the preoperative findings. There was a change in the anorectal angle postoperatively, which became more obtuse, both during rest, straining and during evacuation. CONCLUSIONS: the anatomical and functional changes in the pelvic diaphragm are significant after Duhamel surgery and together, they result in clinical improvement of patients. Sociedade Brasileira de Coloproctologia2013-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S2237-93632013000200062Journal of Coloproctology (Rio de Janeiro) v.33 n.2 2013reponame:Journal of Coloproctology (Rio de Janeiro. Online)instname:Sociedade Brasileira de Coloproctologia (SBCP)instacron:SBCP10.1590/S2237-93632013000200004info:eu-repo/semantics/openAccessMoreira Júnior,HélioMoreira,José P. T.Isaac,Raniere R.Almeida,Arminda C. deMoreira,HélioKlug,Wilmar A.eng2015-07-24T00:00:00Zoai:scielo:S2237-93632013000200062Revistahttp://www.scielo.br/scielo.php?script=sci_serial&pid=2237-9363&lng=pt&nrm=isohttps://old.scielo.br/oai/scielo-oai.php||sbcp@sbcp.org.br2317-64232237-9363opendoar:2015-07-24T00:00Journal of Coloproctology (Rio de Janeiro. Online) - Sociedade Brasileira de Coloproctologia (SBCP)false
dc.title.none.fl_str_mv Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery
title Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery
spellingShingle Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery
Moreira Júnior,Hélio
Chagas disease
Megacolon
Intestinal constipation
Anal canal
Surgical procedures of the digestive system
Perioperative care
Evaluation
title_short Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery
title_full Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery
title_fullStr Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery
title_full_unstemmed Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery
title_sort Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery
author Moreira Júnior,Hélio
author_facet Moreira Júnior,Hélio
Moreira,José P. T.
Isaac,Raniere R.
Almeida,Arminda C. de
Moreira,Hélio
Klug,Wilmar A.
author_role author
author2 Moreira,José P. T.
Isaac,Raniere R.
Almeida,Arminda C. de
Moreira,Hélio
Klug,Wilmar A.
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Moreira Júnior,Hélio
Moreira,José P. T.
Isaac,Raniere R.
Almeida,Arminda C. de
Moreira,Hélio
Klug,Wilmar A.
dc.subject.por.fl_str_mv Chagas disease
Megacolon
Intestinal constipation
Anal canal
Surgical procedures of the digestive system
Perioperative care
Evaluation
topic Chagas disease
Megacolon
Intestinal constipation
Anal canal
Surgical procedures of the digestive system
Perioperative care
Evaluation
description ORIGINAL CONTRIBUTION: understand the reasons why Duhamel surgery results in clinical improvement of constipation in patients with Chagasic colopathy. BACKGROUND: Duhamel surgery is one of the most widespread techniques for the treatment of Chagasic megacolon, with low rates of recurrence of constipation. OBJECTIVE: evaluate the anatomical and physiological changes in the pelvic diaphragm of patients with chagasic colopathy, as well as changes occurring after undergoing Duhamel surgery. DESIGN: clinical data and results of cinedefecography, electromanometry and anorectal ultrasound of the anal canal were evaluated in patients with Chagasic colopathy, before and after Duhamel surgery. LOCATION: Service of Coloproctology - Departament of Surgery, Faculdade de Medicina da Universidade Federal de Goiás. Patients: patients with positive serology for Chagas Disease, with constipation and radiological megacolon, who presented consecutively to the Chagas outpatient clinic and freely agreed to participate in this study, were prospectively included. RESULTS: a total of 20 patients were included, with a mean age of 53.2 years, of which 16 were women. The following parameters were observed in the postoperative period: change in bowel frequency, of, on average, one evacuation every ten days to daily bowel movement; 16 patients used laxatives preoperatively and only one did, intermittently, in postoperative period. Electromanometry showed, postoperatively, a decrease in anal resting pressure (60.88 to 37.2 mmHg p < 0.001) and anal squeeze pressures (244.3 mL to 161.25 p = 0.01), whereas ultrasound showed that 75% of the patients had abnormalities of the internal anal sphincter in the posterior anal canal juxtaposed to the pulled-through colon. Postoperative rectal emptying observed in cinedefecographic tests occurred more quickly and with less effort when compared with the preoperative findings. There was a change in the anorectal angle postoperatively, which became more obtuse, both during rest, straining and during evacuation. CONCLUSIONS: the anatomical and functional changes in the pelvic diaphragm are significant after Duhamel surgery and together, they result in clinical improvement of patients.
publishDate 2013
dc.date.none.fl_str_mv 2013-06-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2237-93632013000200062
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S2237-93632013000200062
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S2237-93632013000200004
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Coloproctologia
publisher.none.fl_str_mv Sociedade Brasileira de Coloproctologia
dc.source.none.fl_str_mv Journal of Coloproctology (Rio de Janeiro) v.33 n.2 2013
reponame:Journal of Coloproctology (Rio de Janeiro. Online)
instname:Sociedade Brasileira de Coloproctologia (SBCP)
instacron:SBCP
instname_str Sociedade Brasileira de Coloproctologia (SBCP)
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institution SBCP
reponame_str Journal of Coloproctology (Rio de Janeiro. Online)
collection Journal of Coloproctology (Rio de Janeiro. Online)
repository.name.fl_str_mv Journal of Coloproctology (Rio de Janeiro. Online) - Sociedade Brasileira de Coloproctologia (SBCP)
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