Esofagectomia trans-hiatal no tratamento do megaesôfago chagásico avançado

• Autor(a) principal: Batista Neto, João [UNIFESP]
• Data de Publicação: 2003
• Outros Autores: Fontan, Alberto Jorge, Nepomuceno, Marcos Da Costa, Lourenço, Laércio Gomes [UNIFESP], Ribeiro, Laércio Tenório, Ramos, Carmen Pereira
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0100-69912003000300011; http://repositorio.unifesp.br/handle/11600/1714
• topic: Esophagectomy; Esophageal achalasia; Barrett esophagus; Chagas disease; Deglutition disorders; Outcome assessment; Esofagectomia; Acalasia esofágica; Esôfago de Barrett; Doença de Chagas; Transtornos de deglutição; Avaliação de resultados

BACKGROUND: To analize the clinical results, radiologic and endoscopic findings of the transhiatal esophagectomy on Chaga's disease megaesophagus. METHODS: A retrospective study was performed from 1982-2000. Twenty-eight chagasic patients, sixteen female and twelve male, were treated at the General Surgery Service of Hospital da Universidade Federal de Alagoas. The disease was diagnosed by serologic trials and epidemiological or anatomopathological information. Variables studied were: a) pre and postoperative surgery patients complaints as dysphagia, regurgitation, pyrosis, diarrhea, dumping, postprandial fullness, pneumonia and weight status; b) post surgery X Rays series (upper GI) evaluation of the cervical esophagogastric anastomosis and the transposed stomach; c) post surgery endoscopic evaluation to analyze the esophagus stump and the anastomotic suture. The follow-up quantitative variable was expressed by medium and error pattern. The Chi-square test was applied to the dysphagia, regurgitation and pyrosis resolution variables considering p<0,05 values significant. The qualitative variables by percentage and the trusting interval calculated within 95% (IC-95%), with the EpiInfo software. RESULTS: Mean follow-up was 58,2 months (from to 4 - 192). Mean age was 36,5 years (from to 16-67). There was no mortality in this series. There was complete resolution of dysphagia in the majority of the patients (21/28 - 71,4%, p<0,05); 7/28 (25%) needed one or more dilatation sessions. Pyrosis was the most important late follow-up symptom (35,7%) and stump esophagitis the most significant endoscopic finding. The majority of X Rays studies findings were normal. CONCLUSIONS: Transhiatal esophagectomy was efficient to the treatment of chagasic megaesophagus dysphagia however the morbidity was high (78,6%). The mortality in this series was none.