Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/311406
Type: TESE
Title: Estudo eletromanometrico do segmento de esofago inferior apos a vagotomia gastrica proximal
Author: Andreollo, Nelson Adami, 1951-
Advisor: Brandalise, Nelson Ary, 1938-
Abstract: Resumo: Os pacientes operados de V.G.P. foram estudados no pôs-operatôrio precoce, isto e, entre o 79 e 219 dia, periodo em que a disfagia freqüentemente ocorre. Os estudos eletromanometricos foram realizados no segmento de esôfago inferior "desnervado" e esôfago medio não atingido pela cirurgia, antes e apôs estimulo do Carbacol na dose de 4ftg/kg de peso por via subcutânea, analisa dos quanto ao numero de contrações, alterações do tônus, tempo de duração e alterações das ondas de deglutição e comparados ao grupo controle de normais. Os resultados demonstraram, mediante cálculos estatisticos, que o numero de contrações do segmento de esôfago inferior nos grupos de pacientes operados de V.G.P. sob estimulo do Carbacol, foi maior que nos normais. A Atônus do segmento inferior do esôfago, sob estimulo do Carbacol, sofreu significante elevação no grupo de pacientes operados de V.G.P. e que apresentaram disfagia no p.o.. O tempo de duração das ondas de deglutição neste mesmo segmento esofágico, antes do estimulo do Carbacol no grupo de doentes operados de V.G.P. e que apresentaram disfagia foi mais elevado e significativo que nos demais. Alem disso, as alterações morfológicas verificadas nas ondas de deglutição no grupo de pacientes sob estimulo do Carbacol foi mais significativo que operados nos normais. Assim, pode-se concluir que o segmento de esôfago inferior e realmente desnervado na V.G.P. e que os pacientes que apresentaram disfagia no põs-operatório teriam si do mais desnervados que os demais. Portanto, deve-se admitir a importante participação do segmento de esôfago inferior desnervado na etiologia da disfagia após V.G.P

Abstract: Proximal Gastric Vagotomy (P.G.V.) is the most modern technique used in the surgical treatment for duodenal peptic ulcers. The mechanism of the dysphagia after P.G.V. i s not clearly understood, despite several studies already performed. This research was performed objective of verifying the participation of the "denervated" segment of the lower esophagus after a P.G.V. on the postoperative dysphagia. Manometric studies were carried out with the aid of a cholinergic agent (Carbachol), in three groups of patients: GROUP 1 - Ten individuals without dysphagia, without esophageal pathologies and not undergoing surgical procedure, were considered the normal control group. GROUP 2 - Ten patients submitted to a P.G.V. without postoperative dysphagia. GROUP 3 - Ten patients submitted to a P.G.V. with postoperative dysphagia. The patients submitted to a P.G.V. were studied in the early postoperative period, i.e., between the 7th and 21st days, the period when normally the dysphagia should occur. Manometric studies were performed on the "denervated" segment of the lower esophagus and in the esophagus where surgery was not performed, before and after stimulus of 4 flg per kilogram by subcutaneous injection Carbachol. The study was determined reviewed according to number of contractions, change of tonus, time of duration and changes of characteristics of deglutition waves, compared controls. The results after statistical analysis show that the number of contractions of the segment of the esophagus in the groups submitted to P.G.V., stimulated with Carbachol, was greater than the constrols. The tonus of lower with the segment of the lower esophagus after stimulus with Carbachol had significant elevation in group 3. The time of duration of the deglutition waves of the esophageal segment before stimulus significant with carbachol in group 3 was elevated and more than in other groups. Above all, the morphological changes ,of the deglutitidn waves on groups 2 and 3 after the stimulus with Carbachol were:more significant than the control group. Therefore, we conclude that the segment of the lower esophàgus is indeed denervated after a P.G.V. and the patients with postoperative dysphagia were more denervated than the others. We must emphasize the important participation the lower esophageal segment denervation in the etiology postoperative dysphagia after a P.G.V.
Subject: Esofago - Doenças
Esôfago - Cirurgia
Language: Português
Editor: [s.n.]
Date Issue: 1984
Appears in Collections:FCM - Tese e Dissertação

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