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Esofagocardiomioplastia transversal extramucosa mais esofagogastrofundoplicatura parcial no tratamento do megaesôfago Transversal extramucosal esophagocardiomioplasty plus partial esofagogastrofundoplicature in treatment of megaesophagus

By Thomaz de Aquino França, Natanael Guedes Filho, René Berindoague Neto and Alcino Lázaro da Silva

Abstract

Foram estudados, num período de vinte anos, 215 doentes com megaesôfago, predominando o chagásico, tratados com esofagocardiomioplastia transversal extramucosa mais esofagogastrofundoplicatura parcial, que denominamos técnica de "Girard-Toupet-Lind". Ela foi usada nos pacientes portadores de megaesôfago de graus 2, 3 e 4. Os doentes operados foram 55,6% masculinos e 44,4% femininos. A faixa etria predominante foi entre a idade de 30 e 40 anos. Os autores descrevem pormenorizadamente a sistematização da técnica operatória, salientando sua fcil execução por via abdominal, criando uma ampla passagem na região esofagogástrica através de uma esofagocardiomioplastia transversal extramucosa e a confecção de uma válvula parcial anti-refluxo. Complicações pós-operatórias mediatas e imediatas ocorreram em sete doentes (3,2%), e salientam a baixa morbidez e mortalidade transoperatória nula. Os doentes foram avaliados através de exame clínico, estudos radiográficos, endoscópicos e histopatológicos. Com os resultados clínicos, radiográficos, endoscópicos e histopatológicos, neste estudo, pareceu-nos que a operação realizada trouxe benefícios aos doentes e inclusive aos portadores de megaesôfago grau 4.<br>Two-hundred fifteen patients were followed for a 20 year period, being Chagas disease was the main cause of the disease. All patients were submitted to a transversal extramucosal esophagogastroplasty and parcial esophagogastrofundoplicature, which we call "Girard-Toupet-Lind" procedure. This procedure was used for the 2nd, 3rd and 4th degree megaesophagus. The mean age of the patients ranged from 30 to 40 years, being 55,6% for males and 44,4% for females. The systematization of the surgical technique is described by the authors. Attention is called for the simplicity of the procedure through abdominal approach, as well as the need of large passage in the esophagogastric region through a transverse extramucosal esophago- cardiomioplasty and parcial antireflux valve. The authors report early and late postoperative complications, pointing out the very low morbidity. Long term results of the surgery were carried out through clinic, radiological, endoscopic and histopathologic examinations. The authors realized that this surgical procedure is safe and brought real benefits to the patients with megaesophagus, even to those 4th degree patients

Topics: Acalasia, Megaesôfago, Cardiomioplastia, Válvula anti-refluxo, Achalasia, Megaoesophagus, Cardioplasty, Anti-Reflux valve, LCC:Surgery, LCC:RD1-811, LCC:Medicine, LCC:R, DOAJ:Surgery, DOAJ:Medicine (General), DOAJ:Health Sciences
Publisher: Colégio Brasileiro de Cirurgiões
Year: 1999
DOI identifier: 10.1590/S0100-69911999000400005
OAI identifier: oai:doaj.org/article:fa42c9b8fe5f4afbbd98e9191a5cb642
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