Estudo clínico do efeito da compressão extrínseca do esôfago causada por bócio mergulhante sobre a motilidade esofágica, utilizando como método a eletromanometria e a videofluoroscopia
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Data
2005
Autores
Tagliarini, José Vicente [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O aumento do volume da glândula tireóide pode levar à extensão da glândula para o mediastino (bócio mergulhante). O componente intratorácico pode ocasionar a compressão da traquéia e do esôfago e causar disfagia. Sendo esta um sintoma freqüente no bócio mergulhante e que desaparece após a remoção cirúrgica do mesmo, não encontramos relato de estudo dos efeitos da compressão extrínseca sobre a motilidade esofágica. Esta pesquisa foi realizada com o objetivo de avaliar as alterações da motilidade esofágica dos pacientes com bócio mergulhante utilizando como métodos a eletromanometria esofágica e a videofluoroscopia. Foram avaliados 40 pacientes com bócio mergulhante e divididos em dois grupos: Grupo 1: n = 24 pacientes com bócio mergulhante e queixas disfágicas. Grupo 2: n= 16 pacientes com bócio mergulhante e sem queixas disfágicas. No momento inicial (M1), os pacientes foram submetidos à eletromanometria esofágica e à videofluoroscopia. A eletromanometria permitiu a análise da amplitude da pressão nos esfíncteres superior e inferior do esôfago, amplitude das contrações nos terços proximal e distal do esôfago e porcentagem das contrações esofágicas peristálticas, peristálticas normotensivas e hipotensivas após a deglutição de água. A videofluoroscopia permitiu analisar os efeitos da compressão do bócio sobre o esôfago. A seguir, os pacientes foram submetidos à cirurgia para remoção do tecido tireoideano que comprimia o esôfago. Em um período de 3 a 6 meses após a cirurgia, os exames foram repetidos (M2). A análise estatística dos parâmetros eletromanométrico não demonstrou diferenças entre momentos no grupo, nem entre os grupos nos 2 momentos. Foi observada no pós-operatório da tireoidectomia a normalização da videofluoroscopia em 81,3% dos pacientes do grupo 1 e em 90% daqueles do grupo 2. Não foram encontradas evidências...
The increase of thyroid gland can promote its extension into the mediastinum (substernal goiter). This extension can lead to compression of trachea and esophagus and cause dysphagia. This symptom is very common in substernal goiter and disappears after thyroidectomy. No report of the effects of extrinsic compression about the esophageal motility was found. This research was made with the objective to investigate esophageal motility alterations of patients with substernal goiter. The methods esophageal eletromanometry and videofluoroscopy were used. Forty patients with substernal goiter were studied and divided in two groups: Group 1: n = 24 patients with substernal goiter and dysphagia symptoms. Group 2: n= 16 patients with substernal goiters and without dysphagia. At the first moment (M1) the patients were submitted to an esophageal eletromanometry and videofluoroscopy. The eletromanometry permitted the analysis of the amplitude of the pressure in the upper and lower esophageal sphincter, the analysis of the amplitude of the upper and distal body pressure and the analysis of the percentage of the total esophageal wave contraction peristalsis, the normal wave contraction and the hypotensive wave contraction after water deglutition. The videofluoroscopy allowed the analysis of the effects of goiter compression on the esophagus. After these exams the patients were submitted to a surgery to remove the thyroid tissue, the cause of the compression of the esophagus. Three to six months after the surgery the exams were repeated (M2). The statistical analysis of eletromanometric parameters didn't prove differences among the moments in the group, neither among the groups in the two moments. It was observed that after the thyroidectomy the videofluoroscopy got normal in 81,3% of the patients in group 1 and in 90% of group 2. There weren't found eletromanometric evidences of alterations... (Complete abstract click electronic access below)
The increase of thyroid gland can promote its extension into the mediastinum (substernal goiter). This extension can lead to compression of trachea and esophagus and cause dysphagia. This symptom is very common in substernal goiter and disappears after thyroidectomy. No report of the effects of extrinsic compression about the esophageal motility was found. This research was made with the objective to investigate esophageal motility alterations of patients with substernal goiter. The methods esophageal eletromanometry and videofluoroscopy were used. Forty patients with substernal goiter were studied and divided in two groups: Group 1: n = 24 patients with substernal goiter and dysphagia symptoms. Group 2: n= 16 patients with substernal goiters and without dysphagia. At the first moment (M1) the patients were submitted to an esophageal eletromanometry and videofluoroscopy. The eletromanometry permitted the analysis of the amplitude of the pressure in the upper and lower esophageal sphincter, the analysis of the amplitude of the upper and distal body pressure and the analysis of the percentage of the total esophageal wave contraction peristalsis, the normal wave contraction and the hypotensive wave contraction after water deglutition. The videofluoroscopy allowed the analysis of the effects of goiter compression on the esophagus. After these exams the patients were submitted to a surgery to remove the thyroid tissue, the cause of the compression of the esophagus. Three to six months after the surgery the exams were repeated (M2). The statistical analysis of eletromanometric parameters didn't prove differences among the moments in the group, neither among the groups in the two moments. It was observed that after the thyroidectomy the videofluoroscopy got normal in 81,3% of the patients in group 1 and in 90% of group 2. There weren't found eletromanometric evidences of alterations... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Cirurgia, Bocio, Esofago - Doenças - Diagnóstico, Radiografia, Bócio substernal, Disfagia, Eletromanometria, Videofluoroscopia, Videofluoroscopy
Como citar
TAGLIARINI, José Vicente. Estudo clínico do efeito da compressão extrínseca do esôfago causada por bócio mergulhante sobre a motilidade esofágica, utilizando como método a eletromanometria e a videofluoroscopia. 2005. 110 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Medicina, 2005.