Incidência de hérnia interna em pacientes submetidos à cirurgia bariátrica em um hospital privado na cidade de Belém do Pará
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (BGYRL) is one of the most performed procedures worldwide, one of its complications is the internal hernia (HI), presenting a significative and highly variable incidence in the literature (0-16%). So, the objective of this study was to analyze...
| Autor principal: | OLIVEIRA, André Luís Meireles de |
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| Grau: | Trabalho de Conclusão de Curso - Graduação |
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2023
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https://bdm.ufpa.br:8443/jspui/handle/prefix/6072 |
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oai:https:--bdm.ufpa.br:8443:prefix-60722023-08-31T03:05:29Z Incidência de hérnia interna em pacientes submetidos à cirurgia bariátrica em um hospital privado na cidade de Belém do Pará OLIVEIRA, André Luís Meireles de YASOJIMA, Edson Yuzur http://lattes.cnpq.br/6901845081643218 https://orcid.org/0000-0002-1377-4895 Cirurgia bariátrica Hérnia interna Obesidade Bariatric surgery Internal hernia Obesity CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::GASTROENTEROLOGIA BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (BGYRL) is one of the most performed procedures worldwide, one of its complications is the internal hernia (HI), presenting a significative and highly variable incidence in the literature (0-16%). So, the objective of this study was to analyze the incidence of internal hernia after BGYRL in a private hospital in the city of Belém, Pará. METHODS: Were revised the records of the patients which were submitted to BGYRL between January/2011 and December/2016 and developed HI in post-operatory diagnosed with laparoscopy. The analytical statistics was utilized to evaluate the results of the categorical variables on the sample through the G test and Pearson’s chi-square test RESULTS: 180 pacients (117 women and 63 men) were submitted to BGYRL at the studied hospital in the stablished period, 16,7% were diagnosed with HI (n=30), demonstrating a higher incidence than was found in the literature. Being 18 females (60%) and 12 males (40%), it wasn’t found statistical significance in the proportion between the sexes (p=0.3613). About the age groups of the patients diagnosed with HI, from 20 to 30 years presented 3 cases (33,3%); 31 to 40 years presented 12 cases (40%); 41 to 50 years presented 10 cases (33,3%); 51 to 60 years presented 5 cases (16,7%). There were no meaningful difference between the age groups (p = 0.0635). The principal site of intestinal herniation found during laparoscopy in patients diagnosed with HI was through Petersen’s space (n=20; 66,7%), there were statistical significance in these group (p=0.0004). Laparoscopy was diagnostic as it was resolutive in 28 patients with HI (p < 0.0001). 29 patients were discharged from hospital (96,67%) and 1 died during hospital internment (3,33%). CONCLUSION: The incidence of HI in patients submitted to BGYRL in the referred hospital is higher than found in the literature. In the majority of the cases the correction of HI was made with success through laparoscopy. There is no consensus in the literature about which would be the principal site of internal herniation. The demographics were not statistically relevant in relation to HI. The conversion rate to laparotomy and the necessity of reoperations practically were not debated in the publicated researches, being necessary more detailed studies to evaluate the importance of these factors in the morbimortality of this pathology. There are few studies about this complication, which is possibly fatal; therefore more researches are necessary, mainly due to the growing number of bariatric surgeries in the last years. NTRODUÇÃO: O bypass gástrico em Y de Roux pela via laparoscópica (BGYRL) é um dos procedimentos mais realizados no mundo atualmente. Uma das complicações mais graves desse procedimento é a Hérnia Interna (HI), apresentando uma incidência significativa e altamente variável na literatura (0-16%). Assim, o objetivo deste estudo é analisar a incidência de hérnia interna após o BGYRL em um hospital particular da cidade de Belém, Pará. MÉTODO: Foram revisados os prontuários de pacientes os quais foram submetidos à BGYRL entre janeiro de 2011 e dezembro de 2016 e evoluíram com HI no pós-operatório diagnosticados através de laparoscopia. A estatística analítica foi utilizada para avaliar os resultados das variáveis categóricas da amostra através do Teste G e Teste Qui-Quadrado Aderência para tabelas univariadas. RESULTADOS: 180 pacientes (117 mulheres e 63 homens) foram submetidos ao BGYRL no hospital estudado no período estabelecido, 16,7% foram diagnosticados com HI (n=30), demonstrando uma incidência maior do que a encontrada na literatura, sendo 18 do sexo feminino (60%) e 12 do sexo masculino (40%), não apresentando significância na proporção entre os sexos (p = 0.3613). Em relação às faixas etárias dos pacientes diagnosticados com HI, de 20 a 30 anos com 3 casos (10%); 31 a 40 anos com 12 casos (40%); 41 a 50 anos com 10 casos (33,3%); 51 a 60 anos com 5 casos (16,7%), não houve diferença relevante entre as faixas etárias (p = 0.0635). O principal local de herniação intestinal encontrado durante a laparoscopia em pacientes diagnosticados com HI foi pelo espaço de Petersen (n=20; 66,67%), a qual houve significância estatística (p=0.0004). A laparoscopia foi tanto diagnóstica quanto resolutiva em 28 pacientes com HI (p < 0.0001). 29 pacientes (96,67%) evoluíram com alta e 1 veio a óbito (3,33%). CONCLUSÃO: A incidência de HI em pacientes submetidos ao BGYRL no referido hospital é maior do que a encontrada na literatura. Na maioria das vezes a correção da HI foi feita com sucesso pela via laparoscópica. Não há consenso na literatura sobre qual seria o principal local de herniação intestinal. Os dados demográficos não se mostraram estatisticamente relevantes em relação à HI. A taxa de conversão para laparotomia e reoperações após correção da HI, praticamente não foram debatidas pelas pesquisas publicadas, sendo necessários estudos mais detalhados para avaliar a importância desses fatores na morbimortalidade dessa patologia. Existem poucos estudos sobre esta complicação que é possivelmente fatal, logo são necessárias mais pesquisas, principalmente devido ao crescimento do número de cirurgias bariátricas nos últimos anos. 2023-08-30T13:51:43Z 2023-08-30T13:51:43Z 2019-05 Trabalho de Conclusão de Curso - Graduação OLIVEIRA, André Luís Meireles de. Incidência de hérnia interna em pacientes submetidos à cirurgia bariátrica em um hospital privado na cidade de Belém do Pará. Orientador: Edson Yuzur Yasojima. 2019. 32 f. Trabalho de Conclusão de Curso (Bacharelado em Medicina) - Faculdade de Medicina, Instituto de Ciências da Saúde, Universidade Federal do Pará, Belém, 2019. Disponível em: https://bdm.ufpa.br:8443/jspui/handle/prefix/6072. Acesso em:. https://bdm.ufpa.br:8443/jspui/handle/prefix/6072 Acesso Aberto 1 CD-ROM |
| institution |
Biblioteca Digital de Monografias - UFPA |
| collection |
MonografiaUFPA |
| topic |
Cirurgia bariátrica Hérnia interna Obesidade Bariatric surgery Internal hernia Obesity CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::GASTROENTEROLOGIA |
| spellingShingle |
Cirurgia bariátrica Hérnia interna Obesidade Bariatric surgery Internal hernia Obesity CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::GASTROENTEROLOGIA OLIVEIRA, André Luís Meireles de Incidência de hérnia interna em pacientes submetidos à cirurgia bariátrica em um hospital privado na cidade de Belém do Pará |
| topic_facet |
Cirurgia bariátrica Hérnia interna Obesidade Bariatric surgery Internal hernia Obesity CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::GASTROENTEROLOGIA |
| description |
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (BGYRL) is one of the
most performed procedures worldwide, one of its complications is the internal hernia
(HI), presenting a significative and highly variable incidence in the literature (0-16%).
So, the objective of this study was to analyze the incidence of internal hernia after
BGYRL in a private hospital in the city of Belém, Pará. METHODS: Were revised the
records of the patients which were submitted to BGYRL between January/2011 and
December/2016 and developed HI in post-operatory diagnosed with laparoscopy.
The analytical statistics was utilized to evaluate the results of the categorical
variables on the sample through the G test and Pearson’s chi-square test RESULTS:
180 pacients (117 women and 63 men) were submitted to BGYRL at the studied
hospital in the stablished period, 16,7% were diagnosed with HI (n=30),
demonstrating a higher incidence than was found in the literature. Being 18 females
(60%) and 12 males (40%), it wasn’t found statistical significance in the proportion
between the sexes (p=0.3613). About the age groups of the patients diagnosed with
HI, from 20 to 30 years presented 3 cases (33,3%); 31 to 40 years presented 12
cases (40%); 41 to 50 years presented 10 cases (33,3%); 51 to 60 years presented 5
cases (16,7%). There were no meaningful difference between the age groups (p =
0.0635). The principal site of intestinal herniation found during laparoscopy in
patients diagnosed with HI was through Petersen’s space (n=20; 66,7%), there were
statistical significance in these group (p=0.0004). Laparoscopy was diagnostic as it
was resolutive in 28 patients with HI (p < 0.0001). 29 patients were discharged from
hospital (96,67%) and 1 died during hospital internment (3,33%). CONCLUSION:
The incidence of HI in patients submitted to BGYRL in the referred hospital is higher
than found in the literature. In the majority of the cases the correction of HI was made
with success through laparoscopy. There is no consensus in the literature about
which would be the principal site of internal herniation. The demographics were not
statistically relevant in relation to HI. The conversion rate to laparotomy and the
necessity of reoperations practically were not debated in the publicated researches,
being necessary more detailed studies to evaluate the importance of these factors in
the morbimortality of this pathology. There are few studies about this complication,
which is possibly fatal; therefore more researches are necessary, mainly due to the
growing number of bariatric surgeries in the last years. |
| author_additional |
YASOJIMA, Edson Yuzur |
| author_additionalStr |
YASOJIMA, Edson Yuzur |
| format |
Trabalho de Conclusão de Curso - Graduação |
| author |
OLIVEIRA, André Luís Meireles de |
| title |
Incidência de hérnia interna em pacientes submetidos à cirurgia bariátrica em um hospital privado na cidade de Belém do Pará |
| title_short |
Incidência de hérnia interna em pacientes submetidos à cirurgia bariátrica em um hospital privado na cidade de Belém do Pará |
| title_full |
Incidência de hérnia interna em pacientes submetidos à cirurgia bariátrica em um hospital privado na cidade de Belém do Pará |
| title_fullStr |
Incidência de hérnia interna em pacientes submetidos à cirurgia bariátrica em um hospital privado na cidade de Belém do Pará |
| title_full_unstemmed |
Incidência de hérnia interna em pacientes submetidos à cirurgia bariátrica em um hospital privado na cidade de Belém do Pará |
| title_sort |
incidência de hérnia interna em pacientes submetidos à cirurgia bariátrica em um hospital privado na cidade de belém do pará |
| publishDate |
2023 |
| url |
https://bdm.ufpa.br:8443/jspui/handle/prefix/6072 |
| _version_ |
1787238429114761216 |
| score |
11.653393 |