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Efeitos da simpaticotomia endosc?pica sobre as art?rias car?ticas e vertebrais na terap?utica cir?rgica da hiperidrose prim?riaCavalcante, Jeancarlo Fernandes 14 April 2005 (has links)
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Previous issue date: 2005-04-14 / Analyze, in patients with primary hyperhidrosis (PH) who was undergone to videothoracoscopic sympathicotomy, the degree of vascular denervation after surgical transection of the thoracic sympathetic chain by measuring ultrasonografic parameters in carotid and vertebral arteries. Methods: Twenty-four patients with PH underwent forty-eight endoscopic thoracic sympathicotomy and were evaluated by duplex eco-doppler measuring systolic peak velocity (SPV), diastolic peak velocity (DPV), pulsatility index (PI) and resistivity index (RI) in bilateral common, internal and external carotids, besides bilateral vertebral arteries. The exams were performed before operations and a month later. Wilcoxon test was used to analyse the differences between the variables before and after the sympatholisis. Results: T3 sympathicotomy segment was the most frequent transection done (95,83%), as only ablation (25%) or in association with T4 (62,50%) or with T2 (8,33%). It was observed increase in RI and PI of the common carotid artery ( p<0,05). The DPV of internal carotid artery decreased in both sides (p<0,05). The SPV and the DPV of the right and left vertebral arteries also increased (p<0,05). Asymmetric findings were observed so that, arteries of the right side were the most frequently affected. Conclusions: Hemodynamic changes in vertebral and carotid arteries were observed after sympathicotomy for PH. SPV was the most often altered parameter, mostly in the right side arteries, meaning significant asymmetric changes in carotid and vertebral vessels. Therefore, the research findings deserve further investigations to observe if they have clinical inferences / O delineamento desse estudo objetiva a an?lise das repercuss?es na hemodin?mica das art?rias car?tidas e vertebrais, respons?veis pela irriga??o do enc?falo, ap?s a desnerva??o da cadeia simp?tica ao n?vel de T2, T3 e/ou T4, provocada pela simpaticotomia tor?cica videotoracosc?pica para tratamento da hiperidrose prim?ria.
Foram estudados pacientes submetidos a 48 simpaticotomias tor?cicas por v?deo, utilizando como par?metros de compara??o pr? e p?s-operat?rios vari?veis num?ricas de velocidade de pico sist?lico, velocidade de pico diast?lico, ?ndice de resist?ncia e ?ndice de pulsatibilidade.
As vari?veis foram obtidas a partir do exame de eco-doppler das art?rias car?tidas e vertebrais bilateralmente utilizando o mesmo aparelho de ultrassom e o mesmo examinador no per?odo de uma semana que antecedeu ao procedimento cir?rgico e 30 dias depois da opera??o.
As diferen?as das vari?veis do pr? e do p?s-operat?rio foram mensuradas pelo teste de Wilcoxon, utilizando o software SPSS? 7.5 for Windows (SPSS, Inc., Chicago, IL).
Os achados de altera??es significativas foram discutidos, observando os dados da literatura m?dica relacionados com estudos na mesma linha de investiga??o e enfatizando os aspectos de interdisciplinaridade cient?fica
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