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Previous issue date: 2004 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Introdução: A hipertrofia mamaria pode levar a dor e diminuicao da capacidade funcional. A mamoplastia redutora parece melhorar esses aspectos. No entanto nao existe na literatura nenhum estudo que demonstra cientificamente essa hipotese. Objetivo: Avaliar o impacto da mamoplastia redutora. na dor e na capacidade funcional das pacientes com hipertrofia mamaria. Metodo: Cem pacientes com hipertrofia mamaria, entre 18 e 56 anos, sem procedimento cirurgico previo nas mamas, foram consecutivamente selecionadas do ambulatorio de Cirurgia Plastica da UNIFESP-EPM. Imediatamente apos, foram divididas, por sorteio, em dois grupos denominados A e B. As 50 pacientes do grupo A foram submetidas a mamoplastia redutora, enquanto que as outras 50 pacientes (grupo B) formaram uma lista de espera para o procedimento cirurgico. Foram avaliados parametros clinicos e demograficos de todas as pacientes e em seguida foram feitas as avaliacoes de dor e capacidade funcional utilizando-se questionarios auto-administrados. Os instrumentos de avaliacao escolhidos foram: Numerical Rating Scale (NRS) para avaliacao de dor especifica em regioes cervical, dorsal e lombar, cuja variacao e de zero (sem dor) a 10 (dor insuportavel); Stanford Health Assessment Questionnaire (HAQ-20) e o questionario de Roland-Morris (RM) para avaliacao da capacidade funcional. O HAQ-20 varia de zero (melhor) a 3 (pior capacidade funcional), ja o RM varia de zero (melhor performance) a 24 (pior). Seis meses depois das cirurgias realizadas nas pacientes do grupo A foram feitas as mesmas avaliacoes de dor e capacidade funcional em ambos os grupos! Resultados; i Completaram o estudo 46 pacientes das 50 da fase 1, tanto no grupo A quanto no grupo B. A media de idade, em anos, nos grupos A e B foram de 31,6(11) e 32,3(12) respectivamente. A media de tecido mamario ressecado na cirurgia foi de 1052g(188). A capacidade funcional melhorou apos seis meses da cirurgia, quando comparada com o grupo controle. Os seguintes aspectos tiveram especial melhora: vestir-se, levantar-se, caminhar, banhar-se, alcancar e preender objetos. Em ambos os grupos o item mudo de posicao frequentemente (tentando deixar minhas costas mais confortaveis foi citado por 80 por cento das pacientes, caindo para 19,6 por cento no grupo A e permanecendo semelhante no grupo B (controle). A intensidade da dor nas regioes lombar, dorsal e cervical caiu de 5,7' 6,1 e 5,2 para 1,3; 1,1 e 0,9 respectivamente. Conclusao: A mamoplastia redutora causa melhora na capacidade funcional e alivio da dor nas regioes lombar, cervical e dorsal em pacientes com hipertrofia mamaria / In the period from April 2002 until March 2004, there were selected sequentbially 100 patients with hypertrophy of the breast, with ages between 18 and 55 years old, without any previous surgery procedure in the breast and sorted at random into two groups (Groups A and B). Group A was composed by 50 patients to be undergoing the reducing surgery of the breast while Group B was composed by 50 patients who would be in the waiting list for the surgery. There were performed evaluations in the phase 1 (pre-surgery) and after six months in the phase 2 (post-surgery) for both groups. In order to spot possible alterations caused by the reducing mastoplasty we used specific evaluation instruments for functional capacity and pain. To evaluate the functional capacity we used “Health Assessment Questionnaire HAQ-20”, that varies from zero to three, being that the patients with indexes nearer to zero presented a better degree of functional capacity; and we used as well the “Roland-Morris” questionnaire, which variation is between zero and 24, being zero the better degree of functional capacity and 24 the worst. To evaluate pain we used the numerical scale (NRS) for each body segment (cervical, dorsal and lumbar), with variation from 0 to 10, meaning zero no pain at all and 10 extreme pain. The descriptive analysis for the socio-demographic data used measures in brief such as medium, standard deviation and proportion. The inference analysis was made by means of the analysis of variations of the two groups and at the two moments of the research. The average age was of 31.6 and 32.3 years for the groups A and B. We had a complete segment of 92% (46/50) and Group A and of 92% (46/50) for Group B. The average weight of the dried breast tissue was of 1,052 g. We found positive alterations in the functional capacity in general. The patients showed to have improved in the following aspects: to get dressed, to get up, to walk, to bath, to reach and fix objects. In Group A as well as in Group B the item “I change positions frequently trying to get a more comfortable position for my back” was mentioned by 80% of the patients, and dropped to 19.6% for the operated patients (Group A) and remaining alike for the patients of the control group (Group B). The intensity of the pain in regions cervical, dorsal and lumbar dropped from 5.2; 6.1 and 5.7 to 0.9; 1.1 and 1.3 respectively. Therefore we conclude that the reducing mammaplasty causes positive alterations in the functional capacity and causes relief of pains in the patients with hypertrophy of the breast. / BV UNIFESP: Teses e dissertações
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.unifesp.br:11600/18914 |
| Date | January 2004 |
| Creators | Freire, Marcia Aparecida Martins da Silva [UNIFESP] |
| Contributors | Universidade Federal de São Paulo (UNIFESP), Sabino Neto, Miguel [UNIFESP] |
| Publisher | Universidade Federal de São Paulo (UNIFESP) |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | 122 p. |
| Source | reponame:Repositório Institucional da UNIFESP, instname:Universidade Federal de São Paulo, instacron:UNIFESP |
| Rights | info:eu-repo/semantics/openAccess |
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