Capacidade funcional de pacientes submetidas a reconstrução mamária tardia com retalho musculocutâneo de latíssimo do dorso
Arquivos
Data
2014
Autores
Guerreiro, Vidal 
Orientadores
Sabino Neto, Miguel
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: Muitos autores estabeleceram que a retirada do musculo latissimo do dorso apresenta pouco efeito sobre a morbidade do ombro, uma vez que os musculos residuais do ombro compensariam a sua falta. Outros, porem, tem notado fraqueza, perda de movimentos, dor e alteracao funcional. Entretanto, a maioria dos estudos nao e limitada a pacientes submetidas a cirurgia mamaria, sao retrospectivos e se apoiam sobre metodologia subjetiva. Objetivo: Avaliar a capacidade funcional em pacientes submetidas a reconstrucao mamaria tardia com retalho musculocutaneo de latissimo do dorso. Metodos: Trinta pacientes, em pos-operatorio tardio de mastectomia, foram submetidas a reconstrucao mamaria com retalho musculocutaneo de latissimo do dorso no periodo de outubro de 2010 a outubro de 2011. Elas responderam aos questionarios HAQ-20 e DASH durante as consultas de pre-operatorio, 3, 6 e 12 meses de pos-operatorio. Um grupo controle composto de 30 mulheres em pos-operatorio tardio de mastectomia foi avaliado em dois tempos (zero e 6 meses). Resultados: Houve diferenca com significancia estatistica entre os tempos de avaliacao, sendo detectada uma piora da capacidade funcional aos 3 meses de pos-operatorio (p<0,001). Esta retornou aos niveis do pre-operatorio apos 6 meses e foi melhorando progressivamente ate os 12 meses de pos-operatorio. Conclusao: O presente estudo oferece evidencia cientifica de que a cirurgia de reconstrucao mamaria com retalho musculocutaneo de latissimo do dorso nao piora a capacidade funcional das pacientes apos um ano de cirurgia
Intoduction: Many authors have established that the removal of the latissimus dorsi muscle has little effect in the shoulder morbidity, since the residual shoulder muscles compensate their lack. Others however, have noticed weakness, loss of motion, pain and functional impairment. However, most studies are retrospective and not limited to patients undergoing to breast surgery and the modalities used for this measurement rely on subjective methods. Objectives: To evaluate the functional capacity of patients undergoing delayed breast reconstruction with latissimus dorsi musculocutaneous flap. Methods: Thirty patients in the late postoperative period of mastectomy underwent breast reconstruction with latissimus dorsi musculocutaneous flap from October 2010 to October 2011. They answered the HAQ-20 and DASH during consultations preoperative, 3, 6 and 12 months postoperatively. A control group of 30 women in the late postoperative period of mastectomy was assessed in two stages (zero and 6 months). Results: There was a statistically significant difference between the times of evaluation. It was detected a worsening of functional capacity at 3 months postoperatively (p<0,001). It returned to preoperative levels after 6 months and was gradually improving until 12 months postoperatively. Conclusion: This study provides scientific evidence that breast reconstruction surgery with latissimus dorsi myocutaneous flap does not worsen the functional capacity of patients one year after surgery
Intoduction: Many authors have established that the removal of the latissimus dorsi muscle has little effect in the shoulder morbidity, since the residual shoulder muscles compensate their lack. Others however, have noticed weakness, loss of motion, pain and functional impairment. However, most studies are retrospective and not limited to patients undergoing to breast surgery and the modalities used for this measurement rely on subjective methods. Objectives: To evaluate the functional capacity of patients undergoing delayed breast reconstruction with latissimus dorsi musculocutaneous flap. Methods: Thirty patients in the late postoperative period of mastectomy underwent breast reconstruction with latissimus dorsi musculocutaneous flap from October 2010 to October 2011. They answered the HAQ-20 and DASH during consultations preoperative, 3, 6 and 12 months postoperatively. A control group of 30 women in the late postoperative period of mastectomy was assessed in two stages (zero and 6 months). Results: There was a statistically significant difference between the times of evaluation. It was detected a worsening of functional capacity at 3 months postoperatively (p<0,001). It returned to preoperative levels after 6 months and was gradually improving until 12 months postoperatively. Conclusion: This study provides scientific evidence that breast reconstruction surgery with latissimus dorsi myocutaneous flap does not worsen the functional capacity of patients one year after surgery
Descrição
Citação
GUERREIRO, Vidal. Capacidade funcional de pacientes submetidas a reconstrução mamária tardia com retalho musculocutâneo de latíssimo do dorso. 2014. 15 f. Dissertação (Mestrado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2014.