Estudo experimental comparativo de métodos de diérese tecidual no tratamento endoscópico do divertículo faringo-esofágico / Experimental study comparing two methods of tissue diaresis for endoscopic treatment of pharingoesophageal diverticulum

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

18/05/2011

RESUMO

The pharyngoesophageal diverticulum (PED), also known as cricopharyngeal or Zenker diverticulum (ZD), is a rare disease with estimated incidence ranging from 0.01% to 0.11% and more present in elderly patients, for whom a less invasive treatment can be desirable. Despite innovations in endoscopic equipment and accessories, bleeding and perforation occur in up to 10 and 15% of the cases, respectively. The finding of pharyngeal diverticulum in domestic pigs turned into an experimental model of major interest for training and scientific purposes. For this reason, the introduction of a technical innovation and its comparison with PED conventional treatment were focused. Our aim was to compare the diaeresis of the PED septum by the harmonic scalpel Ultracision ® monopolar electrocautery (Group M) in an experimental model. Twenty domestic pigs (mean weight 20.2 kg; ±1.35) were divided into groups M and U nonrandomly. No significant differences were found related to diverticulum size (p=0.0897) or insertion time of soft diverticuloscope (p=0.7387). In group U, mean time to divide the septum and total procedure time were significantly shorter (p<0.0001) for both comparisons. Regarding incision extension, mean length was significantly higher in group U (p=0.0047). In relation to microscopic parameters, the lateral thermal spread caused by monopolar current (Group M) was found to be more intense (p<0.0001). As for depth and inflammation presence, no differences were verified between the groups. Hemorrhage was exclusively observed in group M (p=0.01) and it was endoscopically managed at all times. When compared to endoscopic incision with needle-knife and monopolar blend current, the experimental endoscopic diverticulostomy using soft diverticuloscope and harmonic scalpel demonstrated to be faster and related to less tissue damage.

ASSUNTO(S)

animal models divertículo de zenker endoscopia gastrointestinal/métodos estudos experimentais experimental models gastrointestinal endoscopy/methods modelos animais terapia por ultrassom/instrumentação ultrasonic therapy/instrumentation zenker diverticulum

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