O panorama atual sobre o uso da terapia de vácuo endoscópico no trato gastrointestinal superior
DOI:
https://doi.org/10.34119/bjhrv9n1-148Keywords:
terapia por vácuo endoscópico, trato gastrointestinal superior, fístula gastrointestinalAbstract
A terapia por vácuo endoscópico (EVT) tem se consolidado como uma estratégia terapêutica relevante no manejo de lesões do trato gastrointestinal superior, incluindo perfurações, fístulas e deiscências anastomóticas, especialmente em cenários de elevada morbimortalidade cirúrgica. Este estudo teve como objetivo analisar o panorama atual do uso da EVT no trato gastrointestinal superior, com ênfase em sua eficácia, principais indicações, limitações e perspectivas futuras. Trata-se de uma revisão integrativa da literatura, conduzida de acordo com as recomendações do PRISMA, com busca nas bases PubMed, Scopus, Web of Science e LILACS, utilizando descritores controlados do MeSH. Foram incluídos estudos publicados nos últimos oito anos, em língua inglesa, portuguesa ou espanhola. Ao final do processo de seleção, 55 estudos compuseram a análise. Os resultados demonstraram taxas de sucesso elevadas, variando entre 78% e 85%, especialmente no tratamento de deiscências esofágicas e esofagogástricas, perfurações esofágicas espontâneas e vazamentos pós-operatórios. O tempo médio de cicatrização variou entre 10 e 30 dias, com necessidade de 4 a 10 trocas do dispositivo, geralmente realizadas a cada 48 a 72 horas. A EVT mostrou-se associada à redução do tempo de internação, menor necessidade de reoperações e perfil de complicações aceitável, sendo a dor local e o desconforto os efeitos adversos mais frequentes. Apesar de custos iniciais mais elevados, os estudos apontam melhor custo-benefício global em comparação às abordagens cirúrgicas tradicionais. Conclui-se que a EVT representa uma ferramenta eficaz, segura e reprodutível no manejo das lesões do trato gastrointestinal superior, devendo ser incorporada de forma criteriosa e padronizada à prática da cirurgia geral e da endoscopia terapêutica.
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