Avaliação da função respiratória em indivíduos submetidos à abdominoplastia

Abstract

OBJETIVO: Avaliar a função respiratória em indivíduos submetidos à abdominoplastia, através de parâmetros espirométricos. MÉTODO: Estudo prospectivo de 33 mulheres hígidas e não tabagistas, submetidas à abdominoplastia, e com resultados normais para as radiografias de tórax realizadas antes e quatro dias após a operação. Foram realizadas provas espirométricas no pré-operatório, no quarto, 15o e no 30o dias de pós-operatório. RESULTADOS: Provas espirométricas evidenciaram que, exceto pela relação VFE1/CVF e FEF 25-75%/CVF, todos os demais parâmetros avaliados (CVF, VEF1, FEF 25-75% e PFE) se apresentaram significativamente diminuídos no 4o PO em relação aos valores pré-operatórios. Os valores de CVF e PFE se mostraram normalizados à avaliação realizada no 30o PO. Já os valores de VEF1 ainda se revelaram significativamente inferiores aos valores pré-operatórios mesmo na última avaliação. CONCLUSÕES: Ocorreu diminuição da função respiratória no 4º dia de pós-operatório com normalização até o 30º dia de pós-operatório.

Is There a Direct Effect Between the Plication of the Myoaponeurotic Layer and the Force of Inspiratory and Expiratory Muscles After Abdominoplasty?

“…These values increased on the seventh day, returning to normality on the fifteenth day, revealing a curve similar to what occurs in the spirometry evaluations found in prior studies. [12][13][14] The results are not surprising considering that with the exception of the internal intercostal muscles, all other muscles involved in forced expiration are abdominal wall muscles. As previously described, the rectus abdominis and external oblique were sutured during the procedure.…”

“…If this was the case, it would also explain why the VEF1 was not altered (since the expiratory muscles function remained the same). Other studies 11,12,14,28,47 did not reveal the increase in the FVC.…”

“…Some studies evaluated the ventilatory alterations after abdominoplasty using a spirometer [12][13][14]28 ; however, no studies evaluating the inspiratory and expiratory pressures after this surgery were found in the literature.…”

“…6,7 Plications of the myoaponeurotic layer and the use of compressive garments could potentially be responsible for a marked increase of the intra-abdominal pressure (IAP), with a consequent mechanical restriction [8][9][10][11][12] of the ventilatory function. [12][13][14][15] After abdominal surgeries, including abdominoplasty, pulmonary complications such as pulmonary embolism, atelectasia, and respiratory failure may occur. Even though these are very unlikely events, they are considered the most risky.…”

Lipoabdominoplasty: repercussions for diaphragmatic mobility and lung function in healthy women

“…Tercan et al 10 evaluated 14 healthy women who underwent abdominoplasty, observing a significant decline in FVC on POD 10 and subsequent improvement by POD 30, when FVC surpassed the preoperative values, suggesting that correction of diastasis recti abdominis promotes effective containment of the abdominal wall, improving the spirometric parameters over a period > 30 days. Similarly, Helene Junior et al 13 found that, among patients undergoing abdominoplasty, the values of FEV 1 , FVC, FEF 25-75% , and PEF were lower on POD 4 than in the preoperative period, the FEV 1 /FVC ratio remaining constant, although FEV 1 and FVC were both below normal, suggesting a restrictive pattern. The authors also found that FVC and PEF showed significant improvement from POD 4 to POD 15, as well as from POD 15 to POD 30, although neither returned to the preoperative value.…”