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A dor pelvica cronica e um motivo frequente de consulta, que esta presente ate em um 40% das mulheres, e que afeta de forma consideravel sua qualidade de vida. A sindrome de congestao pélvica associada a varizes constitui um fator etiologico desta patologia; no entanto, existe pouca evidencia que descreva a eficacia e seguranca da tecnica cirurgica aberta. Este estudo avalia os resultados clinicos da cirurgia aberta para o manejo das varizes pelvicas. Materiais e métodos: realizou-se um estudo descritivo de corte transversal com 94 pacientes com varizes gonadais, submetidas a cirurgia aberta. Avaliaram-se os achados do metodo diagnostico, os achados intraoperatorios, e a evolucao pos-operatoria. Resultados: 85% das pacientes apresentaram refluxo bilateral, e 15% refluxo unilateral. Mais do 70% dos pacientes consultaram por apresentar dor pelvica maior a 6 meses, dispareunia, dismenorreia, e sintomas urinarios. Encontraram-se diferencas estatisticamente significativas quando se compararam os diametros reportados no duplex, com os medidos intraoperatoriamente, especificamente nas medicoes da veia gonadal direita, tanto em pacientes com refluxo unilateral (p=0.022) quanto bilateral (p= 0.017). O 92% das pacientes apresentou melhoria dos sintomas posterior ao tratamento cirurgico. Conclusões: A ligadura das veias ovarianas por cirurgia aberta e uma alternativa terapeutica para o tratamento das varizes pelvicas, com resultados que demonstram melhoria sintomatica importante. O duplex constitui um método diagnostico util, ainda que o diametro das veias gonadais pode ser subestimado.

Jhon Jairo Celis-Salas

Residente de Cirugía General IV año Universidad del Rosario.

José Rafael Tovar-Cuevas

Profesor asistente, Universidad del Rosario y Escuela de Estadística, Universidad del Valle, Cali Colombia.
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