Alterações cronológicas do perfil dos pacientes e da modalidade de tratamento cirúrgico do megaesôfago chagásico

OBJECTIVE: To analize the changes in the profile of the patients with chagasic megaesophagus and treatment modalities by comparing two groups of patients in different time periods. METHODS: Two series of consecutive patients with chagasic megaesophagus treated surgically were analized in two different time periods, between 1955 and 1962 (n=147) and between 1988 and1998 (n=100). The age, duration of disphagia and the stage of the disease were correlated to the type of surgical procedure. The degree of megaesophagus was defined radiologically. RESULTS: There was a reduction in the number of patients, an increase in the median age and a reduction in the duration of disphagia in the second time period. During the first period, ressectional procedures were more common, while cardiomiotomy predominated in the second. CONCLUSIONS: The profile of the patients with chagasic megaesophagus, treated at the HCFMRP-USP, has changed along the years, the main change being earlier stages of the disease. Earlier medical assistance results in less aggressive surgical procedures with the perspective of better outcomes.