Complicações Gastrointestinais no Pós-Operatório de Transplante de Pulmão: Uma Revisão Integrativa

João Lucas Ribeiro Ribeiro; Olival Cirilo Lucena da Fonseca Neto

Autores

João Lucas Ribeiro Ribeiro Universidade de Pernambuco – Faculdade de Ciências Médicas – Recife (PE) – Brasil. https://orcid.org/0009-0000-6036-3039
Olival Cirilo Lucena da Fonseca Neto Universidade de Pernambuco – Faculdade de Ciências Médicas – Recife (PE) – Brasil |Hospital Universitário Oswaldo Cruz – Serviço de Cirurgia Geral e Transplante de Fígado – Recife (PE) – Brasil. https://orcid.org/0000-0002-2383-8610

Palavras-chave:

Transplante de Pulmão, Complicações Pós-Operatórias, Complicações Gastrointestinais, Gastroparesia, Refluxo Gastroesofágico

Resumo

Objetivos: Investigar o espectro de complicações gastrointestinais (CGIs) em pacientes no pós-operatório de transplante de pulmão (TP), sintetizando as evidências sobre prevalência, fatores de risco, desfechos clínicos e estratégias de manejo. Métodos: Realizou-se uma revisão integrativa da literatura com busca nas bases de dados PubMed e Embase. Os critérios de seleção abrangeram estudos observacionais publicados nos últimos 20 anos que avaliaram CGIs em pacientes adultos pós-TP. Após um processo de triagem estruturado, 19 artigos foram selecionados para a síntese final. Resultados: As CGIs são altamente prevalentes, com a dismotilidade esofágica, o refluxo gastroesofágico e a gastroparesia sendo as condições funcionais mais relatadas. A dismotilidade esofágica emergiu como um fator de risco independente para a rejeição aguda, enquanto a gastroparesia associou-se ao desenvolvimento de disfunção crônica do enxerto (DCE). Complicações cirúrgicas agudas, como diverticulite perfurada e isquemia intestinal, especialmente quando manejadas em caráter de emergência, apresentaram elevada mortalidade. Conclusão: As CGIs são eventos frequentes que impactam negativamente a sobrevida e a qualidade de vida dos pacientes submetidos ao TP. A aplicação clínica desses achados indica a necessidade urgente da padronização de protocolos de triagem e manejo precoce, com ênfase na avaliação funcional do esôfago e estômago, para otimizar os desfechos nessa população.

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