Cicatrização intestinal em ratos submetidos à ingestão de etanol

O consumo abusivo de álcool é considerado um grave problema de saúde pública mundial. O uso excessivo e indiscriminado de bebidas alcoólicas é responsável por mais de 60 agravos a saúde, como câncer de esôfago, estômago e fígado, doenças cardiovasculares, cirrose hepática, pancreatite crônica, úlcera péptica e em muitas dessas patologias pode-se necessitar de intervenções no trato digestivo. Na problemática exposta sobre o alcoolismo há uma série de alterações que podem repercutir nas anastomoses do trato gastrointestinal, como: desnutrição, lesões hepáticas, além do efeito tóxico direto do etanol sobre a mucosa gastrointestinal. Estudar o efeito do alcoolismo no processo de cicatrização intestinal e a evolução no pós-operatório de ratos submetidos à ingestão de etanol. Método: Foram utilizados 160 ratos da linhagem Wistar. Esses animais foram divididos em dois grupos, controle e tratado, sendo que o controle recebeu água e ração em livre demanda e o tratado solução etílica a 30% e ração livre demanda. Após 180 dias foi realizada colotomia cinco centímetros acima da deflexão peritoneal e anastomose em todos os animais. Após o procedimento os grupos foram divididos em quatro subgrupos de 20 ratos para estudo nos seguintes momentos: 40, 70, 140 e 210 pós-operatórios. Os parâmetros analisados foram: força de ruptura longitudinal, dosagem de hidroxiprolina tecidual, complicações pós-operatórias e estudo histopatológico. Resultados: O ganho de peso foi superior no grupo controle quando comparado com o grupo tratado (p<0,05). Agrupados todos os subgrupos, a força de ruptura foi significativamente maior no grupo controle que no grupo tratado (p<0,05). A dosagem de hidroxiprolina não apresentou diferença entre os grupos em cada momento estudado. A análise histopatológica não demonstrou alterações significativas entre...Alcohol abuse is considered to be a serious public-health problem worldwide. The excessive and indiscriminate use of alcoholic beverages is responsible for more than 60 health medical problems, such as esophageal, stomach and liver cancer, cardiovascular diseases, hepatic cirrhosis, chronic pancreatitis and peptic ulcers. Many of these pathologies may require interventions in the digestive tract. The problems stemming from alcoholism include a number of alterations that may lead to anastomosis of the gastrointestinal tract, such as malnutrition and hepatic lesions, in addition to the direct toxic effect of ethanol on the gastrointestinal mucosa. Objective: To study the effect of alcoholism on the process of intestinal healing and the post-operative development of rats submitted to ethanol ingestion. Method: One hundred and sixty Wistar rats were used. These animals were divided into two groups, namely control and treated. The control group received water and animal feed ad libitum, and the treated group was given 30% ethyl alcohol solution and feed ad libitum. One hundred and eighty days later, colotomy 5 cm above peritoneal deflection and anastomosis were performed in all animals. After the procedure, the groups were divided into 4 sub-groups of 20 rats for study at the following post-operative moments: 4th, 7th, 14th and 21st days. The parameters analyzed were rupture strength, tissue hydroxyproline dosage, post-operative complications and histopathology. Results: Weight gain was greater in the control group as compared to that in the treated group (p<0.05). By grouping all the sub-groups, it was observed that rupture strength was significantly greater in the control group than in the treated group (p<0,05). Hydroxyproline dosage did not show any differences between the groups at each studied moment. Histopathological analysis did not show significant alterations between the groups... (Complete abstract click electronic access below)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Study on functional cardiorespiratory changes after laparoscopic Nissen fundoplication Estudo das alterações funcionais cardiorrespiratórias após a fundoplicatura laparoscópica à Nissen

PURPOSE: To analyze the behavior of cardiopulmonary function in postoperative of laparoscopic Nissen fundoplication. METHODS: Thirty-two patients, 13 males (41%) and 19 females (59%), were evaluated. Their age ranged from 25 to 67 years, with a mean of 44.4 ± 10.9. Pulmonary volumes, respiratory pressures and exercise tests were performed in the preoperative period (PRE) and in the first (PO1), second (PO2), fifth (PO5) and thirtieth (PO30) postoperative periods. RESULTS: Thirty-two patients were evaluated, of whom 59% were females. Mean age was 44.4 ± 10.9 years. Lung volumes had significant decrease at PO1 and PO2 and were similar to PRE values at PO5. Respiratory pressures were altered only at PO1. The distance covered in the 6-minute walk test had significant reduction until PO2, and climbing time in the stair-climbing test significantly increased at PO2. CONCLUSION: Patients submitted to LNF surgery have decreased cardiorespiratory function in the early postoperative period; however, they soon return to preoperative conditions.<br>OBJETIVO: Analisar o comportamento da função cardiopulmonar no pós-operatório de fundoplicatura Nissen laparoscópica. MÉTODOS: Trinta e dois pacientes, 13 homens (41%) e 19 mulheres (59%) foram avaliados. A idade variou de 25 to 67 anos, com media de 44.4 ± 10.9. Os volumes pulmonares, as pressões respiratórias e testes de exercício foram realizados no período pré-operatório (PRE) e no primeiro (PO1), segundo (PO2), quinto (PO5) e trigésimo (PO30) períodos pós-operatórios. RESULTADOS: Trinta e dois pacientes foram avaliados, dos quais 59% eram do sexo feminino. A média de idade foi de 44,4 ± 10,9 anos. Os volumes pulmonares apresentaram diminuição significativa no PO1 e PO2 e foram semelhantes aos valores PRE no PO5. As pressões respiratórias estiveram alteradas apenas no PO1. A distância percorrida no teste da caminhada de 6 minutos apresentou redução significativa até o PO2, e o tempo de subida no teste de escada aumentou significativamente no PO2. CONCLUSÃO: Pacientes submetidos à FLN apresentaram diminuição da função cardiorrespiratória no início do período pós-operatório, no entanto, elas rapidamente regressaram às condições pré-operatórias

Ruptura gástrica por barotrauma

INTRODUÇÃO: A ruptura gástrica por barotrauma é uma causa rara de abdome agudo perfurativo, sendo geralmente tratada por laparotomia e rafia primária da lesão. Nas reanimações cardiopulmonares pode ocorrer 9 a 12% de lesões de mucosa gástrica. RELATO DO CASO: Mulher no 5º dia de puerpério necessitou intubação orotraqueal devido à pneumonia hospitalar. Após procedimento evoluiu com distensão abdominal importante, associada a sinais de choque séptico. Após radiografia simples de abdome foi constado pneumoperitôneo. Submetida à laparotomia exploradora evidenciou-se ruptura de pequena curvatura gástrica de 7 cm. O tratamento da lesão foi com sutura primária. Recebeu alta no 14º do pós operatório após término do tratamento para pneumonia. CONCLUSÃO: Apesar de rara, a ruptura gástrica por barotrauma deve ser sempre aventada quando após reanimação cardiopulmonar houver distensão abdominal refratária à sondagem naso-gástrica

O uso do pneumoperitônio progressivo no pré-operatório das hérnias volumosas da parede abdominal

Context - Correction of voluminous hernias and large abdominal wall defects is a big challenge in surgical practice due to technical difficulties and the high incidence of respiratory and cardiovascular complications. Objectives - To present the authors experience with inducing progressive pneumoperitoneum preoperative to surgical treatment of voluminous hernias of the abdominal wall. Methods - Retrospective study of six patients who presented voluminous hernias of the abdominal wall and were operated after installation of a pneumoperitoneum. The procedure was performed by placing a catheter in the abdominal cavity at the level of the left hypochondrium with ambient air insufflation for 10 to 15 days. Results - Four of the six patients were female and two male. Ages ranged from 42 to 62 years. Hernia duration varied from 5 to 40 years. Four patients had incisional, one umbilical, and one inguinal hernias. Mean pneumoperitoneum time was 11.6 days. There were no complications related to pneumoperitoneum installation and maintenance. All hernias were corrected without technical difficulties. The Lichtenstein technique was used to correct the inguinal hernia, peritoneal aponeurotic transposition for one of the incisional hernias, with the rest corrected using polypropylene mesh. One death and one wall infection were observed post operatively. No recurrences were reported until now, in 4 to 36 months of follow-up. Conclusion - Preoperative progressive pneumoperitoneum is a safe and easy executed procedure, which simplifies surgery and reduces post-operative respiratory and cardiovascular complications. It is indicated for patients with hernias that have lost the right of domain in the abdominal cavity

Rotura gástrica por barotrauma

Barogenic rupture of the stomach is a rare complication following cardiopulmonary resuscitation, administration of nasal oxygen by catheter and diving accidents. We report a case of gastric barotrauma following oroesophageal intubation. In most cases, the tears occur along the lesser curvature, what have been already attributed to Laplace's formula and, more recently, to morphological features of the stomach

Efficacy of surgical versus conservative treatment in esophageal perforation: a systematic review of case series studies

PURPOSE: To evaluate the efficacy of surgical treatment for esophageal perforation. METHODS: A systematic review of the literature was performed. We conducted a search strategy in the main electronic databases such as PubMed, Embase and Lilacs to identify all case series. RESULTS: Thirty three case series met the inclusion criteria with a total of 1417 participants. The predominant etiology was iatrogenic (54.2%) followed by spontaneous cause (20.4%) and in 66.1% the localization was thoracic. In 65.4% and 33.4% surgical and conservative therapy, respectively, was considered the first choice. There was a statistically significance different with regards mortality rate favoring the surgical group (16.3%) versus conservative treatment (21.2%) (p<0.05). CONCLUSION: Surgical treatment was more effective and safe than conservative treatment concerning mortality rates, although the possibility of bias due to clinical and methodological heterogeneity among the included studies and the level of evidence that cannot be ruled out