ABSTRACT
OBJETIVO: verificar a viabilidade do transplante autógeno de testículos na parede abdominal e omento, em ratos, sem anastomose vascular, analisando a estrutura histológica das células testiculares após o implante. MÉTODOS: foram utilizados 60 ratos Wistar, machos, de 10-12 semanas de idade, distribuídos em três grupos: grupo controle: 20 ratos sem orquiectomia, com operação simulada; grupo 2: 20 ratos com orquiectomia bilateral sendo um testículo implantado no omento maior; grupo 3: 20 ratos com orquiectomia bilateral, sendo um testículo implantado na parede abdominal. Após dois meses eles foram mortos e os testículos avaliados pelo exame anatomopatológico. RESULTADO: o peso dos implantes teve perda de 0,62g no grupo 2, de 0,73g no grupo 3 e no grupo controle houve aumento de 0,1g. Ao estudo anatomopatológico, no grupo controle a estrutura testicular foi preservada; no grupo 2 encontrou-se 80% de inflamação e necrose, não foram visualizadas células de Sertoli ou de Leydig, em dois animais encontraram-se túbulos seminíferos; no grupo 3 encontrou-se 75% de inflamação e 60% de necrose, somente em um conseguiu-se visualizar células de Sertoli e em três células de Leydig. CONCLUSÃO: não é viável o transplante autógeno de testículo sem anastomose vascular em ratos no omento maior e na parede abdominal.
OBJECTIVE: To verify the feasibility of autologous transplantation of testes to the abdominal wall and omentum of rats without vascular anastomosis, analyzing the histological structure of the testicular cells after implantation. METHODS: We used 60 male Wistar rats, 10-12 weeks of age, which were divided into three groups: control group: 20 rats without orchiectomy with sham operation; group 2: 20 rats undergoing bilateral orchiectomy, with one of the testicles being implanted into the greater omentum; and group 3: 20 rats submitted to bilateral orchiectomy, with one testicle implanted in the abdominal wall. After two months they were euthanized and the testes evaluated by histopathology. RESULTS: the weight of the implants had a loss of 0.62 g in group 2, 0.73 g in group 3, whilst in the control group testes increased by 0.1 g. In pathological studies, the testicular structure was preserved in the control group; in group 2 there was 80% of inflammation and necrosis, Sertoli and Leydig cells were not visualized, and seminiferous tubules were found in two animals; in group 3 we found 75% of inflammation and a 60% necrosis, Sertoli cells could be visualized in only one specimen, while Leydig cells were seen in three. CONCLUSION: autologous transplantation of testis to the greater omentum and abdominal wall without vascular anastomosis is not viable in rats.
Subject(s)
Animals , Male , Mice , Rats , Abdominal Wall/surgery , Omentum/surgery , Testis/transplantation , Autografts , Feasibility Studies , Rats, WistarABSTRACT
Los desórdenes de desarrollo sexual hacen referencia a niños cuyos genitales al nacer presentan características de ambos sexos o aquellos que, teniendo un fenotipo normal, presentan alteraciones del desarrollo en la pubertad o adolescencia. Estos desórdenes representan un reto diagnóstico y terapéutico, debido a que pueden ser desencadenados por diferentes entidades nosológicas, y por otro lado, pacientes portadores de las mismas patologías pueden presentar diferentes alteraciones anatómicas. La laparoscopia juega un importante papel en el abordaje diagnóstico de estos pacientes; permite la visualización de los genitales internos y la toma de muestras de tejidos para estudios histológicos. Desde el punto de vista terapéutico, la cirugía laparoscópica permite la extirpación de estructuras internas opuestas al sexo definitivo del paciente. Se reporta el caso de un adolescente con desorden del desarrollo sexual ovotesticular (Hermafrodita verdadero) a quien una vez definido el sexo social como varón, se le extirparon a través del abordaje laparoscópico, los remanentes embrionarios derivados del Müller. Se practicó mamoplastia reductora e implantación de prótesis testiculares a través de cirugía convencional.
Disorders of sexual development in adolescents refer to children whose genitals at birth present characteristics of both genders, or to those children with normal phenotype that present a development alteration during puberty or adolescence. These disorders represent diagnostic and therapeutic challenges, because they can be triggered by different nosological entities; and on the other hand, patients carrying the same pathologies can present different anatomical alterations. Laparoscopy plays an important role in the diagnostic approach of these patients because, besides the fact that it allows an excellent visualization of the internal genitals anatomy, it also allows tissue sample taking for histological studies. On the other hand, from a therapeutic point of view, laparoscopic surgery allows removal of internal structures opposed to the patients definite gender. We report the case of an adolescent with ovotesticular disorder of sexual development (True Hermaphrodite) from whom, once his male gender was socially defined, the embrionary remnants derived from Müller were removed through laparoscopic approach. Mamoplastic reduction and testicular prosthesis implantation were also practiced through conventional surgery.
Subject(s)
Humans , Male , Adolescent , Mullerian Ducts/abnormalities , Ovotesticular Disorders of Sex Development/surgery , Hypospadias/surgery , Laparoscopy/methods , Mammaplasty/methods , Sexual Development , Testis/transplantation , Endocrinology , General SurgeryABSTRACT
This study was conducted by consecutively transplanting spleens, which had gonads implanted previously. A total of 84 cases for infantile testicles and 106 cases for ovarian follicles were performed. In the case of ovarian implants, the results were determined by the total number of follicle implants. A modified spleen transplantation technique called double implantation of ovarian follicles was applied to increase the amount of the implants. In this technique, an extra spleen is implanted into the potential donor so that the ovarian follicles can be implanted to two different spleens, doubling the amount of implants. Through consecutive spleen transplantation, we observed the results beyond a typical rat's life span. In many of these cases, we found more aggressive forms of malignant tumor, seminoma and dysgerminoma. We present the results and discuss possible pathogenic mechanisms of tumor formation.
Subject(s)
Animals , Female , Male , Rats , Animals, Newborn , Ovarian Neoplasms/etiology , Ovary/transplantation , Rats, Inbred Lew , Spleen/surgery , Testicular Neoplasms/etiology , Testis/transplantation , Transplantation, HeterotopicABSTRACT
En ésta revisión se discuten las posibles intervenciones para proteger la fertilidad futura de aquellos pacientes oncológicos prepúberes o en la pubertad temprana. En el varón, además de la conocida técnica de crioconservación del semen, se proponen alternativas útiles para niños prepúberes y aquellos adolescentes y jóvenes en los que la enfermedad ha deteriorado significativamente la calidad del semen. Se discute la criopreservación de biopsias testiculares que podrán ser utilizadas para: transplante subcutáneo de tejido, auto y xenotransplante de células germinales y para espermatogénesis in vitro. En la mujer se examina la crioconservación de embriones y ovocitos y la conservación de biopsias de ovario destinadas al auto y xeno transplante y la maduración folicular in vitro. Estadísticas recientes indican que 1 de cada 650 niños sufrirá de alguna forma de cáncer y que aproximadamente el 70 por ciento resultará curado. Sin embargo, éste éxito terapéutico trae aparejada una fuerte incidencia de alteraciones graves de la futura función reproductiva, tanto en hombres como mujeres...
Subject(s)
Humans , Male , Female , Antineoplastic Agents/adverse effects , Fertility , Infertility, Female , Infertility, Male , Ovary , Testis/transplantation , Infertility , Infertility, Female , Infertility, Male , Ovary , TestisABSTRACT
Reportamos el caso de un niño de 8 años con criptorquidia bilateral en quien se practicó autotrasplante d eun testículo intr-abdominal utilizando técnica microvascular, con resultado satisfactorio. Se localizó la gónada preoperatoriamente mediante tomografia axial computada. La evaluación de la perfusión testicular postquirúrgica se efectuó con gamagrafía. Diez meses después de la operación el testículo autotrasplantado es normal a la exploración física. Se discuten las indicaciones de este procedimiento, los métodos de evaluación pre y postperatoria y se revisa la literatura. Consideramos que esta técnica es útil cuando la indicación es precisa y sólo si se cuenta con el instrumental y entrenamiento especiales para microcirugía