Preoperative cobalt60 irradiation delays the healing of rectal anastomoses in rats

The healing of colorectal anastomoses after irradiation therapy continues to be a major concern. The authors evaluated the healing of rectal anastomoses in a rat model after a preoperative 500-cGy dose of cobalt60 irradiation. Thirty-six male Wistar rats were divided into two equal groups: control (group A), and irradiation group (group B). Group B received a single 500-cGy dose of irradiation, and a rectal resection and end-to-end anastomosis was performed in both groups on the 7th day after irradiation. Parameters of the healing process included bursting pressure and collagen content on the 5th, 7th, and 14th days after surgery. In the irradiation group, the mean bursting pressure on the 5th, 7th, and 14th days was 116, 218, and 273 mmHg, respectively. The collagen content assessed by histomorphometry was 9.0, 20.8, and 32 percent, respectively. In contrast, the control group had a mean bursting pressure of 175, 225 and 263 mmHg, and a collagen content of 17.8, 28.1, and 32.1 percent, respectively. The adverse effect of irradiation on healing was detectable only on the 5th postoperative day, as demonstrated by lower bursting pressure (P < 0.013) and collagen content (P < 0.008). However, there was no failure of anastomotic healing such as leakage or dehiscence due to irradiation. We conclude that a single preoperative 500-cGy dose of irradiation delays the healing of rectal anastomosis in rats.

Tuberculose intestinal complicada. / Complicated intestinal tuberculosis

Sao apresentados 12 doentes portadores de tuberculose intestinal complicada. Destes, 3 eram portadores de obstrucao intestinal e 9 de perfuracao, sendo 6 em peritonio livre. A mortalidade global foi de 75%, e 77,7% dos que faleceram apresentavam perracao. Na obstrucao, a operacao de escolha e a resseccao da area comprometida, enquanto na perfuracao a resseccao com esteriorizacao deve ser a operacao preferencial

Preparo do colon para cirurgia com neomicina e eritromicina. / Colon preparation for surgery with neomycin and erythromycin

Os autores realizaram estudo prospectivo em 70 doentes, visando avaliar o valor do uso profilatico da associacao entre o sulfato de neomicina e a eritromicina base, usados no dia anterior a cirurgia realizada sobre o intestino grosso. Constataram a incidencia de 11,4% de infeccoes incisionais - 8 casos. Por este dado, observaram a eficiencia da preparacao antimicrobiana na forma empregada, ressaltando o valor relativo do preparo mecanico e a necessidade da obediencia aos preceitos da boa tecnica, a fim de obter baixo indice de infeccao pos-operatoria

Estudo comparativo de dois esquemas medicamentosos no preparo do intestino para a cirurgia colorretal. / Comparative study of 2 drug administration schedule in the preparation of the intestine for colorrectal surgery

Os autores realizaram estudo retrospectivo comparando dois grupos de pacientes que receberam preparo intestinal com antibioticos, visando a avaliar os indices de infeccao incisional. O grupo A foi preparado com sulfatalidina associada a estreptomicina e tetraciclina. O grupo B a associacao da neomicina a eritromicina-base. Em ambos os grupos o intestino foi preparado mecanicamente de forma similar. A diferenca no numero de infeccoes incisionais revelou-se nao significante: 7 em 76 doentes no grupo A e 8 em 70 no grupo B.Concluem pela propriedade de ambos os metodos de preparo, ressaltando a vantagem do esquema neomicina associada a eritromicina-base pelo curto tempo necessario para o preparo