Comparison between the open and the laparoscopic approach in the primary ventral hernia repair: a systematic review and meta-analysis.

BACKGROUND: Ventral hernia repair underwent various developments in the previous decade. Laparoscopic primary ventral hernia repair may be an alternative to open repair since it prevents large abdominal incisions. However, whether laparoscopy improves clinical outcomes has not been systematically assessed. OBJECTIVES: The aim is to compare the clinical outcomes of the laparoscopic versus open approach of primary ventral hernias. METHODS: A systematic search of MEDLINE (PubMed), Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted in February 2023. All randomized controlled trials comparing laparoscopy with the open approach in patients with a primary ventral hernia were included. A fixed-effects meta-analysis of risk ratios was performed for hernia recurrence, local infection, wound dehiscence, and local seroma. Meta-analysis for weighted mean differences was performed for postoperative pain, duration of surgery, length of hospital stay, and time until return to work. RESULTS: Nine studies were included in the systematic review and meta-analysis. The overall hernia recurrence was twice less likely to occur in laparoscopy (RR = 0.49; 95%CI = 0.32-0.74; p < 0.001; I2 = 29%). Local infection (RR = 0.30; 95%CI = 0.19-0.49; p < 0.001; I2 = 0%), wound dehiscence (RR = 0.08; 95%CI = 0.02-0.32; p < 0.001; I2 = 0%), and local seroma (RR = 0.34; 95%CI = 0.19-0.59; p < 0.001; I2 = 14%) were also significantly less likely in patients undergoing laparoscopy. Severe heterogeneity was obtained when pooling data on postoperative pain, duration of surgery, length of hospital stay, and time until return to work. CONCLUSION: The results of available studies are controversial and have a high risk of bias, small sample sizes, and no well-defined protocols. However, the laparoscopic approach seems associated with a lower frequency of hernia recurrence, local infection, wound dehiscence, and local seroma.

Contribution to the study of aortic mural structure of opossum (Didelphis albiventris) / Contribución al estudio de la estructura mural de la aorta del zorrillo (Didelphis albiventris)

Opossum is considered one of the most primitive mammals, with transition evolutive characteristics. In mammals, the aorta artery is referred as the main body blood vessel. The arteries wall structural organization follows a basic pattern, being contituted of three tunics: Intima, Median and Adventicial. After euthanasia, three samples of opossum had segments from the aorta artery ascendent, thoracic descending and abdominal descending portions removed, fixed in phormalin at 10 percent for 48 hours. Then, the material was washed in alcohol 70 percent several times, dehydrated in alcohois of growing concentrations, diafanized in xylol and included in "paraplast". Cuts with 5 to 7um of thickness were placed in histological laminae and submitted to color methods of Hematoxilin-Eosin, Masson, Mallory and Calleja Tricromics. It was observed that in the different portions ascendent, thoracic and abdominal descending of aorta, the intima tunic presents much thick, made up of a layer of smooth muscular cells and elastic fibers, forming a limiting internal elastic membrane. In the three portions studied, the median tunic was the most evident layer, constituted of colagen fibers, smooth muscular cells arranged in a circular manner and elastic fibers, showing a variation in the mural elements proportion. It was evidenced the presence of a external elastic lamina, marking the transition between the median and adventicial tunic, formed by elastic fibers condensation. The aortic adventicial tunic showed to be little organized, having in its structure predominantely colagen fibers beans with some isolated smooth muscular fibers or in small fascicules among a few elastic fibers.

El zorrillo es considerado uno de los mamíferos más primitivos, con transición de características evolutivas. En los mamíferos, la arteria aorta se refiere como el principal vaso sanguíneo del cuerpo. La organización estructural de la pared de las arterias sigue un patrón básico, siendo contituida por tres túnicas: íntima, media y adventicial. Después de la eutanasia, tres muestras de zorrillos fueron seccionadas desde las porciones de la arteria aorta ascendente, descendente torácica y abdominal descendente, removidas, y fijadas en formalina al 10 por ciento durante 48 horas. Luego, el material se lavó varias veces en el alcohol al 70 por ciento, deshidratados en alcoholes en concentraciones crecientes, diafanizadas en xilol y se incluyeron en paraplast. Cortes de 5 a 7 mm de espesor fueron colocados en láminas histológicas y sometidas a los métodos de tinción de Hematoxilina-Eosina, Masson, Mallory y tricrómico de Calleja. Se observó que en las diferentes porciones ascendente, torácica y abdominal descendente de la aorta, la túnica íntima se presentó mucho más gruesa, formada por una capa de células musculares lisas y fibras elásticas, formando una membrana limitante elástica interna. En las tres porciones estudiadas, la túnica media fue la capa más evidentes, constituida por fibras de colágeno, células musculares lisas dispuestas en forma circular y fibras elásticas, mostrando una variación en la proporción de elementos murales. Se evidenció la presencia de una lámina elástica externa, que marca la transición entre la túnica media y adventicia, formada la por condensación de las fibras elásticas. La túnica adventicia aórtica demostró ser poco organizada, presentando en su estructura predominantemente fibras de colágeno con algunas fibras musculares lisas aisladas o en pequeños fascículos entre unas pocas fibras elásticas.

Study on cranial and caudal mesenteric arteries in opossum (Didelphis albiventris) / Estudio de las arterias mesentéricas craneal y caudal del zorrillo (Didelphis albiventris)

The objective of this study is to describe the cranial and caudal mesenteric arteries in 10 opossuns after Neoprene latex injection. The cranial mesenteric artery arises from the abdominal aorta, caudally to the celiac trunk, originating the caudal duodenal pancreatic artery, middle and right colic, jejunal and ileocecocolic arteries. The caudal mesenteric artery arises from the aorta, cranially to the external iliac arteries, originating the cranial rectal and left colic arteries.

El objetivo de este estudio fue describir las arterias mesentéricas craneal y caudal de 10 zorrillos después de la inyección de látex Neoprene. La arteria mesentérica craneal tiene origen en la aorta abdominal, caudalmente al tronco celíaco y da origen a las arterias: pacreáticoduodenal caudal, cólica media derecha, yeyunales e ileocecocólica. La arteria mesentérica caudal con origen en la aorta, cranealmente a las arterias ilíacas externas, da origen a las arterias rectal craneal y cólica izquierda.

Anatomical Study on Domestical Fowl (Gallus domesticus) Reproductive System / Estudio Anatómico del Sistema Reproductor del Gallo Doméstico (Gallus domesticus)

Lately, researchers have taken into consideration studies on birds since they represent an excellent nutritional source. There are several classical descriptions of the male reproductive tract, always aiming at establishing a correlation with shape, testicular size, age and sexual maturity. This study analyzed 50 male Gallus domesticus, 1 to 64 weeks old. The birds were collected with 10 days and then weekly until 24 weeks, following 37, 48, 59 and 64 weeks, and sacrificed by cervical displacement. It was observed the sintopies of testis with the other organs. Further, it was done the testicular measurement and then the statistical analysis by following the model of testis weight variation due to the animal age. Our results showed that the maximum weight of the right and left testes occurred with 167 and 210 days, respectively, what made us infer this species sexual maturity in this period.

Últimamente, los investigadores han tomado en consideración estudiar aves, ya que estas representan un importante recurso nutritional. Existen varias descripciones clásicas del tracto reproductor de ellas, las cuales apuntan a establecer una correlación entre la forma, tamaño testicular, edad y madurez sexual. Este estudio analizó 50 Gallus domesticus machos, entre la semana 1 a 64 de edad. Las aves se recolectaron a los 10 días y semanalmente hasta la semana 24, luego de las semanas 37,48,59 y luego sacrificadas por desplazamiento cervical. Se observó la sintopía de los testículos con los otros órganos. Además, se realizaron la medición de los testículos y el análisis estadístico, seguido del modelo de variación de peso testicular en relación a la edad del animal. Nuestros resultados muestran que el peso máximo de los testículos, derecho e izquierdo, ocurre en los días 167 y 210, respectivamente, lo que nos hace inferir que la madurez sexual ocurre en ese periodo.

Ultrastructural Aspects of Spermatids in Isogenic Black Mouse C57BL6J / Aspectos Ultraestructurales de las Espermátidas en el Ratón Negro Isogénico C57BL6

The objective of this study was to describe some changes in spermatids differentiating events during spermiogenesis, leading to spermatozoa final formation. The animals were sacrificed with ethylic acid inhalation and, then, testis fragments were collected, fixed in Karnovsky and post-fixed in osmium tetroxide. After dehydration, the sections were stained with uranyl acetate 2%. It was observed in early spermatids at Golgi phase, formation of acrosomal granule contained in the acrosomal vesicle, spheroidal nucleus with rugous reticulum around it, and Golgi apparatus made up of lamellae and vesicular structures. At cephalic hood phase, the granule suffers flattening and the marginal fossa is formed. In both phases, it was possible to observe the presence of multivesicular body. At acrosomal phase, the acrosomal system is set up, and several enzymes of endoplasmatic reticulum as well chromatoid body are observed in the cytoplasm. At the last phase, that is, maturation, the nucleus becomes more elongated, the endoplasmatic reticulum regresses, the Golgi apparatus approaches to the flagellum and mitochondrias align next to it.

El objetivo del estudio, fue describir algunas alteraciones producidas en la espermiogénesis, en los eventos que diferencian a las espermátidas y que llevan a la formación final de los espermatozoides. Los ratones fueron sacrificados con inhalación de éter etílico y, enseguida, se recolectaron fragmentos de testículos, los que fueron fijados en Karnovsky y tetróxido de osmio. Después de la deshidratación, los cortes fueron teñidos con acetato de uranilo al 2 %. En espermátidas jóvenes en la fase de Golgi se observan: formación del gránulo acrosómico contenido en la vesícula acrosómica, núcleo esferoidal con retículo rugoso a su alrededor, y aparato de Golgi formado por lamelas y estructuras vesiculares. En la fase de capuz cefálico, el gránulo sufre achatamiento y se forma la fosa marginal. En estas dos fases fue posible observar la presencia del cuerpo multivesicular. En la fase acrosómica se establece el sistema acrosómico, distingiéndose en el citoplasma muchas vesículas de retículo endoplasmático y cuerpo cromatoide. En la última fase, la de maduración, el núcleo se torna más alargado, el retículo endoplasmático retrae, el aparato de Golgi se aproxima al flagelo y las mitocondrias se alinean a lo largo de él.

Anatomical study of the abdominal aorta sacral rami of the opossum (Didelphis albiventris)

El objetivo de este estudio fue describir la anatomía de la aorta abdominal de la comadreja overa (Didelphis albiventris) enfatizando las arterias iliacas comunes, las arterias ilíacas interna y externa y la arteria sacra mediana. Utilizamos 10 animales Didelphis albiventris del Departamento de Anatomía, Instituto de Biociencias - UNESP, Botucatú, Brasil. Después de la laparotomía fueron examinadas la aorta y sus ramas terminales, disecadas bajo microscopio y fotografiadas. La aorta abdominal originó las arterias ilíacas comunes derecha e izquierda, las cuales se dividen en las arterias ilíacas externa e interna. La arteria sacra mediana se originó en el 30 por ciento de los casos de la arteria iliaca común derecha, en el 30 por ciento de la arteria iliaca común izquierda y en el 40 por ciento como una continuación de la aorta abdominal.

Study of the arterial coronary circulation in the dog (canis familiaris)

Study on arterial coronary circulation was performed in 30 dog hearts, by using the dissection and clearing techniques. We observed that the heart is supplied by the right coronary artery (a. coronaria dextra) and three branches of the left coronary artery ( a. coronaria sinistra): paraconal interventricular ( ramus interventricularis paraconalis), septal ( ramus septales ) and circumflex arteries (ramus circumflexus). The left coronary artery arose from a trunk in the ventral aortic sinus and, when there was no trunk formation, it was found two different origins in the aorta, corresponding to the circumflex and paraconal interventricular arteries. The latter, after originating right anterior ventricular, left anterior ventricular and septal ventricular arteries, ended next to the heart apex. The circumflex artery presented its course to the left up to the atrial face, where it ended as subsinuous interventricular artery. Arising from the circumflex artery, it was found the auricular ( rami auricularis), ventricular ( rami ventricularis) and septal (rami septales) branches and branches to the atrio-ventricular node ( nodus atrio-ventricularis). The septal artery (ramus septales) was observed to be originated from the paraconal interventricular artery, with lower frequence of the left coronary artery and in two cases of the circumflex artery. The right coronary artery presented no arterial trunk. In that place, there were two separate origins in the aorta or 2-3 origins in a common sinus. This artery emitted auricular, ventricular branches and to the atrio-ventricular node.

Comparative study of arterial vascularization in swine spleen: sus scrofa domesticus

Estudiamos la vascularización arterial de 20 bazos de suínos inyectados con neoprene latex, fijados con solución de formol 10 por ciento y disecados. Los resultados obtenidos mostraron a la arteria esplénica cruzando el órgano a nivel del hilio dividiendo el bazo en 3 regiones de vascularización: dorsal, media y ventral

Histochemical and structural characteristcs of the testes of isogenic black mice (Rodentia: Muridae)

In the present study we analyzed the histochemical characteristics of glycogen and glycosaminoglycan reactivities in the different regions of the testes of isogenic black mice of the C57B16J strain. Acid glycoconjugates and glycogen were observed in the structure of the tunica albuginea and lamina propria, reflecting the composition of the tunica albuginea by connective tissue and smooth muscle fibers and of the lamina propria by connective matrix and myoid cells, i.e., contractile myoepithelial elements. The adbasal compartment showed positive reactivity for mucosubstances associated with glucide metabolism. We also observed strong PAS positivity in the PAS and amylase + PAS reactions in the adluminal compartiment, which we assume to be due to glycoconjugates of the acrosomes of the cells pesent there.

Vascularizaçäo arterial do epidídimo do camundongo negro isogênico (Rodentia-Muridae) / Arterial vascularization of the black isogenic mouse epididymis

A vascularizaçäo arterial do epidídimo do camundongo negro isogênico é feita pelas artérias epididimárias cranial e caudal, que säo ramos da artéria testicular, e pela artéria deferencial, que é colateral à artéria vesical cranial. O comportamento anatômico destes vasos, em termos de origem,disposiçäo e distribuiçäo, é aqui descrito. Todos os resultados säo discutidos com aqueles existentes na literatura especializada

Consideraçöes sobre a angioarquitetura da junçäo esofagogástrica da cobaia (Cavia porcellus, L.) / Angioarchitecture of the esophagogastric junction of guinea pig (Cavia porcellus, L.)

A angioarquitetura da junçäo esofagogástrica (JEG) da cobaia é descrita neste trabalho através de estudos de microscopia óptica. Para tanto procedeu-se à reconstruçäo tridimensional dos planos vasculares, nas camadas componentes da JEG. Essa análise foi feita através de estudos de cortes histológicos delgados (6*m) e espessos (20*m), obtidos principalmente a partir de secçöes longitudinais da JEG. Previamente aos estudos histológicos, as árvores arteriais de todas as cobaias estudadas foram perfundidas com carväo coloidal em soluçäo salina neutra. Ao nível da JEG foram observados três planos vasculares principais: primeiramente, o plano vascular adventicial; secundariamente, o plano vascular inter-muscular, e, finalmente, a disposiçäo vascular submucosa, extensiva aos limites da lâmina própria da túnica mucosa. O conjunto desses planos vasculares é interligado através de redes capilares

Observaçöes sobre a histoarquitetura geral dos testículos do hamster pós-natal / Observations on the general histoarchitecture of the post-natal hamster's testes

O presente trabalho é uma descriçäo sobre a morfologia da cápsula testicular e do complexo da rede testicular no hamster da variedade champanha, entre 10 e 90 dias de vida pós-natal. Adicionalmente, säo descritas algumas peculiaridades morfológicas dos túbulos seminíferos e do epitélio seminífero. Outras observaçöes apresentadas sobre a morfologia dos túbulos seminíferos e superficial da rede testicular