Wound healing in colonic anastomosis in hypothyroidism.

Colonic anastomosis healing in hypothyroidism was evaluated. Twenty Wistar rats were separated into two groups: the study group (n = 10), which underwent total thyroidectomy to induce hypothyroidism, and the control group (n = 10). After 10 weeks, hypothyroid status was confirmed by blood tests (p < 0.0001). Three days later, a colonic anastomosis was performed, and the animals were sacrificed 1 week later. The colon containing the anastomosis was resected for bursting strength tests and histological studies. The slides were stained with hematoxylin-eosin and with Sirius red to quantify and classify the collagen. Reduced values were found for the bursting strength test (p = 0.0006) and for collagen density in the experimental group. There was a prevalence of immature type III collagen (p < 0.0001) and a decrease in mature type I collagen (p < 0.0001) in the hypothyroid group.

[Terminolateral esophagojejunostomy after gastrectomy with the biofragmentable anastomosis ring in the dog model]. / End-zu-Seit Osophagojejunostomie mit dem biofragmentierbaren Anastomosenring nach Gastrektomie am Hundemodell.

INTRODUCTION: Esophagojejunostomy after total gastrectomy still remains a high risk anastomosis with a considerable morbidity and mortality. The majority of these anastomoses are performed by the intraluminal stapler technique, yet stenoses are a known late complication even after an uneventful postoperative course. In the present study, the osophagojejunostomy with the biofragmentable anastomosis ring (BAR) was examined in dogs. METHODS: 28 dogs were randomized into a group of manual suture (n = 14) and a BAR-group (n = 14). After gastrectomy, the esophagojejunostomy was performed by hand-suture with polypropylene 4-0 in the manual suture group, and with the 25/1.5 mm BAR in the BAR-group. In both groups the Roux-en-Y jejunojejunostomy was performed by hand-suture. The dogs were evaluated on postoperative days 4, 7 and 14 with regard to macroscopy, bursting strength, tissue hydroxyproline and histology. RESULTS: There was one leakage without clinical effect in the hand-sewn group on postoperative day 4; there was no leak in the BAR-group. In observing fibre-free enteral feeding, neither functional disorders nor obstruction of the BAR were observed. The general anastomosis parameters were matchable between the groups. CONCLUSION: The infracarinal BAR-esophagojejunostomy is comparable to the hand-sewn anastomosis in the dog-model.

[Billroth I anastomosis with biodegradable anastomosis ring in the animal model]. / Billroth-I-Anastomose mit dem Biofragmentierbaren Anastomosen-Ring (BAR) im Tiermodell.

In the present study, the Billroth-I anastomosis with the biofragmentable anastomosis ring was examined in dogs. 24 dogs were randomized into a group of manual suturing (n = 12) and a BAR-group (n = 12). In the group of manual suturing, a distal gastric resection and gastroduodenostomy with sero-submucous suture was performed. In the BAR-group, the distal gastric resection was done with the linear stapler PLC-75, whereby the BAR gastroduodenostomy crossed the stapling line. The dogs were evaluated on p.o. days 4, 14, and 30 and tested for bursting strength and bursting location, appearance of mucosa, hydroxyprolin concentration, and histologic features. There was no functional disorder in the gastrointestinal transit in any animal; in summary with regard to the various parameters, the crossing of BAR and stapling line does not represent any additional risk factor in the Billroth-I anastomosis in dogs.

[Evolution of left colon anastomosis after focal peritonitis induction in rats]. / Evolução de anastomoses do cólon esquerdo após a indução de peritonite focal, em ratos.

In order to know the left colon anastomosis evolution with perforation and focus peritonitis, 40 male rats, Wistar-TECPAR, 135 days old and weighing 345 g in average were divided in two groups of 20 animals each. Group A was the control group and group B the experimental group. Submitted to a laparotomy, the B rats had a left colon wound 0.3 cm in diameter, 1.5 cm in distance from the peritoneal reflection. The A rats had only a intestinal handling. All rats had a new laparotomy after 24 hours; a resection and end-to-end anastomosis. An analysis was made on third and seventh days of the macro and microscopic evolution and bursting pressure. On the second laparotomy, in the B rats, peritonitis was absent and only local reaction was present. Dehiscence, fistula or peritonitis were absent at the observation on the third and seventh days. The anastomosis evolution was similar in the two groups. It was concluded that the focus peritonitis was not sufficient to modify the healing process of the left colon anastomosis in rats during the period studied.

Intragastric microflora study in patients with gastroduodenal disease

O conteudo normal de bacterias no estomago e menor que 10ü/ml de suco gastrico. A ausencia de bacterias na cavidade gastrica, muito frequente, e principalmente devida a secrecao acida e a motilidade do orgao. Varias situacoes podem comprometer esses mecanismos de defesa e levar a colonizacao bacteriana, com alta incidencia de complicacoes infecciosas pos-operatorias. Para avaliar a alteracao da microflora gastrica, estudaram-se 25 pacientes, 19 com doenca gastroduodenal e seis controles, divididos em quatro grupos distintos, de acordo com a afeccao de base. Dos portadores de doenca gastroduodenal, 18 (94,73 por cento) apresentaram cultura positiva para aerobios e seis (3,57 por cento), para anaerobios. Cinco pacientes (26,31 por cento) tiveram cultura positiva para Candida sp e cinco outros para S. fecalis. A principal contagem bacteriologica foi de 1,2x10 elevado a seis CFU/ml de suco gastrico, e de 1,4x10 elevado a um CFU/ml de suco gastrico, para anaerobios. As bacterias mais comumente isoladas foram E. coli, Enterobacter sp e Staphylococcus epidermidis.

Avaliaçäo da duraçäo da anti-sepsia pré-operatória da pele abdominal / Evaluation of the duration of preopoerative antisepsis of the abdominal skin

Foi avaliada a eficácia da anti-sepsia da pele abdominal por diferentes períodos de tempo. Um total de 64 pacientes foram submetidos a anti-sepsia da pele com povidina-iodo por 3, 5, 10 minutos, e por dois períodos de 5 minutos cada. Amostras para estudos bacteriológicos para bactérias aeróbica foram obtidas imediatamente antes, 5 minutos, 1 hora e 3 horas após a desinfecçäo. A reduçäo na populaçäo bacteriana foi acima de 96% em todos os grupos e näo houve diferença estatisticamente significativa entre os diferentes grupos, 5 minutos, 1 hora e 3 horas após a degermaçäo da pele