Juliano Alves Figueiredo

EFFECTS OF DIFFERENT PERIODS OF GASTRIC ISCHAEMIA IN THE VIABILITY OF THE TISSUE OF BODY, FUNDUS AND ANTRUM REGION OF RABBIT STOMACH

BACKGROUND: Despite the rich vascular arcade of the stomach, gastric ischemia represents an important medical challenge and can be the consequence of obstructive or non-obstructive vascular processes of pathological or iatrogenic origin. AIM: To assess the effects of acute gastric ischaemia on the different regions of the stomach. METHOD: Fifteen New Zeland rabbits were divided into three groups: group 1, animals were observed during 3 h; group 2, during 6 h; group 3, during 12 h. Rabbit stomachs were subjected to devascularization of the greater and lesser curvatures. After predetermined time, the stomachs were removed for macro and microscopic studies. RESULTS: Haemorrhagic necrosis was more marked in the gastric fundus and body. In contrast, the antropylorus remained preserved in 80% of the animals. Necrosis of the gastric body and fundus mucosa were observed in all animals after 6 h and 12 h of ischaemia. CONCLUSION: Acute gastric ischaemia in rabbits produces haemorrhagic necrosis of the gastric fundus and body even in a short period of time. Beside this, the antropyloric region was significantly more resistant to ischaemia.

Hypoandrogenism related to early skin wound healing resistance in rats.

The purpose of this study was to verify the effect of testosterone depletion on healing of surgical skin wounds at different ages and post‐operative periods. Forty‐four Wistar male rats were divided into four groups: Group 1Y (n = 11) – young control, sham‐operated rats (30‐day old); Group 1A (n = 10) – adult control, sham‐operated rats (3 to 4‐month old); Group 2Y (n = 10) – young rats after bilateral orchiectomy; and Group 2A (n = 11) – adult rats after bilateral orchiectomy. After 6 months, a linear incision was performed on the dorsal region of the animals. The resistance of the wound healing was measured in a skin fragment using a tensiometer, on the 7th and 21st post‐operative days. The wound healing resistance was higher in Group 1Y than in Group 2Y after 7 days (P < 0.05). Wound healing resistance at 21 days was higher than at 7 days in all groups (P < 0.05). Late wound healing resistance was not different between young and adult rats. It is concluded that bilateral orchiectomy diminished the wound healing resistance only in young animals at the 7th post‐operative day.

Is there a relationship between physical performance and orchiectomy

Bilateral orchiectomy is indicated for the treatment of patients with testicular cancer or advanced prostate tumours. The influence of hypogonadism on physical performance is still not known. The purpose of this work was to verify the effect of bilateral orchiectomy on physical performance. Sixteen rats were divided into two groups: Group 1 (Control), in which only skin incision and suture were made (n = 5) and Group 2, in which the rats were submitted to bilateral orchiectomy (n = 11). The animals ran on a treadmill at the speed of 20 m min−1 until they were fatigued and felt once, during 10 s, when the experiment was interrupted. Time to running and weight of animals were verified. The results were compared using the Mann–Whitney test. There was no difference on time to running – minutes – (P = 0.14) and weight – grams – (P = 0.25) between the animals submitted to orchiectomy (100 ± 44 min and 359 ± 38 g) and the control Group (81 ± 40 min to run and 327 ± 25 g). Bilateral orchiectomy does not affect the physical performance of the rat.

Rectal leiomyosarcoma, three-year follow-up

Rectal leiomyosarcomas are rare tumors originated from smooth muscle cells. Differential diagnosis includes gastrointestinal stromal tumors (GIST), leiomyomas or schwannomas, and the differentiation of these tumors is usually made through immunohistochemistry. Due to its rarity, the standard treatment has not been defined. The purpose of this study was to present the follow-up of a patient with leiomyosarcoma of medium rectum submitted to exclusive operative treatment. The tumor size was 6 cm and it had a high mitotic index. The patient remains with good urinary function and good sphincter function, and free of the disease after a three-year follow-up.

Laparoscopic total pelvic exenteration and perineal amputation with wet colostomy. A case report

Advanced rectal tumors can be treated with curative intent by surgical resection of the rectum including other pelvic organs. The reconstruction of the urinary and gastrointestinal tracts depends on the distance between the tumor and the anus, the patients status and the experience of the surgical team. This is a case of a male patient with a locally advanced low rectal tumor that underwent a laparoscopic pelvic exenteration. The anus and the tumor and other organs were excised by peritoneal approach. The uretero-colic anastomosis was performed extra-abdominally. The patient was discharged on the 14th postoperative day and remains healthy six months after the surgery. This approach has shown to be feasible and safe. The aesthetical result was well accepted by the patient. The laparoscopic route should be considered as an alternative approach to pelvic exenteration in the treatment of locally advanced low rectal tumors that demand perineal amputation.

Neoplasia epitelial renal asociada a la enfermedad de Kimura. Presentación de un caso

OBJETIVOS Presentar un caso de enfermedad de Kimura asociada a la neoplasia de rinon. La enfermedad de Kimura se trata de una enfermedad inflamatoria rara, que se presenta comunmente con linfonodos aumentados y masas en regiones de la cabeza y del cuello. El diagnostico diferencial debe incluir linfomas, linfadenopatia reaccional a medicinas o parasitos. En masas y linfonodos aumentados se puede encontrar algun nodulo sugerente de neoplasia. Existe un caso en la literatura que describe a la Enfermedad de Kimura asociada a la neoplasia de rinon. METODOS Se presenta el caso de una paciente joven, con nodulaciones intra y retroperitoneales, incluyendo una de ellas en el polo inferior del rinon izquierdo. Tras el periodo de tratamiento con corticoides, la tomografia computadorizada del abdomen confirmo la presencia de la lesion, con caracteristicas de malignidad. Se realizo nefrectomia parcial izquierda y la evolucion postoperatoria ha sido favorable. RESULTADOS La paciente se encuentra sin manifestaciones de la Enfermedad de Kimura y sin signos de recidiva de la neoplasia 18 meses despues de la operacion. CONCLUSIONES La enfermedad de Kimura esta asociada a algunas neoplasias que deben ser investigadas por el equipo medico. La nefrectomia parcial parece ser una buena opcion terapeutica para nodulos neoplasicos bien definidos y ubicados en polos renales.

Efeito da suplementação nutricional com glicina e glutamina, por via oral, na cicatrização colônica em coelhos

OBJECTIVE To evaluate the effect of two amino-acids, glycine and glutamine, in the epithelialization of the colonic mucosa, size of the scar area, fibrous as well as the tensile strength of the intestinal anastomoses, after the removal of 17 cm of the colon and an end-to-end with interrupted suture. METHODS Forty five male adult rabbits varying between 24 and 28 weeks of age with the starting average weight of 2,362 grams were randomly distributed into five groups, according to their respective type of feeding. Two animals died in each group due to different complications. The rabbits were divided into the following groups, according to the procedures performed on them: Group 1 - (n = 9) received supplemental feeding with glutamine for seven days before and as five days after the operation; Group 2 - (n = 9) received supplemental feeding with glycine for seven days before and five days after the operation; Group 3 - (n = 9) received supplemental feeding with glutamine for five days after the operation; Group 4 - (n = 9) received supplemental feeding with glycine for five days after the operation; Group 5 - (n = 9) did not receive any supplemental feeding. The resistance of the anastomoses was evaluated through the means of assay for pressure of rupture during intraluminal air insufflation. RESULTS Group 2 was the only group that presented rupture values above those of Group 5 (p < 0.05). There was no difference among the groups concerning the histological aspects. CONCLUSION Oral supplementation with glycine, in the pre and post-operative periods increases the tensile strength of colonic anastomoses after partial colectomy in rabbits. The oral supplementation with glutamine did not present detectable effect on the colonic anastomoses in rabbits.

Retrospective evalution of survival for 171 patients with colorectal cancer after trhee years of follow-up

Introduction: Colorectal cancer (CRC) is a common malignant tumor of digestive tract and, in Brazil, is the fourth leading cause of cancer. The survival of patients with CRC is influenced by a number of variables, especially the tumor staging. The main therapeutic modality with the prospect of cure is surgical, and as adjuvant chemotherapy and radiotherapy treatments. Objective: Evaluate survival, and the rate of anastomotic complications of patients with CCR followed between January 2007 and January 2013. Methods: This is a descriptive – series of cases study of 171 patients. The dependent variable was the survival time of the CCR and the independent variables were age, gender, anatomic site of the tumor, tumor infiltration and lymph node metastasis. Results: The overall survival of patients with CRC postoperatively in 12, 24 and 36 months follow-up, were respectively 83.21%, 76.56% and 63.47%. The presence of lymph node involvement and the degree of tumor infiltration accounted for variables related to worse prognosis. The most common tumor sites were the rectum and sigmoid high (43.75%), followed by the rectum (18.75%) and lower rectum (18.75%). The anastomotic leak was the most common postoperative (6.43%) complication. Conclusion: The tumor infiltration in the intestinal wall and the number of positive nodes influenced negatively on the survival of patients Retrospective evalution of survival for 171 patients with colorectal cancer after trhee years of follow-up Juliano Alves Figueiredo1, Frederico Fonseca Campos2, Amanda Jiran Ferreira Marcos2, Matheus Matta Machado Mafra2, Duque Estrada Meyer3, Sara Dalia Barbosa4, Geraldo Felício da Cunha Júnior5 Avaliação retrospectiva da sobrevida de 171 pacientes com câncer colorretal após seguimento de três anos DOI: 10.5935/2238-3182.20140089

Greater resistance of the rabbit antropyloric region to experimental acute gastric ischemia

INTRODUCTION: Gastric ischemia represents an important medical challenge in pathology and surgical practice. OBJECTIVE: The purpose of this study was to assess the effects of acute gastric ischemia on different regions of the stomach. METHOD: Rabbit stomachs were subjected to devascularization of the greater and lesser curvatures for 3, 6 and 12 hours. After these periods, the stomachs were removed for macro and microscopic analysis. RESULTS: Hemorrhagic necrosis was more marked in the gastric fundus and body. In contrast, the antropylorus remained preserved in 100% of the rabbits after 3 hours of ischemia (group I), and in 80% of the rabbits after 6 and 12 hours of ischemia (groups II and III). Necrosis of the gastric body and fundus mucosa were observed in all animals after 6 and 12 hours of ischemia. CONCLUSION: We concluded that this experimental model of acute gastric ischemia was effective in producing hemorrhagic necrosis of the gastric fundus and body in rabbits even within a short period of time. Furthermore, the antropyloric region was preserved in most animals.