Logomarca do periódico: Acta Cirúrgica Brasileira

Open-access Acta Cirúrgica Brasileira

Publication of: Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia
Area: Health Sciences ISSN printed version: 0102-8650
ISSN online version: 1678-2674

Table of contents

Acta Cirúrgica Brasileira, Volume: 30, Issue: 8, Published: 2015

Acta Cirúrgica Brasileira, Volume: 30, Issue: 8, Published: 2015

Document list
Original Articles
Is it possible folic acid reduce anorectal malformations ethylenethiourea induced in rats? Faria, Danilo José Fiorindo Simões, Manuel de Jesus Martins, José Luiz

Abstract in English:

PURPOSE: To investigate the effect of folic acid (FA) in an experimental model of anorectal malformations (ARMs) ethylenethiourea (ETU) induced. METHODS: Eight female Wistar rats were divided randomly in two groups. Group A - ETU; Group B - FA+ETU; Dams from group B received daily, since two weeks before pregnancy to the end of pregnancy, FA (50mg/kg) by gavage. Dams from groups A and B, received 1% ETU (125mk/kg) by gavage on gestational day (GD) 11. Their fetuses were harvested by cesarean section on GD21 and were examined looking for ARMs. The thickness of anal stratified squamous epithelium (ASSE) and intestinal epithelium (IE) were analyzed. p<0.05*. RESULTS: One hundred and one embryos were harvested. The number of embryos; number of ARMs; mean statistical % (± SD) were determined to be, respectively: ETU - 49 [30;65% (±24%)] versus FA+ETU - 52 [1;02% (±3%)] (p=0.025). AMRs were significantly lower in FA+ETU group than in ETU group (p=0.025). The thickness (µm) of ASSE (± SD) and IE (± SD) were measured, respectively: ETU - [27.75 (±0.56) and 18.88 (±0.93)] versus FA+ETU - [28.88 (±0.61) and 21.11 (±0.16)] (p=0.001). The thickness of IE was significantly enlarged when FA was given (p=0.001). CONCLUSION: Folic acid reduces the number and enlarged the IE of ARMs ETU-induced.
Original Articles
Does dexamethasone act in neuropeptides SP and CGRP in neurogenic inflammation of the skin? An experimental study Freitas, Jose Octavio Gonçalves de Quieregatto, Paulo Rogério Hochman, Bernardo Lapin, Guilherme Abbud Franco Mella, Stella Maria Botequio Maximino, Jessica Ruivo Chadi, Gerson Ferreira, Lydia Masako

Abstract in English:

PURPOSE: To investigate the neuropeptides substance P (SP) and calcitonin gene-related peptide (CGRP) after subcutaneous injection of dexamethasone prior to skin incision in rats. METHODS: Twenty seven Wistar-EPM-1 rats were randomly divided into three groups. The sham group (SG) of rats was injected with 0.9 % saline. The second group (Dexa) was injected with 1.0 mg/kg dexamethasone, and the third group (Dexa+) was injected with 10.0 mg/kg dexamethasone. In all groups, the three subcutaneous injections were performed 30 minutes prior to the surgical skin incision and tissue collection. SP and CGRP (15 kDa pro-CGRP and 5 kDa CGRP) were quantified by Western Blotting. RESULTS: No statistically significant differences (p>0.05) were found in pro-CGRP, CGRP and SP values in all three groups. CONCLUSION: The anti-inflammatory effect of dexamethasone did not occur when the substance P and calcitonin gene-related peptide levels were altered during the neurogenic inflammation process of skin wound healing in rats.
Original Articles
Penile reconstruction using mesenchymal stem cells Laks, Marcus Freitas-Filho, Luiz Gonzaga Sayeg, Kleber Leite, Mila Torii Correia Teixeira, Luciana Cristina

Abstract in English:

PURPOSE: To compare the reconstruction of corpus cavernosum segments when seeded with mesenchymal stem cells and when stem cells are infused intravenously. METHODS: Sixteen New Zealand rabbits were submitted to reconstruction of the corpus cavernosum and distributed in Group A - decellularized matrices, Group B - decellularized matrices seeded with mesenchymal stem cells Group C - decellularized matrices submitted to intravenous infusion of mesenchymal stem cells. The mesenchymal stem cells were obtained by bone marrow aspiration. The venous filling aspect of the distal end of the corpus cavernosum was evaluated and the specimens were submitted to histological analisis and to immunohistochemistry. Cavernosometry was done in one animal of each group RESULTS: Three animals on B and three animals on C presented full filling of distal end of the corpus cavernosum. No animals in A presented filling of the distal end of corpus cavernosum. At cavernosometry the animal on B attained 50 cmH2O, on C 110 cmH2O and on A 20 cmH2O. Trabeculae forming cavernous sinuses were found in groups B and C. CONCLUSION: The reconstruction of corpus cavernosum using descellularized matrices and mesenchymal stem cells, either by intravenous injection or directly seeded is possible, with growth of corpus cavernosum-like tissue.
Original Articles
Laparoscopic correction of experimentally induced diaphragmatic rupture in dogs Souza, Diogo Benchimol de Mariano, Carlos Magno Anselmo Andrade Jr., Paulo Sérgio Cruz de Coelho, Gabriela Correa Abílio, Edmundo Jorge

Abstract in English:

PURPOSE: To describe the dog as a model for studying laparoscopic correction of experimental diaphragmatic ruptures. METHODS: Five male dogs were used in this study. Under laparoscopic approach, a defect of 7cm was created on the left ventral insertion of the diaphragm. Fourteen days after this procedure, the abdomen was explored using laparoscopic access and the diaphragmatic defect was corrected with intracorporeal suture. The dislocated organs, surgical time, and suturing time were recorded. Analgesia and clinical condition were monitored during the postoperative period. RESULTS: All animals recovered well from the diaphragmatic rupture creation. After 14 days, abdominal organs (liver, spleen, omentum and/or intestine) were found inside the thoracic cavity in all animals. It was possible to reposition the organs and suture the defect by laparoscopic access in three animals. These animals showed excellent postoperative recovery. It was not possible to reposition the liver safely when it was friable. CONCLUSIONS: Laparoscopic creation of diaphragmatic rupture in dogs is feasible. Dogs are a good model for training and studying the correction of experimentally created diaphragmatic rupture by the laparoscopic approach. A friable liver is a complicating factor that should be taken into account. Animals submitted to laparoscopic correction showed excellent postoperative recovery.
Original Articles
Study on the effect of black cumin (Nigella sativa Linn.) on experimental renal ischemia-reperfusion injury in rats Mousavi, Ghafour

Abstract in English:

PURPOSE: To evaluate the effect of Black cumin (Nigella sativa Linn.) pre-treatment on renal ischemia/reperfusion (I/R) induced injury in the rats. METHODS: A total of 40 male Wistar rats were randomly allocated into five equal groups including Sham, I/R model and three I/R+ Black cumin (0.5, 1 and 2%)-treated groups. I/R groups' kidneys were subjected to 60 min of global ischemia at 37°C followed by 24 h of reperfusion. At the end of reperfusion period, the rats were euthanized. Superoxide dismutase, catalase and glutathione peroxidase activities as well as reduced glutathione and renal malondialdehyde contents were determined in renal tissues. Kidney function tests and histopathological examination were also performed. RESULTS: High serum creatinine, blood urea nitrogen and uric acid as well as malondialhehyde (MDA) levels, and low antioxidant enzyme activities were observed in I/R rats compared to the sham rats. Pre-treatment with Black cumin for three weeks prior to IR operation improved renal function and reduced I/R induced renal inflammation and oxidative injury. These biochemical observations were supported by histopathological test of kidney sections. CONCLUSION: Black cumin significantly prevented renal ischemia/reperfusion induced functional and histological injuries.
Original Articles
Intra and postoperative evaluations of microcirculation and micro-rheological parameters in a rat model of musculocutaneous flap ischemia-reperfusion Klarik, Zoltan Tamas, Robert Toth, Eniko Kiss, Ferenc Kovacs, Eva L. Jäckel, Marta Furka, Istvan Nemeth, Norbert

Abstract in English:

PURPOSE: To examine how the ischemia-reperfusion injury of latissimus dorsi-cutaneous maximus (LDCM) musculocutaneous flap affects the microcirculatory (flap's skin surface) and hemorheological parameters, and whether an intraoperative deterioration would predictively suggest flap failure in the postoperative period. METHODS: Ten healthy male rats were subjected to the study. In Group I the left flap was sutured back after 2-hour, while the contralateral side was right after its elevation. In Group II the same technique was applied, but the pedicle of the left flap was atraumatically clamped for 2-hour. The contralateral side was left intact. On the flap skin surface laser Doppler tissue flowmetry measurements were done before and after and during the protocols applied in the groups. Microcirculatory and hemorheological examinations were done postoperatively. RESULTS: The microcirculatory parameters significantly decreased during immobilization and ischemia. Afterwards, all the regions showed normalization. In the retrospective analysis there was a prominent difference between the microcirculatory parameters of necrotic and survived flap during the early postoperative days (1-3) in Group II. Erythrocyte aggregation and deformability showed only slight differences. CONCLUSIONS: Two-hour ischemia and reperfusion caused deterioration in latissimus dorsi-cutaneous maximus flap microcirculation. Predicting the possible postoperative complication, the intraoperative laser Doppler measurement can be informative.
Original Articles
Adjustable inspiratory occlusion valve in experimental bronchopleural fistula. A new therapeutic perspective Toneloto, Maria Gabriela Cavicchia Moreira, Marcos Mello Bustorff-Silva, Joaquim Murray Souza, Gabriel Franco de Martins, Luiz Claudio Dragosavac, Desanka Falcão, Antonio Luis Eiras

Abstract in English:

PURPOSE: To assess the efficacy of an adjustable inspiratory occlusion valve in experimental bronchopleural fistula during mechanical ventilation. METHODS: We studied six mechanically ventilated pigs in a surgically created, reproducible model of bronchopleural fistula managed with mechanical ventilation and water-sealed thoracic drainage. An adjustable inspiratory occlusion valve was placed between the thoracic drain and the endotracheal tube. Hemodynamic data, capnography and blood gases were recorded before and after the creation of the bronchopleural fistula as well as after every adjustment of the inspiratory occlusion valve. RESULTS: When compared with the standard water-sealed drainage treatment, the use of an adjustable inspiratory occlusion valve improved the alveolar tidal volume and reduced bronchopleural air leak (p<0.001), without hemodynamic compromise when compared with conventional water sealed drainage. CONCLUSION: The use of an adjustable inspiratory occlusion valve improved the alveolar tidal volume, reduced alveolar leak, in an experimental reproducible model of bronchopleural fistula, without causing any hemodynamic derangements when compared with conventional water sealed drainage.
Original Articles
Copaiba oil effect on induced fecal peritonitis in rats Lopes, Letícia Nobre Santos, Felipe Augusto Folha Oliveira, Louize Caroline Marques Percário, Sandro Barros, Charles Alberto Villacorta de Brito, Marcus Vinicius Henriques

Abstract in English:

PURPOSE: To evaluate the effects of copaiba oil as a prophylactic and/or therapeutic substance on survival of rats subjected to cecal ligation and puncture, describing histopathological and oxidative stress findings. METHODS: Forty rats (Ratus norvegicus) were distributed into five study groups (N=8): Sham group (ShG): normal standard animals; Sepse group (SepG): submitted a cecal ligation and puncture (CLP); Pre group (PreG): administered copaiba oil once daily by subcutaneous injection for five days before carrying out CLP; Post CLP group (PostG): administered copaiba oil once daily by subcutaneous injection from the first day of CLP until death by sepsis; and Pre/Post group (Pre/PostG): administered copaiba oil once daily by subcutaneous injection for five days before carrying out CLP and from the first day of CLP until de death by sepsis. After the death of the animals, blood was collected for assessment of oxidative stress and histological analysis were performed. The Kaplan-Meier curves of surviving time were realized. RESULTS: Survival analysis demonstrated that animals treated with copaiba oil prior to the execution of the CLP (PreG and Pre/Post groups) had longer survival compared to the sepsis group (p<0.0001) whereas animals receiving copaiba only after the completion of CLP (PostG) showed no statistically significant difference compared to the sepsis group. However, when comparing the two groups in which was administered copaiba previously (PreG and Pre/PostG groups), there was no statistical significance between the groups (p=0.4672). There was no statistical difference between histopathological findings or the levels of oxidative stress. CONCLUSION: Prophylactic subcutaneous administration of copaiba increases survival of rats subjected to severe sepsis by cecal ligation and puncture.
Original Articles
Does a small size needle puncture cause intervertebral disc changes? Issy, Ana Carolina Castania, Vitor Silveira, Joao Walter Nogueira-Barbosa, Marcello Henrique Salmon, Carlos Ernesto Garrido Del-Bel, Elaine Defino, Helton Luis Aparecido

Abstract in English:

PURPOSE: Small size needles have been regularly used for intradiscal injection of innocuous/potential therapeutic compounds in experimental conditions, but also in clinic procedures, such as discography. Our aim was to investigate if a 30-gauge needle could trigger observable changes on intact intervertebral discs. We compared these effects to those induced by a large size needle (21-gauge), a well-known intervertebral disc degenerative model based on needle puncture. METHODS: Coccygeal intervertebral discs (Co8-9) of adult male Wistar rats were punctured with a 21-gauge needle, while the coccygeal levels Co7-8 and Co9-10 remained intact. The 30-gauge needle was used to inject a safe volume of saline (2 µl) on both intact (Co9-10) and punctured (Co8-9) discs. MRI and histological score were performed at 2, 15 and 42 days after procedure. RESULTS: MRI analyses revealed significant reduction on signal intensity of 21-gauge punctured discs. Intact discs which received a saline injection through a 30-gauge needle also revealed significant alterations in the MRI signal when compared with control discs. No histological changes were observed in the intact saline injected discs at any time analyzed. CONCLUSION: Since significant intervertebral image changes were observed with a 30-gauge needle, cautious interpretation of the pharmacological inoculation findings is required.
Original Articles
The Glasgow Prognostic Score. An useful tool to predict survival in patients with advanced esophageal squamous cell carcinoma Henry, Maria Aparecida Coelho de Arruda Lerco, Mauro Masson Oliveira, Walmar Kerche de Guerra, Anderson Roberto Rodrigues, Maria Aparecida Marchesan

Abstract in English:

PURPOSE: To evaluate the usefulness of the Glasgow Prognostic Score (GPS) in patients with esophageal carcinoma (EC). METHODS: A total of 50 patients with EC were analyzed for GPS, nutritional and clinicopathologic parameters. Patients with CRP ≤ 1.0mg/L and albumin ≥ 3.5mg/L were considered as GPS=0. Patients with only CRP increased or albumin decreased were classified as GPS=1 and patients with CRP > 1.0mg/L and albumin < 3.5mg/L were considered as GPS=2. RESULTS: GPS of 0, 1 and 2 were observed in seven, 23 and 20 patients, respectively. A significant inverse relationship was observed between GPS scores and the survival rate. The survival rate was greatest in patients with GPS= 0 and significantly higher than those from patients with GPS=1 and GPS=2. Minimum 12-month survival was observed in 71% patients with GPS=0 and in 30% patients with GPS=1. None of the patients with GPS=2 survived for 12 months. A significant relationship between CRP or albumin individually and the survival rate was observed. No significant relationship among nutritional, clinic pathological parameters and survival was found. CONCLUSION: Glasgow Prognostic Score is an useful tool to predict survival in patients with esophageal carcinoma.
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