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Acta Cirúrgica Brasileira

versão impressa ISSN 0102-8650versão On-line ISSN 1678-2674

Resumo

AZEVEDO, João Luiz Moreira Coutinho; SILVA, Cássio Edvan Paulino Da; AZEVEDO, Otávio Cansanção  e  SIMOES, Manoel De Jesus. One layer sutures of digestive tract knotted in the lumen, in dogs: perforating stitch versus serosubmucosal suture. Acta Cir. Bras. [online]. 2005, vol.20, n.2, pp.168-173. ISSN 1678-2674.  https://doi.org/10.1590/S0102-86502005000200012.

OBJECTIVE: To compare hand sewn digestive tract single layer anastomosis with knots tied in the lumen: total stitches versus serosubmucosal. METHODS: Six mongrel dogs were submitted to laparotomy, each one with two transversal jejunum sections, 30 and 70 cm far from Treizt angle and suture, serosubmucosal and total stitches, both with knots tied in the lumen, over the mucosa, at the posterior wall. After slaughter (7th post-operative day) was evaluated the peritoneal adhesions at posterior wall. The macro and microscopic features was observed. Wilcox on rank sum test was applied for the histhometry. RESULTS: More profuse adhesions with the serosubmucosal stitches tied in the lumen with adherence tissue over the suture line, avoiding the serosa, within or without healing deformation of the suture lines, doing an anastomosis´angle. There was good serosa reconstitution with total stitches. The epithelium was perfectly reconstituted at serosubmucosa, but not at total stitches, where was residual focus of acute inflammation. The reline and regeneration of wall components (except the serosa, whose regeneration was impaired by peritoneal adherences) were better with serosubmucosal then total stitches. The muscularis never regeneration in anyone suture. The polimorphonuclear cells, macrophages, fibroblasts, and collagen fibers was more numerous (statistical significance) at total stitches. COCLUSION: Total stitches with knots tied in the lumen, at posterior wall, over the mucosa are safe full, despite of major inflammation. Serosubmucosal with knots tied in the lumen, at posterior wall, over the mucosa, allows peritoneal adherences formation, and should be avoided.

Palavras-chave : Anastomosis, Surgical; Intestine, small; Models, animal; Dogs.

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