Histopatologia da seromiotomia dupla e sutura seromuscular no cólon descendente de ratos

Histopathology of double seromyotomy and seromuscular suturing on the descending colon of mice

ARTIGOS ORIGINAIS

Histopatologia da seromiotomia dupla e sutura seromuscular no cólon descendente de ratos

Histopathology of double seromyotomy and seromuscular suturing on the descending colon of mice

Aldérico Luiz da Silva Júnior^I; Alcino Lázaro da Silva, TCBC-MG^II; Lúcia Porto Fonseca de Castro^III

^IMestre em Cirurgia. Médico em Divinópolis - MG

^IIProfessor Titular de Cirurgia do Aparelho Digestivo da UFMG

^IIIProfessor Assistente do Departamento de Anatomia Patológica da UFMG

^{Endereço para correspondência}

RESUMO

Realizamos um estudo experimental em ratos com o objetivo de retardar o trânsito intestinal no cólon e verificar as alterações macroscópicas nas fezes e as histopatológicas ocorridas no intestino grosso. Foram operados 15 ratos e 15 ratas num total de trinta, divididos em três grupos denominados 30, 60 e 90 dias, conforme o tempo proposto para relaparotomia. Todos os ratos foram submetidos a duas seromiotomias extramucosas, no cólon descendente, com incisões circunferenciais (360°). Elas se localizavam, uma a 1 cm e a outra a 2 cm acima da reflexão peritoneal. Após as seromiotomias, fez-se a sutura seromuscular circundando todo o perímetro do cólon. Analisaram-se os aspectos clínicos e histopatológicos. Concluiu-se que há formação de um anel fibroso, com elevação da mucosa em direção à luz, do tipo valvular e descontinuidade da musculatura longitudinal e transversal.

Unitermos: Seromiotornia; Cólon; Constipação; Colostomia; Colostomia perineal.

ABSTRACT

Experiments were carried out on mice, aiming to retard bowel movement in the descending colon. The microscopic alterations in the stools and the histopathological changes in the large intestine were observed. Fifteen male mice and fifteen female mice have been operated on and divided into three groups named 30, 60 and 90 days, according to the time set for the relaparotomy. All mice have been submitted to two extramucous seromytomies in the descending colon with circunferential incisions (360). One of them was located one centimeter; and the other two centimeters, above the peritoneal reflection. After the seromytomias, a seromuscular suture surrouding all over the colon area was performed. We observed visceral and perineal adherence in the three groups, the majority without organic repercurssion. However a mouse from the 60 days group had partial obstructive manifestation that resulted in death on the 40th pos-surgical day. There were complications with total colon obstruction for stools impact in the operated area of two female mice that also developed into death on the 2nd pos - surgical week. A mouse showed deiscence and evisceration of the abdominal suture, dying on the 10th day pos- surgical. Therefore, there were therefore four deaths (13,33%) due to a total, parcial and evisceration obstruction. In the three groups inflamatory reaction was observed, in all the coatings, which was greater in the 30 days groups. 1n the groups 60 and 90 days, sectionalized tissues were repaired by fibrous conjunctive tissue. Our results did not show that the procedure hasn't produced clinics and radiological repercussions, in the distal from the operated site intestine. There were histopathlogical alterations that assured inflamatory process with reaction of strange body type in the sutured colon. This inflamatory process on a same transversal and circunferencial plane, provided a concentrica partial stenose resulting intestine transit delay confirmed by the shape, shine and stools aglomeration. We've concluded that extramucosal seromyotomy with seromuscular suture can be used as a surgical resource in order to retard the intestinal transit in mice.

Key words: Seromyotomy and seromuscular suturing; Colon; Constipation; Colostomy; Perineal colostomy.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Recebido em 1/12/98

Aceito para publicação em 14/10/99

Trabalho realizado no Laboratório de Pós-Graduação em Cirurgia e de Anatomia Patológica da Faculdade de Medicina da Universidade Federal de Minas Gerais - UFMG.

• 1. Stacchini A, Didio LIA, Primo MLS, et al - Artificial sphincters as surgical treatment for experimental massive resection of small intestine. Am J Surg 1982;143:721-726.
• 2. Kapritchkoff E - Piloro artificial. Contribuiçăo para estudo profilaxia da Síndrome de "dumping". Tese Docęncia Livre. Fac. Med. Mogi das Cruzes, 1978.
• 3. Texter Jr EC - Motility in the gastrointestinal tract. J Am Med Ass 1963;184;640-647.
• 4. Miles WE - Rectal surgery. A practical guide to the modern , surgical treatment of rectal diseases. London. Cassell and Co. Ltd., 2Ş ed., 1944, 359p., Cap.12, p.257- 285.
• 5. O'Malley VP, Keyes DM, Cannon lP, et al - Myotomy; A new reservoir for use with ileoanal anastomosis. Current Surgery 1985;43:113- 117
• 6. Tumage RH, Coran AG, Drongowski RA - The value of intestinal myotomy and myectomy in improving the reservoir capacity of the endorectal pull-through. Ann Surg 1990;211(4):463-469.
• 7. Schiller WR, Didio LIA, Anderson MC - Production of artificial sphincters. Arch Surg 1967;95:436-442.
• 8. Prasad lK, Daniel K - Recurrence of high intra colonic pressure following sigmoid myotomy. Brit J Surg 1971;58:304.
• 9. Richardson lD, Griffen WO -lIeocecal valve substitutes as bacterologic barriers. Am J Surg 1972;123:149-153.
• 10. Enriquez LA - A seromiectomia segmentar e perimetral externa no tratamento da síndrome do intestino delgado curto"; uma contribuiçăo experimental no estudo da anatomia funcional do trato jejuno-ileal. Belo Horizonte, Faculdade de Medicina da UFMG, 1981. 96 P. (Tese, Doutorado em Cirurgia Abdominal).
• 11. Blomer A, Düx A, Sobbe A, et al - Operative eingriffe verlangsaming der dünndarmpassage tierexperimentelle untersuchungen. Langenbecks Arch Klin Chir 1972; 330:285-306.
• 12. Aly AL, Fonkalsrud EW - Construction of ileal reservoir with longitudinal ileal myotomy. Am Surg 1988; 54:475-478.
• 13. González MA, Torres RA - Operacion de Miles com colostomia perineal continente. Rev Argent Cirurg 1989; 56: 166-169.
• 14. Devesa JM, Vicente E, Nuńo J, et al- Síndrome de intestino ultracorto: tratamiento quirúrgico de un caso excepcional. Rev E.çp Ent 1993; 84(4): 259-262.
• 15. Ziegler MM, Ross AJIII, Bishop HC - Total intestinal aganglionosis: a new technique for prolonged survival. J Ped Surg 1987; 22 (I) : 82-83.
• 16. Ziegler MM, Royal RE, Brandt J, et al- Extend myectomy - myotomy. A therapeutic alternative for total intestinal aganglionosis. Ann Surg 1993; 218 (4):504-511.
• 17. Lázaro da Silva A - Tentativa de tratamento de "dumping" através de um esfincter ileal. Rev Ass Med MG 1974; 25(1):32-33.
• 18. Correnti FS, Mobardhan S, Parenzi GF, et al - Follow-up results of a new colomyotomy in the treatment of diverticulosis. Surg Gyn Obst 1983; 56:181-186.
• 19. Lázaro da Silva A - Amputaçăo abdômino-perineal com colostomia perineal. Rev Bras Colo-Procto 1991; 11 (3):105-108.
• 20. Lázaro da Silva A - Abdomino perineal excision of rectum and anal canal with perineal colostomy. Eur J Surg 1995; 161:761-764.

Endereço para correspondência:

Dr. Aldérico Luiz da Silva Júnior

Rua Jovelino Rabelo, 600 - Porto Velho

35500-052 - Divinópolis - MG

Datas de Publicação

• Publicação nesta coleção
  24 Nov 2009
• Data do Fascículo
  Dez 1999

Histórico

• Recebido
  01 Dez 1998
• Aceito
  14 Out 1999