Acta Cirúrgica Brasileira, Volume: 12, Issue: 2, Published: 1997
  • Mensagem do presidente Editorial

    Goldenberg, Saul
  • Comparison between coralline porus hidroxyapatite and osseous xenograft in rabbits Nota Preliminar

    Figueiredo, Arthur Silveira de; Takita, Luiz Carlos; Goldenberg, Saul

    Abstract in Portuguese:

    O objetivo da pesquisa é a utilização da hidroxiapatita porosa de coral, como um xenoenxerto ósseo. Utilizou-se onze coelhos da raça Nova Zelândia, nos quais fez-se defeito padrão nas metáfises femorais distais. Nesses locais praticou-se o implante de hidroxiapatita porosa de coral ou enxerto ósseo autógeno. Fez-se estudo clínico, macroscópico, exames radiológicos e histológicos em intervalos de duas, quatro e doze semanas. Os resultados comparativos foram similares enter dois tipos de implantes. Concluiu-se que a hidroxiapatita porosa de coral é um substituto adequado para enxertos ósseos autógenos em coelhos.

    Abstract in English:

    The purpose is to utilize coralline porous hydroxyapatite as osseous xenograft. It was utilized eleven New Zeland rabbits, wich it made pattern defect in the distal femoral mataphise. In this place was used coralline porous hidroxyapatite or autogenous graft. It was made clinical, macroscopic, radiologic and histologic study, with interval of two, four and twelve weeks. The comparatives results was similaries between the two implants types. It was concluded taht coralline porous hidroxyapatite is appropriate replacement for osseos autogenous grafts in rabbits.
  • The relationship between suture number and the healing process of end-to-end arterial anastomosis Original Article

    Yoshida, Winston B; Naresse, Luiz E; Angeleli, Aparecida Y. O; Lastoria, Sidnei; Defaveri, Júlio; Curi, Paulo R; Rodrigues, Antonio

    Abstract in English:

    In spite of the grate experience accumulated in vascular repairing, the ideal number of sutures for vascular anastomosis remains controversial. It is generally thought that the more stitches applied in a vascular anastomosis, the lesser resistant the anastomosis will be. The purpose of this study was to test this hypothesis in 20 rabbits, in which both carotid arteries were cross sectioned and repaired by end-to-end anastomosis with 8 interrupted sutures in one side (G1) and 16 in the other side (G2). After 3 and 15 days, the animals were randomly allocated for tensile strength, hydroxyproline determination (7 animals) and for histologic analysis of the anastomosis (3 animals). Conventional staining procedures (hematoxylin-eosin and Masson methods) and the picrosirius red polarization (PSP) technique for collagen type determination were used. From 3 to 15 days, the tensile strength increased in both groups, from 265.0±-44.4g to 391.2±-49.0g in G1 and from 310.0±-71.5g to 348.7±-84.0g in G2 (p<0.005), with no statistical difference between the groups in each period of study. The hydroxyproline content, expressed as hydroxyproline/protein ratio, varied from 0.04±-0.01 to 0.05±-0.02 in G1 and from 0.05±-0.01 to 0.05±-0.02 in G2, with no significant difference between periods and groups. The histology showed similar inflammatory and reparative aspects in both groups. In both groups and periods the PSP technique demonstrated predominantly type I collagen in relation to type III collagen in the anastomosis. We concluded that even doubling the number of stitches, the healing process and strength did not change in the arterial anastomosis.
  • Evaluation of the cicatrization of left colon anastomoses in the presence of peritonitis: an experimental study on rats Original Article

    Biondo-Simões, Maria de Lourdes Pessole; Canalli, Lucilea dos Santos; Ferreira, Cristiane; Meschino, Renata; Kaimoto, Ticyane; Collaço, Luiz Martins

    Abstract in English:

    To monitor the evolution of anastomoses performed on the distal colon in a situation of experimental peritonitis, 37 Wistar-Tecpar male rats aged 114 to 130 days and weighing on avarage 298 g were divided into two lots: group S (control, N = 18) and group P (experimental, N = 19). P rats were submitted to laparotomy and peritonitis was induced by perforating the cecum with a needle, and S rats were only submitted to manipulation of the cecum. Twenty-four hours later animals were resubmitted to laparotomy and distal colectomy was performed 1.5 cm to the peritoneal reflection. End-to-end anastomosis was performed on a single extramucosal plane using 8 separate stitches with 5-0 polypropylene sutures. The anastomoses were checked on the 3rd and 7th postoperative day. Upon opening the peritoneal cavity, the presence of alterations such as peritonitis or abscesses, adhesions, organs involved, fistulas or dehiscences was reorded. A 4.0 cm segment of the colon containing the anastomosis was resected and rupture pressure was measured. Epithelialization of the mucosal wound was evaluted and the material was studied histopathologically for inflammatory reaction and scar condition. Upon relaparotomy, peritonitis was detected in all P animals and fibrin was observed in the cavity of all animals. Adhesions were present in 2 groups, without significant differences between them. Mean rupture pressure was 108.7 mm Hg in group S and 112.0 mm Hg in group P on the 3rd day and 205.0 mm Hg in group S and 206.6 mm Hg in group P on the 7th day, with no significant difference between groups. Microscopic evolution was similar in the two groups. These results permit us to conclude that peritonitis induced by this method does not modify the healing process of distal colon anastomoses in rats.
  • Peritoneal infection by Candida albicans: study of number and size of limphocytes and phagocitic activy of peritoneal machophages in mice Original Article

    Saad, Flávio; Silva, Maria Regina R. da; Hayashi, Hisakazu; Gompertz, Olga F; Segreto, Roberto de Araújo; Segreto, Helena Regina Comodo; Mestriner, Clara Lúcia B; Novo, Neil Ferreira; Juliano, Yara; Plapler, Hélio

    Abstract in English:

    The main purpose of this investigation was to stdy some aspects of leucocytes (granulocytes and limphocytes) and the phagocitic activity of peritoneal macrophages. In this experimen, which took place at Escola Paulista de Medicina - Universidade Federal de São Paulo - Brazil, it was used twenty female C57BLACK mice. Half of them were submitted to radiation to obtain immunossupressed animals (Group A - irradiated mice). The other ten mice were not iiradiated (Group B - control). The animals were sorted in four subgroups A-2 and B-2, were infected with Candida albicans (ATCC 90029). The resultant data showed significant differences in the number of leucocytes (granulocytes and limphocytes), and in the medium size of limphocytes between irradiated and non irradiated mice. Related to peritoneal macrophages, it was observed that the number of macrophages was lower in irradiated mice and the phagocitic was decreased in the irradiated and infected animals.
  • Immunomodulatory effect by thimic hormones in experimental burn Artigo Original

    Bevilacqua, Lucy Resende; Waitzberg, Dan Linetzky; Soares, Adriana Dias Carrilho; Bevilacqua, Gilson Alves Alves

    Abstract in Portuguese:

    O trauma grave, em particular térmico, promove a imunodepressão. Hormônios tímicos podem modificar a resposta imune nesta comdição. O objetivo desta pesquisa foi investigar o efeito imunomodulador do hormônio tímico timoestimulina sobre a imunidade celular em trauma térmico, traduzida pela resposta dos testes cutâneos de hipersensibilidade tardia. Na primeira etapa do experimento, ratos Wistar foram sensibilizados com KHL e posteriormente submetidos ao teste cutâneo de hipersensibilidade tardia (TCHT). Dez animais com resposta positiva foram submetidos a queimadura cutânea padronizada. Testes cutâneos seqüenciais revelaram significativa anergia cutânea no 21º e 30º dias pós-queimadura e interrupção do ganho de peso. Na etapa seguinte, ratos previamente sensibilizados e com resposta positiva ao TCHT, foram divididos nos grupos TAQ (seis ratos) tratados com timoestimulina, por via intramuscular, na dose de 0,25 mg, antes e após queimadura, grupo TDQ (seis ratos) tratados com a mesma dose de timoestimulina apenas após a queimadura e grupo CSQ (cinco ratos) tratados com solução salina, im, após a queimadura. Ocorreu aumento significativo do peso corpóreo e da resposta do TCHT a partir de duas semanas pós queimadura nos grupos TAQ e TDQ. Nas condições da presente pesquisa, timoestimulina misnistrada antes e após a queimadura experimental associa-se a melhora da resposta ao teste cutâneo de hipersensibilidade tardia e ganho de peso corpóreo.

    Abstract in English:

    Severe trauma, mainly burn, may promote immunodepression. Thimic hormones may modify the immune response to this condition. The aim of this experimental research was to investigate, after burn, the immunomodulatory effect of timoestimulin, a thimic hormone, on celular immunity studied by the delayed hypersensitivity skin test (TCHT). On the first phase of the experiment, Wistar rats were sensitized with KHL and submitted to TCHT. Ten animals with positive tests were submitted to a standardized skin burn. Sequencial skin tests showed significant skin anergy at 21 and 30 days after burn and interruption of weight gain. In the next phase, positively sensitized rats were divided randomly in group TAQ (six) and treated with timoestimulin, 0,25 mg, im, before and after burn; group TDQ (six rats) treated with the same dosage of timoestimulin just after burn and group CSQ (five rats) treated with saline, im, after burn. There was a significant increase of body weight and skin test response at two weeks after burn in TAQ and TDQ groups. At the conditions of the present research, timoestimulin given before and after experimental burn was associated to improvement of delayed cellular hypersensitivity skin test and body weight gain.
  • Bovine pericardium prosthesis arterioplasty: experimental study in dogs Artigo Original

    Costa, Regina de Faria Bittencourt da; Nigro, Amaury José Teixeira; Vieira, Wilma Therezinha Trench

    Abstract in Portuguese:

    Com o objetivo de avaliar a eficácia do pericárdio bovino (PB) para corrigir defeitos arteriais, provocado nas artérias femorais cão, foram realizados remendos de PB e veia cefálica autóloga (VA). Foram utilizados vinte cães, Canis familiaris (oito machos e doze fêmeas), divididos em dois grupos de dez animais (I e II), para serem reoperados no 7º e 30º dias de pós-operatório (PO), respectivamente. Para análise dos dados, aplicou-se o teste do qui-quadrado ou teste exato de Fisher (a£ 0,05). Nas avaliações clínicas não foram observadas alterações significantes, independentemente, do tipo de enxerto utilizado e tempo de observação PO. As avaliações histológicas, entre os enxertos de PB e VA, não diferiram significantemente quanto à presença de infiltrado inflamatório agudo e trombo mural, que predominaram no 7º PO, enquanto a presença de tecido de granulação, placa miofibroblástica e células endoteliais predominaram no 30º PO. A presença de necrose, no 7º PO, entre os enxertos de PB e VA, foi significantemente maior no PB. Os enxertos não sofreram calcificação. Ocorreu significante reação tipo corpo estranho ao fio de polipropileno, no 30º PO, em ambos os enxertos. O PB mostrou-se eficaz como substituto arterial em cães, comparável à VA, para o período de observação estabelecido.

    Abstract in English:

    The aim of this work was to evaluate the efficacy of bovine pericardium (BP) patch graft to treat arterial defects created in the femoral artery of dogs, compared to the cephalic vein autograft (CVA) on both side of the arteries. Twenty mongrel dogs (eight males and twelve females), were used and disbuted in two groups of ten animals (I and II), to be re-operated on 7th and 30th post operative days, respstively. Clinical and histolgical data analysis were done using the chi-square an exact Fisher test (a£ 0,05). Significant alterations wasn't found in the clinical examinations, independetly, of the kin of graft used and post operative observation period. It wasn't found any significant difference between the BP and CVA grafts in the histological analyses concerning the presence of inflammatory cell infiltration and mural thrombi that predominated on the 7th post operative day. Whilst, the presence of granulation tisseu, myofibroblastic plaque and endothelization predominated on the 30th post operative day. The presence of necrosis was found significant for both BP and CVA, on the 7th post operative day, being higher for BP. Calcification of the grafts was not observed. A significant reaction of strange body kind to the polypropylene yarn take place on the 30th PO for both grafts. These results sugested that BP was efficient as artery substitute for dogs, which was comparable to CVA, for the settled period of observation.
  • Intrapleural and intraperitoneal anesthesia in guinea-pigs Artigo Original

    Saad-Hossne, Rogério

    Abstract in Portuguese:

    Em estudo experimental randomizado foi realizada análise comparativa, quando ao efeito anestésico, das vias de administração intrapleural e intraperitoneal, na cobaia. Foram utilizados 24 animais; empregou-se como droga anestésica, o pentobarbital sódico (0,33mg/Kg peso, solução 100mg em 3ml da solução fisiológica), injetado com seringa de insulina, agulha 13x4. Os efeitos de sedação, anestesia e de resuperação foram mais rápidos no caso de via intrapleural. Conclui-se que a via intrapleural pode ser útil em trabalhos de pesquisa experimental, quando se utiliza a cobaia como animal de experimentação.

    Abstract in English:

    In a randomized experimental trial, the intrapleural was compared with the intraperitoneal anesthesia (pentobarbital), in guinea-pig (24 animals). Best results were observed in the intrapleural injection group: sedation and recuperation developed more quickly than the peritoneal group. Accidents and/or adverse reactions were not observed in either group. The author consider this technique useful for surgical procedures, in experimental surgery and for research, in guinea-pig.
  • Bacterial translocation to kidney in obstructive experimental jaundice Artigo Original

    Medeiros, Aldo da Cunha; Ramos, Ana Maria de Oliveira; Carvalho, Maria Goretti Freire de; Silva, Marli Pinheiro da; Dantas Filho, Antônio Medeiros; Dantas Júnior, José Hipólito; Freitas, Fernando César M

    Abstract in Portuguese:

    Estudo com o objetivo de verificar a possibilidade de ocorrência de translocação bacteriana para os rins de ratos, após ligadura de colédoco. Foram utilizados 29 ratos Wistar com peso médio de 171 ± 12,6g. Os animais foram divididos aleatoriamente em grupo I (n=14) e grupo II (n=15). Com técnica asséptica, nos ratos no grupo I foi feita ligadura de colédoco com fio de seda nº 3 zeros e no grupo II foi simulada a ligadura com a simples manipulação do colédoco com pinça de Adson ("sham operation"). No 7º dia pós-operatório os animais foram sacrificados e ressecados os rins para exame histopatológico (coloração H.E.) e microbiológico (meios agar sangue e agar MacConkey). Houve crescimento bacteriano de Klebsiela sp em 28,5% dos casos no grupo I e foram observadas alterações histopatológicas significativas no mesmo grupo. As diferenças foram estatisticamente significantes quando foram comparados os 2 grupos (p<0,05). Concluímos que a icterícia obstrutiva em ratos provoca translocação bacteriana para os rins e alterações histopatológicas associadas.

    Abstract in English:

    Experimental study in order to determine if obstructive jaundice promotes basterial translocation from the gastrointestinal tract to the kidney in rats. We used 29 Wistar male rats weighing 171±12,6g. They were ramdomly separated in goup I (n=14) and group II (n=15) and operated with asseptic technic. The group I underwent common bile ducts ligature with number 000 silk suture, and in group II (control) the common bile ducts were manipulated with Adson forceps, as a sham operation. On 7th postoperative day the rats were killed with an overdose of anesthesic and had their kidneys resected. Portions of each kidney were harvested for quantitation of bacterial translocation and histopatologic examination. The incidance of bacterial translocation was 28,5% (Klebsiella sp) in group I and 0% in group II (p<0,05). Intersticial edema, nephrosis and tubular degeneration were observed in group I and the histology was normal in group II. The authors conclude that obstructive ajundice promotes bacterial translocation to the kidney, associted to histopatological alterations in this organ.
  • Technique for experimental cryptorchidism in rats Artigo Original

    Alves, Elaine; Rangel, Carlos; Garcia, Alexandre; Cammarota, Maurícia; Tubino, Paulo

    Abstract in Portuguese:

    Foram utilizados 18 ratos machos albinos Wistar, divididos em dois grupos de acordo com a idade e a época do sacrifício. Todos foram submetidos ao fechamento do ânulo inguinal superficial esquerdo para a produção de criptorquia experimental. Os animais de ambos os grupos sobreviveram ao procedimento e foram sacrificados no 30º. e no 60º. dias de pós-operatório. Todos apresentavam o testículo esquerdo retido.

    Abstract in English:

    Eighteen albine Wistar rats were used, divided in two groups according to the age and the time of sacrifice. In all of then we have been closed the left superficial inguinal ring, with the goal of producing experimental cryptorchidism. All rats survived and were sacrifyed on the 30th and on 60th postoperative day. In all cases the left testis were inside the inguinal canal.
  • Evaluation of the efficacy of different kinds of transoperatory colon washout associating or not the prophylacties with antibiotics: experimental study in rats Artigo Original

    Greca, Fernanddo Hintz; Repka, João Carlos; Souza Filho, Zacarias Alves de; Araújo, Celso Fernando Ribeiro; Strobel, Rodrigo; Pacheco, Alderson Luiz; Cabrera, Pablo Fabian Aviles

    Abstract in Portuguese:

    A limpeza mecânica do cólon e a antibioticoprolaxia profilática foram os procedimentos responsáveis pela significante diminuição de morbidade e mortalidade na cirurgia colorretal. O objetivo do presente estudo foi avaliar, do ponto de vista bacteriológico, a eficácia de alguns métodos de preparo mecânico do cólon associado ou não ao emprego da antibioticoprolaxia. Foram estudados 64 ratos, machos, Wistar, com peso corporal entre 250-350g. Os animais foram divididos em grupos e submetidos a limpeza transoperatória do cólon utilizando-se diferentes tipos de solução (água de torneira, solução salina isotônica (SSI) e solução de polivinilpirrolidona (PVPI) a 5%). Cada grupo foi subdividido em dois subgrupos, que receberam ou não antibioticoprolaxia (cefoxitina sódica, 30 mg/ Kg, via intraperitoneal) 1 hora antes da intervenção cirúrgica. Os resultados foram comparados com o grupo controle no qual não foi realizado qualquer tipo de procedimento. Não se verificou diferença significativa entre os diferentes tipos de preparo mecânico do cólon. Concluímos que houve uma diminuição da flora bacteriana do cólon com o preparo mecânico, todavia a diminuição foi mais acentuada quando se fez uso da antibioticoprolaxia.

    Abstract in English:

    Teh significant decreasing in morbity and mortality rates in colorectal surgery was due to the bowel preparation and the antibiotic prophylacticts. The aim of the present study was to evaluate, in a bacteriologic point of view, the different methods of colon cleasing associated or not with an antimicrobial agent. Sixty four male rats, Wistar, ranging in weight from 250g to 350g were used. The animals were allocated for intraoperative irrigation of the colon using different washout solutions ( tap water, isotonic saline solution (SSI), and 5% solution of povidine iodine). Half of the animals of each group received prophylactic antibiotics ( cefoxitin, 30 mg/Kg, intraperitoneal) one hour before procedure. The results were compared with a control group where neither antibiotics prophylactics or bowel preparation were done. No significantly difference was observed when comparing the many types of intraoperative irrigation of the colon. We conclued that the bacterial concentration in the colon lumen has a significantly decrease with the mechanical preparation, however, the most important reduction was achieved with the use of parenteral antibiotics.
  • Taracotomia sem intubação orotraqueal: modelo experimental em ratos Artigo Original

    Seidel, Amélia C; Bahls, Alvacir S; Moreschi Jr, Dorival; Muraro, Carla B

    Abstract in Portuguese:

    O objetivo deste trabalho é descrever uma técnica para realização de toracotomias, com ou sem ressecções pulmonares sem intubação orotraqueal. Foram utilizados 36 Rattus novergucus albinus, Wistar, adultos, fêmeas, submetidos a ressecção pulmonar sob vetilzação espontânea e caráter de oxigênio com fluxo de 1 litro / minuto em um capacete que envolvia toda cabeça do animal. Não houve óbito no per ou pó-operatório devido complicações inerentes ao procedimento. Os resultados mostraram que esta operação, sem intubação orotraqueal pode ser realizada, apresentando como vantagens, a simplicidade na execução e ausência de trauma traqueal.
  • Functional and histologic alterations of the parathyroid glands after jejunocolic bypass: a compartive study in rats Artigo Original

    Carreiro, Mario Castro; Matos, Ediriomar Peixoto; Goldenberg, Saul; Andrade, Zilton; Barboza, Arion; Novo, Neil Ferreira; Juliano, Yara

    Abstract in Portuguese:

    Com a finalidade de estudar as glândulas paratireóides durante a fase de redução ponderal, 48 ratos Wistar, machos, foram distribuídos em dois grupos. Os animais do Grupo1, no total de 28, foram submetidos à derivação jejuno-cólica. Os animais do Grupo2, no total de 20, foram submetidos à operação simulada. Estudaram-se, à microscopia óptica, os aspectos histológicos, e à microscopia eletrônica, os aspectos ultraestruturais. A função das glândulas paratireóides foi estudada mediante determinações séricas do Hormônio da Paratireóide - Parato-hormônio (PTH), Cálcio, Fosfato, Albumina e Proteínas Totais. Procedeu-se à avaliação da evolução ponderal e variação percentual, pesando-se os animais nos dias 7, 14, 21 e 28. A determinação sérica do PTH, Cálcio, Fosfato, Albumina e Proteínas Totais foi realizada antes dos sacrifícios e os estudados da microscopia, após os mesmos, nos 7o, 14o, 21o e 28o dias. Os valores do peso, da variação percentual e das dosagens bioquímicas e hormonais foram submetidos à análise estatística separadamente para cada grupo. Compararam-se também os Grupos 1 e 2 em relação aos valores das variáveis estudadas nos 7o, 14o, 21o e 28o dias do sacrifício. Os animais submetidos à derivação jejuno-cólica apresentaram progressiva perda ponderal demonstrada a partir do sétimo dia e os animais de controle, crescente ganho de peso a partir do 14o dia. A média dos valores das determinações séricas do PTH dos ratos submetidos à derivação jejuno-cólica foi maior do que dos animais-controle já a partir do 7o dia, embora estatisticamente significantes. Os valores séricos do fosfato só foram estatisticamente significantes no 21o dia, o da albumina no 14o, 21o e 28o dias e os das proteínas totais em todos os períodos. A média dos valores do cálcio foi menor nos animais-controle dos que nos submetidos à derivação jejuno-cólica, não sendo esse valores estatisticamente significantes. O estudo da microscopia eletrônica e óptica nos animais submetidos à derivação jejuno-cólica diferenciou dos encontrados nos animais-controle pela predominância das células principais, sendo que as células escuras predominam no 21o dia e as células claras no 28º dia.

    Abstract in English:

    To study the parathyroid glands during the weigth reduction phase, 48 male Wistar rats were divided into two groups. The animals in group one, totaling 28, were submitted to jujunocolic shunts (JCS). The animals in group two, were submitted to sham operations. The histological aspects were study by optical and electronic microscopy. Parathyroid gland function was tested by serial determination of serum parathyroid hormone (PTH) level, and serum calcium, phosphate, albumin and total protein. The evolutionevaluations was carried out by weighing the animal on days 0, 7, 14, 21 and 28. Serial determinations of PTH, calcium, phosphate, albumin and total protein levels were carried out prior to sacrificing the animals. The hystological studies were done after thet on days 7, 14, 21 and 28 respectively, depending on witch day the animal was submitted to JCS. The values for weights and their percentage deviations as well as the biochemical and hormonal determinations were sumitted to separate statistical analyses for each group. Group aon and two were also compared relative to the variables studied on each of the periods of sacrifice. The animals given JCS presented with progressive weight loss beginning on day 7 foward. The control animals demonstrated increasing weight gain starting on day 14. The avarage values of PTH in the rats given JCS were greater than those of control animals starting on the 7th day , although the p values were not statistically signification . P values for the serial phosphate values were statistically signification only on the 21st and the albumin values on days 14, 21 and 28. The values for serum toral proteins were statistically significant during the whole study period. The average values of calcium were smaller in the control group given JCS, although the difference was not statistically significant. The histologic findings of both groups were compared under light and electronic microscopy. The major distinction between their respective histological aspects consisted in the predominance of the dark and light principal cells in the operated group. The predominance of the dark cells occurred on the 21st day and the light cells occurred on the 28 day.
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