Colonic anastomosis healing in hypothyroidism was evaluated. Twenty Wistar rats were separated into two groups: the study group (n = 10), which underwent total thyroidectomy to induce hypothyroidism, and the control group (n = 10). After 10 weeks, hypothyroid status was confirmed by blood tests (p < 0.0001). Three days later, a colonic anastomosis was performed, and the animals were sacrificed 1 week later. The colon containing the anastomosis was resected for bursting strength tests and histological studies. The slides were stained with hematoxylin-eosin and with Sirius red to quantify and classify the collagen. Reduced values were found for the bursting strength test (p = 0.0006) and for collagen density in the experimental group. There was a prevalence of immature type III collagen (p < 0.0001) and a decrease in mature type I collagen (p < 0.0001) in the hypothyroid group.
A triple-lumen Moss(c) gastrostomy tube was advanced into the proximal duodenum as an adjunct to the postoperative management of patients who underwent vertical banded gastroplasty (VBG) for the treatment of morbid obesity. The tube efficiently aspirated the proximal duodenum and stomach to prevent postoperative ileus and allow maximum immediate postoperative absorption of an elemental diet fed simultaneously into the distal duodenum. Decompression and feeding were started as soon as the patient arrived in the recovery room. Both were continued for at least the first 48 h after surgery. Patients seemed to improve better clinically on this postoperative regimen than with only the traditional i.v. infusion of fluids, carbohydrates, and electrolytes. The length of stay also was shorter than that allowed in the Diagnosis Related Group (DRG) for the; surgical management of morbid obesity: with the average of 3.0 days (range 2-6 days) versus the general mean length of stay of 7.4 days. Immediate enteral decompression and hyperalimentation through a gastroduodenostomy tube is a useful adjunct to the post-VBG treatment of morbidly obese patients.
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