Estudo prospectivo da incidência de complicações infecciosas, após operações para câncer colorretal. Sessenta e nove pacientes foram divididos em dois grupos, tendo o primeiro grupo recebido neomicina e metronidazol, por via oral, associados a gentamicina e metronizadol por via parenteral e o segundo grupo somente gentamicina e metronidazol por via parenteral. Foi estabelecido como objetivo principal a avaliação da influência do antimicrobiano administrado no preparo intestinal sobre a incidência de complicações infecciosas pós-operatórias. Os pacientes que receberam antimicrobianos por via oral no preparo intestinal apresentaram menor porcentagem de complicações infecciosas (14,29%) em relação aos pacientes que receberam apenas antimicrobiano por via parenteral (38,24%), sendo esta diferença estatisticamente significante, em nível de 5%. Esses dados apóiam a sugestão de associar antimicrobianos por via oral aos antimicrobianos por via parenteral na tentativa de reduzir as complicações infecciosas na cirurgia colorretal.
the function of the major duodenal papilla is partially committed with the dilation, therefore it provoked the basal pressure decrease and compromising of the capacity of sphincter in its cyclical contractions up to the 28 days of observation.
PuRPOsE: To study outcomes and functional results of a telescopic straight ileo-anal anastomosis.METHOds: Thirty-six mongrel dogs were submitted to total proctocolectomy and telescopic straight ileo-anal anastomosis (ileal mucosa-submucosa pulled-through the rectal cuff). They were divided in 3 groups, sacrificed after one, two or eight weeks after the initial procedure. Gross and microscopic (degree of cooptation and signs of ischemia) aspects of the anastomosis, as well, the aspect of defecation were analyzed. REsuLTs: On microscopy all anastomosis analysed showed a continuous epithelial line and were considered good. After two-months no signs of ischemia were identified. Defecation aspect has considerably changed during the study, so no dogs presented solid defecation within the first two weeks, whereas 80% of dogs presented solid stools after two months.CONCLusION: Telescopic ileo-anal anastomosis is a safe alternative and may provide good functional results after some small period of time.Keywords: Colectomy. Anastomosis, Surgical. Colorectal Surgery. Dogs. REsuMOOBJETIVO: Estudar os resultados cirúrgicos e funcionais de uma anastomose íleo-anal por telescopagem. MéTOdOs:Trinta e seis cães sem raça definida foram submetidos à procto-colectomia total e anastomose ileo-anal por telescopagem da mucosa-submucosa ao coto retal. Os animais foram divididos em três grupos cujos sacrifícios ocorreram 1, 2 e 8 semanas após o procedimento inicial. O aspecto da anastomose foi analisado no momento do sacrifício e microscopicamente (grau de coaptação e sinais de isquemia), bem como o aspecto da evacuação nos canis de cada cão.REsuLTAdOs: O estudo microscópico evidenciou continuidade do epitélio em todas as anastomoses. Nos cães sacrificados após dois meses não houve sinais de isquemia nas anastomoses. O aspecto das fezes alterou-se consideravelmente com o tempo, assim, enquanto nenhum cão apresentou fezes sólidas nas primeiras duas semanas, ao término do segundo mês 80% dos cães apresentavam fezes sólidas na maior parte do tempo.CONCLusãO: A anastomose íleo-anal por telescopagem é uma alternativa segura e pode assegurar bons resultados funcionais após alguns meses. descritores: Colectomia. Anastomose Cirúrgica. Cirurgia Colorretal. Cães. -Acta Cirúrgica Brasileira -Vol. 26 (5) 2011Lupinacci RA et al.
Purpose: To evaluate, in dogs, the biliary sphincter subjected to dilation by hydrostatic balloon by the point of view of structural alterations of the papilla and the biochemestry and bacterial contamination of the bile. Methods: Twenty dogs were submitted to laparotomy, duodenotomy, and enlargement of the major duodenal papilla-GA(n=10) -with balloon of 8mm inflated with pressure of 0,5atm, during 2 minutes or to the sham procedure -GB(n=10). Blood samples collected on times t(0day), t(7days) and t(28days) were subjected to dosages of alkaline phosphatase (ALP) and gammaglutamyltransferase (GGT) for cholestasis evaluation. The collected material from the gall bladder at the same times were registered and numbered to be submitted to culture in BHI, blood agar (rich, non-selective element) and Mac Conkey (selective element for Gram-negative bacillus. On the 28 th day three fragments of the papilla were tranversally cut by the choledoc axis 3mm from the duodenal papilla and the cuts, stained with hematoxylin-eosin and Masson's tricome, were evaluated according to their inflammatory reaction. Results: The GGT and ALP averages on the three periods in the groups A and B did not show significant differences, not being characterizes the cholestasis. The bacterian contamination was significantly higher in GA (2,19) than in GB (1,96); the contamination was lower in the initial time compared with 7 and 28 days (t0
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